Rich, white, and vulnerable: rethinking oppressive socialization in the euthanasia debate.

PubMed

Krag, Erik

2014-08-01

Anita Silvers (1998) has criticized those who argue that members of marginalized groups are vulnerable to a special threat posed by physician-assisted suicide (PAS) and voluntary active euthanasia (VAE). She argues that paternalistic measures prohibiting PAS/VAE in order to protect these groups only serve to marginalize them further by characterizing them as belonging to a definitively weak class. I offer a new conception of vulnerability, one that demonstrates how rich, educated, white males, who are typically regarded as having their autonomy enhanced by their social status, are just as, if not more, vulnerable to threats posed by PAS/VAE as a result of the harmful social messages at work just below the surface of contemporary Western culture. I use this new conception of vulnerability to reinforce arguments for continued statutory prohibitions on PAS/VAE. © The Author 2014. Published by Oxford University Press, on behalf of the Journal of Medicine and Philosophy Inc. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

76 FR 48073 - Hazardous Waste Management System: Identification and Listing of Hazardous Waste: Carbon Dioxide...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-08

... Science Basis. Contribution of Working Group I to the Fourth Assessment Report of the Intergovernmental Panel on Climate Change [Solomon, S., D. Qin, M. Manning, Z. Chen, M. Marquis, K.B. Averyt, M. Tignor... Vulnerability. Contribution of Working Group II to the Fourth Assessment Report of the Intergovernmental Panel...

Social Determinants of Health, Disaster Vulnerability, Severe and Morbid Obesity in Adults: Triple Jeopardy?

PubMed Central

2017-01-01

Severe and morbid obesity are associated with highly elevated risks of adverse health outcomes and the prevalence of severe obesity is increasing globally. To date, disaster literature has not considered severe and morbid obesity as a specific vulnerability, despite reports of people being left behind during disasters because of their body size, shape or weight. The complex causes of obesity are associated with the social determinants of health and one’s potential vulnerability to disasters. The absence of appropriate considerations may lead to people being exposed to disproportionate and potentially avoidable risk. The intersection of the social determinants of health, disaster vulnerability, severe and morbid obesity is explored. Previously identified vulnerable groups are also represented in severe and morbid obesity data. This poses the prospect for ‘triple jeopardy’ compounding the social determinants of health, disaster vulnerability and considerations with and for people with morbid obesity. When working to reduce disaster risk for vulnerable groups, the author proposes specific consideration is required to ensure ‘all-of-society engagement and partnership’ in an inclusive, accessible and non-discriminatory manner, to ensure no one is left behind.

Safeguarding Vulnerable Groups Act 2006: The Implications for Employers in Educational Settings

ERIC Educational Resources Information Center

Oliver, Hazel; White, Laura

2008-01-01

Vetting those who work with children and vulnerable adults is an emotive topic and one which can prove a challenging area for employers. The legitimate interest that parents, carers and employers have in screening those charged with the care of others can be in direct conflict with the most fundamental principles of economic freedom and employees'…

Changes to criminal records checks used to safeguard vulnerable patients.

PubMed

Griffith, Richard; Tengnah, Cassam

2012-07-01

The Protection of Freedoms Act 2012 is introducing changes to the Criminal Records Bureau (CRB) checks carried out on those people who work with vulnerable groups. The new law is the coalition Government's response to the criticism of the Safeguarding Vulnerable Group Act 2006. It will merge the CRB and Independent Safeguarding Authority into a new Disclosure and Barring Service and will enhance the rights of applicants to challenge the CRB's right to disclose non-conviction information as part of an enhanced criminal records check. In the first of two articles on the Protection of Freedoms Act 2012, Richard Griffith and Cassam Tengnah discuss the current framework for disclosing criminal records and the impact of the changes on district nurses applying for new posts.

The ethics and regulatory landscape of including vulnerable populations in pragmatic clinical trials.

PubMed

Welch, Mary Jane; Lally, Rachel; Miller, Jennifer E; Pittman, Stephanie; Brodsky, Lynda; Caplan, Arthur L; Uhlenbrauck, Gina; Louzao, Darcy M; Fischer, James H; Wilfond, Benjamin

2015-10-01

Policies have been developed to protect vulnerable populations in clinical research, including the US federal research regulations (45 Code of Federal Regulations 46 Subparts B, C, and D). These policies generally recognize vulnerable populations to include pregnant women, fetuses, neonates, children, prisoners, persons with physical handicaps or mental disabilities, and disadvantaged persons. The aim has been to protect these populations from harm, often by creating regulatory and ethical checks that may limit their participation in many clinical trials. The recent increase in pragmatic clinical trials raises at least two questions about this approach. First, is exclusion itself a harm to vulnerable populations, as these groups may be denied access to understanding how health interventions work for them in clinical settings? Second, are groups considered vulnerable in traditional clinical trials also vulnerable in pragmatic clinical trials? We argue first that excluding vulnerable subjects from participation in pragmatic clinical trials can be harmful by preventing acquisition of data to meaningfully inform clinical decision-making in the future. Second, we argue that protections for vulnerable subjects in traditional clinical trial settings may not be translatable, feasible, or even ethical to apply in pragmatic clinical trials. We conclude by offering specific recommendations for appropriately protecting vulnerable research subjects in pragmatic clinical trials, focusing on pregnant women, fetuses, neonates, children, prisoners, persons with physical handicaps or mental disabilities, and disadvantaged persons. © The Author(s) 2015.

Work disability prevention in rural healthcare workers.

PubMed

Franche, Renée L; Murray, Eleanor J; Ostry, Aleck; Ratner, Pamela A; Wagner, Shannon L; Harder, Henry G

2010-01-01

Approximately 20% of healthcare workers in high-income countries such as Australia, Canada and the USA work in rural areas. Healthcare workers are known to be vulnerable to occupational injury and poor work disability outcomes; given their rural-urban distribution, it is possible to compare work disability prevention in rural and urban areas. However, little attention has been paid to work disability prevention issues specific to rural workers, including rural healthcare workers. A comprehensive review of the literature was conducted to identify rural-urban differences in work disability outcomes (defined as the incidence of occupational injury and the duration of associated work absence), as well as risk factors for poor work disability outcomes in rural healthcare workers. The databases MEDLINE, CINAHL, and EMBASE were searched, as were relevant research centers and government agencies, to identify all quantitative and qualitative English-language studies published between 1 January 2000 and 6 October 2009 that discussed occupational injury, work absence duration, work disability management, or risk factors for poor work disability outcomes, for rural workers specifically, or in comparison with urban workers. To ensure inclusion of studies of healthcare workers as a distinct group among other sector-specific groups, a broad search for literature related to all industrial sectors was conducted. Of 860 references identified, 5 discussed work disability outcomes and 25 discussed known risk factors. Known risk factors were defined as factors firmly established to be associated with poor work disability outcomes in the general worker population based on systematic reviews, well-established conceptual models of work disability prevention, and public health literature. Although somewhat conflicting, the evidence suggests that rural healthcare workers experience higher rates of occupational injury compared with urban healthcare workers, within occupational categories. Rural workers also appear to be more vulnerable to prolonged work absence although the data are limited. No studies directly compared risk factors for work disability prevention outcomes between rural and urban healthcare workers. However, potential risk factors were identified at the level of the environment, worker, job, organization, worker compensation system and healthcare access. Important methodological limitations were noted, including unclear definitions of rurality, inadequate methods of urban-rural comparisons such as comparing samples from different countries, and a paucity of studies applying longitudinal or multivariate designs. There is a notable lack of evidence about work disability prevention issues for healthcare workers in rural areas. Available evidence supports the hypothesis that rural healthcare workers are vulnerable to occupational injury, and suggests they are vulnerable to prolonged work absence. They may be particularly vulnerable to poor work disability prevention outcomes due to complex patient needs in the context of risk factors such as heavy workloads, long hours, heavy on-call demands, high stress levels, limited support and workplace violence. Additional vulnerability may occur because their work conditions are managed in distant urban administrative centers, and due to barriers in their own healthcare access. Although rural healthcare workers seem generally at greater risk of injury, one study suggests that urban emergency medical service workers experience a high vulnerability to injury that may outweigh the effects of rurality. Additional research is needed to document rural-urban disparities in work disability outcomes and to identify associated sources and risk factors. Other issues to address are access to and quality of healthcare for rural healthcare workers, streamlining the compensation system, the unique needs of Aboriginal healthcare workers, and the management of prolonged work absence. Finally, occupational injury and work absence duration programs should be tailored to meet the needs of rural workers.

Participatory flood vulnerability assessment: a multi-criteria approach

NASA Astrophysics Data System (ADS)

Madruga de Brito, Mariana; Evers, Mariele; Delos Santos Almoradie, Adrian

2018-01-01

This paper presents a participatory multi-criteria decision-making (MCDM) approach for flood vulnerability assessment while considering the relationships between vulnerability criteria. The applicability of the proposed framework is demonstrated in the municipalities of Lajeado and Estrela, Brazil. The model was co-constructed by 101 experts from governmental organizations, universities, research institutes, NGOs, and private companies. Participatory methods such as the Delphi survey, focus groups, and workshops were applied. A participatory problem structuration, in which the modellers work closely with end users, was used to establish the structure of the vulnerability index. The preferences of each participant regarding the criteria importance were spatially modelled through the analytical hierarchy process (AHP) and analytical network process (ANP) multi-criteria methods. Experts were also involved at the end of the modelling exercise for validation. The final product is a set of individual and group flood vulnerability maps. Both AHP and ANP proved to be effective for flood vulnerability assessment; however, ANP is preferred as it considers the dependences among criteria. The participatory approach enabled experts to learn from each other and acknowledge different perspectives towards social learning. The findings highlight that to enhance the credibility and deployment of model results, multiple viewpoints should be integrated without forcing consensus.

Conducting Science in Disasters: Recommendations from the NIEHS Working Group for Special IRB Considerations in the Review of Disaster Related Research.

PubMed

Packenham, Joan P; Rosselli, Richard T; Ramsey, Steve K; Taylor, Holly A; Fothergill, Alice; Slutsman, Julia; Miller, Aubrey

2017-09-25

Research involving human subjects after public health emergencies and disasters may pose ethical challenges. These challenges may include concerns about the vulnerability of prospective disaster research participants, increased research burden among disaster survivors approached by multiple research teams, and potentially reduced standards in the ethical review of research by institutional review boards (IRBs) due to the rush to enter the disaster field. The NIEHS Best Practices Working Group for Special IRB Considerations in the Review of Disaster Related Research was formed to identify and address ethical and regulatory challenges associated with the review of disaster research. The working group consists of a diverse collection of disaster research stakeholders across a broad spectrum of disciplines. The working group convened in July 2016 to identify recommendations that are instrumental in preparing IRBs to review protocols related to public health emergencies and disasters. The meeting included formative didactic presentations and facilitated breakout discussions using disaster-related case studies. Major thematic elements from these discussions were collected and documented into 15 working group recommendations, summarized in this article, that address topics such as IRB disaster preparedness activities, informed consent, vulnerable populations, confidentiality, participant burden, disaster research response integration and training, IRB roles/responsibilities, community engagement, and dissemination of disaster research results. https://doi.org/10.1289/EHP2378.

Conducting Science in Disasters: Recommendations from the NIEHS Working Group for Special IRB Considerations in the Review of Disaster Related Research

PubMed Central

Rosselli, Richard T.; Ramsey, Steve K.; Taylor, Holly A.; Fothergill, Alice; Slutsman, Julia; Miller, Aubrey

2017-01-01

Summary: Research involving human subjects after public health emergencies and disasters may pose ethical challenges. These challenges may include concerns about the vulnerability of prospective disaster research participants, increased research burden among disaster survivors approached by multiple research teams, and potentially reduced standards in the ethical review of research by institutional review boards (IRBs) due to the rush to enter the disaster field. The NIEHS Best Practices Working Group for Special IRB Considerations in the Review of Disaster Related Research was formed to identify and address ethical and regulatory challenges associated with the review of disaster research. The working group consists of a diverse collection of disaster research stakeholders across a broad spectrum of disciplines. The working group convened in July 2016 to identify recommendations that are instrumental in preparing IRBs to review protocols related to public health emergencies and disasters. The meeting included formative didactic presentations and facilitated breakout discussions using disaster-related case studies. Major thematic elements from these discussions were collected and documented into 15 working group recommendations, summarized in this article, that address topics such as IRB disaster preparedness activities, informed consent, vulnerable populations, confidentiality, participant burden, disaster research response integration and training, IRB roles/responsibilities, community engagement, and dissemination of disaster research results. https://doi.org/10.1289/EHP2378 PMID:28949918

When Working Becomes Hazardous. Punching, Spitting, Swearing, Shooting: Violence at Work Goes Global.

ERIC Educational Resources Information Center

World of Work, 1998

1998-01-01

Workplace violence has gone global, crossing borders, work settings, and occupational groups. A report from the International Labor Organization points out high-risk occupations and indicates that women are especially vulnerable. It highlights the problem and provides ways for policymakers to remove violence from the workplace. (JOW)

Vulnerability and risk in children living with a physical disability.

PubMed

Heaslip, Vanessa; Hewitt-Taylor, Jaqui

2014-12-01

Children are identified as a vulnerable group in need of a degree of safeguarding. About 6% of children in the UK have a disability, which can increase their level of vulnerability. How disability is perceived by others may affect the way they work with these young people in coping with life's risks, which may be increased due to the disability. Each individual's perception of the risks and benefits of a given venture varies. Children's nurses work with these young people and their families, aiming to give them maximum autonomy, self-reliance, empowerment and independence in adulthood. This involves risk-taking, as every young person needs to learn from graduated exposure to new experiences, environments, associations and hazards; the chance of harm must be balanced with the disadvantages of over-protection.

When sex work becomes your everything: The complex linkages between economy and affection among male sex workers in Peru

PubMed Central

Bayer, Angela M.; Garvich, Mijail; Díaz, David A.; Sánchez, Hugo; García, Patricia J.; Coates, Thomas J.

2014-01-01

In Peru, there are few studies on male sex workers (MSWs) and existing studies explore limited sub-groups or offer limited information about MSWs’ perspectives. This study provides in-depth perspectives from 40 MSWs who work in downtown Lima (Cercado) and in surrounding urban neighborhoods (non-Cercado) through interviews on their identities, lives and HIV/STI risks and vulnerabilities. Findings are that entry into sex work links economy and affection, particularly among Cercado MSWs. Continued sex work cements this link, making it difficult to exit sex work and establish goals. Ties between economics and affections influence MSWs’ perceived HIV/STI risks, vulnerabilities and prevention practices. Although Cercado MSWs report higher HIV/STI risks and vulnerabilities than non-Cercado peers, they report fewer prevention practices given inability to buy condoms and acceptance of client offers of higher payment, especially clients they feel affection for. MSWs need support to strengthen their self-perceptions and define and pursue their goals in order to improve their HIV/STI prevention practices, health and well-being. PMID:24368712

The double whammy of a work handicap (differential) effects of health on working conditions and outcomes.

PubMed

Steenbeek, Romy; Giesen, Femke B M; Ybema, Jan Fekke

2009-08-01

To determine the effect of health on working conditions and outcomes. Data were collected in the longitudinal Study on Health at Work (n = 1597 employees), using multiple regression analyses and focusing on three groups of employees: 1) healthy, 2) chronic health complaints without a work handicap, and 3) chronic health complaints with a work handicap. 1) Employees with a work handicap experienced less favorable working conditions and outcomes than other employees. 2) Employees with a work handicap experienced less favorable working conditions and outcomes over time. 3) Employees with chronic health complaints were more vulnerable to the influence of working conditions on outcomes, whereas employees with a work handicap, unexpectedly, benefited from high work pressure and low autonomy. 1) Employees with a work handicap differ considerably from employees with chronic health complaints. 2) Employees with a work handicap drift into less favorable working conditions and outcomes. 3) Healthy employees, employees with chronic health complaints, and employees with a work handicap, all are vulnerable to different working conditions.

Vulnerability to heatwaves and implications for public health interventions - A scoping review.

PubMed

Mayrhuber, Elisabeth Anne-Sophie; Dückers, Michel L A; Wallner, Peter; Arnberger, Arne; Allex, Brigitte; Wiesböck, Laura; Wanka, Anna; Kolland, Franz; Eder, Renate; Hutter, Hans-Peter; Kutalek, Ruth

2018-05-31

Heatwaves form a serious public health threat, especially for vulnerable groups. Interventions such as active outreach programs, exposure reduction measures and monitoring and mapping of at-risk groups are increasingly implemented across the world but little is known about their effect. To assess how vulnerable groups are identified and reached in heat health interventions, to understand the effectiveness and efficiency of those interventions, and to identify research gaps in existing literature. We performed a literature search in relevant scientific literature databases and searched with a four element search model for articles published from 1995 onward. We extracted data on intervention measures, target group and evaluation of effectiveness and efficiency. We identified 23 eligible studies. Patterns exist in type of interventions 1) to detect and 2) to influence extrinsic and intrinsic risk and protective factors. Results showed several intervention barriers related to the variety and intersection of these factors, as well as the self-perception of vulnerable groups, and misconceptions and unfavorable attitudes towards intervention benefits. While modest indications for the evidence on the effectiveness of interventions were found, efficiency remains unclear. Interventions entailed logical combinations of measures, subsumed as packages. Evidence for effective and efficient intervention is limited by the difficulty to determine effects and because single measures are mutually dependent. Interventions prioritized promoting behavioral change and were based on behavioral assumptions that remain untested and mechanisms not worked out explicitly. Multifaceted efforts are needed to tailor interventions, compiled in heat health warning systems and action plans for exposure reduction and protection of vulnerable populations, to fit the social, economic and geographical context. Besides adequately addressing relevant risk and protective factors, the challenge is to integrate perspectives of vulnerable groups. Future research should focus on intervention barriers and improving the methods of effectiveness and efficiency evaluation. Copyright © 2018 Elsevier Inc. All rights reserved.

Oxytocin motivates non-cooperation in intergroup conflict to protect vulnerable in-group members.

PubMed

De Dreu, Carsten K W; Shalvi, Shaul; Greer, Lindred L; Van Kleef, Gerben A; Handgraaf, Michel J J

2012-01-01

Intergroup conflict is often driven by an individual's motivation to protect oneself and fellow group members against the threat of out-group aggression, including the tendency to pre-empt out-group threat through a competitive approach. Here we link such defense-motivated competition to oxytocin, a hypothalamic neuropeptide involved in reproduction and social bonding. An intergroup conflict game was developed to disentangle whether oxytocin motivates competitive approach to protect (i) immediate self-interest, (ii) vulnerable in-group members, or (iii) both. Males self-administered oxytocin or placebo (double-blind placebo-controlled) and made decisions with financial consequences to themselves, their fellow in-group members, and a competing out-group. Game payoffs were manipulated between-subjects so that non-cooperation by the out-group had high vs. low impact on personal payoff (personal vulnerability), and high vs. low impact on payoff to fellow in-group members (in-group vulnerability). When personal vulnerability was high, non-cooperation was unaffected by treatment and in-group vulnerability. When personal vulnerability was low, however, in-group vulnerability motivated non-cooperation but only when males received oxytocin. Oxytocin fuels a defense-motivated competitive approach to protect vulnerable group members, even when personal fate is not at stake.

Structural factors that increase HIV/STI vulnerability among indigenous people in the Peruvian amazon.

PubMed

Orellana, E Roberto; Alva, Isaac E; Cárcamo, Cesar P; García, Patricia J

2013-09-01

We examined structural factors-social, political, economic, and environmental-that increase vulnerability to HIV among indigenous people in the Peruvian Amazon. Indigenous adults belonging to 12 different ethnic groups were purposively recruited in four Amazonian river ports and 16 indigenous villages. Qualitative data revealed a complex set of structural factors that give rise to environments of risk where health is constantly challenged. Ferryboats that cross Amazonian rivers are settings where unprotected sex-including transactional sex between passengers and boat crew and commercial sex work-often take place. Population mobility and mixing also occurs in settings like the river docks, mining sites, and other resource extraction camps, where heavy drinking and unprotected sex work are common. Multilevel, combination prevention strategies that integrate empirically based interventions with indigenous knowledge are urgently needed, not only to reduce vulnerability to HIV transmission, but also to eliminate the structural determinants of indigenous people's health.

Testing principle working mechanisms of the health action process approach for subjective physical age groups.

PubMed

Wienert, Julian; Kuhlmann, Tim; Fink, Sebastian; Hambrecht, Rainer; Lippke, Sonia

2016-01-01

This study investigated differences in social-cognitive predictors and self-regulatory planning, as proposed by the health action process approach (HAPA), across three different subjective physical age groups for physical activity. With a cross-sectional design, 521 participants across the chronological age span from 25 to 86 years (M = 48.79; SD = 12.66) were separated into three groups: those who feel physically younger than they are in terms of chronological age, the same perceived and chronological age, and feeling physically older compared to their chronological age. Participants were assessed regarding their perceived vulnerability, outcome expectancies, general intentions, planning, self-efficacy, and stages of physical activity (non-intenders, intenders, and actors). Data were analysed via mean comparison and multigroup structural equation modelling. Mean differences for all but one construct were eminent in all groups, generally showing that those feeling physically younger also report better social-cognitive predictors of physical activity (e.g. lower perceived vulnerability) in comparison to those who feel the same age or older. The model showed that basic working mechanisms of the HAPA can be applied to all groups. With that, the results provide for the first time evidence that principle working mechanism of the HAPA can be applied to all subjective physical age groups. These may be used to tailor health promoting interventions according to participants' needs as a more suitable proxy than chronological age.

An Analysis of the Extent of Social Inclusion and Equity Consideration in Malawi's National HIV and AIDS Policy Review Process.

PubMed

Chinyama, Mathews Junior; MacLachlan, Malcolm; McVeigh, Joanne; Huss, Tessy; Gawamadzi, Sylvester

2017-07-29

Equity and social inclusion for vulnerable groups in policy development processes and resulting documents remain a challenge globally. Most often, the marginalization of vulnerable groups is overlooked in both the planning and practice of health service delivery. Such marginalization may occur because authorities deem the targeting of those who already have better access to healthcare a cheaper and easier way to achieve short-term health gains. The Government of Malawi wishes to achieve an equitable and inclusive HIV and AIDS Policy. The aim of this study is to assess the extent to which the Malawi Policy review process addressed regional and international health priorities of equity and social inclusion for vulnerable groups in the policy content and policy revision process. This research design comprised two phases. First, the content of the Malawi HIV and AIDS Policy was assessed using EquiFrame regarding its coverage of 21 Core Concepts of human rights and inclusion of 12 Vulnerable Groups. Second, the engagement of vulnerable groups in the policy process was assessed using the EquIPP matrix. For the latter, 10 interviews were conducted with a purposive sample of representatives of public sector, civil society organizations and development partners who participated in the policy revision process. Data was also collected from documented information of the policy processes. Our analyses indicated that the Malawi HIV and AIDS Policy had a relatively high coverage of Core Concepts of human rights and Vulnerable Groups; although with some notable omissions. The analyses also found that reasonable steps were taken to engage and promote participation of vulnerable groups in the planning, development, implementation, monitoring and evaluation processes of the HIV and AIDS Policy, although again, with some notable exceptions. This is the first study to use both EquiFrame and EquIPP as complimentary tools to assess the content and process of policy. While the findings indicate inclusive processes, commitment to Core Concepts of human rights and inclusion of Vulnerable Groups in relation to the Malawi HIV and AIDS Policy, the results also point to areas in which social inclusion and equity could be further strengthened. © 2018 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Multilevel Interventions Targeting Obesity: Research Recommendations for Vulnerable Populations.

PubMed

Stevens, June; Pratt, Charlotte; Boyington, Josephine; Nelson, Cheryl; Truesdale, Kimberly P; Ward, Dianne S; Lytle, Leslie; Sherwood, Nancy E; Robinson, Thomas N; Moore, Shirley; Barkin, Shari; Cheung, Ying Kuen; Murray, David M

2017-01-01

The origins of obesity are complex and multifaceted. To be successful, an intervention aiming to prevent or treat obesity may need to address multiple layers of biological, social, and environmental influences. NIH recognizes the importance of identifying effective strategies to combat obesity, particularly in high-risk and disadvantaged populations with heightened susceptibility to obesity and subsequent metabolic sequelae. To move this work forward, the National Heart, Lung, and Blood Institute, in collaboration with the NIH Office of Behavioral and Social Science Research and NIH Office of Disease Prevention convened a working group to inform research on multilevel obesity interventions in vulnerable populations. The working group reviewed relevant aspects of intervention planning, recruitment, retention, implementation, evaluation, and analysis, and then made recommendations. Recruitment and retention techniques used in multilevel research must be culturally appropriate and suited to both individuals and organizations. Adequate time and resources for preliminary work are essential. Collaborative projects can benefit from complementary areas of expertise and shared investigations rigorously pretesting specific aspects of approaches. Study designs need to accommodate the social and environmental levels under study, and include appropriate attention given to statistical power. Projects should monitor implementation in the multiple venues and include a priori estimation of the magnitude of change expected within and across levels. The complexity and challenges of delivering interventions at several levels of the social-ecologic model require careful planning and implementation, but hold promise for successful reduction of obesity in vulnerable populations. Copyright © 2016. Published by Elsevier Inc.

Multilevel Interventions Targeting Obesity: Research Recommendations for Vulnerable Populations

PubMed Central

Stevens, June; Pratt, Charlotte; Boyington, Josephine; Nelson, Cheryl; Truesdale, Kimberly P.; Ward, Dianne S.; Lytle, Leslie; Sherwood, Nancy E.; Robinson, Thomas N.; Moore, Shirley; Barkin, Shari; Cheung, Ying Kuen; Murray, David M.

2017-01-01

Introduction The origins of obesity are complex and multifaceted. To be successful, an intervention aiming to prevent or treat obesity may need to address multiple layers of biological, social, and environmental influences. Methods NIH recognizes the importance of identifying effective strategies to combat obesity, particularly in high-risk and disadvantaged populations with heightened susceptibility to obesity and subsequent metabolic sequelae. To move this work forward, the National Heart, Lung, and Blood Institute, in collaboration with the NIH Office of Behavioral and Social Science Research and NIH Office of Disease Prevention convened a working group to inform research on multilevel obesity interventions in vulnerable populations. The working group reviewed relevant aspects of intervention planning, recruitment, retention, implementation, evaluation, and analysis, and then made recommendations. Results Recruitment and retention techniques used in multilevel research must be culturally appropriate and suited to both individuals and organizations. Adequate time and resources for preliminary work are essential. Collaborative projects can benefit from complementary areas of expertise and shared investigations rigorously pretesting specific aspects of approaches. Study designs need to accommodate the social and environmental levels under study, and include appropriate attention given to statistical power. Projects should monitor implementation in the multiple venues and include a priori estimation of the magnitude of change expected within and across levels. Conclusions The complexity and challenges of delivering interventions at several levels of the social—ecologic model require careful planning and implementation, but hold promise for successful reduction of obesity in vulnerable populations. PMID:28340973

Oxytocin Motivates Non-Cooperation in Intergroup Conflict to Protect Vulnerable In-Group Members

PubMed Central

De Dreu, Carsten K. W.; Shalvi, Shaul; Greer, Lindred L.; Van Kleef, Gerben A.; Handgraaf, Michel J. J.

2012-01-01

Intergroup conflict is often driven by an individual's motivation to protect oneself and fellow group members against the threat of out-group aggression, including the tendency to pre-empt out-group threat through a competitive approach. Here we link such defense-motivated competition to oxytocin, a hypothalamic neuropeptide involved in reproduction and social bonding. An intergroup conflict game was developed to disentangle whether oxytocin motivates competitive approach to protect (i) immediate self-interest, (ii) vulnerable in-group members, or (iii) both. Males self-administered oxytocin or placebo (double-blind placebo-controlled) and made decisions with financial consequences to themselves, their fellow in-group members, and a competing out-group. Game payoffs were manipulated between-subjects so that non-cooperation by the out-group had high vs. low impact on personal payoff (personal vulnerability), and high vs. low impact on payoff to fellow in-group members (in-group vulnerability). When personal vulnerability was high, non-cooperation was unaffected by treatment and in-group vulnerability. When personal vulnerability was low, however, in-group vulnerability motivated non-cooperation but only when males received oxytocin. Oxytocin fuels a defense-motivated competitive approach to protect vulnerable group members, even when personal fate is not at stake. PMID:23144787

Connecting the Spots: Combating Transnational Terrorist Groups Through Leveraging Indigenous Security Forces

DTIC Science & Technology

2009-04-01

terrorist social networks are quite vulnerable to penetration and exploitation by indigenous personnel working in the communities where the groups operate...LEVERAGING INDIGENOUS SECURITY FORCES by Mack-Jan H. Spencer, Maj, USAF A Research Report Submitted to the Faculty In Partial Fulfillment of the...4. TITLE AND SUBTITLE Connecting the Spots: Combating Transnational Terrorist Groups Through Leveraging Indigenous Security Forces 5a. CONTRACT

Assessing climate change and health vulnerability at the local level: Travis County, Texas.

PubMed

Prudent, Natasha; Houghton, Adele; Luber, George

2016-10-01

We created a measure to help comprehend population vulnerability to potential flooding and excessive heat events using health, built environment and social factors. Through principal component analysis (PCA), we created non-weighted sum index scores of literature-reviewed social and built environment characteristics. We created baseline poor health measures using 1999-2005 age-adjusted cardiovascular and combined diabetes and hypertension mortality rates to correspond with social-built environment indices. We mapped US Census block groups by linked age-adjusted mortality and a PCA-created social-built environment index. The goal was to measure flooding and excessive heat event vulnerability as proxies for population vulnerability to climate change for Travis County, Texas. This assessment identified communities where baseline poor health, social marginalisation and built environmental impediments intersected. Such assessments may assist targeted interventions and improve emergency preparedness in identified vulnerable communities, while fostering resilience through the focus of climate change adaptation policies at the local level. No claim to original US government works. Journal compilation © 2016 Overseas Development Institute.

Creating a Space for Acknowledgment and Generativity in Reflective Group Supervision.

PubMed

Paré, David

2016-06-01

Small group supervision is a powerful venue for generative conversations because of the multiplicity of perspectives available and the potential for an appreciative audience to a practitioner's work. At the same time, the well-intentioned reflections by a few practitioners in a room can inadvertently duplicate normative discourses that circulate in the wider culture and the profession. This article explores the use of narrative practices for benefiting from the advantages of group supervision while mindful of the vulnerability that comes with sharing one's work among colleagues. The reflective group supervision processes described were modified from the work of Tom Andersen and Michael White to provide a venue that encourages the creative multiplicity of group conversation while discouraging unhelpful discourses which constrain generative conversation. © 2016 Family Process Institute.

Policy reform to shift the health and human rights environment for vulnerable groups: the case of Kyrgyzstan's Instruction 417.

PubMed

Beletsky, Leo; Thomas, Rachel; Smelyanskaya, Marina; Artamonova, Irina; Shumskaya, Natalya; Dooronbekova, Aijan; Mukambetov, Aibek; Doyle, Heather; Tolson, Rebecca

2012-12-15

Police activities shape behavior and health outcomes among drug users, sex workers, and other vulnerable groups. Interventions to change the policing of drug consumption and sex work in ways that facilitate public health programming and respect for human rights have included policy reforms, education, and litigation. In 2009, the Kyrgyz government promulgated "Instruction 417," prohibiting police interference with "harm reduction" programs, re-enforcing citizen rights, addressing police occupational safety concerns, and institutionalizing police-public health collaboration. Although ample evidence points to gaps between intended and actual impact of policy and other structural interventions, there is little research on the impact of initiatives designed to align policing, health, and human rights. We conducted a police officer survey to assess links between Instruction 417 knowledge and legal and public health knowledge, attitudes towards harm reduction programs, and intended practices targeting vulnerable groups. In a 319-officer sample, 79% understood key due process regulations, 71.1% correctly characterized law on sex work, 54.3% understood syringe possession law, while only 44.4% reported familiarity with Instruction 417. Most (72.9%) expressed positive attitudes toward condom distribution, while only 56% viewed syringe access favorably. Almost half (44%) agreed that police should refer vulnerable groups to disease prevention programs, but only 20% reported doing so. In multivariate analysis, knowledge of Instruction 417 was associated with significantly better knowledge about (aOR=1.84, 95%CI: 1.12-3.00) and attitudes towards harm reduction programs (aOR=3.81, 95%CI:1.35-10.75), and knowledge of due process for the detention of sex workers (aOR=2.53, 95%CI:1.33-4.80). Younger, junior officers and those in rural areas may not be well-informed about the policy. While reflecting positively on Instruction 417 as a structural approach to aligning policing and public health, this analysis highlights gaps in policy dissemination and calls for further research to assess street-level impact of interventions on the health and human rights environment for vulnerable groups. Copyright © 2012 Beletsky et al. This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original author and source are credited.

Eating practices among low-income overweight /obese Brazilian mothers: a Bourdieusian approach.

PubMed

de Morais Sato, Priscila; Dimitrov Ulian, Mariana; Fernandez Unsain, Ramiro; Baeza Scagliusi, Fernanda

2018-05-16

We investigated the eating practices of socially vulnerable overweight and obese Brazilian mothers, exploring the relationships between eating practices, capitals, fields and excess-weight. We conducted a qualitative study involving in-depth interviews of 21 women living in three vulnerable urban regions. Content analyses were performed and codes were used to locate actors in relation to each other in terms of 'capitals' and 'fields', forming a typology based on Bourdieu's theory with five groups. Socioeconomic conditions during childhood and liking to cook were the main characteristics related to each group's distinct eating practices. While socioeconomic conditions during childhood were related to region of origin and food tastes, liking to cook worked as a type of cultural capital, called culinary capital, which produced pleasure and status. For each pattern of eating practices, different factors seemed to contribute to participants' excess weight, including liked foods, enjoying cooking, and financial constraints. One group combined a highly vulnerable economic situation and health problems, shedding light onto a habitus that demands special attention from public health studies and interventions. This study illustrates the complexity of practices within a seemingly homogeneous group and reinforces that health studies should not assume homogeneity within a group of overweight/obese low-income women. © 2018 Foundation for the Sociology of Health & Illness.

Psychological vulnerability, burnout, and coping among employees of a business process outsourcing organization.

PubMed

Machado, Tanya; Sathyanarayanan, Vidya; Bhola, Poornima; Kamath, Kirthi

2013-01-01

The business process outsourcing (BPO) sector is a contemporary work setting in India, with a large and relatively young workforce. There is concern that the demands of the work environment may contribute to stress levels and psychological vulnerability among employees as well as to high attrition levels. As part of a larger study, questionnaires were used to assess psychological distress, burnout, and coping strategies in a sample of 1,209 employees of a BPO organization. The analysis indicated that 38% of the sample had significant psychological distress on the General Health Questionnaire (GHQ-28; Goldberg and Hillier, 1979). The vulnerable groups were women, permanent employees, data processors, and those employed for 6 months or longer. The reported levels of burnout were low and the employees reported a fairly large repertoire of coping behaviors. The study has implications for individual and systemic efforts at employee stress management and workplace prevention approaches. The results point to the emerging and growing role of mental health professionals in the corporate sector.

Energy technology evaluation report: Energy security

NASA Astrophysics Data System (ADS)

Koopman, R.; Lamont, A.; Schock, R.

1992-09-01

Energy security was identified in the National Energy Strategy (NES) as a major issue for the Department of Energy (DOE). As part of a process designed by the DOE to identify technologies important to implementing the NES, an expert working group was convened to consider which technologies can best contribute to reducing the nation's economic vulnerability to future disruptions of world oil supplies, the working definition of energy security. Other working groups were established to deal with economic growth, environmental quality, and technical foundations. Energy Security working group members were chosen to represent as broad a spectrum of energy supply and end-use technologies as possible and were selected for their established reputations as experienced experts with an ability to be objective. The time available for this evaluation was very short. The group evaluated technologies using criteria taken from the NES which can be summarized for energy security as follows: diversifying sources of world oil supply so as to decrease the increasing monopoly status of the Persian Gulf region; reducing the importance of oil use in the US economy to diminish the impact of future disruptions in oil supply; and increasing the preparedness of the US to deal with oil supply disruptions by having alternatives available at a known price. The result of the first phase of the evaluation process was the identification of technology groups determined to be clearly important for reducing US vulnerability to oil supply disruptions. The important technologies were mostly within the high leverage areas of oil and gas supply and transportation demand but also included hydrogen utilization, biomass, diversion resistant nuclear power, and substitute industrial feedstocks.

Inclusion of vulnerable groups in health policies: Regional policies on health priorities in Africa

PubMed Central

Eide, Arne Henning; Amin, Mutamad; MacLachlan, Malcom; Mannan, Hasheem

2013-01-01

Background If access to equitable health care is to be achieved for all, policy documents must mention and address in some detail different needs of groups vulnerable to not accessing such health care. If these needs are not addressed in the policy documents, there is little chance that they will be addressed at the stage of implementation. Objectives This paper reports on an analysis of 11 African Union (AU) policy documents to ascertain the frequency and the extent of mention of 13 core concepts in relation to 12 vulnerable groups, with a specific focus on people with disabilities. Method The paper applied the EquiFrame analytical framework to the 11 AU policy documents. The 11 documents were analysed in terms of how many times a core concept was mentioned and the extent of information on how the core concept should be addressed at the implementation level. Each core concept mention was further analysed in terms of the vulnerable group in referred to. Results The analysis of regional AU policies highlighted the broad nature of the reference made to vulnerable groups, with a lack of detailed specifications of different needs of different groups. This is confirmed in the highest vulnerable group mention being for ‘universal’. The reading of the documents suggests that vulnerable groups are homogeneous in their needs, which is not the case. There is a lack of recognition of different needs of different vulnerable groups in accessing health care. Conclusion The need for more information and knowledge on the needs of all vulnerable groups is evident. The current lack of mention and of any detail on how to address needs of vulnerable groups will significantly impair the access to equitable health care for all. PMID:28729986

Confidence in public institutions: A focus group study on views on the Swedish Social Insurance Agency.

PubMed

Holmgren, K; Rosstorp, F; Rohdén, H

2016-09-27

From a public health perspective among the working population, it is very important that confidence in the welfare system is high, ensuring the citizens economic security and protecting them from economic stress when falling ill. The aim of this study was to explore how people with experience of health insurance perceive their confidence in the Swedish Social Insurance Agency (SSIA). Eight focus groups (n = 41) were conducted and each group met on one occasion. The participants described a systemic change in the work of the SSIA where the rule-of-law was disregarded, with arbitrary assessment, and no transparency. The reception by the SSIA shaped the image of the SSIA. The participants described vulnerability in relation to the SSIA. They felt mistrusted, which left a feeling of impotence that worsened their health. Experiencing vulnerability left a strong impression and affected the participants' confidence negatively. The following has to be acknowledged to prevent clients from experiencing impaired health, promote return-to-work possibilities, and to push public confidence in the institution in a more positive direction: Politicians and public administrators need to clarify the regulations. The decision-making process needs to be transparent and just. The entire procedure, including continuity as well as a personal, nice reception, has to be ensured.

Personal vulnerability and work-home interaction: the effect of job performance-based self-esteem on work/home conflict and facilitation.

PubMed

Innstrand, Siw Tone; Langballe, Ellen Melbye; Espnes, Geir Arild; Aasland, Olaf Gjerløw; Falkum, Erik

2010-12-01

The aim of the present study was to examine the longitudinal relationship between job performance-based self-esteem (JPB-SE) and work-home interaction (WHI) in terms of the direction of the interaction (work-to-home vs. home-to-work) and the effect (conflict vs. facilitation). A sample of 3,475 respondents from eight different occupational groups (lawyers, physicians, nurses, teachers, church ministers, bus drivers, and people working in advertising and information technology) supplied data at two points of time with a two-year time interval. The two-wave, cross-lagged structural equations modeling (SEM) analysis demonstrated reciprocal relationships between these variables, i.e., job performance-based self-esteem may act as a precursor as well as an outcome of work-home interaction. The strongest association was between job performance-based self-esteem and work-to-home conflict. Previous research on work-home interaction has mainly focused on situational factors. This longitudinal study expands the work-home literature by demonstrating how individual vulnerability (job performance-based self-esteem) contributes to the explanation of work-home interactions. © 2010 The Authors. Scandinavian Journal of Psychology © 2010 The Scandinavian Psychological Associations.

Gaps, conflicts, and consensus in the ethics statements of professional associations, medical groups, and health plans.

PubMed

Berkman, N D; Wynia, M K; Churchill, L R

2004-08-01

Patients today interact with physicians, physician groups, and health plans, each of which may follow distinct ethical guidelines. We systematically compared physician codes of ethics with ethics policies at physician group practices and health plans, using the 1998-99 policies of 38 organisations-18 medical associations (associations), nine physician group practices (groups), and 12 health plans (plans)-selected using random and stratified purposive sampling. A clinician and a social scientist independently abstracted each document, using a 397-item health care ethics taxonomy; a reconciled abstraction form was used for analysis. This study focuses on ethics policies regarding professional obligation towards patients, resource allocation, and care for the vulnerable in society. A majority in all three groups mention "fiduciary obligations" of one sort or another, but associations generally address physician/patient relations but not health plan obligations, while plans rarely endorse physicians' obligations of advocacy, beneficence, and non-maleficence. Except for occasional mentions of cost effectiveness or efficiency, ethical considerations in resource allocation rarely arise in the ethics policies of all three organisational types. Very few associations, groups, or plans specifically endorse obligations to vulnerable populations. With some important exceptions, we found that the ethics policies of associations, groups, and plans are narrowly focused and often ignore important ethical concerns for society, such as resource allocation and care for vulnerable populations. More collaborative work is needed to build integrated sets of ethical standards that address the aims and responsibilities of the major stakeholders in health care delivery.

[Food intake in indigenous and non-indigenous Chilean schoolchildren of different social vulnerability].

PubMed

García, Vanessa; Amigo, Hugo; Bustos, Patricia

2002-12-01

The study was based on a cross-sectional design of children from six to nine year olds. Indigenous children were those whose parents had all surnames of this ethnic origin. Non-indigenous children were those with Hispanic surnames. Participants belonged to one of the three social vulnerability groups: high vulnerability (extreme poverty) living in rural communities in a southern region of the country (n = 184); medium vulnerability living in urbanized settings in the same region (n = 248); low vulnerability living in Santiago of Chile (n = 336). Food intake was estimated using a 24-hours recall questionnaire. Total energy intake was similar in the two ethnic groups in all vulnerabilities. It was observed that energy and macronutrient intake increased with the improvement of the social vulnerability: High 1679 kcal. with a standard deviation (SD) of 461, Medium 1878 (SD 484), Low 1894 (SD 495). Children in the high social vulnerability group had a total energy intake below the WHO/FAO recommendations. Consumption of milk, meat, vegetables and fruits was insufficient in all social vulnerability levels but it was closer to the recommendation in the low vulnerability group. Bread accounted for almost 50% of the total energy intake in the high and medium vulnerability groups. It is concluded that differences in the access to an adequate feeding are related to social vulnerability and not ethnicity.

Perceptions of vulnerability to a future outbreak: a study of horse managers affected by the first Australian equine influenza outbreak

PubMed Central

2013-01-01

Background A growing body of work shows the benefits of applying social cognitive behavioural theory to investigate infection control and biosecurity practices. Protection motivation theory has been used to predict protective health behaviours. The theory outlines that a perception of a lack of vulnerability to a disease contributes to a reduced threat appraisal, which results in poorer motivation, and is linked to poorer compliance with advised health protective behaviours. This study, conducted following the first-ever outbreak of equine influenza in Australia in 2007, identified factors associated with horse managers’ perceived vulnerability to a future equine influenza outbreak. Results Of the 200 respondents, 31.9% perceived themselves to be very vulnerable, 36.6% vulnerable and 31.4% not vulnerable to a future outbreak of equine influenza. Multivariable logistic regression modelling revealed that managers involved in horse racing and those on rural horse premises perceived themselves to have low levels of vulnerability. Managers of horse premises that experienced infection in their horses in 2007 and those seeking infection control information from specific sources reported increased levels of perceived vulnerability to a future outbreak. Conclusion Different groups across the horse industry perceived differing levels of vulnerability to a future outbreak. Increased vulnerability contributes to favourable infection control behaviour and hence these findings are important for understanding uptake of recommended infection control measures. Future biosecurity communication strategies should be delivered through information sources suitable for the horse racing and rural sectors. PMID:23902718

Perceptions of vulnerability to a future outbreak: a study of horse managers affected by the first Australian equine influenza outbreak.

PubMed

Schemann, Kathrin; Firestone, Simon M; Taylor, Melanie R; Toribio, Jenny-Ann L M L; Ward, Michael P; Dhand, Navneet K

2013-07-31

A growing body of work shows the benefits of applying social cognitive behavioural theory to investigate infection control and biosecurity practices. Protection motivation theory has been used to predict protective health behaviours. The theory outlines that a perception of a lack of vulnerability to a disease contributes to a reduced threat appraisal, which results in poorer motivation, and is linked to poorer compliance with advised health protective behaviours. This study, conducted following the first-ever outbreak of equine influenza in Australia in 2007, identified factors associated with horse managers' perceived vulnerability to a future equine influenza outbreak. Of the 200 respondents, 31.9% perceived themselves to be very vulnerable, 36.6% vulnerable and 31.4% not vulnerable to a future outbreak of equine influenza. Multivariable logistic regression modelling revealed that managers involved in horse racing and those on rural horse premises perceived themselves to have low levels of vulnerability. Managers of horse premises that experienced infection in their horses in 2007 and those seeking infection control information from specific sources reported increased levels of perceived vulnerability to a future outbreak. Different groups across the horse industry perceived differing levels of vulnerability to a future outbreak. Increased vulnerability contributes to favourable infection control behaviour and hence these findings are important for understanding uptake of recommended infection control measures. Future biosecurity communication strategies should be delivered through information sources suitable for the horse racing and rural sectors.

Are Sexual and Reproductive Health Policies Designed for All? Vulnerable Groups in Policy Documents of Four European Countries and Their Involvement in Policy Development.

PubMed

Ivanova, Olena; Dræbel, Tania; Tellier, Siri

2015-08-12

Health policies are important instruments for improving population health. However, experience suggests that policies designed for the whole population do not always benefit the most vulnerable. Participation of vulnerable groups in the policy-making process provides an opportunity for them to influence decisions related to their health, and also to exercise their rights. This paper presents the findings from a study that explored how vulnerable groups and principles of human rights are incorporated into national sexual and reproductive health (SRH) policies of 4 selected countries (Spain, Scotland, Republic of Moldova, and Ukraine). It also aimed at discussing the involvement of vulnerable groups in SRH policy development from the perspective of policy-makers. Literature review, health policy analysis and 5 semi-structured interviews with policy-makers were carried out in this study. Content analysis of SRH policies was performed using the EquiFrame analytical framework. The study revealed that vulnerable groups and core principles of human rights are differently addressed in SRH policies within 4 studied countries. The opinions of policy-makers on the importance of mentioning vulnerable groups in policy documents and the way they ought to be mentioned varied, but they agreed that a clear definition of vulnerability, practical examples, and evidences on health status of these groups have to be included. In addition, different approaches to vulnerable group's involvement in policy development were identified during the interviews and the range of obstacles to this process was discussed by respondents. Incorporation of vulnerable groups in the SRH policies and their involvement in policy development were found to be important in addressing SRH of these groups and providing an opportunity for them to advocate for equal access to healthcare and exercise their rights. Future research on this topic should include representatives of vulnerable communities which could help to build a dialogue and present the problem from multiple perspectives. © 2015 by Kerman University of Medical Sciences.

Falling through the cracks: a qualitative study of HIV risks among women who use drugs and alcohol in Northeast India

PubMed Central

2013-01-01

Background HIV risks for women who inject drugs and those who engage in sex work are well documented. Women who are dependent on non-injecting drugs and alcohol are also likely to have increased vulnerability to HIV infection, but until they actually inject drugs or engage in sex work, are unlikely to come to the attention of HIV prevention programs. Methods We undertook a qualitative study involving nine focus group discussions (FGDs) and 27 key informant interviews to investigate the context of female drug and alcohol use in two high HIV prevalence states of India (Manipur and Nagaland) and to describe their HIV risks. The FGD and interview transcripts were thematically analyzed Results The women were relatively young (mean age 31 years in Manipur and 28 years in Nagaland), but 64% in Manipur and 35% in Nagaland were widowed or divorced. Both heroin and alcohol were commonly used by the women from Manipur, while alcohol was primarily used by the women from Nagaland, especially in the context of ‘booze joints’ (illicit bars). Reasons for drug and alcohol use included: to avoid symptoms of withdrawal, to suppress emotional pain, to overcome the shame of sex work, pleasure, and widowhood. HIV vulnerability was clearly described, not only in relation to injecting drug use and sex work, but also alcohol consumption. Conclusions The contribution of alcohol use to the HIV vulnerability of women is not currently considered when HIV prevention programs are being designed and implemented leaving a group of high-risk women uncovered by much needed services such as treatment for a range of health problems including alcohol dependence. PMID:23360360

Workplace support after breast cancer treatment: recognition of vulnerability.

PubMed

Tiedtke, Corine; Dierckx de Casterlé, Bernadette; Donceel, Peter; de Rijk, Angelique

2015-01-01

Support from the workplace seems to be a key element in addressing the poor return-to-work (RTW) rate of employees with breast cancer. We aim to acquire an in-depth understanding of how Flemish employees experience their RTW after breast cancer and the support from the workplace. Fourteen in-depth interviews of women who experienced breast cancer and returned to work (high school graduates, age range 42-55 years, mean age 48 at time of surgery) were analysed using the Qualitative Analysis Guide of Leuven (QUAGOL), based on a Grounded Theory approach. The key experiences were feeling vulnerable, feeling able to work and need for support. Although little diversity in RTW experiences was found, the background of the vulnerability varied. Women experienced support (which could be emotional or practical) only as adequate if it addressed their specific vulnerability. Employees felt particularly vulnerable. Vulnerability is not the same as low-work ability and as such it should be added as theoretical concept in RTW research. Adequate workplace support addresses the specific vulnerability of an individual woman. Our study offers a nuanced insight into the RTW process of breast cancer survivors. Upon actual return-to-work (RTW) after breast cancer treatment, women feel vulnerable but able to work and, hence, have a high need for workplace support. Support from the workplace during RTW after breast cancer treatment is experienced as adequate when it expresses genuine recognition of the individual woman's vulnerability.

Vulnerability to unhealthy behaviours across different age groups in Swedish Adolescents: a cross-sectional study

PubMed Central

Paulsson Do, Ulrica; Edlund, Birgitta; Stenhammar, Christina; Westerling, Ragnar

2014-01-01

Purpose: There is lack of evidence on the effects of health-promoting programmes among adolescents. Health behaviour models and studies seldom compare the underlying factors of unhealthy behaviours between different adolescent age groups. The main objective of this study was to investigate factors including sociodemographic parameters that were associated with vulnerability to health-damaging behaviours and non-adoption of health-enhancing behaviours in different adolescent age groups. Methods: A survey was conducted among 10,590 pupils in the age groups of 13–14, 15–16 and 17–18 years. Structural equation modelling was performed to determine whether health-damaging behaviours (smoking and alcohol consumption) and non-adoption of health-enhancing behaviours (regular meal habits and physical activity) shared an underlying vulnerability. This method was also used to determine whether gender and socio-economic status were associated with an underlying vulnerability to unhealthy behaviours. Results: The findings gave rise to three models, which may reflect the underlying vulnerability to health-damaging behaviours and non-adoption of health-enhancing behaviours at different ages during adolescence. The four behaviours shared what was interpreted as an underlying vulnerability in the 15–16-year-old age group. In the youngest group, all behaviours except for non-participation in physical activity shared an underlying vulnerability. Similarly, alcohol consumption did not form part of the underlying vulnerability in the oldest group. Lower socio-economic status was associated with an underlying vulnerability in all the age groups; female gender was associated with vulnerability in the youngest adolescents and male gender among the oldest adolescents. Conclusions: These results suggest that intervention studies should investigate the benefits of health-promoting programmes designed to prevent health-damaging behaviours and promote health-enhancing behaviours in adolescents of different ages. Future studies should examine other factors that may contribute to the underlying vulnerability in different age groups. PMID:25750783

Are Sexual and Reproductive Health Policies Designed for All? Vulnerable Groups in Policy Documents of Four European Countries and Their Involvement in Policy Development

PubMed Central

Ivanova, Olena; Dræbel, Tania; Tellier, Siri

2015-01-01

Background: Health policies are important instruments for improving population health. However, experience suggests that policies designed for the whole population do not always benefit the most vulnerable. Participation of vulnerable groups in the policy-making process provides an opportunity for them to influence decisions related to their health, and also to exercise their rights. This paper presents the findings from a study that explored how vulnerable groups and principles of human rights are incorporated into national sexual and reproductive health (SRH) policies of 4 selected countries (Spain, Scotland, Republic of Moldova, and Ukraine). It also aimed at discussing the involvement of vulnerable groups in SRH policy development from the perspective of policy-makers. Methods: Literature review, health policy analysis and 5 semi-structured interviews with policy-makers were carried out in this study. Content analysis of SRH policies was performed using the EquiFrame analytical framework. Results: The study revealed that vulnerable groups and core principles of human rights are differently addressed in SRH policies within 4 studied countries. The opinions of policy-makers on the importance of mentioning vulnerable groups in policy documents and the way they ought to be mentioned varied, but they agreed that a clear definition of vulnerability, practical examples, and evidences on health status of these groups have to be included. In addition, different approaches to vulnerable group’s involvement in policy development were identified during the interviews and the range of obstacles to this process was discussed by respondents. Conclusion: Incorporation of vulnerable groups in the SRH policies and their involvement in policy development were found to be important in addressing SRH of these groups and providing an opportunity for them to advocate for equal access to healthcare and exercise their rights. Future research on this topic should include representatives of vulnerable communities which could help to build a dialogue and present the problem from multiple perspectives. PMID:26673176

Study on mobility-disadvantage group' risk perception and coping behaviors of abrupt geological hazards in coastal rural area of China.

PubMed

Pan, Anping

2016-07-01

China is a country highly vulnerable to abrupt geological hazards. The present study aims to investigate disaster preparedness and perception of abrupt geological disasters (such as rock avalanches, landslide, mud-rock flows etc) in mobility-disadvantage group living in coastal rural area of China. This research is to take into account all factors regarding disasters and to design the questionnaires accordingly. Two debris flow vulnerable townships are selected as study areas including Hedi Township in Qinyuan County and Xianxi Township in Yueqing City which are located in East China's Zhejiang Province. SPSS was applied to conduct descriptive analysis, which results in an effective empirical model for evacuation behavior of the disable groups. The result of this study shows mobility-disadvantage groups' awareness on disaster prevention and mitigation is poor and their knowledge about basic theory and emergency response is limited. Errors and distortions in public consciousness on disaster prevention and mitigation stimulate the development of areas with frequent disasters, which will expose more life and property to danger and aggravate the vulnerability of hazard bearing body. In conclusion, before drafting emergency planning, the government should consider more the disable group's expectations and actual evacuation behavior than the request of the situation to ensure the planning is good to work. Copyright © 2016 Elsevier Inc. All rights reserved.

Encounters with a Pedagogista

ERIC Educational Resources Information Center

Vintimilla, C. D.

2018-01-01

This article documents the initial work and encounters of a pedagogista with a group of educators on the west coast of Canada. The article retraces the complexities and vulnerabilities of such encounters, and presents them as generative and rich conversations that were carried along by, and not despite, their difficulty. They followed a practice…

"They Talk Like That, But We Keep Working": Sexual Harassment and Sexual Assault Experiences Among Mexican Indigenous Farmworker Women in Oregon.

PubMed

Murphy, Jeanne; Samples, Julie; Morales, Mavel; Shadbeh, Nargess

2015-12-01

In order to examine the experiences of sexual harassment and sexual assault among indigenous and non-indigenous Mexican immigrant farmworkers in Oregon's Willamette Valley, a community-academic participatory research partnership initiated a study, which included focus groups, conducted and analyzed by skilled practitioners and researchers. The themes that emerged from the focus groups included direct and indirect effects of sexual harassment and sexual assault on women and risk factors associated with the farmworker workplace environment, and the increased vulnerability of non-Spanish-speaking indigenous women due to low social status, poverty, cultural and linguistic issues, and isolation. Recommendations for prevention and improved services for vulnerable women will be discussed as well as limitations and future research directions.

Vulnerable Bullies: Perpetration of Peer Harassment Among Youths Across Sexual Orientation, Weight, and Disability Status.

PubMed

Eisenberg, Marla E; Gower, Amy L; McMorris, Barbara J; Bucchianeri, Michaela M

2015-09-01

We examined perpetration of bullying among youths in vulnerable groups relative to youths in peer groups not categorized as vulnerable. Data were collected in 2013 from a large school-based survey of adolescents conducted in Minnesota (n = 122,180). We used the χ(2) test and logistic regression to compare measures of perpetration of physical and relational bullying, as well as experiences of victimization and perpetration (or both), across categories of sexual orientation, weight status, and disability status. Rates of physical and relational bullying perpetration were significantly higher among youths in vulnerable groups than among those not in vulnerable groups. With respect to context of victimization experiences, young men and women from vulnerable groups were overrepresented in the group comprising both perpetrators and victims. For example, odds of being both a perpetrator and a victim were 1.41 to 3.22 times higher among gay, lesbian, and bisexual youths than among heterosexual youths. Vulnerable youths, who are prone to peer harassment, may also act as perpetrators of bullying. Prevention strategies should address the particular needs of these populations; targeted programming may be appropriate.

IPCC Climate Change 2013: Impacts, Adaptation and Vulnerability: Key findings and lessons learned

NASA Astrophysics Data System (ADS)

Giorgi, Filippo; Field, Christopher; Barros, Vicente

2014-05-01

The Working Group II contribution to the Fifth Assessment Report of the Intergivernmental Panel on Climate Change, Impacts, Adaptation and Vulnerability, will be completed and approved in March 2014. It includes two parts, Part A covering Global and Sectoral Aspects, and Part B, covering Regional Aspects. The WGII report spans a very broad range of topics which are approached in a strong interdisciplinary context. It highlights how observed impacts of climate change are now widespread and consequential, particularly for natural systems, and can be observed on all continents and across the oceans. Vulnerability to climate change depends on interactions with non-climatic stressors and inequalities, resulting in highly differential risks associated with climate change. It is also found that adaptation is already occurring across scales and is embedded in many planning processes. Continued sustained warming thrughout the 21st century will exacerbate risks and vulnerabilities across multiple sectors, such as freshwater resources, terrestrial and inland water systems, coastal and marine systems, food production, human health, security and livelihood. The report stresses how risks and vulnerabilities need to be assessed within a multi-stressor and regionally specific context, and can be reduced and managed by adopting climate-resilient pathwyas combining suitable adaptation and mitigation options with synergies and tradeoffs occurring both within and across regions. The Working group II report includes a large number of Chapters (30) and contributors (310 including authors and review editors), with expertise in a broad range of disciplines, from the physical science to the impact and socio-economic sciences. The communication across chapters and disciplines has been a challenge, and will continue to be one as the Global Change problem will increasingly require a fully integrated and holistic approach. Note that text on this abstract is not approved at the time its submission, but it will be discussed in the report.

Psychological vulnerability, burnout, and coping among employees of a business process outsourcing organization

PubMed Central

Machado, Tanya; Sathyanarayanan, Vidya; Bhola, Poornima; Kamath, Kirthi

2013-01-01

Background: The business process outsourcing (BPO) sector is a contemporary work setting in India, with a large and relatively young workforce. There is concern that the demands of the work environment may contribute to stress levels and psychological vulnerability among employees as well as to high attrition levels. Materials and Methods: As part of a larger study, questionnaires were used to assess psychological distress, burnout, and coping strategies in a sample of 1,209 employees of a BPO organization. Results: The analysis indicated that 38% of the sample had significant psychological distress on the General Health Questionnaire (GHQ-28; Goldberg and Hillier, 1979). The vulnerable groups were women, permanent employees, data processors, and those employed for 6 months or longer. The reported levels of burnout were low and the employees reported a fairly large repertoire of coping behaviors. Conclusions: The study has implications for individual and systemic efforts at employee stress management and workplace prevention approaches. The results point to the emerging and growing role of mental health professionals in the corporate sector. PMID:24459370

No Pet or Their Person Left Behind: Increasing the Disaster Resilience of Vulnerable Groups through Animal Attachment, Activities and Networks.

PubMed

Thompson, Kirrilly; Every, Danielle; Rainbird, Sophia; Cornell, Victoria; Smith, Bradley; Trigg, Joshua

2014-05-07

Increased vulnerability to natural disasters has been associated with particular groups in the community. This includes those who are considered de facto vulnerable (children, older people, those with disabilities etc.) and those who own pets (not to mention pets themselves). The potential for reconfiguring pet ownership from a risk factor to a protective factor for natural disaster survival has been recently proposed. But how might this resilience-building proposition apply to vulnerable members of the community who own pets or other animals? This article addresses this important question by synthesizing information about what makes particular groups vulnerable, the challenges to increasing their resilience and how animals figure in their lives. Despite different vulnerabilities, animals were found to be important to the disaster resilience of seven vulnerable groups in Australia. Animal attachment and animal-related activities and networks are identified as underexplored devices for disseminating or 'piggybacking' disaster-related information and engaging vulnerable people in resilience building behaviors (in addition to including animals in disaster planning initiatives in general). Animals may provide the kind of innovative approach required to overcome the challenges in accessing and engaging vulnerable groups. As the survival of humans and animals are so often intertwined, the benefits of increasing the resilience of vulnerable communities through animal attachment is twofold: human and animal lives can be saved together.

Perceived barriers to smoking cessation in selected vulnerable groups: a systematic review of the qualitative and quantitative literature

PubMed Central

Twyman, Laura; Bonevski, Billie; Paul, Christine; Bryant, Jamie

2014-01-01

Objectives To identify barriers that are common and unique to six selected vulnerable groups: low socioeconomic status; Indigenous; mental illness and substance abuse; homeless; prisoners; and at-risk youth. Design A systematic review was carried out to identify the perceived barriers to smoking cessation within six vulnerable groups. Data sources MEDLINE, EMBASE, CINAHL and PsycInfo were searched using keywords and MeSH terms from each database's inception published prior to March 2014. Study selection Studies that provided either qualitative or quantitative (ie, longitudinal, cross-sectional or cohort surveys) descriptions of self-reported perceived barriers to quitting smoking in one of the six aforementioned vulnerable groups were included. Data extraction Two authors independently assessed studies for inclusion and extracted data. Results 65 eligible papers were identified: 24 with low socioeconomic groups, 16 with Indigenous groups, 18 involving people with a mental illness, 3 with homeless groups, 2 involving prisoners and 1 involving at-risk youth. One study identified was carried out with participants who were homeless and addicted to alcohol and/or other drugs. Barriers common to all vulnerable groups included: smoking for stress management, lack of support from health and other service providers, and the high prevalence and acceptability of smoking in vulnerable communities. Unique barriers were identified for people with a mental illness (eg, maintenance of mental health), Indigenous groups (eg, cultural and historical norms), prisoners (eg, living conditions), people who are homeless (eg, competing priorities) and at-risk youth (eg, high accessibility of tobacco). Conclusions Vulnerable groups experience common barriers to smoking cessation, in addition to barriers that are unique to specific vulnerable groups. Individual-level, community-level and social network-level interventions are priority areas for future smoking cessation interventions within vulnerable groups. Trial registration number: A protocol for this review has been registered with PROSPERO International Prospective Register of Systematic Reviews (Identifier: CRD42013005761). PMID:25534212

Gaps, conflicts, and consensus in the ethics statements of professional associations, medical groups, and health plans

PubMed Central

Berkman, N; Wynia, M; Churchill, L

2004-01-01

Background: Patients today interact with physicians, physician groups, and health plans, each of which may follow distinct ethical guidelines. Method: We systematically compared physician codes of ethics with ethics policies at physician group practices and health plans, using the 1998–99 policies of 38 organisations—18 medical associations (associations), nine physician group practices (groups), and 12 health plans (plans)—selected using random and stratified purposive sampling. A clinician and a social scientist independently abstracted each document, using a 397-item health care ethics taxonomy; a reconciled abstraction form was used for analysis. This study focuses on ethics policies regarding professional obligation towards patients, resource allocation, and care for the vulnerable in society. Results: A majority in all three groups mention "fiduciary obligations" of one sort or another, but associations generally address physician/patient relations but not health plan obligations, while plans rarely endorse physicians' obligations of advocacy, beneficence, and non-maleficence. Except for occasional mentions of cost effectiveness or efficiency, ethical considerations in resource allocation rarely arise in the ethics policies of all three organisational types. Very few associations, groups, or plans specifically endorse obligations to vulnerable populations. Conclusions: With some important exceptions, we found that the ethics policies of associations, groups, and plans are narrowly focused and often ignore important ethical concerns for society, such as resource allocation and care for vulnerable populations. More collaborative work is needed to build integrated sets of ethical standards that address the aims and responsibilities of the major stakeholders in health care delivery. PMID:15289536

Experts' perspectives on SwissDRG: Second class care for vulnerable patient groups?

PubMed

Leu, A; Wepf, H; Elger, B; Wangmo, T

2018-03-14

On the 1st of January 2012, Switzerland introduced the diagnosis-related group hospital tariff structure (SwissDRG). It was recognised that healthcare provided to the most vulnerable patient groups would be a challenge for the new SwissDRG. Coincident with the implementation of SwissDRG, we explored hospital experts' perceptions of which patient groups are vulnerable under the SwissDRG system, what has changed for this group, as well as solutions to ensure adequate access to health care for them. We interviewed 43 experts from 40 Swiss hospitals. Participating experts named several vulnerable patient groups who share some common characteristics. These hospital experts were concerned about the patient groups that are not financially profitable and questioned the practicability of the current regulation. At the same time, they highlighted the complexity associated with caring for this group under the new SwissDRG and reported measures at the macro, meso, and micro levels to protect vulnerable patient groups from negative effects. To curb negative outcomes for vulnerable patient groups after the introduction of the SwissDRG, the Swiss legislation has introduced various instruments including the acute and transitional care (ATC) measures. We conclude that ATC measures do not produce the expected effect the legislators had hoped for. More health data is needed to identify situations where vulnerable patient groups are more susceptible to inadequate health care access in Switzerland. Copyright © 2018 Elsevier B.V. All rights reserved.

Multinational Experiment 7: Access to the Global Commons. Objective 3.3 Lexicon and Abbreviations. Version 1.1

DTIC Science & Technology

2012-05-28

operation in Europe OSINT Open Source Intelligence PDA Personal Digital Assistant SME Subject Matter Expert SWGCA Special Working Group on the...Form Approved Report Documentation Page OMB No. 0704-0/88 · 1 d’ the time for reviewing instructions, searching existing data sources , gathering and...illegal and covert activity of exploiting vulnerabilities and collecting protected information or intelligence in cyberspace (MNE 7 Outcome 3 Working

Vulnerable Bullies: Perpetration of Peer Harassment Among Youths Across Sexual Orientation, Weight, and Disability Status

PubMed Central

Gower, Amy L.; McMorris, Barbara J.; Bucchianeri, Michaela M.

2015-01-01

Objectives. We examined perpetration of bullying among youths in vulnerable groups relative to youths in peer groups not categorized as vulnerable. Methods. Data were collected in 2013 from a large school-based survey of adolescents conducted in Minnesota (n = 122 180). We used the χ2 test and logistic regression to compare measures of perpetration of physical and relational bullying, as well as experiences of victimization and perpetration (or both), across categories of sexual orientation, weight status, and disability status. Results. Rates of physical and relational bullying perpetration were significantly higher among youths in vulnerable groups than among those not in vulnerable groups. With respect to context of victimization experiences, young men and women from vulnerable groups were overrepresented in the group comprising both perpetrators and victims. For example, odds of being both a perpetrator and a victim were 1.41 to 3.22 times higher among gay, lesbian, and bisexual youths than among heterosexual youths. Conclusions. Vulnerable youths, who are prone to peer harassment, may also act as perpetrators of bullying. Prevention strategies should address the particular needs of these populations; targeted programming may be appropriate. PMID:26180987

How Does Iranian's Legal System Protect Human Vulnerability and Personal Integrity in Medical Research?

PubMed Central

Karoubi, Mohammad Taghi; Akhondi, Mohammad Mehdi

2011-01-01

The astonishing advance of medical science in recent decades has had endless advantages for humans, including improved level of health, prevention of disease and advances in treatment. These advances depend to a great extent on conducting continuous research. However, besides its enormous advantages, the sole interest of medical science undermines the principles of respect for human vulnerability and personal integrity, in both positive and negative approaches. The positive approach refers to the people who participate in research and practice, while the negative approach refers to people who are deprived of research and practice. The authors of this work, based on legal or moral grounds try to analyse the tension between the principle of respect for human vulnerability and personal integrity and the interest of medical science. Undoubtedly, in applying scientific knowledge and medical practice human vulnerability should be taken into account. In this regard, especially vulnerable individuals and groups should be protected and the personal integrity of such individuals respected. In the light of the merits of Islamic law, this paper is designed to examine the significance of the principles of human vulnerability and personal integrity in medical research by studying the international documents as formalised by UNESCO in order to explore the place of these principles in the Iranian legal system. PMID:23408269

Convergence Analysis of Micro-Lesions (CAML): An approach to mapping of diffuse lesions from carotid revascularization.

PubMed

Rosen, Allyson C; Soman, Salil; Bhat, Jyoti; Laird, Angela R; Stephens, Jeffrey; Eickhoff, Simon B; Fox, P Mickle; Long, Becky; Dinishak, David; Ortega, Mario; Lane, Barton; Wintermark, Max; Hitchner, Elizabeth; Zhou, Wei

2018-01-01

Carotid revascularization (endarterectomy, stenting) prevents stroke; however, procedure-related embolization is common and results in small brain lesions easily identified by diffusion weighted magnetic resonance imaging (DWI). A crucial barrier to understanding the clinical significance of these lesions has been the lack of a statistical approach to identify vulnerable brain areas. The problem is that the lesions are small, numerous, and non-overlapping. Here we address this problem with a new method, the Convergence Analysis of Micro-Lesions (CAML) technique, an extension of the Anatomic Likelihood Analysis (ALE). The method combines manual lesion tracing, constraints based on known lesion patterns, and convergence analysis to represent regions vulnerable to lesions as probabilistic brain atlases. Two studies were conducted over the course of 12 years in an active, vascular surgery clinic. An analysis in an initial group of 126 patients at 1.5 T MRI was cross-validated in a second group of 80 patients at 3T MRI. In CAML, lesions were manually defined and center points identified. Brains were aligned according to side of surgery since this factor powerfully determines lesion distribution. A convergence based analysis, was performed on each of these groups. Results indicated the most consistent region of vulnerability was in motor and premotor cortex regions. Smaller regions common to both groups included the dorsolateral prefrontal cortex and medial parietal regions. Vulnerability of motor cortex is consistent with previous work showing changes in hand dexterity associated with these procedures. The consistency of CAML also demonstrates the feasibility of this new approach to characterize small, diffuse, non-overlapping lesions in patients with multifocal pathologies.

In Search of the Third Eye, When the Two Others Are Shamefacedly Shut? Comment on "Are Sexual and Reproductive Health Policies Designed for All? Vulnerable Groups in Policy Documents of Four European Countries and Their Involvement in Policy Development".

PubMed

Keygnaert, Ines

2016-02-11

Ivanova et al explored how vulnerable groups and principles of human rights are incorporated into national sexual and reproductive health (SRH) policies in 4 countries. They adapted the EquiFrame of Amin and colleagues of 2011, to SRH vulnerable groups which we believe could now be used for analysis of national SRH polices beyond those 4 countries. Although we fully agree with the authors' two main findings that vulnerable groups and human rights' principles are not sufficiently integrated in SRH policies nor granted the possibility to participate in the process of development in those four countries, we do believe that these shortcomings are not limited to those countries only nor to the identified vulnerable groups either. We are convinced that the issue of SRH as such is still framed within a very limited logic for all with vulnerable groups being perceived as an extra threat or an extra burden. © 2016 by Kerman University of Medical Sciences.

Remote Sensing Data for Coastal Zone Vulnerability Assessment- the Bay of Algiers Case

NASA Astrophysics Data System (ADS)

Rabehi, Walid; Guerfi, Mokhtar; Mahi, Habib

2016-08-01

Like many of South Mediterranean coastlines, the Algerian coastal zone and Algiers' bay specifically, is one of the most vulnerable zone. Because of the natural pressures occurring in the region such as earthquake, tsunami risk, erosion / accretion, marine intrusion, etc. Combined with other anthropogenic factors as urban sprawl, pollution, loss of biodiversity and economic value etc... A high degradation of this coastline is noticeable despite all the protection measures brought to these zones, which have sometimes increased its vulnerability.The aim of this work is to generate the Coastal Vulnerability Index (CVI) map related to erosion and flooding. This index, created by Gornitz & White (1990), was particularly focused on "physical parameters of the coast" [3], Then it was improved by McLaughlin & Cooper (2010), who added a socio-economical approach by calculating parameters like demography, land use...etc. The index is obtained by integrating in a GIS, different vulnerability factors of the coastal area.. Many relevant parameters were derived from remote sensing, combined with other data; they are analyzed with a Multicriteria method after being grouped in three sub- indexes; coastal physical characteristics, coastal forcing and socioeconomic factors, in order to produce the CVI.

Sex Workers, Fem Queens, and Cross-Dressers: Differential Marginalizations and HIV Vulnerabilities Among Three Ethnocultural Male-to-Female Transgender Communities in New York City.

PubMed

Hwahng, Sel Julian; Nuttbrock, Larry

2007-12-01

This article describes 3 distinct ethnocultural male-to-female transgender communities in New York City: the low-income African American/Black and Latina(o) House Ball community; low-income, often undocumented immigrant Asian sex workers; and middle-class White cross-dressers. These communities are highly socially isolated from each other and are more connected to their ethnocultural contexts than to an abstract and shared transgender identity. Whereas previous research either has viewed male-to-female transgender people as one monolithic group or has separated them into abstract racial categories unconnected to their communities and lifestyles, this article positions them within specific social networks, cultures, neighborhoods, and lifestyles. With regard to HIV vulnerabilities, violence, and rape, House Ball community members seemed to engage in the riskiest form of survival sex work, whereas Asian sex workers seemed to engage in moderate-risk survival sex work. White cross-dressers seemed to engage in very low-risk recreational sex work.

No Pet or Their Person Left Behind: Increasing the Disaster Resilience of Vulnerable Groups through Animal Attachment, Activities and Networks

PubMed Central

Thompson, Kirrilly; Every, Danielle; Rainbird, Sophia; Cornell, Victoria; Smith, Bradley; Trigg, Joshua

2014-01-01

Simple Summary The potential for reconfiguring pet ownership from a risk factor to a protective factor for natural disaster survival has been recently proposed. But how might this resilience-building proposition apply to members of the community who are already considered vulnerable? This article addresses this important question by synthesizing information about what makes seven particular groups vulnerable, the challenges to increasing their resilience and how animals figure in their lives. It concludes that animal attachment could provide a novel conduit for accessing, communicating with and motivating vulnerable people to engage in resilience building behaviors that promote survival and facilitate recovery. Abstract Increased vulnerability to natural disasters has been associated with particular groups in the community. This includes those who are considered de facto vulnerable (children, older people, those with disabilities etc.) and those who own pets (not to mention pets themselves). The potential for reconfiguring pet ownership from a risk factor to a protective factor for natural disaster survival has been recently proposed. But how might this resilience-building proposition apply to vulnerable members of the community who own pets or other animals? This article addresses this important question by synthesizing information about what makes particular groups vulnerable, the challenges to increasing their resilience and how animals figure in their lives. Despite different vulnerabilities, animals were found to be important to the disaster resilience of seven vulnerable groups in Australia. Animal attachment and animal-related activities and networks are identified as underexplored devices for disseminating or ‘piggybacking’ disaster-related information and engaging vulnerable people in resilience building behaviors (in addition to including animals in disaster planning initiatives in general). Animals may provide the kind of innovative approach required to overcome the challenges in accessing and engaging vulnerable groups. As the survival of humans and animals are so often intertwined, the benefits of increasing the resilience of vulnerable communities through animal attachment is twofold: human and animal lives can be saved together. PMID:26480038

Heat Vulnerability Index Mapping for Milwaukee and Wisconsin.

PubMed

Christenson, Megan; Geiger, Sarah Dee; Phillips, Jeffrey; Anderson, Ben; Losurdo, Giovanna; Anderson, Henry A

Extreme heat waves elevate the population's risk for heat-related morbidity and mortality, specifically for vulnerable groups such as older adults and young children. In this context, we developed 2 Heat Vulnerability Indices (HVIs), one for the state of Wisconsin and one for the Milwaukee metropolitan area. Through the creation of an HVI, state and local agencies will be able to use the indices as a planning tool for extreme heat events. Data used for the HVIs were grouped into 4 categories: (1) population density; (2) health factors; (3) demographic and socioeconomic factors; and (4) natural and built environment factors. These categories were mapped at the Census block group level. Unweighted z-score data were used to determine index scores, which were then mapped by quantiles ranging from "high" to "low" vulnerability. Statewide, Menominee County exhibited the highest vulnerability to extreme heat. Milwaukee HVI findings indicated high vulnerability in the city's inner core versus low vulnerability along the lakeshore. Visualization of vulnerability could help local public health agencies prepare for future extreme heat events.

Recovery after shift work: Relation to coronary risk factors in women.

PubMed

Axelsson, John; Lowden, Arne; Kecklund, Göran

2006-01-01

Shift work increases the risk for developing cardiovascular disease. There is, however, little knowledge of what aspects of shift scheduling that are detrimental and what characteristics promote good health. The aim of the present study was to evaluate whether coronary risk factors deteriorate after a hard work period and whether recovery, in the form of a week off, was sufficient to improve them. A total of 19 women worked an extremely rapidly rotating and clockwise shift schedule at a paper and pulp factory. They underwent two health examinations, one at the end of the work period and one after the week off. In addition, the women were divided into a tolerant and a vulnerable group, depending on their satisfaction with their work hours. Most risk factors did not change, but total cholesterol and low-density lipoprotein (LDL)-cholesterol were lower after the working period than after the week-off. In addition, vulnerable women had higher levels of total cholesterol and a higher ratio of total cholesterol/high-density lipoprotein (HDL) than tolerant ones. In conclusion, the finding that a week-off worsens cholesterol levels was against our hypothesis and suggests further studies on how activities/responsibilities outside the workplace affect shift-working women. It was also shown that susceptible shift workers had worse lipid profiles.

Auditory working memory impairments in individuals at familial high risk for schizophrenia.

PubMed

Seidman, Larry J; Meyer, Eric C; Giuliano, Anthony J; Breiter, Hans C; Goldstein, Jill M; Kremen, William S; Thermenos, Heidi W; Toomey, Rosemary; Stone, William S; Tsuang, Ming T; Faraone, Stephen V

2012-05-01

The search for predictors of schizophrenia has accelerated with a growing focus on early intervention and prevention of psychotic illness. Studying nonpsychotic relatives of individuals with schizophrenia enables identification of markers of vulnerability for the illness independent of confounds associated with psychosis. The goal of these studies was to develop new auditory continuous performance tests (ACPTs) and evaluate their effects in individuals with schizophrenia and their relatives. We carried out two studies of auditory vigilance with tasks involving working memory (WM) and interference control with increasing levels of cognitive load to discern the information-processing vulnerabilities in a sample of schizophrenia patients, and two samples of nonpsychotic relatives of individuals with schizophrenia and controls. Study 1 assessed adults (mean age = 41), and Study 2 assessed teenagers and young adults age 13-25 (M = 19). Patients with schizophrenia were impaired on all five versions of the ACPTs, whereas relatives were impaired only on WM tasks, particularly the two interference tasks that maximize cognitive load. Across all groups, the interference tasks were more difficult to perform than the other tasks. Schizophrenia patients performed worse than relatives, who performed worse than controls. For patients, the effect sizes were large (Cohen's d = 1.5), whereas for relatives they were moderate (d = ~0.40-0.50). There was no age by group interaction in the relatives-control comparison except for participants <31 years of age. Novel WM tasks that manipulate cognitive load and interference control index an important component of the vulnerability to schizophrenia.

Early adolescent deaf boys: a biopsychosocial approach.

PubMed

Feinstein, C B

1983-01-01

In this chapter I have reviewed observations from clinical consultation and group-therapy work with early adolescent deaf boys in a special day school for the deaf. I have stressed how problems in communication exert a profound effect on the lives of these youngsters, both by virtue of their past and present influence on family life and by their ongoing effect on peer-group processes and academic adjustment. Primary consideration was given to certain "here and now" aspects of these boys' lives: ongoing problems in the social fabric of their home and school; narcissistic vulnerabilities and defenses against shame; and language-processing difficulties. The ways in which these problems undermine the supportive effect of the peer group at a time when it plays a particularly important role in development were reviewed. By emphasizing current sources of difficulty, using a biopsychosocial approach, I hope to point out fruitful opportunities for significant psychiatric intervention in a psychiatrically vulnerable population whose needs for professional service have never been met.

Parental style and vulnerability to depression: the role of core beliefs.

PubMed

Shah, R; Waller, G

2000-01-01

This study considers the potential role of core beliefs (unconditional schema-level representations) in the relationship between recalled parenting in childhood and major depression in adulthood, comparing a group of depressed outpatients (N = 60) with a healthy community sample (N = 67). The depressed group were differentiated by poorer perceived parenting (low care and high overprotection) and by three unhealthy core beliefs (defectiveness/shame, self-sacrifice, and insufficient self-control). Among nonclinical participants, it appears that vulnerability to harm beliefs act as a partial mediator of the relationship between poor paternal care and the development of depressive features. In contrast, a broader set of core beliefs appears to mediate the relationship of maternal bonding and paternal overprotection with depressive symptoms among the depressed group. The findings suggest that clinical work with adults with major depression might need to take account of parental style. Where parents are reported to be uncaring or overprotective, cognitive-behavioral therapy might need to include a schema-focused component.

Situating Hazard Vulnerability: People's Negotiations with Wildfire Environments in the U.S. Southwest

NASA Astrophysics Data System (ADS)

Collins, Timothy W.; Bolin, Bob

2009-09-01

This article is based on a multimethod study designed to clarify influences on wildfire hazard vulnerability in Arizona’s White Mountains, USA. Findings reveal that multiple factors operating across scales generate socially unequal wildfire risks. At the household scale, conflicting environmental values, reliance on fire insurance and firefighting institutions, a lack of place dependency, and social vulnerability (e.g., a lack of financial, physical, and/or legal capacity to reduce risks) were found to be important influences on wildfire risk. At the regional-scale, the shift from a resource extraction to environmental amenity-based economy has transformed ecological communities, produced unequal social distributions of risks and resources, and shaped people’s social and environmental interactions in everyday life. While working-class locals are more socially vulnerable than amenity migrants to wildfire hazards, they have also been more active in attempting to reduce risks in the aftermath of the disastrous 2002 Rodeo-Chediski fire. Social tensions between locals and amenity migrants temporarily dissolved immediately following the disaster, only to be exacerbated by the heightened perception of risk and the differential commitment to hazard mitigation displayed by these groups over a 2-year study period. Findings suggest that to enhance wildfire safety, environmental managers should acknowledge the environmental benefits associated with hazardous landscapes, the incentives created by risk management programs, and the specific constraints to action for relevant social groups in changing human-environmental context.

Situating hazard vulnerability: people's negotiations with wildfire environments in the U.S. southwest.

PubMed

Collins, Timothy W; Bolin, Bob

2009-09-01

This article is based on a multimethod study designed to clarify influences on wildfire hazard vulnerability in Arizona's White Mountains, USA. Findings reveal that multiple factors operating across scales generate socially unequal wildfire risks. At the household scale, conflicting environmental values, reliance on fire insurance and firefighting institutions, a lack of place dependency, and social vulnerability (e.g., a lack of financial, physical, and/or legal capacity to reduce risks) were found to be important influences on wildfire risk. At the regional-scale, the shift from a resource extraction to environmental amenity-based economy has transformed ecological communities, produced unequal social distributions of risks and resources, and shaped people's social and environmental interactions in everyday life. While working-class locals are more socially vulnerable than amenity migrants to wildfire hazards, they have also been more active in attempting to reduce risks in the aftermath of the disastrous 2002 Rodeo-Chediski fire. Social tensions between locals and amenity migrants temporarily dissolved immediately following the disaster, only to be exacerbated by the heightened perception of risk and the differential commitment to hazard mitigation displayed by these groups over a 2-year study period. Findings suggest that to enhance wildfire safety, environmental managers should acknowledge the environmental benefits associated with hazardous landscapes, the incentives created by risk management programs, and the specific constraints to action for relevant social groups in changing human-environmental context.

Structural Factors That Increase HIV/STI Vulnerability Among Indigenous People in the Peruvian Amazon

PubMed Central

Orellana, E. Roberto; Alva, Isaac E.; Cárcamo, Cesar P.; García, Patricia J.

2015-01-01

We examined structural factors—social, political, economic, and environmental—that increase vulnerability to HIV among indigenous people in the Peruvian Amazon. Indigenous adults belonging to 12 different ethnic groups were purposively recruited in four Amazonian river ports and 16 indigenous villages. Qualitative data revealed a complex set of structural factors that give rise to environments of risk where health is constantly challenged. Ferryboats that cross Amazonian rivers are settings where unprotected sex—including transactional sex between passengers and boat crew and commercial sex work—often take place. Population mobility and mixing also occurs in settings like the river docks, mining sites, and other resource extraction camps, where heavy drinking and unprotected sex work are common. Multilevel, combination prevention strategies that integrate empirically based interventions with indigenous knowledge are urgently needed, not only to reduce vulnerability to HIV transmission, but also to eliminate the structural determinants of indigenous people’s health. PMID:23925407

Plutonium working group report on environmental, safety and health vulnerabilities associated with the department`s plutonium storage. Volume II, Appendix B, Part 9: Oak Ridge site site team report

DOE Office of Scientific and Technical Information (OSTI.GOV)

NONE

1994-09-01

This report provides the input to and results of the Department of Energy (DOE) - Oak Ridge Operations (ORO) DOE Plutonium Environment, Safety and Health (ES & H) Vulnerability Assessment (VA) self-assessment performed by the Site Assessment Team (SAT) for the Oak Ridge National Laboratory (ORNL or X-10) and the Oak Ridge Y-12 Plant (Y-12) sites that are managed by Martin Marietta Energy Systems, Inc. (MMES). As initiated (March 15, 1994) by the Secretary of Energy, the objective of the VA is to identify and rank-order DOE-ES&H vulnerabilities associated for the purpose of decision making on the interim safe managementmore » and ultimate disposition of fissile materials. This assessment is directed at plutonium and other co-located transuranics in various forms.« less

[The genetic effects in the somatic cells of persons working under chronic irradiation of different intensities after the accident at the Chernobyl Atomic Electric Power Station].

PubMed

Pilinskaia, M A; Shemetun, A M; Dybskiĭ, S S; Red'ko, D V

1996-01-01

A complex genetic study of two groups from of Chernobyl NPP personnel (from "Shelter" unit and 3rd Block) has been carried out using classical cytogenetic and GPA methods. The first group was the most vulnerable from the viewpoint of accumulated dose (exceeding 25 cGy for the moment of study). Positive correlation between individual and group frequencies of cytogenetic markers of irradiation (stable and unstable chromosomes aberrations) and NO mutations in the GPA locus was found.

Software Vulnerability Taxonomy Consolidation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Polepeddi, Sriram S.

2004-12-07

In today's environment, computers and networks are increasing exposed to a number of software vulnerabilities. Information about these vulnerabilities is collected and disseminated via various large publicly available databases such as BugTraq, OSVDB and ICAT. Each of these databases, individually, do not cover all aspects of a vulnerability and lack a standard format among them, making it difficult for end-users to easily compare various vulnerabilities. A central database of vulnerabilities has not been available until today for a number of reasons, such as the non-uniform methods by which current vulnerability database providers receive information, disagreement over which features of amore » particular vulnerability are important and how best to present them, and the non-utility of the information presented in many databases. The goal of this software vulnerability taxonomy consolidation project is to address the need for a universally accepted vulnerability taxonomy that classifies vulnerabilities in an unambiguous manner. A consolidated vulnerability database (CVDB) was implemented that coalesces and organizes vulnerability data from disparate data sources. Based on the work done in this paper, there is strong evidence that a consolidated taxonomy encompassing and organizing all relevant data can be achieved. However, three primary obstacles remain: lack of referencing a common ''primary key'', un-structured and free-form descriptions of necessary vulnerability data, and lack of data on all aspects of a vulnerability. This work has only considered data that can be unambiguously extracted from various data sources by straightforward parsers. It is felt that even with the use of more advanced, information mining tools, which can wade through the sea of unstructured vulnerability data, this current integration methodology would still provide repeatable, unambiguous, and exhaustive results. Though the goal of coalescing all available data, which would be of use to system administrators, software developers and vulnerability researchers is not yet achieved, this work has resulted in the most exhaustive collection of vulnerability data to date.« less

An interactive database for setting conservation priorities for western neotropical migrants

Treesearch

Michael F. Carter; Keith Barker

1993-01-01

We develop and explain a species ranking system for the states and physiographic regions of the Neotropical Migratory Bird Conservation Program's West Working Group. The ranking criteria attempt to measure characteristics of species which make them vulnerable to extirpation, as well as assess the relative importance of different geographic and/or political areas...

Child Domestic Labour: A Modern Form of Slavery

ERIC Educational Resources Information Center

Blagbrough, Jonathan

2008-01-01

This article provides a global scene for the scope of child domestic labour and explores the inter-woven relationship between the practice and slavery, as well as the consequences for this uniquely vulnerable group of child workers. In doing so, it seeks to dispel the myths that child domestic work is a safe form of employment for girls…

Adolescent female sex workers: invisibility, violence and HIV.

PubMed

Silverman, Jay G

2011-05-01

A large number of female sex workers are children. Multiple studies demonstrate that up to 40% of women in prostitution started this work prior to age 18. In studies across India, Nepal, Thailand and Canada, young age at entry to sex work has been found to heighten vulnerability to physical and sexual violence victimisation in the context of prostitution, and relates to a two to fourfold increase in HIV infection. Although HIV risk reduction among adult female sex workers has been a major focus of HIV prevention efforts across the globe, no public health interventions, to date, have addressed the increased hazards and HIV risk faced by adolescent female sex workers. Beyond the structural barriers that limit access to this vulnerable group, historical tensions between HIV prevention and child protection agencies must be overcome in order to develop effective strategies to address this large scale yet little recognised human rights and HIV-related crisis.

Improving tsunami resiliency: California's Tsunami Policy Working Group

USGS Publications Warehouse

Real, Charles R.; Johnson, Laurie; Jones, Lucile M.; Ross, Stephanie L.; Kontar, Y.A.; Santiago-Fandiño, V.; Takahashi, T.

2014-01-01

California has established a Tsunami Policy Working Group to facilitate development of policy recommendations for tsunami hazard mitigation. The Tsunami Policy Working Group brings together government and industry specialists from diverse fields including tsunami, seismic, and flood hazards, local and regional planning, structural engineering, natural hazard policy, and coastal engineering. The group is acting on findings from two parallel efforts: The USGS SAFRR Tsunami Scenario project, a comprehensive impact analysis of a large credible tsunami originating from an M 9.1 earthquake in the Aleutian Islands Subduction Zone striking California’s coastline, and the State’s Tsunami Preparedness and Hazard Mitigation Program. The unique dual-track approach provides a comprehensive assessment of vulnerability and risk within which the policy group can identify gaps and issues in current tsunami hazard mitigation and risk reduction, make recommendations that will help eliminate these impediments, and provide advice that will assist development and implementation of effective tsunami hazard risk communication products to improve community resiliency.

[Children and adolescents in street situation: contributions to an understanding of vulnerability and disaffiliation].

PubMed

Gontijo, Daniela; Medeiros, Marcelo

2009-01-01

The concept of vulnerability is being discussed in the public health area as a potential tool toward the transformation of the health practices for allowing an articulation individual-community. Understanding health as a process of subjectivation determined by social, cultural and historical contexts, this article aims to approach the question children and adolescents in street situation on the basis of the concept of civil vulnerability, using the theoretical background presented by Robert Castel. This author understands the social marginalization lived by different individuals and social groups in a dynamic form, determined by the association of work and social insertion. As refers to children and adolescents in street situation, we believe that they are reflecting a process of intensified vulnerability (culminating in disaffiliation) to which thousands of Brazilian families are subject due to the extreme social inequalities in our country. We hope that our theoretical discussion will be able to contribute to the development of a theoretical reference in public health and to the planning and implementation of health actions directed to this population.

The vulnerabilities in childhood and adolescence and the Brazilian public policy intervention.

PubMed

Fonseca, Franciele Fagundes; Sena, Ramony Kris R; dos Santos, Rocky Lane A; Dias, Orlene Veloso; Costa, Simone de Melo

2013-06-01

To review and discuss childhood and adolescence vulnerabilities, as well as Brazilian public policies of intervention. A narrative review was performed, considering studies published between 1990 and 2012, found in the Virtual Health Library databases (Biblioteca Virtual em Saúde - BVS). A combination of the following descriptors was used in the search strategy: "Adolescent Health", "Child Health", "Health Public Politics" and "Vulnerability". In addition, Brazilian official documents, the Statute of the Child and the Adolescent, Guardianship Council, Bolsa Família and Saúde na Escola Programs were evaluated. The results were divided into five categories of analysis: Vulnerability of Children and Adolescents in Brazil, Public Politics of Intervention to Risk Factors in Childhood and Adolescence, the Statute of the Child and the Adolescent and Guardianship Council, Bolsa Família Program and Saúde na Escola Program. The studies show that children and adolescents are vulnerable to environmental and social situations. Vulnerabilities are exhibited in daily violence within families and schools, which results in the premature entrance of children and adolescents in the work environment and/or in the drug traffic. To deal with these problems, the Brazilian Government established the Statute of the Child and the Adolescent as well as social programs. Literature exposes the risks experienced by children and adolescents in Brazil. In the other hand, a Government endeavor was identified to eliminate or minimize the suffering of those in vulnerable situations through public policies targeted to this population group.

Risks, benefits and survival strategies-views from female sex workers in Savannakhet, Laos

PubMed Central

2012-01-01

Background Female sex workers (FSWs) are vulnerable to sexually transmitted infections (STIs) and encounter socio-economic and health problems, including STIs/HIV, unintended pregnancy and complications from unsafe abortion, stigma, violence, and drug addiction. Reducing risks associated with sex work requires an understanding of the social and cultural context in which sex workers live and work. This study aimed to explore the working environment and perceived risks among FSWs in Savannakhet province in Laos. Methods Five focus group discussions (FGDs) and seven interviews were conducted with FSWs in Kaysone Phomvihan district in Laos. Latent content analysis was used to analyze the transcribed text. Results The results revealed that the FSWs were aware of risks but they also talked about benefits related to their work. The risks were grouped into six categories: STIs/HIV, unintended pregnancy, stigma, violence, being cheated, and social and economic insecurity. The reported benefits were financial security, fulfilling social obligations, and sexual pleasure. The FSWs reported using a number of strategies to reduce risks and increase benefits. Conclusions The desire to be self-sufficient and earn as much money as possible put the FSWs in disadvantaged and vulnerable situations. Fear of financial insecurity, obligations to support one’s family and the need to secure the future influenced FSWs’ decisions to have safe or unsafe sex. The FSWs were, however, not only victims. They also had some control over their lives and working environment, with most viewing their work as an easy and good way of earning money. PMID:23164407

Adolescents' Exposure to Disasters and Substance Use.

PubMed

Schiff, Miriam; Fang, Lin

2016-06-01

This paper reviews the impact of exposure to man-made or natural disasters on adolescent substance use. It covers empirical studies published from 2005 to 2015 concerning (a) the scope of the problem, (b) vulnerable groups and risk and protective factors, and (c) evidence-based interventions. The review suggests a strong link between adolescent substance use and exposure to either man-made or natural disaster. Vulnerable groups include adolescents with previous exposure to traumatic events, living in areas that are continually exposed to disasters, and ethnic minorities. Risk and protective factors at the individual, familial, community, and societal levels are described based on the bioecological model of mass trauma. Given that mass trauma is unfortunately a global problem, it is important to establish international interdisciplinary working teams to set gold standards for comparative studies on the etiology for adolescent substance use in the context of disasters.

Attending to social vulnerability when rationing pandemic resources.

PubMed

Vawter, Dorothy E; Garrett, J Eline; Gervais, Karen G; Prehn, Angela Witt; DeBruin, Debra A

2011-01-01

Pandemic plans are increasingly attending to groups experiencing health disparities and other social vulnerabilities. Although some pandemic guidance is silent on the issue, guidance that attends to socially vulnerable groups ranges widely, some procedural (often calling for public engagement), and some substantive. Public engagement objectives vary from merely educational to seeking reflective input into the ethical commitments that should guide pandemic planning and response. Some plans that concern rationing during a severe pandemic recommend ways to protect socially vulnerable groups without prioritizing access to scarce resources based on social vulnerability per se. The Minnesota Pandemic Ethics Project (MPEP), a public engagement project on rationing scarce health resources during a severe influenza pandemic, agrees and recommends an integrated set of ways to attend to the needs of socially vulnerable people and avoid exacerbation of health disparities during a severe influenza pandemic. Among other things, MPEP recommends: 1. Engaging socially vulnerable populations to clarify unique needs and effective strategies; 2. Engaging socially vulnerable populations to elicit ethical values and perspectives on rationing; 3. Rejecting rationing based on race, socioeconomic class, citizenship, quality of life, length of life-extension and first-come, first-served; 4. Prioritizing those in the general population for access to resources based on combinations of risk (of death or severe complications from influenza, exposure to influenza, transmitting influenza to vulnerable groups) and the likelihood of responding well to the resource in question. 5. Protecting critical infrastructures on which vulnerable populations and the general public rely; 6. Identifying and removing access barriers during pandemic planning and response; and 7. Collecting and promptly analyzing data during the pandemic to identify groups at disproportionate risk of influenza-related mortality and serious morbidity and to optimize the distribution of resources.

Equine road user safety: public attitudes, understandings and beliefs from a qualitative study in the United Kingdom.

PubMed

Chapman, Catherine; Musselwhite, Charles B A

2011-11-01

Horse riders represent a significant group of vulnerable road user and are involved in a number of accidents and near misses on the road. Despite this horse riders have received little attention both in terms of academic research and transport policy. Based on literature on vulnerable road user safety, including attitudes to road user safety and behaviour of drivers and their relationship with cyclists and motorcyclists, this paper examines the attitudes and reported behaviour of drivers and horse riders. A total of 46 participants took part in six focus groups divided into four groups of drivers with little or no horse riding experience and two groups of frequent horse riders. Each group investigated five key topic areas stemming from the literature review on vulnerable road users including hazard perception, risk perception, emotion, attitudes to sharing the road and empathy. It was found that drivers and horse riders are not always aware of the same hazards in the road and that this may lead drivers to under-estimate the risk when encountering horses. Drivers often had good intentions to overtake horses safely, but were unaware of how vulnerable passing very wide and slow made them feel until they had begun the manoeuvre and hence quickly reduced such feelings either by speeding up or cutting in too soon. However, other than this, drivers had good skills when encountering horses. But these skills could be impeded by frustration when encountering a slow moving horse which was further compounded by a feeling, mainly by younger drivers, that horse riding was for leisure and as such should not get in the way of necessary work journeys. There is a need for drivers to be more aware of the potential hazards a horse rider faces on the road and these could be achieved through inducing empathy amongst drivers for horse riders, creating nudges for drivers in the environment and better education for drivers. Copyright © 2011 Elsevier Ltd. All rights reserved.

Work organization and occupational health: perspectives from Latinos employed on crop and horse breeding farms.

PubMed

Swanberg, Jennifer E; Clouser, Jess Miller; Westneat, Susan

2012-08-01

Agriculture is hazardous and increasingly dependent on Latino workers, a vulnerable population. However, little research has studied how work organization influences Latino farmworker health. Using a work organization framework, this cross-sectional study describes and compares the work organization and occupational health characteristics of a sample of Latino crop (n = 49) and horse production (n = 54) workers in Kentucky. Crop workers experienced more physical demands, work-related and environmental stressors, and musculoskeletal and ill-health symptoms. Significantly more crop workers indicated work-related illness or missed work due to work-related illness/injury, though one-fourth of both groups reported work-related injury in the past year. A majority of both groups cited exposure to toxic chemicals, a minority of whom received training on their use. Further surveillance is needed to understand the rate and precursors of illness/injury in these populations, as is research on the relationship between supervisory practices, psychosocial stressors, and occupational health. Copyright © 2012 Wiley Periodicals, Inc.

Self-employed individuals performing different types of work have different occupational safety and health problems.

PubMed

Park, Jungsun; Han, Boyoung; Kim, Yangho

2018-05-22

We assessed the occupational safety and health (OSH) issues of self-employed individuals in Korea. The working conditions and OSH issues in three groups were analyzed using the Korean Working Conditions Survey of 2014. Among self-employed individuals, "Physical work" was more common among males, whereas "Emotional work" was more common among females. Self-employed individuals performing "Mental work" had more education, higher incomes, and the lowest exposure to physical/chemical and ergonomic hazards in the workplace. In contrast, those performing "Physical work" were older, had less education, lower incomes, greater exposure to physical/chemical and ergonomic hazards in the workplace, and more health problems. Individuals performing "Physical work" were most vulnerable to OSH problems. The self-employed are a heterogeneous group of individuals. We suggest development of specific strategies that focus on workers performing "Physical work" to improve the health and safety of self-employed workers in Korea. © 2018 Wiley Periodicals, Inc.

Using visual art and collaborative reflection to explore medical attitudes toward vulnerable persons

PubMed Central

Kidd, Monica; Nixon, Lara; Rosenal, Tom; Jackson, Roberta; Pereles, Laurie; Mitchell, Ian; Bendiak, Glenda; Hughes, Lisa

2016-01-01

Background Vulnerable persons often face stigma-related barriers while seeking health care. Innovative education and professional development methods are needed to help change this. Method We describe an interdisciplinary group workshop designed around a discomfiting oil portrait, intended to trigger provocative conversations among health care students and practitioners, and we present our mixed methods analysis of participant reflections. Results After the workshop, participants were significantly more likely to endorse the statements that the observation and interpretive skills involved in viewing visual art are relevant to patient care and that visual art should be used in medical education to improve students’ observational skills, narrative skills, and empathy with their patients. Subsequent to the workshop, significantly more participants agreed that art interpretation should be required curriculum for health care students. Qualitative comments from two groups from two different education and professional contexts were examined for themes; conversations focused on issues of power, body image/self-esteem, and lessons for clinical practice. Conclusions We argue that difficult conversations about affective responses to vulnerable persons are possible in a collaborative context using well-chosen works of visual art that can stand in for a patient. PMID:27103949

Using visual art and collaborative reflection to explore medical attitudes toward vulnerable persons.

PubMed

Kidd, Monica; Nixon, Lara; Rosenal, Tom; Jackson, Roberta; Pereles, Laurie; Mitchell, Ian; Bendiak, Glenda; Hughes, Lisa

2016-01-01

Vulnerable persons often face stigma-related barriers while seeking health care. Innovative education and professional development methods are needed to help change this. We describe an interdisciplinary group workshop designed around a discomfiting oil portrait, intended to trigger provocative conversations among health care students and practitioners, and we present our mixed methods analysis of participant reflections. After the workshop, participants were significantly more likely to endorse the statements that the observation and interpretive skills involved in viewing visual art are relevant to patient care and that visual art should be used in medical education to improve students' observational skills, narrative skills, and empathy with their patients. Subsequent to the workshop, significantly more participants agreed that art interpretation should be required curriculum for health care students. Qualitative comments from two groups from two different education and professional contexts were examined for themes; conversations focused on issues of power, body image/self-esteem, and lessons for clinical practice. We argue that difficult conversations about affective responses to vulnerable persons are possible in a collaborative context using well-chosen works of visual art that can stand in for a patient.

Respectable Gentlemen and Street-Savvy Men: HIV Vulnerability in Sri Lanka.

PubMed

Hewamanne, Sandya

2017-01-01

In this article, I investigate how particular discourses surrounding class specific understandings of sexual behavior and female morality shape awareness and views of the disease and personal vulnerability. Although both groups belong to the working class, those employed by the transportation board consider themselves government servants and, therefore, "respectable gentlemen." Construction workers identify easily with their class position, recognizing and sometimes trying to live up to the stereotypes of free sexuality. These different perceptions directly affect their concern and awareness of risk factors for sexually transmissible infections and safe-sex practices. While the "respectable gentlemen" consider themselves invulnerable, the "street-savvy men" learned about risks and took precautions to prevent STIs.

Feeling "overloaded" and "shortcomings": milieu therapists' experiences of vulnerability in caring for severely mentally ill patients.

PubMed

Bachmann, Liv; Michaelsen, Ragnhild A; Vatne, Solfrid

2016-01-01

Milieu therapists' relationships with patients with severe mental illnesses are viewed as challenging. Elucidating vulnerability from their perspective in daily face-to-face encounters with patients might contribute to extending our knowledge about milieu therapists' vulnerability and the dynamics of the interaction between patients in mental health services and expertise in building caring and therapeutic relationships. The aim of this project was to study educated milieu therapists' experiences of their own vulnerability in their interactions with patients in mental health services. The data collection method was focus-group interviews. Thirteen part-time master's in mental health students (eight nurses, three social workers, two social educators) participated. All participants had experience with community or specialized mental health services (2-8 years). The milieu therapists mainly related their experiences of vulnerability to negative feelings elicited by challenging work conditions, disclosed as two main themes: 1) "overloaded", by the possibility of being physically and mentally hurt and the burdens of long-lasting close relationships; milieu therapists were extremely vulnerable because of their difficulty in protecting themselves; and 2) "shortcomings", connected to feelings of despair associated with not acting in concordance with their professional standards and insecurity about their skills to handle challenging situations, which was a threat to their professional integrity. There seemed to be coherence between vulnerability and professional inauthenticity. A misunderstanding that professionalism refers to altruism seems to increase milieu therapist vulnerability. Vulnerability in health care is of interest to multiple disciplines, and is of relevance for knowledge development in higher education. Extended knowledge and understanding about milieu therapists' vulnerability might strengthen their personal and professional integrity in professional practice in mental health services. Health care managers' focus on the supervision of individual professionals in practice and practical training is important. Further research on the coherence between vulnerability and professionalism is recommended.

[Socioeconomic vulnerability and obesity in Chilean schoolchildren attending first grade: comparison between 2009 and 2013].

PubMed

Herrera, Juan Carlos; Lira, Mariana; Kain, Juliana

2017-12-01

Although obesity is related to socioeconomic level, studies are inconclusive. To determine obesity risk according to socioeconomic vulnerability among Chilean children (1st grade) in 2009 and 2013 and assess its change during that period, by sex and geographical area. Cross-sectional study (N = 175,462 in 2009) and (N = 189,055 in 2013) which included: weight, height, rural / urban, gender and vulnerability obtained from JUNAEB's survey. BMI Z, % obesity and 3 categories of vulnerability (very vulnerable, moderate, non-vulnerable) were determined. For the descriptive analyses, we used t tests and for predictor variables (2 categories of vulnerability) and outcome (obesity) by sex and area, we used %2. Logistic regression models determined OR to develop obesity by. % obesity was 19.6% and 24.1% in 2009 and 2013, higher in boys. In urban and rural areas respectively, OR to develop obesity were: 0.85 (0.82-0.88) and 0.70 (0.64-0.75) in the most vulnerable students and 0.94 (0.91-0.97) and 0.81 (0.74-0.88) in those with moderate vulnerability in 2009 and 0.96 (0.93-0.98) and 0.89 (0.82-0.96) in the most vulnerable students and 0.99 (0.96-1.02) and 0.94 (0.86-1.02) in students with moderate vulnerability in 2013. The highest increase in obesity was observed among the most vulnerable group from rural areas (16, 6 to 24.3%). vulnerability. The non-vulnerable group had the highest % obesity. Although the most vulnerable students in rural areas had the lowest obesity risk in both years, the highest increase in obesity during the period, occurred in that group.

[Women in informal economy health and work conditions Bogotá. 2007].

PubMed

Sotelo-Suárez, Nidia R; Quiroz-Arcentáles, Jorge L; Mahecha-Montilla, Charo P; López-Sánchez, Paola A

2012-06-01

To determine work and health conditions of women working in informal economy in Bogotá, as well as to recommend priority action plans for preventing illnesses and accidents related to work and their consequences. Descriptive observational study. This study analyzed information collected by local groups in work-related contexts during 2007 as part of a set of forms of intervention established according to the Plan de Atención Básica (Primary Care Plan). This plan included 3 715 units of informal work from every point of the city. 3 936 women registers in all were analyzed. This study reveals evident precariousness conditions of women in this economic sector. Specifically, there are certain evident conditions that had shown in this study such as low education levels, incomes below the minimum legal standards, high exposure to damaging health work conditions, long work hours, and few hours for leisure and free time. Furthermore, 75 % of women included in this study are female head of household. This condition makes them more vulnerable to a heavier family and social burden. Closer attention to informal economy phenomenon is suggested in order to avoid vulnerable conditions of working women. Besides, it is necessary to improve the articulation between Academy and forms of intervention through public policies for knowing deeply repeated phenomena regarding the population of study. This articulation can be thought for implementing programs designed for improving women's quality of life.

Constructing the Indicators of Assessing Human Vulnerability to Industrial Chemical Accidents: A Consensus-based Fuzzy Delphi and Fuzzy AHP Approach.

PubMed

Fatemi, Farin; Ardalan, Ali; Aguirre, Benigno; Mansouri, Nabiollah; Mohammadfam, Iraj

2017-04-10

Industrial chemical accidents have been increased in developing countries. Assessing the human vulnerability in the residents of industrial areas is necessary for reducing the injuries and causalities of chemical hazards. The aim of this study was to explore the key indicators for the assessment of human vulnerability in the residents living near chemical installations. The indicators were established in the present study based on the Fuzzy Delphi method (FDM) and Fuzzy Analytic Hierarchy Process (FAHP). The reliability of FDM and FAHP was calculated. The indicators of human vulnerability were explored in two sets of social and physical domains. Thirty-five relevant experts participated in this study during March-July 2015. According to experts, the top three indicators of human vulnerability according to the FDM and FAHP were vulnerable groups, population density, and awareness. Detailed sub-vulnerable groups and awareness were developed based on age, chronic or severe diseases, disability, first responders, and residents, respectively. Each indicator and sub-indicator was weighted and ranked and had an acceptable consistency ratio. The importance of social vulnerability indicators are about 7 times more than physical vulnerability indicators. Among the extracted indicators, vulnerable groups had the highest weight and the greatest impact on human vulnerability. however, further research is needed to investigate the applicability of established indicators and generalizability of the results to other studies. Fuzzy Delphi; Fuzzy AHP; Human vulnerability; Chemical hazards.

Constructing the Indicators of Assessing Human Vulnerability to Industrial Chemical Accidents: A Consensus-based Fuzzy Delphi and Fuzzy AHP Approach

PubMed Central

Fatemi, Farin; Ardalan, Ali; Aguirre, Benigno; Mansouri, Nabiollah; Mohammadfam, Iraj

2017-01-01

Introduction: Industrial chemical accidents have been increased in developing countries. Assessing the human vulnerability in the residents of industrial areas is necessary for reducing the injuries and causalities of chemical hazards. The aim of this study was to explore the key indicators for the assessment of human vulnerability in the residents living near chemical installations. Methods: The indicators were established in the present study based on the Fuzzy Delphi method (FDM) and Fuzzy Analytic Hierarchy Process (FAHP). The reliability of FDM and FAHP was calculated. The indicators of human vulnerability were explored in two sets of social and physical domains. Thirty-five relevant experts participated in this study during March-July 2015. Results: According to experts, the top three indicators of human vulnerability according to the FDM and FAHP were vulnerable groups, population density, and awareness. Detailed sub-vulnerable groups and awareness were developed based on age, chronic or severe diseases, disability, first responders, and residents, respectively. Each indicator and sub-indicator was weighted and ranked and had an acceptable consistency ratio. Conclusions: The importance of social vulnerability indicators are about 7 times more than physical vulnerability indicators. Among the extracted indicators, vulnerable groups had the highest weight and the greatest impact on human vulnerability. however, further research is needed to investigate the applicability of established indicators and generalizability of the results to other studies. Key words: Fuzzy Delphi; Fuzzy AHP; Human vulnerability; Chemical hazards PMID:28480124

Vulnerability and Agency: Beyond an Irreconcilable Dichotomy for Social Service Providers Working with Young Refugees in the UK

ERIC Educational Resources Information Center

O'Higgins, Aoife

2012-01-01

Many young refugees face significant difficulties in securing support from social services providers. This study invited 21 young refugees aged 16 to 21 to take part in focus groups and follow-up interviews about their experiences of accessing this support. The findings reveal that young refugees may deliberately conform to expectations about…

When Schoolgirls Become Mothers: Reflections from a Selected Group of Teenage Girls in Durban

ERIC Educational Resources Information Center

Bhana, Deevia; Mcambi, Sithembile Judith

2013-01-01

Schools are obliged to support young women who become mothers. Drawing from an interview study of young women in a Durban school, this article shows how their experience is situated within discourses of shame and stigma. Such shame works to reduce their agency and increase their vulnerability to drop out of school. Both teachers and peers are…

A Critical Interdisciplinary Analysis of Culturally Appropriate Research Approach and Practices in Health Care and Social Work

ERIC Educational Resources Information Center

Shams, Manfusa; Robinson, Lena

2005-01-01

This paper presents a critique of research approaches used in health and social care research with vulnerable and socially disadvantaged groups, and children and young people from minority ethnic backgrounds in Britain. The paper aims to critically examine research processes in health and social care from a psychological perspective and a social…

Addressing Issues for Land Change Science

NASA Astrophysics Data System (ADS)

Braimoh, Ademola; Huang, He Qing

2009-09-01

Workshop on Vulnerability and Resilience of Land Systems in Asia; Beijing, China, 15-17 June 2009; There is a growing international community of scholars who work within the interdisciplinary field of land change science, a scientific domain that seeks to understand the dynamics of the land system as a coupled human-environment system. A coupled human-environment system is one in which the social and biophysical subsystems are intertwined so that the system's condition and responses to external forcing are based on the synergy of the two subsystems. Research on land system vulnerability, defined as a function of exposure and sensitivity to natural and anthropogenic perturbations, such as climate variability and sudden changes in macroeconomic conditions and the ability to cope with the impacts of those perturbations, is a fundamental component of land change science. To address issues related to land system vulnerability, the Global Land Project (GLP; http://www.glp-beijing.org.cn/index.php and http://www.glp.hokudai.ac.jp) brought together an interdisciplinary group of researchers with backgrounds ranging from environmental to social sciences. Participants came from both developed and developing countries. The workshop sought to (1) improve knowledge of the causal processes that affect a system's vulnerability and capacity to cope with different perturbations and (2) identify factors that hinder the integration of vulnerability assessment into policies and decision making.

Prefrontal vulnerabilities and whole brain connectivity in aging and depression.

PubMed

Lamar, Melissa; Charlton, Rebecca A; Ajilore, Olusola; Zhang, Aifeng; Yang, Shaolin; Barrick, Thomas R; Rhodes, Emma; Kumar, Anand

2013-07-01

Studies exploring the underpinnings of age-related neurodegeneration suggest fronto-limbic alterations that are increasingly vulnerable in the presence of disease including late life depression. Less work has assessed the impact of this specific vulnerability on widespread brain circuitry. Seventy-nine older adults (healthy controls=45; late life depression=34) completed translational tasks shown in non-human primates to rely on fronto-limbic networks involving dorsolateral (Self-Ordered Pointing Task) or orbitofrontal (Object Alternation Task) cortices. A sub-sample of participants also completed diffusion tensor imaging for white matter tract quantification (uncinate and cingulum bundle; n=58) and whole brain tract-based spatial statistics (n=62). Despite task associations to specific white matter tracts across both groups, only healthy controls demonstrated significant correlations between widespread tract integrity and cognition. Thus, increasing Object Alternation Task errors were associated with decreasing fractional anisotropy in the uncinate in late life depression; however, only in healthy controls was the uncinate incorporated into a larger network of white matter vulnerability associating fractional anisotropy with Object Alternation Task errors using whole brain tract-based spatial statistics. It appears that the whole brain impact of specific fronto-limbic vulnerabilities in aging may be eclipsed in the presence of disease-specific neuropathology like that seen in late life depression. Copyright © 2013 Elsevier Ltd. All rights reserved.

CNAs Making Meaning of Direct Care

PubMed Central

Pfefferle, Susan G.; Weinberg, Dana Beth

2009-01-01

Using qualitative data from 87 focus groups with CNAs in 16 nursing homes in Massachusetts, this study explores ways CNAs make meaning of their work despite devaluations such as lack of respect from management and residents, and the physical and emotional demands of such low status work. CNAs' meaning-making represents an effort to assert a positive identity rather than accept the stigmatization associated with their work. Assertions of the value help CNAs reconstitute their identities. Assertions of meaning, which depend upon providing good care to residents regardless of financial reward or management respect and support, make CNAs vulnerable to exploitation. PMID:18552321

The use of whey or skimmed milk powder in fortified blended foods for vulnerable groups.

PubMed

Hoppe, Camilla; Andersen, Gregers S; Jacobsen, Stine; Mølgaard, Christian; Friis, Henrik; Sangild, Per T; Michaelsen, Kim F

2008-01-01

Fortified blended foods (FBF), especially corn soy blend, are used as food aid for millions of people worldwide, especially malnourished individuals and vulnerable groups. There are only a few studies evaluating the effect of FBF on health outcomes, and the potential negative effect of antinutrients has not been examined. Different lines of evidence suggest that dairy proteins have beneficial effects on vulnerable groups. Here we review the evidence on the effects of adding whey or skimmed milk powder to FBF used for malnourished infants and young children or people living with HIV or AIDS. Adding whey or skimmed milk powder to FBF improves the protein quality, allowing a reduction in total amount of protein, which could have potential metabolic advantages. It also allows for a reduced content of soy and cereal and thereby a reduction of potential antinutrients. It is possible that adding milk could improve weight gain, linear growth, and recovery from malnutrition, but this needs to be confirmed. Bioactive factors in whey might have beneficial effects on the immune system and muscle synthesis, but evidence from vulnerable groups is lacking. Milk proteins will improve flavor, which is important for acceptability in vulnerable groups. The most important disadvantage is a considerable increase in price. Adding 10-15% milk powder would double the price, which means that such a product should be used only in well-defined vulnerable groups with special needs. The potential beneficial effects of adding milk protein and lack of evidence in vulnerable groups call for randomized intervention studies.

Neuropsychological and psychiatric functioning in sheep farmers exposed to low levels of organophosphate pesticides

PubMed Central

Ross, Sarah Jane Mackenzie; Brewin, Chris Ray; Curran, Helen Valerie; Furlong, Clement Eugene; Abraham-Smith, Kelly Michelle; Harrison, Virginia

2011-01-01

The study aim was to determine whether low level exposure to organophosphate pesticides (OPs) causes neuropsychological or psychiatric impairment. Methodological weaknesses of earlier studies were addressed by: recruiting participants who had retired on ill health grounds; excluding participants with a history of acute poisoning, medical or psychiatric conditions that might account for ill health; and exploring factors which may render some individuals more vulnerable to the effects of OPs than others. Performance on tests of cognition and mood of 127 exposed sheep farmers (67 working, 60 retired) was compared with 78 unexposed controls (38 working, 40 retired) and published test norms derived from a cross section of several thousand adults in the general population. Over 40% of the exposed cohort reported clinically significant levels of anxiety and depression compared to less than 23% of controls. Exposed subjects performed significantly worse than controls and standardisation samples on tests of memory, response speed, fine motor control, mental flexibility and strategy making, even after controlling for the effects of mood. The pattern was similar for both working and retired groups. The cognitive deficits identified cannot be attributed to mood disorder, malingering, a history of acute exposure or genetic vulnerability in terms of PON1192 polymorphisms. Results suggest a relationship may exist between low level exposure to organophosphates and impaired neurobehavioural functioning and these findings have implications for working practice and for other occupational groups exposed to OPs such as aviation workers and Gulf War veterans. PMID:20227490

Might depression, psychosocial adversity, and limited social assets explain vulnerability to and resistance against violent radicalisation?

PubMed

Bhui, Kamaldeep; Everitt, Brian; Jones, Edgar

2014-01-01

This study tests whether depression, psychosocial adversity, and limited social assets offer protection or suggest vulnerability to the process of radicalisation. A population sample of 608 men and women of Pakistani or Bangladeshi origin, of Muslim heritage, and aged 18-45 were recruited by quota sampling. Radicalisation was measured by 16 questions asking about sympathies for violent protest and terrorism. Cluster analysis of the 16 items generated three groups: most sympathetic (or most vulnerable), most condemning (most resistant), and a large intermediary group that acted as a reference group. Associations were calculated with depression (PHQ9), anxiety (GAD7), poor health, and psychosocial adversity (adverse life events, perceived discrimination, unemployment). We also investigated protective factors such as the number social contacts, social capital (trust, satisfaction, feeling safe), political engagement and religiosity. Those showing the most sympathy for violent protest and terrorism were more likely to report depression (PHQ9 score of 5 or more; RR = 5.43, 1.35 to 21.84) and to report religion to be important (less often said religion was fairly rather than very important; RR = 0.08, 0.01 to 0.48). Resistance to radicalisation measured by condemnation of violent protest and terrorism was associated with larger number of social contacts (per contact: RR = 1.52, 1.26 to 1.83), less social capital (RR = 0.63, 0.50 to 0.80), unavailability for work due to housekeeping or disability (RR = 8.81, 1.06 to 37.46), and not being born in the UK (RR = 0.22, 0.08 to 0.65). Vulnerability to radicalisation is characterised by depression but resistance to radicalisation shows a different profile of health and psychosocial variables. The paradoxical role of social capital warrants further investigation.

Occupational Safety and Health Conditions Aboard Small- and Medium-Size Fishing Vessels: Differences among Age Groups.

PubMed

Zytoon, Mohamed A; Basahel, Abdulrahman M

2017-02-24

Although marine fishing is one of the most hazardous occupations, research on the occupational safety and health (OSH) conditions aboard marine fishing vessels is scarce. For instance, little is known about the working conditions of vulnerable groups such as young and aging fishermen. The objective of the current paper is to study the OSH conditions of young and aging fishermen compared to middle-aged fishermen in the small- and medium-size (SM) marine fishing sector. A cross-sectional study was designed, and 686 fishermen working aboard SM fishing vessels were interviewed to collect information about their safety and health. The associations of physical and psychosocial work conditions with safety and health outcomes, e.g., injuries, illnesses and job satisfaction, are presented. The results of the current study can be utilized in the design of effective accident prevention and OSH training programs for the three age groups and in the regulation of working conditions aboard fishing vessels.

Occupational Safety and Health Conditions Aboard Small- and Medium-Size Fishing Vessels: Differences among Age Groups

PubMed Central

Zytoon, Mohamed A.; Basahel, Abdulrahman M.

2017-01-01

Although marine fishing is one of the most hazardous occupations, research on the occupational safety and health (OSH) conditions aboard marine fishing vessels is scarce. For instance, little is known about the working conditions of vulnerable groups such as young and aging fishermen. The objective of the current paper is to study the OSH conditions of young and aging fishermen compared to middle-aged fishermen in the small- and medium-size (SM) marine fishing sector. A cross-sectional study was designed, and 686 fishermen working aboard SM fishing vessels were interviewed to collect information about their safety and health. The associations of physical and psychosocial work conditions with safety and health outcomes, e.g., injuries, illnesses and job satisfaction, are presented. The results of the current study can be utilized in the design of effective accident prevention and OSH training programs for the three age groups and in the regulation of working conditions aboard fishing vessels. PMID:28245578

Identifying the "vulnerables" in biomedical research: the vox populis from the Tuskegee Legacy Project.

PubMed

Chiu, Christopher T; Katz, Ralph V

2011-01-01

This report presents, for the first time, findings on the vox populis as to who constitutes the "vulnerables in biomedical research" The 3-City Tuskegee Legacy Project (TLP) study used the TLP questionnaire as administered via random-digit-dial telephone interviews to 1162 adult Black people, non-Hispanic White people, and two Puerto Rican (PR) Hispanic groups: Mainland United States and San Juan (SJ) in three cities. The classification schema was based upon respondents' answers to an open-ended question asking which groups of people were the most vulnerable when participating in biomedical research. Subjects provided 749 valid open-ended responses, which were grouped into 29 direct response categories, leading to a four-tier classification schema for vulnerability traits. Tier 1, the summary tier, had five vulnerability categories: (1) Race/ ethnicity; (2) Age; (3) SES; (4) Health; and, (5) Gender. Black people and Mainland United States PR Hispanics most frequently identified Race/Ethnicity as a vulnerability trait (42.1 percent of Black people and 42.6 percent of Mainland United States. PR Hispanics versus 15.4 percent of White people and 16.7 percent of SJ R Hispanics) (P < 0.007), while White people and SJ PR Hispanics most frequently identified Age (48.3 percent and 29.2 percent) as a vulnerability trait. The response patterns on "who was vulnerable" were similar for the two minority groups (Black people and Mainland US PR Hispanics), and notably different from the response patterns of the two majority groups (White people and SJ PR Hispanics). Further, the vox populis definition of vulnerables differed from the current official definitions as used by the U.S. federal government.

The ethics of conducting a co-operative inquiry with vulnerable people.

PubMed

Tee, Stephen R; Lathlean, Judith A

2004-09-01

Mental health services users have been calling for greater participation in clinical research. Participation in this context means research 'with' rather than 'on' groups of people. Conducting a co-operative inquiry involving the participation of vulnerable individuals as co-researchers, in particular those with a history of mental health problems, places an obligation on researchers to articulate and justify sound ethical procedures. The aim of this paper is to consider how the ethical issues encountered when conducting participative research with vulnerable people can be addressed in the implementation of a co-operative inquiry with users of mental health services. The study was based on personal reflection and a critical review of associated literature obtained from a database search using Boolean logic. The findings, presented under the headings of the four prima facie moral principles, suggest the need for researchers using participative approaches to demonstrate the humanistic attributes required for engaging and working with people over a period of time. These include building and maintaining trusting relationships, assessing competence to participate, managing interpersonal and group dynamics and making complex collaborative decisions about participants' continued participation in a study. When using a co-operative inquiry approach involving vulnerable individuals, researchers need to demonstrate clearly how a balance between autonomy and paternalism will be achieved, how risks will be anticipated and managed and how fairness will be maintained throughout all procedures. Researchers using participative approaches need to have developed a level of personal insight and self-awareness through access to supervision which focuses on sources of unintended manipulation and interpersonal dynamics that may arise at the inception of a study and throughout its course. Researchers and ethics committees have a shared responsibility to ensure that vulnerable people are appropriately engaged to maintain the advancement of user knowledge which informs nursing practice.

Vulnerability to mild predator stress in serotonin transporter knockout mice.

PubMed

Adamec, Robert; Burton, Paul; Blundell, Jacqueline; Murphy, Dennis L; Holmes, Andrew

2006-06-03

Effect of predator stress on rat and mouse anxiety-like behavior may model aspects of post traumatic stress disorder (PTSD). A single cat exposure of wild type (C57, CFW) mice can produce lasting anxiety-like effects in the elevated plus maze, light/dark box tests and startle. In addition, female but not male C57 mice are made more anxious in the plus maze by exposure to predator odors alone, suggesting differential vulnerability to predator stressors of differing intensity. There is a link between genetic variation in the serotonin (5-HT) transporter (SERT) and anxiety in humans. This prompted the generation of SERT knockout mice [see Holmes A, Murphy DL, Crawley, JN. Biol Psychiatry 2003;54(10):953-9]. Present work used these mice to determine if there was a link between vulnerability to the anxiogenic effects of predator odors and abnormalities of 5-HT transmission induced by a life long reduction in 5-HT reuptake. Wild type (WT, C57 background), heterozygous (SERT +/-, HET) mice and homozygous knockout (SERT -/-, KO) were assigned to handled control groups or groups exposed for 10 min to a large testing room rich in cat odor. One week after handling or room exposure, anxiety testing took place in the dark phase of the light/dark cycle, in red light. Predator odor exposure was selectively anxiogenic in the plus maze and light/dark box tests in SERT -/- mice. Exposure to predator odor did not potentiate startle. Findings suggest a role for abnormalities in 5-HT transmission in vulnerability to some of the lasting anxiogenic effects of species relevant stressors and possibly in vulnerability to PTSD.

Social vulnerabilities as determinants of overweight in 2-, 4- and 6-year-old Spanish children.

PubMed

Iguacel, Isabel; Fernández-Alvira, Juan M; Labayen, Idoia; Moreno, Luis A; Samper, María Pilar; Rodríguez, Gerardo

2018-04-01

Differences in obesity prevalence among vulnerable groups exist in childhood but it remains unclear whether these differences may be partly determined by socioeconomic status (SES), parental body mass index (BMI) and early life risk factors. We aimed to explore (i) longitudinal associations between belonging to a minority group and being overweight/obese at age 2, 4 and 6 and (ii) associations between accumulation of social vulnerabilities and being overweight/obese at age 6. In total, 1031 children (53.8% boys) were evaluated at birth and re-examined during a 6-year follow-up in a representative cohort of Aragon (Spain). Children from minority (vulnerable) groups included Spanish Roma/gypsies, Eastern Europeans, Latin Americans and Africans. Two more vulnerable groups were defined at baseline as children whose parents reported low occupation and education. Ethnicity, SES and parental BMI were collected via interviews. We used logistic mixed-effects models and adjusted for parental BMI, SES, mother's tobacco use, maternal weight gain, birth weight, infant weight gain and breastfeeding practices. Regardless of confounders, Roma/gypsy children (OR = 4.63;[1.69-12.70]95%CI) and with Latin American background (OR = 3.04;[1.59-5.82]95%CI) were more likely to be overweight/obese at age 6 compared with non-gypsy Spanish group. Children with three vulnerabilities (OR = 2.18;[1.31-3.64]95%CI) were more likely to be overweight/obese at age 6 compared with children with no vulnerabilities. No associations were found between belonging to a minority group and overweight/obesity in children under 6. Interventions should target Roma/gypsy children, Latin American children and those who accumulate more vulnerabilities as they are at higher risk of being overweight/obese at age 6.

Vulnerability

NASA Technical Reports Server (NTRS)

Taback, I.

1979-01-01

The discussion of vulnerability begins with a description of some of the electrical characteristics of fibers before definiting how vulnerability calculations are done. The vulnerability results secured to date are presented. The discussion touches on post exposure vulnerability. After a description of some shock hazard work now underway, the discussion leads into a description of the planned effort and some preliminary conclusions are presented.

Auditory working memory impairments in individuals at familial high risk for schizophrenia

PubMed Central

Seidman, Larry J.; Meyer, Eric C.; Giuliano, Anthony J.; Breiter, Hans C.; Goldstein, Jill M.; Kremen, William S.; Thermenos, Heidi W.; Toomey, Rosemary; Stone, William S.; Tsuang, Ming T.; Faraone, Stephen V.

2012-01-01

Objectives The search for predictors of schizophrenia has accelerated with a growing focus on early intervention and prevention of psychotic illness. Studying nonpsychotic relatives of individuals with schizophrenia enables identification of markers of vulnerability for the illness independent of confounds associated with psychosis. The goal of these studies was to develop new auditory continuous performance tests (ACPTs) and evaluate their effects in individuals with schizophrenia and their relatives. Methods We carried out two studies of auditory vigilance with tasks involving working memory (WM) and interference control with increasing levels of cognitive load to discern the information processing vulnerabilities in a sample of schizophrenia patients, and two samples of nonpsychotic relatives of individuals with schizophrenia and controls. Study 1 assessed adults (mean age = 41), and Study 2 assessed teenagers and young adults age 13-25 (mean =19). Results Patients with schizophrenia were impaired on all five versions of the ACPTs, while relatives were impaired only on WM tasks, particularly the two interference tasks that maximize cognitive load. Across all groups, the interference tasks were more difficult to perform than the other tasks. Schizophrenia patients performed worse than relatives who performed worse than controls. For patients, the effect sizes were large (Cohen’s d =1.5), whereas for relatives, they were moderate (d = ~0.40-0.50). There was no age by group interaction in the relatives –control comparison except for participants <31 years of age. Conclusions Novel WM tasks that manipulate cognitive load and interference control index an important component of the vulnerability to schizophrenia. PMID:22563872

Intimate Partner Violence Is As Important As Client violence in Increasing Street-based Female Sex Workers’ Vulnerability to HIV in India

PubMed Central

Panchanadeswaran, Subadra; Johnson, Sethulakshmi C.; Sivaram, Sudha; Srikrishnan, A.K.; Latkin, Carl; Bentley, Margaret E.; Solomon, Suniti; Go, Vivian F.; Celentano, David

2008-01-01

Objectives There are no studies that examine street-based female sex workers’ vulnerability to HIV from both clients and intimate partners. This study documents street-based female sex workers’ experiences of client and intimate partners, examines the intersections of violence, alcohol use in condom use, and highlights survival strategies used to avert harm. Methods Ethnographic data were collected from 49 female sex workers though focus group discussions and in-depth interviews. Results Female sex workers experienced multifarious forms of severe client and intimate partner violence. Sexual coercion and forced group sex in the context of alcohol use posed formidable barriers for condom use negotiation. Further, traditional gender norms dictated women’s inabilities to negotiate condom-use with intimate partners. However, there was evidence of adoption of successful survival strategies in the face of danger and women’s positive evaluations of the benefits of sex work and their contributions to family well-being. Conclusions Harm reduction efforts with female sex workers need to account for their vulnerability to HIV from intimate partners in addition to clients. HIV prevention programmes need to include male clients in order to reduce harm among street-based female sex workers. There is an urgent need to build on sex workers’ strengths and involve them in designing individual level, community, and structural interventions that could help in reducing women’s vulnerability to intimate partner violence and HIV in India. PMID:18187314

Sex Workers, Fem Queens, and Cross-Dressers: Differential Marginalizations and HIV Vulnerabilities Among Three Ethnocultural Male-to-Female Transgender Communities in New York City

PubMed Central

Hwahng, Sel Julian; Nuttbrock, Larry

2008-01-01

This article describes 3 distinct ethnocultural male-to-female transgender communities in New York City: the low-income African American/Black1 and Latina(o) House Ball community; low-income, often undocumented immigrant Asian sex workers; and middle-class White cross-dressers. These communities are highly socially isolated from each other and are more connected to their ethnocultural contexts than to an abstract and shared transgender identity. Whereas previous research either has viewed male-to-female transgender people as one monolithic group or has separated them into abstract racial categories unconnected to their communities and lifestyles, this article positions them within specific social networks, cultures, neighborhoods, and lifestyles. With regard to HIV vulnerabilities, violence, and rape, House Ball community members seemed to engage in the riskiest form of survival sex work, whereas Asian sex workers seemed to engage in moderate-risk survival sex work. White cross-dressers seemed to engage in very low-risk recreational sex work.2 PMID:19079558

Aging and the Vulnerability of Speech to Dual Task Demands

PubMed Central

Kemper, Susan; Schmalzried, RaLynn; Hoffman, Lesa; Herman, Ruth

2010-01-01

Tracking a digital pursuit rotor task was used to measure dual task costs of language production by young and older adults. Tracking performance by both groups was affected by dual task demands: time on target declined and tracking error increased as dual task demands increased from the baseline condition to a moderately demanding dual task condition to a more demanding dual task condition. When dual task demands were moderate, older adults’ speech rate declined but their fluency, grammatical complexity, and content were unaffected. When the dual task was more demanding, older adults’ speech, like young adults’ speech, became highly fragmented, ungrammatical, and incoherent. Vocabulary, working memory, processing speed, and inhibition affected vulnerability to dual task costs: vocabulary provided some protection for sentence length and grammaticality, working memory conferred some protection for grammatical complexity, and processing speed provided some protection for speech rate, propositional density, coherence, and lexical diversity. Further, vocabulary and working memory capacity provided more protection for older adults than for young adults although the protective effect of processing speed was somewhat reduced for older adults as compared to the young adults. PMID:21186917

Prioritizing vulnerable children: why should we address inequity?

PubMed

Joshua, P; Zwi, K; Moran, P; White, L

2015-11-01

Children and young people from vulnerable population groups, including Indigenous Australians, those in out of home care, those with disabilities and those from refugee families, have difficulties in accessing health services and are at high risk of adverse outcomes, driving population health inequity. Although heterogeneous, these groups face common disadvantage and shared challenges in health service utilization. This study aims to analyse the demographics of vulnerable child populations in NSW, the rationale for focussing on their health needs and strategies for addressing population health inequity. A literature review was undertaken on vulnerable child populations and successful strategies for improving their health outcomes. NSW data on vulnerable children were collated. Vulnerable children in NSW are estimated to comprise 10-20% of the childhood population. Efforts to improve their health and well-being can be justified based on child rights, a focus on equity and effectiveness of care, public opinion and the evidence base supporting such interventions. Targeted (subpopulation specific) interventions and delivery of universally applied (population wide) strategies that disproportionately benefit vulnerable populations have been shown to be effective in reducing healthcare disparities. Most available information relates to specific vulnerable population groups. However, some effective strategies and key principles are broadly applicable to the vulnerable child population as a whole. Vulnerable children should be a key focus of healthcare interventions if inequities are to be addressed. © 2015 John Wiley & Sons Ltd.

Masculinities fathering and health: the experiences of African-Caribbean and white working class fathers.

PubMed

Williams, Robert Alan

2007-01-01

There is a developing body of research that investigates the links between masculinities and men's health experiences, but the links between masculinities and the health of fathers has been a neglected focus for research in the UK. This paper presents some of the findings drawn from a parent study which investigated African-Caribbean and white working class fathers' experiences of fathering, health and social connectedness. Data are drawn from interviews with 13 men (6 African-Caribbean and 7 White working class) living in a city in the West Midlands area of the UK. In this paper, I analyse and discuss African-Caribbean and white working class fathers' stories about the meaning of health, the influences upon their health, and their health practices. It was found that for the African-Caribbean fathers specifically, anticipated or perceived racist prejudice, abuse or discrimination influenced their health experiences. However, the meaning of health for both ethnic groups of fathers was as functional capacity, that is health was an asset that allowed fathers to meet the obligations of paid work and fathering. These obligations were also associated with a restricted sense of personal agency for the men interviewed, and the associated constraints were linked to transgressive consumption of alcohol, food and tobacco. In addition, fathers were also involved in solitary ways of dealing with their vulnerability, vulnerability that was associated with fathers' health concerns, and other difficult life experiences. Fathers' solitary experiences of vulnerability were also mediated by hegemonic forms of masculinity. Nevertheless, the experience of fathering within the lifecourse influenced men's health experiences: reflexivity and challenges to both transgressive consumption and solitary experiences were linked to fathers' perceived obligations to children. The significance of gender, ethnicity and social class for theory and future research with working class fathers and boys is identified, and the need for gender-sensitive public health and health promotion interventions regarding the 'work-family balance' and working class fathers' personal and social skills is also discussed.

Working up a Debt: Students as Vulnerable Consumers

ERIC Educational Resources Information Center

Robson, Julie; Farquhar, Jillian Dawes; Hindle, Christopher

2017-01-01

Students are recognized as vulnerable consumers where financial matters are concerned, particularly with reference to indebtedness. This study examines student indebtedness in order to initiate wider debate about student vulnerability. We consider vulnerability as dynamic and temporal, linked to an event that renders the consumer susceptible to…

Security Vulnerability Profiles of Mission Critical Software: Empirical Analysis of Security Related Bug Reports

NASA Technical Reports Server (NTRS)

Goseva-Popstojanova, Katerina; Tyo, Jacob

2017-01-01

While some prior research work exists on characteristics of software faults (i.e., bugs) and failures, very little work has been published on analysis of software applications vulnerabilities. This paper aims to contribute towards filling that gap by presenting an empirical investigation of application vulnerabilities. The results are based on data extracted from issue tracking systems of two NASA missions. These data were organized in three datasets: Ground mission IVV issues, Flight mission IVV issues, and Flight mission Developers issues. In each dataset, we identified security related software bugs and classified them in specific vulnerability classes. Then, we created the security vulnerability profiles, i.e., determined where and when the security vulnerabilities were introduced and what were the dominating vulnerabilities classes. Our main findings include: (1) In IVV issues datasets the majority of vulnerabilities were code related and were introduced in the Implementation phase. (2) For all datasets, around 90 of the vulnerabilities were located in two to four subsystems. (3) Out of 21 primary classes, five dominated: Exception Management, Memory Access, Other, Risky Values, and Unused Entities. Together, they contributed from 80 to 90 of vulnerabilities in each dataset.

Compensatory Policies Attending Equality and Inequality in Mexico Educational Practice among Vulnerable Groups in Higher Education

ERIC Educational Resources Information Center

Flores, René Pedroza; Monroy, Guadalupe Villalobos; Fabela, Ana María Reyes

2015-01-01

This paper presents an estimate of the prevalence of social inequality in accessing higher education among vulnerable groups in Mexico. Estimates were determined from statistical data provided by governmental agencies on the level of poverty among the Mexican population. In Mexico, the conditions of poverty and vulnerability while trying to access…

Tsunami survivors' perspectives on vulnerability and vulnerability reduction: evidence from Koh Phi Phi Don and Khao Lak, Thailand.

PubMed

Steckley, Marylynn; Doberstein, Brent

2011-07-01

This paper presents the results of primary research with 40 survivors of the 2004 Indian Ocean tsunami in two communities: Khao Lak (n=20) and Koh Phi Phi Don (n=20), Thailand. It traces tsunami survivors' perceptions of vulnerability, determines whether residents felt that the tsunami affected different communities differently, identifies the populations and sub-community groups that survivors distinguished as being more vulnerable than others, highlights community-generated ideas about vulnerability reduction, and pinpoints a range of additional vulnerability reduction actions. Tsunami survivors most consistently identified the 'most vulnerable' community sub-populations as women, children, the elderly, foreigners, and the poor. In Khao Lak, however, respondents added 'Burmese migrants' to this list, whereas in Koh Phi Phi Don, they added 'Thai Muslims'. Results suggest that the two case study communities, both small, coastal, tourism-dominated communities no more than 100 kilometres apart, have differing vulnerable sub-groups and environmental vulnerabilities, requiring different post-disaster vulnerability reduction efforts. © 2011 The Author(s). Disasters © Overseas Development Institute, 2011.

A Midwestern Response to the Events of September 11, 2001

ERIC Educational Resources Information Center

Masters, Julie L.

2005-01-01

The events of September 11, 2001, seemingly changed the way Americans viewed the world and their sense of vulnerability. What is not clear is the impact 9/11 had on different age groups shortly after the attacks. A quasi-experimental design was employed to study the effects of 9/11 on 298 older and younger adults. Drawing on the work of Leon…

Narrowing the Gap in Outcomes: Further Overview of Data and Evidence on the ECM Outcomes for Vulnerable Groups. Progress Report and Update

ERIC Educational Resources Information Center

Morris, Marian; Easton, Claire

2008-01-01

Narrowing the Gap (NtG) is a two-year development and research programme, funded by the Department for Children, Schools and Families (DCSF) and the Local Government Association (LGA), working in partnership with other agencies, including local authorities. It seeks to make a significant difference, on a national scale, to the performance of…

Reflections on Ethical Dilemmas in Working with So-Called "Vulnerable" and "Hard-to-Reach" Groups: Experiences from the Foodways and Futures Project

ERIC Educational Resources Information Center

Gombert, Karolina; Douglas, Flora; McArdle, Karen; Carlisle, Sandra

2016-01-01

This article reflects on ethical limitations and dilemmas encountered during fieldwork of the Foodways and Futures project (2013-2016). Foodways and Futures is a qualitative action research project aimed at exploring the food choices of former homeless young people (aged 16-25) in Aberdeenshire. In Scotland, where over 13,000 young people become…

Climate Change 2014: Technical Summary

USGS Publications Warehouse

Field, Chrisopher B.; Barros, Vicente; Mach, Katherine; Mastrandrea, Michael; van Aalst, Maarten; Adger, Niel; Arent, Douglas J; Barnett, Jonathan; Betts, Richard; Bilir, Eren; Birkmann, Joern; Carmin, Joann; Chadee, Dave; Challinor, Andrew; Chaterjee, Monalisa; Cramer, Wolfgang; Davidson, Debra; Estrada, Yuka; Gatusso, Jean-Pierre; Hijioka, Yasuakai; Yohe, Gary; Hiza, Margaret; Hoegh-Guldberg, Ove; Huang, He-Qing; Insarov, Gregory; Jones, Roger; Kovats, Sari; Lankao, Patricia Romero; Larsen, Joan Nymand; Losada, Iñigo; Marengo, José; McLean, Roger; Mearns, Linda; Mechler, Reinhard; Morton, John; Niang, Isabelle; Oki, Taikan; Olwoch, Jane Mukarugwiza; Opondo, Maggie; Poloczanska, Elvira; Pörtner, Hans -O.; Reisinger, Andy; Revi, Aromar; Schmidt, Daniela; Shaw, Rebecca; Solecki, William; Stone, Dáithí; Stone, John; Strzepek, Ken; Suarez, Avelino G.; Tschakert, Petra; Valentini, Riccardo; Vicuna, Sebastian; Villamizar, Alicia; Vincent, Katharine; Warren, Rachel; White, Leslie; Wilbanks, Thomas; Wong, Poh Poh

2014-01-01

Human interference with the climate system is occurring (WGI AR5 SPM Section D.3; WGI AR5 Sections 2.2, 6.3, 10.3 to 10.6, 10.9). Climate change poses risks for human and natural systems. The assessment of impacts, adaptation, and vulnerability in the Working Group II contribution to the IPCC’s Fifth Assessment Report (WGII AR5) evaluates how patterns of risks and potential benefits are shifting due to climate change. It considers how impacts and risks related to climate change can be reduced and managed through adaptation and mitigation. The report assesses needs, options, opportunities, constraints, resilience, limits, and other aspects associated with adaptation. It recognizes that risks of climate change will vary across regions and populations, through space and time, dependent on myriad factors including the extent of adaptation and mitigation. For the past 2 decades, IPCC’s Working Group II has developed assessments of climate change impacts, adaptation, and vulnerability. The WGII AR5 builds from the WGII contribution to the IPCC’s Fourth Assessment Report (WGII AR4), published in 2007, and the Special Report on Managing the Risks of Extreme Events and Disasters to Advance Climate Change Adaptation (SREX), published in 2012. It follows the Working Group I contribution to the AR5. The WGII AR5 is presented in two parts (Part A: Global and Sectoral Aspects, and Part B: Regional Aspects), reflecting the expanded literature basis and multidisciplinary approach, increased focus on societal impacts and responses, and continued regionally comprehensive coverage. [1.1 to 1.3] The number of scientific publications available for assessing climate change impacts, adaptation, and vulnerability more than doubled between 2005 and 2010, with especially rapid increases in publications related to adaptation, allowing for a more robust assessment that supports policymaking (high confidence). The diversity of the topics and regions covered has similarly expanded, as has the geographic distribution of authors contributing to the knowledge base for climate change assessments. Authorship of climate change publications from developing countries has increased, although it still represents a small fraction of the total. The unequal distribution of publications presents a challenge to the production of a comprehensive and balanced global assessment.

Ensuring Resident Competence: A Narrative Review of the Literature on Group Decision Making to Inform the Work of Clinical Competency Committees.

PubMed

Hauer, Karen E; Cate, Olle Ten; Boscardin, Christy K; Iobst, William; Holmboe, Eric S; Chesluk, Benjamin; Baron, Robert B; O'Sullivan, Patricia S

2016-05-01

Background The expectation for graduate medical education programs to ensure that trainees are progressing toward competence for unsupervised practice prompted requirements for a committee to make decisions regarding residents' progress, termed a clinical competency committee (CCC). The literature on the composition of these committees and how they share information and render decisions can inform the work of CCCs by highlighting vulnerabilities and best practices. Objective We conducted a narrative review of the literature on group decision making that can help characterize the work of CCCs, including how they are populated and how they use information. Methods English language studies of group decision making in medical education, psychology, and organizational behavior were used. Results The results highlighted 2 major themes. Group member composition showcased the value placed on the complementarity of members' experience and lessons they had learned about performance review through their teaching and committee work. Group processes revealed strengths and limitations in groups' understanding of their work, leader role, and information-sharing procedures. Time pressure was a threat to the quality of group work. Conclusions Implications of the findings include the risks for committees that arise with homogeneous membership, limitations to available resident performance information, and processes that arise through experience rather than deriving from a well-articulated purpose of their work. Recommendations are presented to maximize the effectiveness of CCC processes, including their membership and access to, and interpretation of, information to yield evidence-based, well-reasoned judgments.

Ensuring Resident Competence: A Narrative Review of the Literature on Group Decision Making to Inform the Work of Clinical Competency Committees

PubMed Central

Hauer, Karen E.; Cate, Olle ten; Boscardin, Christy K.; Iobst, William; Holmboe, Eric S.; Chesluk, Benjamin; Baron, Robert B.; O'Sullivan, Patricia S.

2016-01-01

Background The expectation for graduate medical education programs to ensure that trainees are progressing toward competence for unsupervised practice prompted requirements for a committee to make decisions regarding residents' progress, termed a clinical competency committee (CCC). The literature on the composition of these committees and how they share information and render decisions can inform the work of CCCs by highlighting vulnerabilities and best practices. Objective We conducted a narrative review of the literature on group decision making that can help characterize the work of CCCs, including how they are populated and how they use information. Methods English language studies of group decision making in medical education, psychology, and organizational behavior were used. Results The results highlighted 2 major themes. Group member composition showcased the value placed on the complementarity of members' experience and lessons they had learned about performance review through their teaching and committee work. Group processes revealed strengths and limitations in groups' understanding of their work, leader role, and information-sharing procedures. Time pressure was a threat to the quality of group work. Conclusions Implications of the findings include the risks for committees that arise with homogeneous membership, limitations to available resident performance information, and processes that arise through experience rather than deriving from a well-articulated purpose of their work. Recommendations are presented to maximize the effectiveness of CCC processes, including their membership and access to, and interpretation of, information to yield evidence-based, well-reasoned judgments. PMID:27168881

A qualitative study into the perceived barriers of accessing healthcare among a vulnerable population involved with a community centre in Romania.

PubMed

George, Siân; Daniels, Katy; Fioratou, Evridiki

2018-04-03

Minority vulnerable communities, such as the European Roma, often face numerous barriers to accessing healthcare services, resulting in negative health outcomes. Both these barriers and outcomes have been reported extensively in the literature. However, reports on barriers faced by European non-Roma native communities are limited. The "Health Care Access Barriers" (HCAB) model identifies pertinent financial, structural and cognitive barriers that can be measured and potentially modified. The present study thus aims to explore the barriers to accessing healthcare for a vulnerable population of mixed ethnicity from a charity community centre in Romania, as perceived by the centre's family users and staff members, and assess whether these reflect the barriers identified from the HCAB model. Eleven community members whose children attend the centre and seven staff members working at the centre participated in face-to-face semi-structured interviews, exploring personal experiences and views on accessing healthcare. The interviews were transcribed and analysed using an initial deductive and secondary inductive approach to identify HCAB themes and other emerging themes and subthemes. Identified themes from both groups aligned with HCAB's themes of financial, structural and cognitive barriers and emergent subthemes important to the specific population were identified. Specifically, financial barriers related mostly to health insurance and bribery issues, structural barriers related mostly to service availability and accessibility, and cognitive barriers related mostly to healthcare professionals' attitudes and discrimination and the vulnerable population's lack of education and health literacy. A unique theme of psychological barriers emerged from both groups with associated subthemes of mistrust, hopelessness, fear and anxiety of this vulnerable population. The current study highlights healthcare access barriers to a vulnerable non-Roma native population involved with a charity community centre in Romania. The "Healthcare Access Barriers for Vulnerable Populations" (HABVP) model is proposed as an adaption to the existing HCAB model to account for the unique perceived barriers to healthcare for this population. Recommendations for future resolution of these identified barriers are proposed.

Masculinity, sexuality and vulnerability in 'working' with young men in South African contexts: 'you feel like a fool and an idiot … a loser'.

PubMed

Shefer, Tamara; Kruger, Lou-Marie; Schepers, Yeshe

2015-01-01

South Africa has seen a rapid increase in scholarship and programmatic interventions focusing on gender and sexuality, and more recently on boys, men and masculinities. In this paper, we argue that a deterministic discourse on men's sexuality and masculinity in general is inherent in many current understandings of adolescent male sexuality, which tend to assume that young women are vulnerable and powerless and young men are sexually powerful and inevitably also the perpetrators of sexual violence. Framed within a feminist, social constructionist the oretical perspective, the current research looked at how the masculinity and sexuality of South African young men is constructed, challenged or maintained. Focus groups were conducted with young men between the ages of 15 and 20 years from five different schools in two regions of South Africa, the Western and Eastern Cape. Data were analysed using Gilligan's listening guide method. Findings suggest that participants in this study have internalised the notion of themselves as dangerous, but were also exploring other possible ways of being male and being sexual, demonstrating more complex experiences of manhood. We argue for the importance of documenting and highlighting the precariousness, vulnerability and uncertainty of young men in scholarly and programmatic work on masculinities.

What Does Vulnerability Mean?

ERIC Educational Resources Information Center

Parley, Fiona F

2011-01-01

Protection of those deemed vulnerable has received increasing attention since 2000. This article reports on care staff views of vulnerability using original data from a research study (Parley. "Vulnerability and abuse: an exploration of views of care staff working with people who have learning disabilities," PhD Thesis, 2007) in which care staff…

An Activist Approach to Sport Meets Youth From Socially Vulnerable Backgrounds: Possible Learning Aspirations.

PubMed

Luguetti, Carla; Oliver, Kimberly L; Dantas, Luiz Eduardo Pinto Basto Tourinho; Kirk, David

2017-03-01

This study was a 2-phase activist research project aimed at co-creating a prototype pedagogical model for working with youth from socially vulnerable backgrounds in a sport context. This article addresses the learning aspirations (learning outcomes) that emerged when we created spaces for youth to develop strategies to manage the risks they face in their community. This study took place in a socially and economically disadvantaged neighborhood in a Brazilian city where we worked with a group of 17 boys aged 13 to 15 years old, 4 coaches, a pedagogic coordinator, and a social worker. During a 6-month period, we collected multiple sources of data including field journal entries/observations (38) and audio records of youth work sessions (18), coaches' work sessions (16), combined coaches and youth work sessions (3), and meetings between the lead and the 2nd author for debriefing and planning sessions (36). By using an activist approach, 4 learning aspirations emerged: becoming responsible/committed, learning from mistakes, valuing each other's knowledge, and communicating with others. Findings suggest there is a need for more sports programs that start from young people's concrete needs and life situations and look to create places for youth to see alternative possibilities and take action.

Health adaptation policy for climate vulnerable groups: a 'critical computational linguistics' analysis.

PubMed

Seidel, Bastian M; Bell, Erica

2014-11-28

Many countries are developing or reviewing national adaptation policy for climate change but the extent to which these meet the health needs of vulnerable groups has not been assessed. This study examines the adequacy of such policies for nine known climate-vulnerable groups: people with mental health conditions, Aboriginal people, culturally and linguistically diverse groups, aged people, people with disabilities, rural communities, children, women, and socioeconomically disadvantaged people. The study analyses an exhaustive sample of national adaptation policy documents from Annex 1 ('developed') countries of the United Nations Framework Convention on Climate Change: 20 documents from 12 countries. A 'critical computational linguistics' method was used involving novel software-driven quantitative mapping and traditional critical discourse analysis. The study finds that references to vulnerable groups are relatively little present or non-existent, as well as poorly connected to language about practical strategies and socio-economic contexts, both also little present. The conclusions offer strategies for developing policy that is better informed by a 'social determinants of health' definition of climate vulnerability, consistent with best practice in the literature and global policy prescriptions.

Irritable bowel symptoms, use of healthcare, costs, sickness and disability pension benefits: A long-term population-based study.

PubMed

Poulsen, Chalotte H; Eplov, Lene F; Hjorthøj, Carsten; Hastrup, Lene H; Eliasen, Marie; Dantoft, Thomas M; Schröder, Andreas; Jørgensen, Torben

2018-05-01

Irritable bowel syndrome (IBS) is associated with increased healthcare use and work absenteeism. We aimed to investigate long-term use of healthcare services and social benefits across IBS symptom groups. Additionally, we estimated excess healthcare costs. A longitudinal population-based study comprising two 5-year follow-up studies: The Danish part of the Multinational Monitoring of Trends and Determinants in Cardiovascular Disease (Dan-MONICA) 1 (1982-1987) and Inter99 (1999-2004) recruited from the western part of Copenhagen County. The total study population ( n = 7278) was divided into symptom groups according to degree of IBS definition fulfillment at baseline and/or 5-year follow-up and was followed until 31 December 2013 in Danish central registries. Poisson regression was used for the analyses adjusting for age, sex, length of education, comorbidity, cohort membership and mental vulnerability. IBS symptom groups compared to no IBS symptoms were associated with an increased number of contacts with primary and secondary healthcare, as well as weeks on sickness and disability benefits. Accounting for mental vulnerability decreased the estimates and all but two associations between IBS symptom groups and outcomes remained statistically significant. The two associations that became insignificant were contacts with psychiatric hospitals and weeks on disability pension. The excess unadjusted healthcare costs for IBS were 680 Euros per year and the overall association between symptom groups and total healthcare costs were statistically significant. IBS symptoms influence the long-term use and costs of healthcare, as well as the use of social benefits in the general population. Mental vulnerability explained some, but not all, of the use of healthcare and social benefits.

Community vulnerability and stratified risk: Hegemonic masculinity, socioeconomic status, and HIV/AIDS in a sex work community in Kampala, Uganda.

PubMed

Schmidt-Sane, Megan M

2018-01-29

This article examines the social patterning of health, economic uncertainty, hegemonic masculinity, and vulnerability among men who live and work in a low-income sex work community in Kampala, Uganda. This problematises the notion that vulnerable communities are homogenous, in demographics, economic status, and risk. This article draws on ethnographic data collected in 2016, including semi-structured interviews and participant observation. This article uses a stratified risk framework to describe the central finding of this study, which is that men's experience in Kataba is characterised by a struggle to fulfil the provider role that constitutes a core aspect of their socially ascribed gender role. In a context of economic scarcity, men's lives are fraught with strain and this intersects with other forms of risk. Finally, by focusing on community vulnerability rather than individual risk, this work contributes to theories of gender and sex work, and informs HIV/AIDS praxis.

[Health inequality among vulnerable groups in Mexico: older adults, indigenous people, and migrants].

PubMed

Juárez-Ramírez, Clara; Márquez-Serrano, Margarita; Salgado de Snyder, Nelly; Pelcastre-Villafuerte, Blanca Estela; Ruelas-González, María Guadalupe; Reyes-Morales, Hortensia

2014-04-01

Health vulnerability refers to a lack of protection for specific population groups with specific health problems, as well as the disadvantages they face in solving them in comparison with other population groups. This major public health problem has multiple and diverse causes, including a shortage of trained health care personnel and the lack of family, social, economic, and institutional support in obtaining care and minimizing health risks. Health vulnerability is a dynamic condition arising from the confluence of multiple social determinants. This article attempts to describe the health situation of three vulnerable groups in Mexico-older adults, indigenous people, and migrants-and, after defining the needs of each, explore measures that could contribute to the design and implementation of public health policies better tailored to their respective needs.

Rockfall exposures in Montserrat mountain

NASA Astrophysics Data System (ADS)

Fontquerni Gorchs, Sara; Vilaplana Fernández, Joan Manuel; Guinau Sellés, Marta; Jesús Royán Cordero, Manuel

2015-04-01

This study shows the developed methodology to analyze the exposure level on a 1:25000 scale, and the results obtained by applying it to an important part of the Monataña de Montserrat Natural Park for vehicles with and without considering their occupants. The development of this proposal is part of an ongoing study which focuses more in-depth in the analysis of the rockfall risk exposure in different scales and in different natural and social contexts. This research project applies a methodology to evaluate the rockfall exposure level based on the product of the frequency of occurrence of the event by an exposure function of the vulnerable level on a 1:25,000 scale although the scale used for the study was 1:10,000. The proposed methodology to calculate the exposure level is based on six phases: 1- Identification, classification and inventory of every element potentially under risk. 2- Zoning of the frequency of occurrence of the event in the studied area. 3- Design of the exposure function for each studied element. 4- Obtaining the Exposure index, it can be defined as the product of the frequency of occurrence by the exposure function of the vulnerable element through SIG analysis obtained with ArcGis software (ESRI) 5- Obtaining exposure level by grouping into categories the numerical values of the exposure index. 6- Production of the exposition zoning map. The different types of vulnerable elements considered in the totality of the study are: Vehicles in motion, people in vehicles in motion, people on paths, permanent elements and people in buildings. Each defined typology contains all elements with same characteristics and an exposure function has been designed for each of them. For the exposure calculation, two groups of elements have been considered; firstly the group of elements with no people involved and afterwards same group of elements but with people involved. This is a first comprehensive and synthetic work about rockfall exposure on the Montserrat Mountain. It is important to mention that the exposure level calculation has been obtained from natural hazard data do not protected by defense works. Results of this work enable us to consider best strategies to reduce rockfalls risk in the PNMM. It is clear that, apart from the required structural defense works, some of them already made, implementation of strategies not involving structural defense is, in the medium and long term, the best policy to mitigate the risk. In the PNMM case, rethinking of mobility and traffic management on the mountain access would be definitely helpful to achieve a minimized geological risk.

Vulnerability and resilience in a group intervention with hospital personnel during exposure to extreme and prolonged war stress.

PubMed

Palgi, Yuval; Ben-Ezra, Menachem; Possick, Chaya

2012-02-01

The current study presents a pilot demonstration of a new therapeutic procedure to mitigate symptoms of post-traumatic stress disorder (PTSD). The pilot took place during the Second Lebanon War. Vulnerability and resilience statements, as well as post-traumatic symptoms, were measured among special army administrative staff (SAAS) who worked in a hospital setting during extreme and prolonged war stress. All 13 soldiers in the unit studied participated in seven group therapy intervention sessions. It was hypothesized that shifting the focus of therapeutic intervention from the scenes of the events to the personal and professional narratives of preparing for the event would change the content of the soldiers' narratives. It was believed that subtracting the number of positive statements from the number of negative statements would yield increasingly higher "resilience scores" during and after the war. It also was believed that such a change would be reflected in reduction of post-traumatic symptoms. As expected, the participants showed a decrease in vulnerability and an increase in resilience contents, as well as a decrease in traumatic symptoms during and after the war. These findings may reflect the effects of the ceasefire, the mutually supportive attitude of the participants, and the therapeutic interventions.

Examining occupational health and safety vulnerability among Canadian workers with disabilities.

PubMed

Breslin, F Curtis; Lay, A Morgan; Jetha, Arif; Smith, Peter

2017-05-26

To compare workers with and without disabilities on their reported workplace hazard exposure and the presence of occupational health and safety vulnerability factors. Working-aged adults in Ontario or British Columbia were recruited to participate in a cross-sectional survey (n = 1988). Self-reported measures included demographic factors, work-related variables, perceived level of activity limitation at work, and presence of work safety vulnerability factors utilizing a novel framework. Reporting a disability at work was significantly associated with greater hazard exposure than those without a disability. In addition, those reporting a disability at work were more likely to be employed in conditions where hazard exposure was combined with inadequate policies and procedures, or hazard exposures were combined with inadequate empowerment. Work safety vulnerability is one way that health inequalities can be perpetuated even among those with disabilities who have found work. Our results suggest that employers and policy makers need to focus on assessing and addressing hazard exposures and targeting occupational health and safety resources in the workplace in a way that includes workers with disabilities. Implications for Rehabilitation Workers with disabilities experience greater hazard exposure than those without a disability. Those with moderate and severe disabilities reported occupational health and safety vulnerability, suggesting that workplace accommodations should be available to a broader range of disability levels. It appears that, above and beyond standard safety procedures, providing workplace accommodations for people with disabilities may further reduce their hazard exposure and improve their safety.

Criminalisation of clients: reproducing vulnerabilities for violence and poor health among street-based sex workers in Canada-a qualitative study.

PubMed

Krüsi, A; Pacey, K; Bird, L; Taylor, C; Chettiar, J; Allan, S; Bennett, D; Montaner, J S; Kerr, T; Shannon, K

2014-06-02

To explore how criminalisation and policing of sex buyers (clients) rather than sex workers shapes sex workers' working conditions and sexual transactions including risk of violence and HIV/sexually transmitted infections (STIs). Qualitative and ethnographic study triangulated with sex work-related violence prevalence data and publicly available police statistics. Vancouver, Canada, provides a unique opportunity to evaluate the impact of policies that criminalise clients as the local police department adopted a sex work enforcement policy in January 2013 that prioritises sex workers' safety over arrest, while continuing to target clients. 26 cisgender and 5 transgender women who were street-based sex workers (n=31) participated in semistructured interviews about their working conditions. All had exchanged sex for money in the previous 30 days in Vancouver. Thematic analysis of interview transcripts and ethnographic field notes focused on how police enforcement of clients shaped sex workers' working conditions and sexual transactions, including risk of violence and HIV/STIs, over an 11-month period postpolicy implementation (January-November 2013). Sex workers' narratives and ethnographic observations indicated that while police sustained a high level of visibility, they eased charging or arresting sex workers and showed increased concern for their safety. However, participants' accounts and police statistics indicated continued police enforcement of clients. This profoundly impacted the safety strategies sex workers employed. Sex workers continued to mistrust police, had to rush screening clients and were displaced to outlying areas with increased risks of violence, including being forced to engage in unprotected sex. These findings suggest that criminalisation and policing strategies that target clients reproduce the harms created by the criminalisation of sex work, in particular, vulnerability to violence and HIV/STIs. The current findings support decriminalisation of sex work to ensure work conditions that support the health and safety of sex workers in Canada and globally. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Psychosocial Needs Assessment among Earthquake Survivors in Lorestan Province with an Emphasis on the Vulnerable Groups

PubMed Central

Forouzan, A.; Eftekhari, M. Baradaran; Falahat, K.; Dejman, M.; Heidari, N.; Habibi, E.

2013-01-01

Introduction: Iran is one of the ten most earthquake prone countries in the world. Earthquakes not only cause new psychological needs among the population but particularly so when one considers vulnerable groups. This in - depth study was conducted with the aim of assessing psychosocial needs six months after an earthquake happened in the west of the county in Lorestan province. Methods: This is a qualitative study using focus group discussion that focuses mainly on the vulnerable groups (women, children, elderly and disabled people) after an earthquake in Boz-azna; a village in Lorestan province in western part of Iran. Findings: Results of the psychosocial assessment indicated feelings of anxiety and worries in four vulnerable groups. Horror, hyper-excitement, avoidance and disturbing thoughts were observed in all groups with the exception of the elderly. Educational failures, loneliness and isolation were highlighted in children. All groups encountered socio-economic needs that included loss of assets and sense of insecurity and also reproductive problems were reported in women's group. Discussion and Conclusion: Modification of a protocol on psychosocial support considering the context of the rural and urban areas with emphasis on the specific needs of the vulnerable groups is an appropriate strategy in crisis management. It seems that appropriate public awareness regarding assistance programs can be effective in reducing stress and needs of disaster survivors. PMID:23777724

Vulnerability to stress in migratory contexts: a study with Eastern European immigrants residing in Portugal.

PubMed

de Almeida Vieira Monteiro, Ana Paula Teixeira; Serra, Adriano Vaz

2011-08-01

The assessment of individual vulnerability to stress emerges as a predictive factor of a higher risk of developing stress-related disorders. In the last decade, the geography of immigration in Portugal experienced intense transformations in terms of recruitment and patterns of geographic settlement, with an increasing and exponential inflow of new and diversified migratory groups. The immigrant populations coming from Eastern European countries are a recent migratory flow, with linguistic, cultural and socio-demographic specificities which are very different from the general Portuguese population. This makes them a paradigmatic group in potential transcultural studies on mental health issues. The primary aim of the study was to describe the characteristics of vulnerability to stress and determine their impact on the mental health status of Russian-speaking immigrants residing in Portugal. The relationship between vulnerability to stress, sociodemographic variables, mental health status and social support were analyzed, using the SSQ6, GHQ28, 23QVS and a socio-demographic questionnaire. A comparative analysis was carried out, using a control group of 110 Portuguese subjects without previous migratory experiences, matched by sex, age group and academic qualifications. The eastern European immigrants reported high levels of vulnerability to stress assessed by the cut-off point of the 23QVS. Immigrants also reported higher percentage of vulnerability to stress and lower social support levels of social support versus the control group. Several factors inherent to the dynamics of the migratory process were related to the presence of vulnerability to stress. The findings suggest that vulnerability to stress is positively correlated with worse mental health outcomes and negatively correlated with the social support perceived as available--number of supporters and satisfaction with social support.

Issues, considerations and recommendations on emergency preparedness for vulnerable population groups.

PubMed

Chen, Jing; Wilkinson, Diana; Richardson, Richard B; Waruszynski, Barbara

2009-06-01

The Workshop on Emergency Preparedness for Vulnerable Population Groups was held on 2 and 3 March 2009 in Ottawa, ON, Canada. The purpose of the workshop was to enhance communications within the emergency community response network and to identify the needs and gaps of emergency preparedness against chemical, biological, radiological, nuclear and explosives events for vulnerable population groups. The workshop was organised to enable extensive round-table discussions and provide a summary of key issues, considerations and recommendations for emergency response planners.

Identifying typical patterns of vulnerability: A 5-step approach based on cluster analysis

NASA Astrophysics Data System (ADS)

Sietz, Diana; Lüdeke, Matthias; Kok, Marcel; Lucas, Paul; Carsten, Walther; Janssen, Peter

2013-04-01

Specific processes that shape the vulnerability of socio-ecological systems to climate, market and other stresses derive from diverse background conditions. Within the multitude of vulnerability-creating mechanisms, distinct processes recur in various regions inspiring research on typical patterns of vulnerability. The vulnerability patterns display typical combinations of the natural and socio-economic properties that shape a systems' vulnerability to particular stresses. Based on the identification of a limited number of vulnerability patterns, pattern analysis provides an efficient approach to improving our understanding of vulnerability and decision-making for vulnerability reduction. However, current pattern analyses often miss explicit descriptions of their methods and pay insufficient attention to the validity of their groupings. Therefore, the question arises as to how do we identify typical vulnerability patterns in order to enhance our understanding of a systems' vulnerability to stresses? A cluster-based pattern recognition applied at global and local levels is scrutinised with a focus on an applicable methodology and practicable insights. Taking the example of drylands, this presentation demonstrates the conditions necessary to identify typical vulnerability patterns. They are summarised in five methodological steps comprising the elicitation of relevant cause-effect hypotheses and the quantitative indication of mechanisms as well as an evaluation of robustness, a validation and a ranking of the identified patterns. Reflecting scale-dependent opportunities, a global study is able to support decision-making with insights into the up-scaling of interventions when available funds are limited. In contrast, local investigations encourage an outcome-based validation. This constitutes a crucial step in establishing the credibility of the patterns and hence their suitability for informing extension services and individual decisions. In this respect, working at the local level provides a clear advantage since, to a large extent, limitations in globally available observational data constrain such a validation on the global scale. Overall, the five steps are outlined in detail in order to facilitate and motivate the application of pattern recognition in other research studies concerned with vulnerability analysis, including future applications to different vulnerability frameworks. Such applications could promote the refinement of mechanisms in specific contexts and advance methodological adjustments. This would further increase the value of identifying typical patterns in the properties of socio-ecological systems for an improved understanding and management of the relation between these systems and particular stresses.

Supporting Community in Schools: The Relationship of Resilience and Vulnerability.

ERIC Educational Resources Information Center

Calderwood, Patricia E.

This paper examines the role of community in education. It focuses on the relation between vulnerability and resilience and how this dialectic is fundamental to the workings of community. Community without vulnerability is impoverished since it offers no chance to build resilience. However, vulnerabilities may be perceived as flaws that could be…

The prevalence of heat-related cardiorespiratory symptoms: the vulnerable groups identified from the National FINRISK 2007 Study

NASA Astrophysics Data System (ADS)

Näyhä, Simo; Rintamäki, Hannu; Donaldson, Gavin; Hassi, Juhani; Jousilahti, Pekka; Laatikainen, Tiina; Jaakkola, Jouni J. K.; Ikäheimo, Tiina M.

2017-04-01

The prevalence of heat-related cardiorespiratory symptoms among vulnerable groups is not well known. We therefore estimated the prevalence of heat-related cardiorespiratory symptoms among the Finnish population and their associations with social and individual vulnerability factors. The data came from the National FINRISK 2007 Study, in which 4007 men and women aged 25-74 answered questions on heat-related cardiorespiratory symptoms in the Oulu Cold and Heat Questionnaire 2007. Logistic regression was used to calculate odds ratios (ORs), their 95 % confidence intervals (CIs), and model-predicted prevalence figures. The prevalence of heat-related cardiorespiratory symptoms was 12 %. It increased with age, from 3 % at the age of 25 years to 28 % at the age of 75 years. The symptoms were associated with pre-existing lung (OR 3.93; CI 3.01-5.13) and cardiovascular diseases (OR 2.27; 1.78-2.89); being a pensioner (OR 2.91; 1.65-5.28), unemployed (OR 2.82; 1.47-5.48), or working in agriculture (OR 2.27; 1.14-4.46) compared with working in industry; having only basic vs academic education (OR 1.98; 1.31-3.05); being female (OR 1.94; 1.51-2.50); being heavy vs light alcohol consumer (OR 1.89; 1.02-3.32); undertaking hard vs light physical work (OR 1.48;1.06-2.07); and being inactive vs active in leisure time (OR 1.97; 1.39-2.81). The adjusted prevalence of symptoms showed a wide range of variation, from 3 to 61 % depending on sex, age, professional field, education, and pre-existing lung and cardiovascular diseases. In conclusion, heat-related cardiorespiratory symptoms are commonly perceived among people with pre-existing lung or cardiovascular disease, agricultural workers, unemployed, pensioners, and people having only basic education. This information is needed for any planning and targeting measures to reduce the burden of summer heat.

An Analysis of the Extent of Social Inclusion and Equity Consideration in Malawi’s National HIV and AIDS Policy Review Process

PubMed Central

Chinyama, Mathews Junior; MacLachlan, Malcolm; McVeigh, Joanne; Huss, Tessy; Gawamadzi, Sylvester

2018-01-01

Background: Equity and social inclusion for vulnerable groups in policy development processes and resulting documents remain a challenge globally. Most often, the marginalization of vulnerable groups is overlooked in both the planning and practice of health service delivery. Such marginalization may occur because authorities deem the targeting of those who already have better access to healthcare a cheaper and easier way to achieve short-term health gains. The Government of Malawi wishes to achieve an equitable and inclusive HIV and AIDS Policy. The aim of this study is to assess the extent to which the Malawi Policy review process addressed regional and international health priorities of equity and social inclusion for vulnerable groups in the policy content and policy revision process. Methods: This research design comprised two phases. First, the content of the Malawi HIV and AIDS Policy was assessed using EquiFrame regarding its coverage of 21 Core Concepts of human rights and inclusion of 12 Vulnerable Groups. Second, the engagement of vulnerable groups in the policy process was assessed using the EquIPP matrix. For the latter, 10 interviews were conducted with a purposive sample of representatives of public sector, civil society organizations and development partners who participated in the policy revision process. Data was also collected from documented information of the policy processes. Results: Our analyses indicated that the Malawi HIV and AIDS Policy had a relatively high coverage of Core Concepts of human rights and Vulnerable Groups; although with some notable omissions. The analyses also found that reasonable steps were taken to engage and promote participation of vulnerable groups in the planning, development, implementation, monitoring and evaluation processes of the HIV and AIDS Policy, although again, with some notable exceptions. This is the first study to use both EquiFrame and EquIPP as complimentary tools to assess the content and process of policy. Conclusion: While the findings indicate inclusive processes, commitment to Core Concepts of human rights and inclusion of Vulnerable Groups in relation to the Malawi HIV and AIDS Policy, the results also point to areas in which social inclusion and equity could be further strengthened. PMID:29626397

Treating disorganized attachment in the Group Attachment-Based Intervention (GABI©): A case study.

PubMed

Knafo, Hannah; Murphy, Anne; Steele, Howard; Steele, Miriam

2018-05-24

This paper describes the treatment of a mother and child who demonstrated disorganized attachment behaviors in their interactions with one another. The mother, who was diagnosed with Borderline Personality Disorder, felt incapable of managing her aggressive toddler and his emotional needs. The dyad was referred for therapy due to concerns about his developmental progress, evident delays having been mainly attributed to the problems observed within the parent-child relationship. The primary intervention applied to working with the dyad was the Group Attachment-Based Intervention (GABI©), developed by Anne Murphy in collaboration with Miriam Steele and Howard Steele. The mother also received individual psychotherapy as a supplement to the dyadic and group work of GABI©. The process and outcome of this comprehensive approach to treating a vulnerable dyad is explored in this case study. © 2018 Wiley Periodicals, Inc.

"The Life of Crime Does Not Pay; Stop and Think!": The Process of Co-Constructing a Prototype Pedagogical Model of Sport for Working with Youth from Socially Vulnerable Backgrounds

ERIC Educational Resources Information Center

Luguetti, Carla; Oliver, Kimberly L.; Dantas, Luiz E. P. B. T.; Kirk, David

2017-01-01

Purpose: This study discusses the process of co-constructing a prototype pedagogical model for working with youth from socially vulnerable backgrounds. Participants and settings: This six-month activist research project was conducted in a soccer program in a socially vulnerable area of Brazil in 2013. The study included 17 youths, 4 coaches, a…

Individual, occupational, and workplace correlates of occupational health and safety vulnerability in a sample of Canadian workers.

PubMed

Lay, A Morgan; Saunders, Ron; Lifshen, Marni; Breslin, Curtis; LaMontagne, Anthony; Tompa, Emile; Smith, Peter

2016-02-01

To describe OH&S vulnerability across a diverse sample of Canadian workers. A survey was administered to 1,835 workers employed more than 15 hrs/week in workplaces with at least five employees. Adjusted logistic models were fitted for three specific and one overall measure of workplace vulnerability developed based on hazard exposure and access to protective OH&S policies and procedures, awareness of employment rights and responsibilities, and workplace empowerment. More than one third of the sample experienced some OH&S vulnerability. The type and magnitude of vulnerability varied by labor market sub-group. Younger workers and those in smaller workplaces experienced significantly higher odds of multiple types of vulnerability. Temporary workers reported elevated odds of overall, awareness- and empowerment-related vulnerability, while respondents born outside of Canada had significantly higher odds of awareness vulnerability. Knowing how labor market sub-groups experience different types of vulnerability can inform better-tailored primary prevention interventions. © 2015 The Authors. American Journal of Industrial Medicine Published by Wiley Periodicals, Inc.

Social and cultural vulnerability to sexually transmitted infection: the work of exotic dancers.

PubMed

Maticka-Tyndale, E; Lewis, J; Clark, J P; Zubick, J; Young, S

1999-01-01

This article examines the social and cultural factors that influence the vulnerability of female exotic dancers to sexually transmitted infections. Results are based on a qualitative, exploratory study using observations in 10 clubs and in-depth interviews with 30 dancers in southern Ontario. The social and cultural context within which exotic dancing takes place contributes to a chronic state of sexual harassment and sexual assault in the strip clubs. Women are pressured by economics and by their customers to engage in sex for pay. The defence mechanisms that some women use to deal with these work conditions also contribute to women's vulnerability. The social structure of strip clubs and their policies toward employees and customers can either reduce or exacerbate the vulnerability of dancers. Workplace policies and health and safety standards appear to be the most effective ways to decrease the vulnerability of dancers. Public health units can work with employers and dancers to establish workplace policies and programmes that contribute to the health and wellbeing of dancers.

Future Job Openings: Australia in the Knowledge Economy. Project 2000-02: Changing Skill Requirements in the Australian Labour Force in a Knowledge Economy. Working Paper.

ERIC Educational Resources Information Center

Shah, Chandra; Burke, Gerald

Forecasts of Australian labor market growth, net replacement needs, and net job openings to 2006 are presented using the nine-way grouping of occupations described by (Maglen and Shah, 1999). Analysis is based on classifying occupations by whether they are advantaged by globalization and technological change, relatively insulated, or vulnerable.…

Binge ethanol effects on prefrontal cortex neurons, spatial working memory and task-induced neuronal activation in male and female rats.

PubMed

West, Rebecca K; Maynard, Mark E; Leasure, J Leigh

2018-05-01

Excessive alcohol intake is associated with a multitude of health risks, especially for women. Recent studies in animal models indicate that the female brain is more negatively affected by alcohol, compared to the male brain. Among other regions, excessive alcohol consumption damages the frontal cortex, an area important for many functions and decision making of daily life. The objective of the present study was to determine whether the medial prefrontal cortex (mPFC) in female rats is selectively vulnerable to alcohol-induced damage. In humans, loss of prefrontal grey matter resulting from heavy alcohol consumption has been documented, however this volume loss is not necessarily due to a decrease in the number of neurons. We therefore quantified both number and nuclear volume of mPFC neurons following binge alcohol, as well as performance and neuronal activation during a prefrontal-dependent behavioral task. Adult male and female Long-Evans rats were assigned to binge or control groups and exposed to ethanol using a well-established 4-day model of alcohol-induced neurodegeneration. Both males and females had significantly smaller average neuronal nuclei volumes than their respective control groups immediately following alcohol binge, but neither sex showed a decrease in neuron number. Binged rats of both sexes initially showed spatial working memory deficits. Although they eventually achieved control performance, binged rats of both sexes showed increased c-Fos labeling in the mPFC during rewarded alternation, suggesting decreased neural efficiency. Overall, our results substantiate prior evidence indicating that the frontal cortex is vulnerable to alcohol, but also indicate that sex-specific vulnerability to alcohol may be brain region-dependent. Copyright © 2018 Elsevier Inc. All rights reserved.

State budget transfers to health insurance funds: extending universal health coverage in low- and middle-income countries of the WHO European Region.

PubMed

Mathauer, Inke; Theisling, Mareike; Mathivet, Benoit; Vilcu, Ileana

2016-04-02

Many low-and middle-income countries (LMIC) of the World Health Organization (WHO) European Region have introduced social health insurance payroll taxes after the political transition in the late 1980s, combined with budget transfers to allow for exempting specific population groups from paying contributions, such as those outside formal sector work and in particular vulnerable groups. This paper assesses the institutional design aspects of such financing arrangements and their performance with respect to universal health coverage progress in LMIC of the European region. The study is based on a literature review and review of secondary databases for the performance assessment. Such financing arrangements currently exist in 13 LMIC of that region, with strong commonalities in institutional design: This includes a wide range of different eligible population groups, mostly mandatory membership, integrated pools for both the exempted and contributors, and relatively comprehensive benefit packages. Performance is more varied. Enrolment rates range from about 65 % to above 95 %, and access to care and financial protection has improved in several countries. Yet, inequities between income quintiles persist. Budget transfers to health insurance arrangements have helped to deepen UHC or maintain achievements with respect to UHC in these European LMICs by covering those outside formal sector work, and in particular vulnerable population groups. However, challenges remain: a comprehensive benefit package on paper is not enough as long as supply side constraints and quality gaps as well as informal payments prevail. A key policy question is how to reach those so far uncovered.

Are older people a vulnerable group? Philosophical and bioethical perspectives on ageing and vulnerability.

PubMed

Bozzaro, Claudia; Boldt, Joachim; Schweda, Mark

2018-05-01

The elderly are often considered a vulnerable group in public and academic bioethical debates and regulations. In this paper, we examine and challenge this assumption and its ethical implications. We begin by systematically delineating the different concepts of vulnerability commonly used in bioethics, before then examining whether these concepts can be applied to old age. We argue that old age should not, in and of itself, be used as a marker of vulnerability, since ageing is a process that can develop in a variety of different ways and is not always associated with particular experiences of vulnerability. We, therefore, turn to more fundamental phenomenological considerations in order to reconstruct from a first person perspective the intricate interconnections between the experiences of ageing and vulnerability. According to this account, ageing and old age are phenomena in which the basic anthropological vulnerability of human beings can manifest itself in an increased likelihood of harm and exploitation. Thus, we plead for a combined model of vulnerability that helps to avoid problems related to the current concepts of vulnerability. We conclude first that old age as such is not a sufficient criterion for being categorized as vulnerable in applied ethics, and second that reflections on ageing can help to develop a better understanding of the central role of vulnerability in human existence and in applied ethics. © 2018 John Wiley & Sons Ltd.

Love, power, resilience and vulnerability: relationship dynamics between female sex workers in Ghana and their intimate partners.

PubMed

Onyango, Monica Adhiambo; Adu-Sarkodie, Yaw; Adjei, Rose Odotei; Agyarko-Poku, Thomas; Kopelman, Carol Hunsberger; Green, Kimberly; Wambugu, Samuel; Clement, Nana Fosua; Wondergem, Peter; Beard, Jennifer

2018-04-19

Little is known about female sex workers' daily lives or emotional relationships. Using relational-cultural theory, this study explored the relationship dynamics between sex workers and their intimate partners in Kumasi, Ghana. We collected qualitative data from 37 male intimate partners through 24 in-depth interviews and two focus group discussions (FGDs) with 13 male partners. We also conducted three FGDs with 20 women involved in sex work. Relationships between sex workers and their intimate partners were mutual, reciprocal and transactional. Male partners provided protection for financial support, a place to sleep and intimacy. Both men and women described their relationships in terms of friendship, love and a hopeful future. Women were reluctant to quit sex work because they depended on it for income. Most respondents did not use condoms in these romantic relationships, citing trust, love, faithfulness and commitment. Both men and women described high levels of violence in their relationships. The context of sex work heightens vulnerability but also appears to facilitate resilience and creative coping strategies. The relational dynamics between sex workers and their intimate partners in Ghana merit further exploration to examine the extent to which women involved in sex work hold and exert power within these relationships.

[Information hygiene and regulation of information for vulnerable groups of the population].

PubMed

Denisov, E I; Eremin, A L; Sivochalova, O V; Kurerov, N N

2014-01-01

Development of information society engenders the problem of hygienic regulation of information load for the population, first of all for vulnerable groups. There are presented international and Russian normative legal documents and experience in this area, there are described the negative effects of information (such as stress, depression, suicidal ideations). There are considered social-psychological characteristics of vulnerable groups that requires their best protection from loads of information, doing harm, particularly in terms of reproductive health, family relationships, children, etc. There was noted the desirability of improvement of sanitary, legislation on the regulation of the information load on the population, especially in vulnerable groups, in terms of optimization of parameters of the signal-carriers on volume, brightness and the adequacy of the volume and content of information in radio and television broadcasting, in an urban environment and at the plant to preserve the health and well-being of the population.

Understanding Young Women's Sexual Relationship Experiences: The Nature and Role of Vulnerability

ERIC Educational Resources Information Center

Maxwell, Claire

2006-01-01

This paper seeks to operationalise the concept of social "vulnerability" and explore its usefulness as a framework for understanding sexual relationships. Data from 30 vulnerable and less vulnerable young women in one UK city were collected through in-depth interviews and focus groups. An analysis of differences and similarities in…

[Quality of life in Latin American immigrant caregivers in Spain].

PubMed

Bover, Andreu; Taltavull, Joana Maria; Gastaldo, Denise; Luengo, Raquel; Izquierdo, María Dolores; Juando-Prats, Clara; Sáenz de Ormijana, Amaia; Robledo, Juana

2015-01-01

To describe perceived quality of life in Latin American caregivers working in Spain and how it varies in relation to certain variables shared by this group. We used the SF-36 to measure perceived quality of life in 517 women residing in five Spanish regions: the Balearic Islands, Catalonia, the Basque Country, the Canary Islands, and Madrid. Several variables related to the socio-demographic profile and migration process were studied using Student's t test, ANOVA and linear regression models. The participants scored very low on the dimensions of physical and emotional roles. The factors associated with lower quality of life scores within the group were working as a live-in caregiver, lack of contract, multitasking, irregular status, and younger age. The vulnerability of these women can be explained by poor working conditions and other factors related to the migratory process. Copyright © 2014 SESPAS. Published by Elsevier Espana. All rights reserved.

Individual, occupational, and workplace correlates of occupational health and safety vulnerability in a sample of Canadian workers

PubMed Central

Saunders, Ron; Lifshen, Marni; Breslin, Curtis; LaMontagne, Anthony; Tompa, Emile; Smith, Peter

2015-01-01

Objective To describe OH&S vulnerability across a diverse sample of Canadian workers. Methods A survey was administered to 1,835 workers employed more than 15 hrs/week in workplaces with at least five employees. Adjusted logistic models were fitted for three specific and one overall measure of workplace vulnerability developed based on hazard exposure and access to protective OH&S policies and procedures, awareness of employment rights and responsibilities, and workplace empowerment. Results More than one third of the sample experienced some OH&S vulnerability. The type and magnitude of vulnerability varied by labor market sub‐group. Younger workers and those in smaller workplaces experienced significantly higher odds of multiple types of vulnerability. Temporary workers reported elevated odds of overall, awareness‐ and empowerment‐related vulnerability, while respondents born outside of Canada had significantly higher odds of awareness vulnerability. Conclusion Knowing how labor market sub‐groups experience different types of vulnerability can inform better‐tailored primary prevention interventions. Am. J. Ind. Med. 59:119–128, 2016. © 2015 The Authors. American Journal of Industrial Medicine Published by Wiley Periodicals, Inc. PMID:26771101

Beyond the checklist: understanding rural health vulnerability in a South African context.

PubMed

Vergunst, Richard; Swartz, Leslie; Mji, Gubela; Kritzinger, Janis; Braathen, Stine Hellum

2016-01-01

Vulnerability in the past has sometimes been measured and understood in terms of checklists or common understanding. It is argued here that vulnerability is a more complex issue than this. Although checklists of vulnerable groups are important, they do not capture the essence and dynamics of vulnerability. The case of rural health vulnerability in South Africa is discussed to show that classifying people into vulnerable groups does not portray the complexity and intricacies of what it means to have vulnerability. We also wish to show that there are different kinds of vulnerabilities, and the difference between access vulnerability and illness vulnerability is highlighted. As part of a larger study, this case study is presented to show how vulnerability in a poor rural community in South Africa has to be understood in a contextual and dynamic manner as opposed to a static manner. Family and social dynamics can influence health. For example, fractured families were seen as a vulnerable issue within the community, while being a person with a disability can lead to isolation and callous attitudes towards them. It is these family and social dynamics that lead proximally to vulnerability to ill health. A contextual approach can assist in giving a more layered understanding of vulnerability than a checklist approach can do. Interventions to change health cannot be addressed simply by medical means. Social conditions need to be changed, and part of changing social conditions is the process of assisting those who are isolated or experience themselves as vulnerable to reconnect with others in the community. Poverty leads to social exclusion; social and family inclusion may be key to well-being.

Coastal vulnerability: climate change and natural hazards perspectives

NASA Astrophysics Data System (ADS)

Romieu, E.; Vinchon, C.

2009-04-01

Introduction Studying coastal zones as a territorial concept (Integrated coastal zone management) is an essential issue for managers, as they have to consider many different topics (natural hazards, resources management, tourism, climate change…). The recent approach in terms of "coastal vulnerability" studies (since the 90's) is the main tool used nowadays to help them in evaluating impacts of natural hazards on coastal zones, specially considering climate change. This present communication aims to highlight the difficulties in integrating this concept in risk analysis as it is usually practiced in natural hazards sciences. 1) Coastal vulnerability as a recent issue The concept of coastal vulnerability mainly appears in the International panel on climate change works of 1992 (IPCC. 2001), where it is presented as essential for climate change adaptation. The concept has been defined by a common methodology which proposes the assessment of seven indicators, in regards to a sea level rise of 1m in 2100: people affected, people at risk, capital value at loss, land at loss, wetland at loss, potential adaptation costs, people at risk assuming this adaptation. Many national assessments have been implemented (Nicholls, et al. 1995) and a global assessment was proposed for three indicators (Nicholls, et al. 1999). The DINAS-Coast project reuses this methodology to produce the DIVA-tool for coastal managers (Vafeidis, et al. 2004). Besides, many other methodologies for national or regional coastal vulnerability assessments have been developed (review by (UNFCCC. 2008). The use of aggregated vulnerability indicators (including geomorphology, hydrodynamics, climate change…) is widespread: the USGS coastal vulnerability index is used worldwide and was completed by a social vulnerability index (Boruff, et al. 2005). Those index-based methods propose a vulnerability mapping which visualise indicators of erosion, submersion and/or socio economic sensibility in coastal zones. This concept is a great tool for policy makers to help managing their action and taking into account climate change (McFadden, et al. 2006). However, in those approaches, vulnerability is the output itself (cost of effective impacts, geomorphologic impacts…), but is not integrated it in a risk analysis. Furthermore, those studies emerged from a climatic perspective, which leads to consider climate change as a hazard or pressure whereas risk studies commonly consider hazards such as erosion and flooding, where climate change modifies the drivers of the hazard. 2) The natural hazards and socio economic perspectives In order to reduce impacts of natural hazards, decision makers need a complete risk assessment (probability of losses). Past studies on natural risks (landslide, earthquake...) highlighted the pertinence of defining risk as a combination of : (1)hazard occurrence and intensity, (2) exposition and (3)vulnerability of assets and population to this hazard (e.g. Douglas. 2007, Sarewitz, et al. 2003). Following the Renn and Klinke risk assessment frame, high uncertainties associated with coastal risks considering climatic and anthropic change highlights the importance of working on that concept of "vulnerability" (Klinke and Renn. 2002). Past studies on vulnerability assessment showed a frequently mentioned gap between "impact based" and "human based" points of view. It is nowadays a great issue for natural risk sciences. Many research efforts in FP7 projects such as MOVE and ENSURE focus on integrating the different dimensions of vulnerability (Turner, et al. 2003, Birkmann. 2006). Coastal risk studies highlight another issue of concern. We previously detailed the different use of the term "vulnerability" in the coastal context, quite different of the "natural risk's" use. Interaction of social, economic and physical sciences is considered within two french research projects (Vulsaco, Miseeva), in order to identify the vulnerability of a system to flooding or erosion (i.e. its characteristics that create potential harm), and integrate them in a risk assessment. Global change is considered by modifications of hazard, anthropogenic pressure and exposition, in order to point out possible modification of vulnerabilities. 3) Learning from both perspectives Coastal vulnerability in its "end in itself" and climate change dimension is a widespread tool for decision makers but it can be inadequate when vulnerability is a component of risk. This is mainly due to the consideration of climate change as a "hazard", so that coastal vulnerability is seen as the possible adverse impacts of climate change. As a matter of fact, this concept is clearly well considered by managers, who feel deeply concerned by climate change. However, coastal risk managers would gain in considering climate change more like a driver able to modify existing hazards than like the pressure in itself. Using this concept could lead to new perspectives of coastal risk mitigation for decision makers (social vulnerability, risk perception…), learning from other disciplines and sciences thanks to research projects such as MOVE (FP7). Acknowledgements The authors would like to thank the BRGM coastal team for rich discussions and fruitful collaborations in coastal vulnerability studies, more specially Déborah Idier for animating the Vulsaco project and Manuel Garcin for his work on tsunamis in Sri Lanka. They are also grateful to the MISEEVA and MOVE teams, which are doing some great trans-disciplinary work. References Birkmann, J., 2006. Measuring vulnerability to Natural Hazards : towards disaster resilient societies. United Nations University Press. Boruff, B. J., Emrich, C., Cutter, S. L., 2005. Erosion hazard vulnerability of US coastal counties. Journal of Coastal Research. 21, 932-942. Douglas, J., 2007. Physical vulnerability modelling in natural hazard risk assessment. Natural Hazards and Earth System Sciences. 7, 283-288. IPCC, 2001. Climate change 2001 : synthesis report. A contribution of working groups I, II and III to the Third Assesment Report of the Intergovernmental Panel on Climate Change. Klinke, A. and Renn, O., 2002. A new approach to risk evaluation and management : risk based, precaution based and discourse based strategies. Risk Analysis. 22, 1071-1094. McFadden, L., Nicholls, R.J., Penning-Rowsell, E. (Eds.), 2006. Managing coastal vulnerability. Elsevier Science. Nicholls, R. J., Hoozemans, F. M. J., Marchand, M., 1999. Increasing flood risk and wetland losses due to global sea-level rise: regional and global analyses. Global Environmental Change, Part A: Human and Policy Dimensions. 9, S69-S87. Nicholls, R. J., Leatherman, S. P., Volonte, C. R., 1995. Impacts and responses to sea-level rise; qualitative and quantitative assessments; Potential impacts of accelerated sea-level rise on developing countries. Journal of Coastal Research. Special issue 14, 26-43. Sarewitz, D., Pielke, R., Keykhah, M., 2003. Vulnerability and Risk: Some Thoughts from a Political and Policy Perspective. Risk Analysis. 23, 805-810. Turner, B. L.,II, Kasperson, R. E., Matson, P. A., McCarthy, J. J., Corell, R. W., Christensen, L., Eckley, N., Kasperson, J. X., Luers, A., Martello, M. L., Polsky, C., Pulsipher, A., Schiller, A., 2003. A framework for vulnerability analysis in sustainability science. Proceedings of the National Academy of Sciences, USA. 100, 8074-8079. UNFCCC, 2008. Compendium on methods and tools to evaluate impacts of vulnerability and adaptation to climate change. Vafeidis, A., Nicholls, R., McFadden, L., 2004. Developing a database for global vulnerability analysis of coastal zones: The DINAS-COAST project and the DIVA tool.

Awareness of Tobacco-Related Health Harms among Vulnerable Populations in Bangladesh: Findings from the International Tobacco Control (ITC) Bangladesh Survey

PubMed Central

Driezen, Pete; Abdullah, Abu S.; Nargis, Nigar; Hussain, A. K. M. Ghulam; Fong, Geoffrey T.; Thompson, Mary E.; Quah, Anne C. K.; Xu, Steve

2016-01-01

This study assessed the knowledge of the harmful effects of tobacco use among vulnerable populations in Bangladesh and whether vulnerability was associated with the presence of complete home smoking bans. Data came from Wave 3 (2011–2012) of the International Tobacco Control (ITC) Bangladesh Survey, a nationally-representative survey of 3131 tobacco users and 2147 non-users. Socio-demographic measures of disadvantage were used as proxy measures of vulnerability, including sex, residential location, education and income. Outcome measures were awareness of the harmful effects of (a) cigarette smoking and (b) smokeless tobacco use and (c) whether respondents had complete smoking bans in their homes. Logistic regression was used to examine whether the adjusted prevalence of each outcome differed by socio-demographic proxies of vulnerability. Smaller percentages of women, the illiterate, urban slum residents and low-income Bangladeshis were aware of the health harms of tobacco. These vulnerable groups generally had lower odds of awareness compared to the least disadvantaged groups. Incomplete knowledge of tobacco’s harms may prevent vulnerable groups from taking steps to protect their health. Development goals, such as increasing literacy rates and empowering women, can complement the goals of WHO’s Framework Convention on Tobacco Control. PMID:27571090

Awareness of Tobacco-Related Health Harms among Vulnerable Populations in Bangladesh: Findings from the International Tobacco Control (ITC) Bangladesh Survey.

PubMed

Driezen, Pete; Abdullah, Abu S; Nargis, Nigar; Hussain, A K M Ghulam; Fong, Geoffrey T; Thompson, Mary E; Quah, Anne C K; Xu, Steve

2016-08-25

This study assessed the knowledge of the harmful effects of tobacco use among vulnerable populations in Bangladesh and whether vulnerability was associated with the presence of complete home smoking bans. Data came from Wave 3 (2011-2012) of the International Tobacco Control (ITC) Bangladesh Survey, a nationally-representative survey of 3131 tobacco users and 2147 non-users. Socio-demographic measures of disadvantage were used as proxy measures of vulnerability, including sex, residential location, education and income. Outcome measures were awareness of the harmful effects of (a) cigarette smoking and (b) smokeless tobacco use and (c) whether respondents had complete smoking bans in their homes. Logistic regression was used to examine whether the adjusted prevalence of each outcome differed by socio-demographic proxies of vulnerability. Smaller percentages of women, the illiterate, urban slum residents and low-income Bangladeshis were aware of the health harms of tobacco. These vulnerable groups generally had lower odds of awareness compared to the least disadvantaged groups. Incomplete knowledge of tobacco's harms may prevent vulnerable groups from taking steps to protect their health. Development goals, such as increasing literacy rates and empowering women, can complement the goals of WHO's Framework Convention on Tobacco Control.

Accounting for vulnerable populations in rural hazard mitigation plans: results of a survey of emergency managers.

PubMed

Horney, Jennifer A; Nguyen, Mai; Cooper, John; Simon, Matthew; Ricchetti-Masterson, Kristen; Grabich, Shannon; Salvesen, David; Berke, Philip

2013-01-01

Rural areas of the United States are uniquely vulnerable to the impacts of natural disasters. One possible way to mitigate vulnerability to disasters in rural communities is to have a high-quality hazard mitigation plan in place. To understand the resources available for hazard mitigation planning and determine how well hazard mitigation plans in rural counties meet the needs of vulnerable populations, we surveyed the lead planning or emergency management official responsible for hazard mitigation plans in 96 rural counties in eight states in the Southeastern United States. In most counties, emergency management was responsible for implementing the county's hazard mitigation plan and the majority of counties had experienced a presidentially declared disaster in the last 5 years. Our research findings demonstrated that there were differences in subjective measures of vulnerability (as reported by survey respondents) and objective measures of vulnerability (as determined by US Census data). In addition, although few counties surveyed included outreach to vulnerable groups as a part of their hazard mitigation planning process, a majority felt that their hazard mitigation plan addressed the needs of vulnerable populations "well" or "very well." These differences could result in increased vulnerabilities in rural areas, particularly for certain vulnerable groups.

What we know, do not know, and need to know about climate change vulnerability in the western Canadian Arctic: a systematic literature review

NASA Astrophysics Data System (ADS)

Ford, James D.; Pearce, Tristan

2010-01-01

This letter systematically reviews and synthesizes scientific and gray literature publications (n = 420) to identify and characterize the nature of climate change vulnerability in the Inuvialuit Settlement Region of the western Canadian Arctic and identify gaps in understanding. The literature documents widespread evidence of climate change, with implications for human and biophysical systems. Adaptations are being employed to manage changing conditions and are indicative of a high adaptive capacity. However, barriers to adaptation are evident and are expected to constrain adaptive capacity to future climate change. Continued climate change is predicted for the region, with differential exposure sensitivity for communities, groups and sectors: a function of social-economic-biophysical characteristics and projected future climatic conditions. Existing climate risks are expected to increase in magnitude and frequency, although the interaction between projected changes and socio-economic-demographic trends has not been assessed. The capacity for adapting to future climate change has also not been studied. The review identifies the importance of targeted vulnerability research that works closely with community members and other stakeholders to address research needs. Importantly, the fully categorized list of reviewed references accompanying this letter will be a valuable resource for those working or planning to work in the region, capturing climate change research published since 1990. At a broader level, the systematic review methodology offers a promising tool for climate/environmental change studies in general where there is a large and emerging body of research but limited understanding of research gaps and needs.

Climate volatility deepens poverty vulnerability in developing countries

NASA Astrophysics Data System (ADS)

Ahmed, Syud A.; Diffenbaugh, Noah S.; Hertel, Thomas W.

2009-07-01

Extreme climate events could influence poverty by affecting agricultural productivity and raising prices of staple foods that are important to poor households in developing countries. With the frequency and intensity of extreme climate events predicted to change in the future, informed policy design and analysis requires an understanding of which countries and groups are going to be most vulnerable to increasing poverty. Using a novel economic-climate analysis framework, we assess the poverty impacts of climate volatility for seven socio-economic groups in 16 developing countries. We find that extremes under present climate volatility increase poverty across our developing country sample—particularly in Bangladesh, Mexico, Indonesia, and Africa—with urban wage earners the most vulnerable group. We also find that global warming exacerbates poverty vulnerability in many nations.

Effect of dysfunctional attitudes and postpartum state on vulnerability to depressed mood.

PubMed

Dowlati, Yekta; Segal, Zindel V; Ravindran, Arun V; Steiner, Meir; Stewart, Donna E; Meyer, Jeffrey H

2014-06-01

Postpartum depression (PPD) is the most common complication of childbearing with a 13% prevalence. Vulnerability to depressed mood has an important role in the onset of major depressive episodes (MDE), but has not been investigated in postpartum. The aim is to assess whether day-5 postpartum blues and severity of dysfunctional attitudes predicts vulnerability to depressed mood. About 45 healthy women were recruited: group 1 (n=12) was day-5 postpartum during the typical peak of postpartum blues. Group 2 (n=11) was within 18 months postpartum and reported a vulnerability to cry (and had elevated dysfunctional attitudes but no MDE). Group 3 (n=11) was within 18 months postpartum and no vulnerability to cry. Group 4 (n=11) was not recently postpartum. Vulnerability to depressed mood was measured by the change in the visual analog scale from the sad mood induction procedure (MIP). Univariate analysis of covariance demonstrated that day-5 postpartum blues and level of dysfunctional attitudes were highly predictive of change in sad mood (postpartum blues: F(1,41)=12.9, p<0.005, dysfunctional attitudes scale score: F(1,41)=11.49, p<0.005). Although the effects were robust, sample sizes were 11-12 within each group. Two factors (day-5 postpartum and severity of dysfunctional attitudes) predicted vulnerability to sad mood. Since the severity of postpartum blues predicts PPD, MIP on day-5 postpartum represents a quantitative measure that can be applied to screen novel, early interventions for preventing PPD. Interventions to prevent PPD through increasing resilience against mood induction should target postpartum women with greater severity of dysfunctional attitudes. Copyright © 2014 Elsevier B.V. All rights reserved.

Identifying the ‘Vulnerables’ in Biomedical Research: the vox populis from the Tuskegee Legacy Project

PubMed Central

Wiley, John

2011-01-01

Objectives This report presents, for the first time, findings on the vox populis as to who constitutes the ‘vulnerables in biomedical research’. Methods The 3-City Tuskegee Legacy Project (TLP) study used the TLP Questionnaire as administered via RDD telephone interviews to 1,162 adult Blacks, non-Hispanic Whites, and two Puerto Rican (PR) Hispanic groups: Mainland U.S. and San Juan (SJ) in 3 cities. The classification schema was based upon respondents’ answers to an open-ended question asking which groups of people were the most vulnerable when participating in biomedical research. Results Subjects provided 749 valid open-ended responses which were grouped into 29 direct response categories, leading to a 4 tier classification schema for vulnerability traits. Tier 1, the summary tier, had five vulnerability categories: 1) Race/ethnicity; 2) Age; 3) SES; 4) Health; and, 5) Gender. Blacks and Mainland U.S. PR Hispanics most frequently identified Race/Ethnicity as a vulnerability trait (42.1% of Blacks and 42.6% of Mainland U.S. PR Hispanics vs. 15.4% of Whites and 16.7% of San Juan R Hispanics) (p<.007), while Whites and SJ PR Hispanics most frequently identified Age (48.3% and 29.2%) as a vulnerability trait. Conclusions The response patterns on ‘who was vulnerable’ were similar for the two minority groups (Blacks and Mainland U.S. PR Hispanics), and notably different from the response patterns of the two majority groups (Whites and SJPR Hispanics). Further, the vox populis definition of vulnerables differed from the current official definitions as used by the U.S. federal government. PMID:21972462

Interactions among variants in TXA2R, P2Y12 and GPIIIa are associated with carotid plaque vulnerability in Chinese population.

PubMed

Yi, Xingyang; Lin, Jing; Luo, Hua; Zhou, Ju; Zhou, Qiang; Wang, Yanfen; Wang, Chun

2018-04-03

The associations between variants in platelet activation-relevant genes and carotid plaque vulnerability are not fully understood. The aim of the present study was to investigate the associations of the variants in platelet activation-relevant genes and interactions among these variants with carotid plaque vulnerability. There were no significant differences in the frequencies of genotypes of the 11 variants between patients and controls. Among 396 patients, 102 patients had not carotid plaque, 106 had VP, and 188 had SP. The 11 variants were not independently associated with risk of carotid plaque vulnerability after adjusting for potential confounding variables. However, the GMDR analysis showed that there were synergistic effects of gene-gene interactions among TXA2Rr s1131882, GPIIIa rs2317676 and P2Y12 rs16863323 on carotid plaque vulnerability. The high-risk interactions among the three variants were associated with high platelet activation, and independently associated with the risk of carotid plaque vulnerability. Eleven variants in platelet activation-relevant genes were examined using mass spectrometry methods in 396 ischemic stroke patients and 291controls. Platelet-leukocyte aggregates and platelet aggregation were also measured. Carotid plaques were assessed by B-mode ultrasound. According to the results of ultrasound, the patients were stratified into three groups: non-plaque group, vulnerable plaque (VP) group and stable plaque (SP) group. Furthermore, gene-gene interactions were analyzed using generalized multifactor dimensionality reduction (GMDR) methods. The rs1131882, rs2317676, and rs16863323 three-loci interactions may confer a higher risk of carotid plaque vulnerability, and might be potential markers for plaque instability.

Applying critical theories to nursing in communities.

PubMed

Stevens, P E; Hall, J M

1992-03-01

Public health realities in the United States indicate that unsafe physical surroundings, oppressive social arrangements, economic impoverishment, and political disenfranchisement threaten the safety and well-being of countless aggregates. To affect change in health-damaging conditions, nurses are urged to join with vulnerable groups, working together to expose oppressive situations and take action. As a guide for such emancipatory practice, the use of critical theories as the conceptual basis for community health nursing is advocated.

Medical Students' Empathy for Vulnerable Groups: Results From a Survey and Reflective Writing Assignment.

PubMed

Wellbery, Caroline; Saunders, Pamela A; Kureshi, Sarah; Visconti, Adam

2017-12-01

As medical education curricula increasingly acknowledge the contributions of the social determinants of health to individual health, new methods of engaging students in the care of vulnerable groups are needed. Empathy is one way to connect students with patients, but little is known about how to nurture students' empathy on behalf of populations. This study examined the relationship between individual and social empathy as groundwork for cultivating students' empathy for vulnerable groups. In 2014-2015, first-year medical students completed the Social Empathy Index at the start and end of a two-semester population health course, and they completed a reflective writing assignment exploring the challenges of caring for vulnerable patients. Pre- and posttest mean survey scores were compared, and reflective writing assignments were analyzed for themes concerning social empathy. Data from 130 students were analyzed. Scores for the contextual understanding of systemic barriers domain increased significantly. There was a trend toward increased cumulative social empathy scores that did not reach statistical significance. Students' essays revealed three themes relating to individual empathy as the foundation for social empathy; civic and moral obligations; and the role of institutional practices in caring for vulnerable groups. This study extends understanding of empathy beyond care for the individual to include care for vulnerable groups. Thus, social empathy may function as a valuable concept in developing curricula to support students' commitment to care for the underserved. Educators first need to address the many barriers students cited that impede both individual and social empathy.

How older workers with coronary heart disease perceive the health effects of work.

PubMed

Dickson, Victoria Vaughan

2013-11-01

More than 3.4 million workers have coronary heart disease (CHD) with significant work limitations and disability. Although the cohort of aging workers with CHD is growing, little is known about how older workers with CHD perceive the relationship between the work environment, including job stress, and their health. The purpose of this qualitative, descriptive study was to explore the perceptions of the health effects of work among older workers with CHD and describe how they cope with work stress. The sample was 47% female and 33% African American. Their mean age was 59.21 (± 5.4) years, and most (55%) worked in professional or managerial jobs. Themes emerged about perceptions of the health effects of work and coping strategies. Because older employees are a vulnerable work group, understanding the perceived health effects of work may guide future workplace program development and policy. Copyright 2013, SLACK Incorporated.

Teaching yoga to seniors: essential considerations to enhance safety and reduce risk in a uniquely vulnerable age group.

PubMed

Krucoff, Carol; Carson, Kimberly; Peterson, Matthew; Shipp, Kathy; Krucoff, Mitchell

2010-08-01

Seniors age 65 and older represent the fastest-growing sector of the population and, like many Americans, are increasingly drawn to yoga. This presents both an extraordinary opportunity and a serious challenge for yoga instructors who must be both a resource and guardians of safety for this uniquely vulnerable group. A typical class of seniors is likely to represent the most diverse mix of abilities of any age group. While some may be exceedingly healthy, most fit the profile of the average older adult in America, 80% of whom have at least one chronic health condition and 50% of whom have at least two. This article discusses the Therapeutic Yoga for Seniors program, offered since 2007 at Duke Integrative Medicine to fill a critical need to help yoga instructors work safely and effectively with the increasing number of older adults coming to yoga classes, and explores three areas that pose the greatest risk of compromise to older adult students: sedentary lifestyle, cardiovascular disease, and osteoporosis. To provide a skillful framework for teaching yoga to seniors, we have developed specific Principles of Practice that integrate the knowledge gained from Western medicine with yogic teachings.

Defining HIV risk and determining responsibility in postsocialist Poland.

PubMed

Owczarzak, Jill

2009-12-01

Drawing on 15 months of ethnographic research on HIV prevention programs in Poland, I explore the consequences of the shift from models of HIV prevention that emphasize "risk groups" and AIDS blame, to models that focus on "risky behaviors" and universal risk. The centrality of choice making and individual risk management in these models suggests objective risk assessment free from moralizing arguments. The Polish national prevention strategy shifted to focus on choice making, address all risk groups, and include concrete prevention strategies. This shift created a backlash that resulted in the reassertion of moral arguments about risk and risk groups that positioned those most vulnerable to HIV outside the purview of prevention efforts. AIDS organizations working with marginalized, "morally problematic" populations used the label "at risk" to legitimize claims to resources. They enacted a model of risk reduction in which the relevant actor is the individual buffeted by social forces; behavior change, and therefore HIV risk reduction, is a long process because of myriad forms of vulnerability clients face. Despite efforts to reconceptualize risk, organizations positioned the individual as the locus of HIV prevention interventions, rather than attempting to address the social context that shapes risk.

Might Depression, Psychosocial Adversity, and Limited Social Assets Explain Vulnerability to and Resistance against Violent Radicalisation?

PubMed Central

Bhui, Kamaldeep; Everitt, Brian; Jones, Edgar

2014-01-01

Background This study tests whether depression, psychosocial adversity, and limited social assets offer protection or suggest vulnerability to the process of radicalisation. Methods A population sample of 608 men and women of Pakistani or Bangladeshi origin, of Muslim heritage, and aged 18–45 were recruited by quota sampling. Radicalisation was measured by 16 questions asking about sympathies for violent protest and terrorism. Cluster analysis of the 16 items generated three groups: most sympathetic (or most vulnerable), most condemning (most resistant), and a large intermediary group that acted as a reference group. Associations were calculated with depression (PHQ9), anxiety (GAD7), poor health, and psychosocial adversity (adverse life events, perceived discrimination, unemployment). We also investigated protective factors such as the number social contacts, social capital (trust, satisfaction, feeling safe), political engagement and religiosity. Results Those showing the most sympathy for violent protest and terrorism were more likely to report depression (PHQ9 score of 5 or more; RR = 5.43, 1.35 to 21.84) and to report religion to be important (less often said religion was fairly rather than very important; RR = 0.08, 0.01 to 0.48). Resistance to radicalisation measured by condemnation of violent protest and terrorism was associated with larger number of social contacts (per contact: RR = 1.52, 1.26 to 1.83), less social capital (RR = 0.63, 0.50 to 0.80), unavailability for work due to housekeeping or disability (RR = 8.81, 1.06 to 37.46), and not being born in the UK (RR = 0.22, 0.08 to 0.65). Conclusions Vulnerability to radicalisation is characterised by depression but resistance to radicalisation shows a different profile of health and psychosocial variables. The paradoxical role of social capital warrants further investigation. PMID:25250577

Coverage of Large-Scale Food Fortification of Edible Oil, Wheat Flour, and Maize Flour Varies Greatly by Vehicle and Country but Is Consistently Lower among the Most Vulnerable: Results from Coverage Surveys in 8 Countries123

PubMed Central

Aaron, Grant J; Friesen, Valerie M; Jungjohann, Svenja; Garrett, Greg S; Myatt, Mark

2017-01-01

Background: Large-scale food fortification (LSFF) of commonly consumed food vehicles is widely implemented in low- and middle-income countries. Many programs have monitoring information gaps and most countries fail to assess program coverage. Objective: The aim of this work was to present LSFF coverage survey findings (overall and in vulnerable populations) from 18 programs (7 wheat flour, 4 maize flour, and 7 edible oil programs) conducted in 8 countries between 2013 and 2015. Methods: A Fortification Assessment Coverage Toolkit (FACT) was developed to standardize the assessments. Three indicators were used to assess the relations between coverage and vulnerability: 1) poverty, 2) poor dietary diversity, and 3) rural residence. Three measures of coverage were assessed: 1) consumption of the vehicle, 2) consumption of a fortifiable vehicle, and 3) consumption of a fortified vehicle. Individual program performance was assessed based on the following: 1) achieving overall coverage ≥50%, 2) achieving coverage of ≥75% in ≥1 vulnerable group, and 3) achieving equity in coverage for ≥1 vulnerable group. Results: Coverage varied widely by food vehicle and country. Only 2 of the 18 LSFF programs assessed met all 3 program performance criteria. The 2 main program bottlenecks were a poor choice of vehicle and failure to fortify a fortifiable vehicle (i.e., absence of fortification). Conclusions: The results highlight the importance of sound program design and routine monitoring and evaluation. There is strong evidence of the impact and cost-effectiveness of LSFF; however, impact can only be achieved when the necessary activities and processes during program design and implementation are followed. The FACT approach fills an important gap in the availability of standardized tools. The LSFF programs assessed here need to be re-evaluated to determine whether to further invest in the programs, whether other vehicles are appropriate, and whether other approaches are needed. PMID:28404836

Coverage of Large-Scale Food Fortification of Edible Oil, Wheat Flour, and Maize Flour Varies Greatly by Vehicle and Country but Is Consistently Lower among the Most Vulnerable: Results from Coverage Surveys in 8 Countries.

PubMed

Aaron, Grant J; Friesen, Valerie M; Jungjohann, Svenja; Garrett, Greg S; Neufeld, Lynnette M; Myatt, Mark

2017-05-01

Background: Large-scale food fortification (LSFF) of commonly consumed food vehicles is widely implemented in low- and middle-income countries. Many programs have monitoring information gaps and most countries fail to assess program coverage. Objective: The aim of this work was to present LSFF coverage survey findings (overall and in vulnerable populations) from 18 programs (7 wheat flour, 4 maize flour, and 7 edible oil programs) conducted in 8 countries between 2013 and 2015. Methods: A Fortification Assessment Coverage Toolkit (FACT) was developed to standardize the assessments. Three indicators were used to assess the relations between coverage and vulnerability: 1 ) poverty, 2 ) poor dietary diversity, and 3 ) rural residence. Three measures of coverage were assessed: 1 ) consumption of the vehicle, 2 ) consumption of a fortifiable vehicle, and 3 ) consumption of a fortified vehicle. Individual program performance was assessed based on the following: 1 ) achieving overall coverage ≥50%, 2) achieving coverage of ≥75% in ≥1 vulnerable group, and 3 ) achieving equity in coverage for ≥1 vulnerable group. Results: Coverage varied widely by food vehicle and country. Only 2 of the 18 LSFF programs assessed met all 3 program performance criteria. The 2 main program bottlenecks were a poor choice of vehicle and failure to fortify a fortifiable vehicle (i.e., absence of fortification). Conclusions: The results highlight the importance of sound program design and routine monitoring and evaluation. There is strong evidence of the impact and cost-effectiveness of LSFF; however, impact can only be achieved when the necessary activities and processes during program design and implementation are followed. The FACT approach fills an important gap in the availability of standardized tools. The LSFF programs assessed here need to be re-evaluated to determine whether to further invest in the programs, whether other vehicles are appropriate, and whether other approaches are needed.

Evaluating Youth Work with Vulnerable Young People.

ERIC Educational Resources Information Center

Furlong, Andy; Cartmel, Fred; Powney, Janet; Hall, Stuart

This report presents the results of an 18-month research project that studied the effectiveness of youth work with vulnerable young people. The research, representing six distinct geographical areas of Scotland characterized by disadvantage, focused on young people aged 13 to 16. In each neighborhood, the project examined the experiences of young…

[Narratives of intimate partner violence practiced against women].

PubMed

Moura, Leides Barroso Azevedo; Lefevre, Fernando; Moura, Valter

2012-04-01

Research was conducted with women aged 15 to 49 living in an economically vulnerable area of the Brazilian state capital on the experience of victims of Intimate Partner Violence (IPV). The study adopted a qualitative technique called Collective Subject Discourse. During the interviews in their homes between February and July, 195 women reported incidents of violence throughout their lives. The discourses were grouped by similar violence using the CSD technique and organized into 7 major categories based on 395 key words; i) IPV Engineering (N = 114; 58.5%); ii) Rape of vulnerable sex (N = 77; 39.5%); iii) Silent or silenced violence (N = 43; 21%); iv) Years of Suffering (N = 43; 21%); v) New time despite the suffering (N = 39; 20%); vi) Talking about violence (N = 35; 18%); Violence is a language (N = 34; 17.4%). Three reports with the highest prevalence, entitled "IPV Engineering," are presented in full in this work. The narratives of violence revealed show the strength of vulnerability and abuse suffered by women and the existence of multiple dynamics of violence in intimate affective relationships.

Mobile Phones and Psychosocial Therapies with Vulnerable People: a First State of the Art.

PubMed

Vázquez, Maria Yolanda García; Sexto, Carlos Ferrás; Rocha, Álvaro; Aguilera, Adrián

2016-06-01

Mobile phones are becoming a communication tool commonly used by people all over the world; and they are started to be adopted in psychosocial therapies involving vulnerable people. We are herein presenting the results of an academic literature review. We identified scientific papers published between 2006 and 2015 resorting to academic databases available on the Internet, applying a systematic selection method based on quality criteria. Secondly, we analysed contents, highlighting the scarcity of research involving vulnerable people. The available literature specialized in psychosocial therapies offers investigation results which involve mobile phones and patients in general, focusing particularly on the clinical psychology field and, to a lesser extent, on the social work field. Particularly significant are the investigation works developed in the United States. In the present paper we introduce a first "state of the art", identifying opportunities and also the limitations surrounding the use of mobile phones in psychosocial therapies targeting the vulnerable. Issues concerning privacy and data confidentiality, and the access of vulnerable people to mobile phones and how they use them, pose significant challenges; but they offer the opportunity to reach isolated or impoverished populations, or even to facilitate access to social and healthcare services. We close this paper formulating possible orientations, hypotheses and goals to design new investigation works involving vulnerable populations.

Parental stress and perceived vulnerability at 5 and 10 years after pediatric SCT.

PubMed

Vrijmoet-Wiersma, C M J; Egeler, R M; Koopman, H M; Bresters, D; Norberg, A L; Grootenhuis, M A

2010-06-01

With the aim of assessing parental stress after SCT, 73 parents of children and adolescents who underwent SCT 5 or 10 years ago responded to questionnaires on general distress (General Health Questionnaire (GHQ)), disease-related stress (Pediatric Inventory for Parents-short form (PIP-SF)) and perceptions of child vulnerability (Child Vulnerability Scale (CVS)). General distress scores were comparable with the reference groups, but 40% of the mothers at 5 years after SCT reported increased stress levels as compared with 26% in the community-based reference group. Disease-related stress was comparable with the reference group of parents of children who were just off cancer treatment, 5 years after SCT. At 10 years after SCT, scores were lower than the reference group. Perceived child vulnerability did diminish over time, but remained high in parents of SCT survivors, compared with parents of healthy children: 96% of the parents at 5 years after SCT and 76% of the parents at 10 years after SCT scored above the cutoff point. Perceived vulnerability was found to be a predictor for parental disease-related stress. To conclude, although most parents of SCT survivors are resilient, the majority of parents perceive their child to be much more vulnerable as compared with parents of healthy children. This perception is associated with disease-related stress and may induce overprotective parenting.

Cluster Analysis of Vulnerable Groups in Acute Traumatic Brain Injury Rehabilitation.

PubMed

Kucukboyaci, N Erkut; Long, Coralynn; Smith, Michelle; Rath, Joseph F; Bushnik, Tamara

2018-01-06

To analyze the complex relation between various social indicators that contribute to socioeconomic status and health care barriers. Cluster analysis of historical patient data obtained from inpatient visits. Inpatient rehabilitation unit in a large urban university hospital. Adult patients (N=148) receiving acute inpatient care, predominantly for closed head injury. Not applicable. We examined the membership of patients with traumatic brain injury in various "vulnerable group" clusters (eg, homeless, unemployed, racial/ethnic minority) and characterized the rehabilitation outcomes of patients (eg, duration of stay, changes in FIM scores between admission to inpatient stay and discharge). The cluster analysis revealed 4 major clusters (ie, clusters A-D) separated by vulnerable group memberships, with distinct durations of stay and FIM gains during their stay. Cluster B, the largest cluster and also consisting of mostly racial/ethnic minorities, had the shortest duration of hospital stay and one of the lowest FIM improvements among the 4 clusters despite higher FIM scores at admission. In cluster C, also consisting of mostly ethnic minorities with multiple socioeconomic status vulnerabilities, patients were characterized by low cognitive FIM scores at admission and the longest duration of stay, and they showed good improvement in FIM scores. Application of clustering techniques to inpatient data identified distinct clusters of patients who may experience differences in their rehabilitation outcome due to their membership in various "at-risk" groups. The results identified patients (ie, cluster B, with minority patients; and cluster D, with elderly patients) who attain below-average gains in brain injury rehabilitation. The results also suggested that systemic (eg, duration of stay) or clinical service improvements (eg, staff's language skills, ability to offer substance abuse therapy, provide appropriate referrals, liaise with intensive social work services, or plan subacute rehabilitation phase) could be beneficial for acute settings. Stronger recruitment, training, and retention initiatives for bilingual and multiethnic professionals may also be considered to optimize gains from acute inpatient rehabilitation after traumatic brain injury. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Emotion-cognition interaction in people at familial high risk for schizophrenia: the impact of sex differences.

PubMed

Phillips, Laura K; Giuliano, Anthony J; Lee, Erica H; Faraone, Stephen V; Tsuang, Ming T; Seidman, Larry J

2011-11-01

Cognitive deficits are fundamental to schizophrenia, and research suggests that negative emotion abnormally interferes with certain cognitive processes in those with the illness. To a lesser extent, cognitive impairment is found in persons at risk for schizophrenia, but there is limited research on the impact of emotion on cognitive processing in at-risk groups. It is unknown whether interference of negative emotion precedes illness and contributes to vulnerability for the disorder. We studied the extent to which negative emotional information interferes with working memory in 21 adolescent and young adult first-degree relatives of people with schizophrenia and 22 community controls. Groups were comparable in age, sex, education, ethnicity, and socioeconomic status. Primary measures were n-back tasks varying in cognitive load (1-back, 2-back, 3-back) with emotional faces (neutral, happy, fearful) as stimuli. The control group's response times (RTs) and the women's RTs, regardless of group, differed depending on the emotion condition. In contrast, the RTs of the relatives and of the men, regardless of group, did not differ by emotion. This study is the first to examine emotion-cognition interactions in relatives of individuals with schizophrenia. Reduced efficiency in processing emotional information may contribute to a greater vulnerability for schizophrenia that may be heightened in men. Additional research with larger samples of men and women is needed to test these preliminary findings.

Shared Decision Making With Vulnerable Populations in the Emergency Department.

PubMed

Castaneda-Guarderas, Ana; Glassberg, Jeffrey; Grudzen, Corita R; Ngai, Ka Ming; Samuels-Kalow, Margaret E; Shelton, Erica; Wall, Stephen P; Richardson, Lynne D

2016-12-01

The emergency department (ED) occupies a unique position within the healthcare system, serving as a safety net for vulnerable patients, regardless of their race, ethnicity, religion, country of origin, sexual orientation, socioeconomic status, or medical diagnosis. Shared decision making (SDM) presents special challenges when used with vulnerable population groups. The differing circumstances, needs, and perspectives of vulnerable groups invoke issues of provider bias, disrespect, judgmental attitudes, and lack of cultural competence, as well as patient mistrust and the consequences of their social and economic disenfranchisement. A research agenda that includes community-engaged approaches, mixed-methods studies, and cost-effectiveness analyses is proposed to address the following questions: 1) What are the best processes/formats for SDM among racial, ethnic, cultural, religious, linguistic, social, or otherwise vulnerable groups who experience disadvantage in the healthcare system? 2) What organizational or systemic changes are needed to support SDM in the ED whenever appropriate? 3) What competencies are needed to enable emergency providers to consider patients' situation/context in an unbiased way? 4) How do we teach these competencies to students and residents? 5) How do we cultivate these competencies in practicing emergency physicians, nurses, and other clinical providers who lack them? The authors also identify the importance of using accurate, group-specific data to inform risk estimates for SDM decision aids for vulnerable populations and the need for increased ED-based care coordination and transitional care management capabilities to create additional care options that align with the needs and preferences of vulnerable populations. © 2016 by the Society for Academic Emergency Medicine.

Mobilising "vulnerability" in the public health response to pandemic influenza.

PubMed

Stephenson, Niamh; Davis, Mark; Flowers, Paul; MacGregor, Casimir; Waller, Emily

2014-02-01

Analysis of public health's growing interest in "vulnerability" has largely focused on health policy, with little interrogation of how vulnerability is being actively appropriated, countered, ignored or reworked by the publics whose health such policy is designed to protect. Once the assemblage of public health is understood as comprised of different forms of expertise and actors, including publics, addressing this gap matters. We examine the use of vulnerability in the specific context of pandemic influenza preparedness. Pandemic preparedness raises some familiar dilemmas for public health governance: how to engage with publics without fuelling social divisions and disruption; and whether to invoke publics as passive recipients of public health advice or to recognise publics as collective agents responding to the threat of pandemic influenza. Thus, we ask how the mobilisation of vulnerability connects with these dilemmas. To examine vulnerability in pandemic preparedness, two forms of qualitative data are analysed: 1) interviews and focus groups with "vulnerable" and "healthy" people (conducted 2011-12) discussing seasonal and pandemic influenza and; 2) international, Australian national and state level pandemic plans (1999-2013). Vulnerability is variously used in plans as a way to identify groups at particular risk of infection because of pre-existing clinical conditions, and as a free-floating social category that could apply to a broad range of people potentially involved in the social disruption a pandemic might entail. Our interview and focus group data indicate that healthy people rework the free-floating extension of vulnerability, and that people designated vulnerable encounter an absence of any collective responsibility for the threat of pandemic influenza. Our analysis suggests that vulnerability's mobilisation in pandemic preparedness limits the connection between public health governance and its publics: here, the openness and unpredictability of people's collective agency is something to be tightly controlled by a government concerned with protecting people from themselves. Copyright © 2013 Elsevier Ltd. All rights reserved.

Carotid artery stenting for vulnerable plaques on MR angiography and ultrasonography: utility of dual protection and blood aspiration method.

PubMed

Sakamoto, Shigeyuki; Kiura, Yoshihiro; Okazaki, Takahito; Shinagawa, Katsuhiro; Ishii, Daizo; Ichinose, Nobuhiko; Kurisu, Kaoru

2016-10-01

Carotid artery stenting (CAS) for internal carotid artery (ICA) stenosis with vulnerable plaques is controversial. We analyzed the effect of a dual protection and blood aspiration method during CAS in patients with vulnerable plaques. A total of 111 patients with ICA stenosis underwent CAS using the dual protection (simultaneous flow reversal and distal filter) and blood aspiration method. In 103 of 111 patients, preoperative carotid plaque was estimated by both 3 T MRI and ultrasonography (US). ICA plaques with a high intensity signal on time-of-flight-MR angiography (TOF-MRA) and/or mobile component on US were defined as vulnerable plaques. We assessed major adverse events (MAE) (ie, major stroke, myocardial infarction, and death) and hyperintense spots on diffusion-weighted images (DWI) after CAS. We then evaluated the visible debris captured by dual protection and blood aspiration during CAS. The preoperative ICA plaque on TOF-MRA and US was judged to be vulnerable in 48.5% (50/103 patients). The success rate of the CAS procedure was 100% with no MAE within 30 days. DWI showed small hyperintense spots in 18% (9/50 patients) and 18.9% (10/53 patients) in the vulnerable and non-vulnerable plaque groups, respectively. Visible debris was captured in 68% (34/50 patients) and 45.3% (24/53 patients) in the vulnerable and non-vulnerable plaque groups, respectively (p=0.0286). The combination of dual protection and blood aspiration could provide effective distal embolic protection although vulnerable plaques on TOF-MRA and US had a high incidence of debris during CAS. Thus, CAS using dual protection and blood aspiration is safe in patients with vulnerable plaques. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Informality and employment vulnerability: application in sellers with subsistence work.

PubMed

Garzón-Duque, María Osley; Cardona-Arango, María Doris; Rodríguez-Ospina, Fabio León; Segura-Cardona, Angela María

2017-10-05

To describe the origin, evolution, and application of the concept of employment vulnerability in workers who subsist on street sales. We have carried out an analysis of the literature in database in Spanish, Portuguese, and English, without restriction by country. This is a review of the gray literature of government reports, articles, and documents from Latin America and the Caribbean. We have analyzed information on the informal economy, social-employment vulnerability, and subsistence workers. The concept of informal economy is dispersed and suggested as synonymous with employment vulnerability. As a polysemic term, it generates confusion and difficulty in identifying defined profiles of employment vulnerability in informal subsistence workers, who sell their products on the streets and sidewalks of cities. The lack of a clear concept and profile of employment vulnerability for this type of workers generates a restriction on defined actions to reduce employment vulnerability. The profiles could facilitate access to the acquisition of assets that support their structure of opportunities, facilitating and mediating in the passage from vulnerability to social mobility with opportunities. We propose as a concept of employment vulnerability for subsistence workers in the informal sector, the condition of those who must work by day to eat at night, who have little or no ownership of assets, and who have a minimum structure of opportunities to prevent, face, and resist the critical situations that occur daily, putting at risk their subsistence and that of the persons who are their responsibility, thus making the connection between social and employment vulnerability.

Rehabilitation of vulnerable groups in emergencies and disasters: A systematic review

PubMed Central

Sheikhbardsiri, Hojjat; Yarmohammadian, Mohammad H.; Rezaei, Fatemeh; Maracy, Mohammad Reza

2017-01-01

BACKGROUND: Natural and man-made disasters, especially those occurring in large scales not only result in human mortality, but also cause physical, psychological, and social disabilities. Providing effective rehabilitation services in time can decrease the frequency of such disabilities. The aim of the current study was to perform a systematic review related to rehabilitation of vulnerable groups in emergencies and disasters. METHODS: The systematic review was conducted according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. The key words “recovery”, “rehabilitation”, “reconstruction”, “transformation”, “transition”, “emergency”, “disaster”, “crisis”, “hazard”, “catastrophe”, “tragedy”, “mass casualty incident”, “women”, “female”, “children”, “pediatric”, “disable”, “handicap”, “elder”, “old” and “vulnerable” were used in combination with Boolean operators OR and AND. ISI Web of Science, PubMed, Scopus, Science Direct, Ovid, ProQuest, Wiley, Google Scholar were searched. RESULTS: In this study a total of 11 928 articles were considered and 25 articles were selected for final review of rehabilitation of vulnerable groups based on the objective of this study. Twenty-five studies including six qualitative, sixteen cross-sectional and three randomized controlled trials were reviewed for rehabilitation of vulnerable groups in emergencies and disasters. Out of the selected papers, 23 were studied based on rehabilitation after natural disasters and the remaining were man-made disasters. Most types of rehabilitation were physical, social, psychological and economic. CONCLUSION: The review of the papers showed different programs of physical, physiological, economic and social rehabilitations for vulnerable groups after emergencies and disasters. It may help health field managers better implement standard rehabilitation activities for vulnerable groups. PMID:29123602

Methods to Secure Databases Against Vulnerabilities

DTIC Science & Technology

2015-12-01

for several languages such as C, C++, PHP, Java and Python [16]. MySQL will work well with very large databases. The documentation references...using Eclipse and connected to each database management system using Python and Java drivers provided by MySQL , MongoDB, and Datastax (for Cassandra...tiers in Python and Java . Problem MySQL MongoDB Cassandra 1. Injection a. Tautologies Vulnerable Vulnerable Not Vulnerable b. Illegal query

The effect of captopril and losartan on the electrophysiology of myocardial cells of myocardial ischemia rats.

PubMed

Shi, Xiangmin; Shan, Zhaoling; Yuan, Hongtao; Guo, Hongyang; Wang, Yutang

2014-01-01

This study aims to investigate the effect of captopril and losartan on the electrophysiology of myocardial cells parameters in ventricular vulnerable period and effective refractory period of myocardial ischemia rats. 96 wistar rats were enrolled in the study and divided into six groups: Captopril myocardial ischemia group, losartan myocardial ischemia group, myocardial ischemia control group, captopril normal group, losartan normal group and normal control group (n=16). We observed morphological changes of myocardial tissue in each group. The cardiac electrophysiological parameters in effective refractory period of each group were measured. Creatine kinase (CK), alanine aminotransferase (GOT), lactate dehydrogenase (LDH), the expression of Cardiotrophin 1 (CT-1) and malonaldehyde (MDA) were detected. Compared the losartan and captopril group with the control group, (P<0.05). Losartan and captopril can shorten the ventricular vulnerable period of the normal group and ischemic group. There was no interaction effect between losartan and captopril group and the acute myocardial ischemia group. The effect of losartan and captopril on time window in ventricular vulnerable period showed that compared with the control group (P<0.05). Losartan and captopril had a significant effect on prolonged effective refractory period of normal and ischemic rats. There was no interaction effect between losartan and captopril group and the acute myocardial ischemia group. Compared with the myocardial ischemia control group, CK, GOT, LDH and MDA decreased in captopril and losartan myocardial ischemia groups (P<0.05). Losartan and captopril had a significant effect on prolonged effective refractory period and shorten ventricular vulnerable period, they can also effectively prevent arrhythmias.

Hispanic adolescent farmworkers' perceptions associated with pesticide exposure.

PubMed

Salazar, Mary K; Napolitano, Marie; Scherer, Jennifer A; McCauley, Linda A

2004-03-01

The migrant farmworker population in the United States is a vulnerable and understudied population whose characteristics are constantly shifting. The number of youth involved in agriculture work is increasing, and they, in particular, may be at increased risk for occupational hazards, such as pesticide exposure. The present study utilized an ecological framework for focus group discussions with 33 adolescent migrant farmworkers in Oregon. Adolescents' risk perception and health beliefs associated with pesticide exposure are examined on four levels of environmental influence: microenvironment, organizational environment, social/community environment, and macroenvironment. Adolescents provided insight on such topics as perceived vulnerability of illness due to pesticide exposure, attitudes toward farmwork, influence of their boss, knowledge of occupational hazards, safety training, and barriers to occupational choice. Cultural influences on occupational safety and health are discussed and increased attention to safety training is recommended.

Identifying psychosocial stressors of well-being and factors related to substance use among Latino day laborers.

PubMed

Nalini Junko Negi

2011-08-01

Day labor is largely comprised of young Latino immigrant men, many of who are undocumented, and thus vulnerable to a myriad of workers' rights abuses. The difficult work and life conditions of this marginalized population may place them at heightened risk for mental health problems and substance use and abuse. However, factors related to Latino day laborers' well-being and substance misuse are largely unknown. This article utilizes ethnographic and focus group methodology to elucidate participant identified factors associated to well-being and substance use and abuse. This study has implications for informing public health and social service programming as it provides thick description regarding the context and circumstances associated to increased vulnerability to substance abuse and lack of well-being among this hard-to-reach population of Latino immigrants.

Identifying Psychosocial Stressors of Well-Being and Factors Related to Substance Use Among Latino Day Laborers

PubMed Central

2012-01-01

Day labor is largely comprised of young Latino immigrant men, many of who are undocumented, and thus vulnerable to a myriad of workers’ rights abuses. The difficult work and life conditions of this marginalized population may place them at heightened risk for mental health problems and substance use and abuse. However, factors related to Latino day laborers’ well-being and substance misuse are largely unknown. This article utilizes ethnographic and focus group methodology to elucidate participant identified factors associated to well-being and substance use and abuse. This study has implications for informing public health and social service programming as it provides thick description regarding the context and circumstances associated to increased vulnerability to substance abuse and lack of well-being among this hard-to-reach population of Latino immigrants. PMID:21107694

Measuring and Managing Army Supply Chain Risk: A Quantitative Approach by Item Number and Commercial Entity Code

DTIC Science & Technology

2015-01-01

services to the end user across the modes of transport .” As such, the supply chain “may include vendors, manufacturing facilities, logistics providers...sharing them with a group, before ranking each. For more information, see Van De Ven and Delbecq, 1974. 12 “When working through the vulnerability...are cost-effective (Kiser and Cantrell, 2006), avoiding higher production and transportation costs. Figure 2.5 outlines two prevalent supply chain

Feasibility of Implementing an Opioid Risk Mitigation System

DTIC Science & Technology

2016-05-20

System 7. FUNDING RECEIVED FOR THIS STUDY? 181 YES 0 NO FUNDING SOURCE: JPC-5 Substance Abuse Working Group 8. DO YOU NEED FUNDING SUPPORT FOR...Perceptions •Provider ro I e Isett in g •Education/training ° Forma l training in pain or substance abuse relatively rare •Prior POMP experience ° Few...Active duty, retirees, dependents, injured, polytrauma •Opioid abuse /misuse/diversion •Patient needs and vulnerabilities 0 Let me make a comment on

Legal professionals and witness statements from people with a suspected mental health diagnosis.

PubMed

Reavey, Paula; Wilcock, Rachel; Brown, Steven D; Batty, Richard; Fuller, Serina

2016-01-01

Individuals with mental health problems are considered to be part of a group labeled 'vulnerable' in forensic psychology literature and the legal system more generally. In producing witness statements, there are numerous guidelines in the UK, designed to facilitate the production of reliable and valid accounts by those deemed to be vulnerable witnesses. And yet, it is not entirely clear how mental health impacts on reliability and validity within the judicial system, partly due to the diversity of those who present with mental health difficulties. In this paper, we set out to explore how legal professionals operating in the UK understand the impact of mental distress on the practical production of witness testimonies. Twenty legal professionals, including police officers, judges, magistrates and detectives were involved in a semi-structured interview to examine their knowledge and experience of working with mental health problems, and how they approached and worked with this group. A thematic analysis was conducted on the data and specific themes relevant to the overall research question are presented. These include a) dilemmas and deficiencies in knowledge of mental health, b) the abandonment of diagnosis and c) barriers to knowledge: time restrictions, silence, professional identity and fear. Finally, we explore some of the implications of these barriers, with regard to professional practice. Crown Copyright © 2016. Published by Elsevier Ltd. All rights reserved.

[The Effects of a Health Mentoring Program in Community-dwelling Vulnerable Elderly Individuals with Diabetes].

PubMed

Sung, Ki Wol; Kang, Hye Seung; Nam, Ji Ran; Park, Mi Kyung; Park, Ji Hyeon

2018-04-01

This study aimed to estimate the effects of a health mentoring program on fasting blood sugar, total cholesterol, triglyceride, physical activity, self care behavior and social support changes among community-dwelling vulnerable elderly individuals with diabetes. A non-equivalent control group pre-post-test design was used. Participants were 70 community-dwelling vulnerable elderly individuals with diabetes. They were assigned to the experimental (n=30) or comparative (n=30) or control group (n=28). The experimental group participated in the health mentoring program, while the comparative group participated in health education program, the control group did not participate in any program. Data analyses involved a chi-square test, Fisher's exact test, a generalized linear model, and the Bonferroni correction, using SPSS 23.0. Compared to the control group, the experimental and comparative groups showed a significant decrease in fasting blood sugar, total cholesterol, and triglyceride. Compared to the comparative and control groups, the experimental group showed significant improvement in self care behavior. However, there were no statistical differences in physical activity or social support among the three groups. These findings indicate that the health mentoring program is an effective intervention for community-dwelling vulnerable elderly individuals with diabetes. This program can be used as an efficient strategy for diabetes self-management within this population. © 2018 Korean Society of Nursing Science.

What a difference a year makes: comparing relationships between stressful life events, mood and life satisfaction among older adults, and their working-age counterparts.

PubMed

Hannaford, Elizabeth; Moore, Fhionna; Macleod, Fiona J

2017-10-11

Stressful life events (SLEs) have been linked to depression, anxiety, and reduced life satisfaction. The inoculation hypothesis of aging suggests older adults may be less vulnerable to poor psychological outcomes following SLEs than working-age adults. The current study compared relationships between SLEs, mood and life satisfaction among older adults (65+), and adults aged 50-64, and investigated whether group identification and loneliness moderate these relationships. A community-based sample of 121 Scottish participants responded to measures of SLEs (modified Social Readjustment Rating Scale), symptoms of depression and anxiety (Hospital Anxiety and Depression Scale), life satisfaction (Life Satisfaction Index A), group identification (Group Identification Scale), and loneliness (UCLA Loneliness Scale). In the 50-64 age group, the number of SLEs was significantly associated with greater symptoms of depression and anxiety, and reduced life satisfaction. Group identification and loneliness did not moderate these relationships. There were no significant relationships in the older adult group. The finding of relationships in working-age, but not older adults, supports the inoculation hypothesis of aging. Further research to better understand changes across the lifespan, and inter-relationships with related variables, would be valuable from both theoretical and clinical perspectives.

Theory of mind and verbal working memory deficits in parents of autistic children.

PubMed

Gokcen, Sezen; Bora, Emre; Erermis, Serpil; Kesikci, Hande; Aydin, Cahide

2009-03-31

The objective of this study was to investigate the potential values of executive function and social cognition deficits as endophenotypes of autism. While theory of mind (ToM) is generally accepted as a unitary concept, some have suggested that ToM may be separated into two components (mental state reasoning and decoding). In this study, both aspects of ToM and verbal working memory abilities were investigated with relatively demanding tasks. The authors used a neurocognitive battery to compare the executive function and social cognition skills of 76 parents of autistic probands with 41 parents of healthy children. Both groups were matched for IQ, age and gender. Index parents had verbal working memory deficits. They had also low performance on a mental state reasoning task. Index parents had difficulties in reasoning about others' emotions. In contrast to findings in the control group, low performance of mental state reasoning ability was not associated with working memory deficit in index parents. Social cognition and working memory impairments may represent potential endophenotypes, related to an underlying vulnerability for autistic spectrum disorders.

Influence of gender, working field and psychosocial factors on the vulnerability for burnout in mental hospital staff: results of an Austrian cross-sectional study.

PubMed

Schadenhofer, Petra; Kundi, Michael; Abrahamian, Heidemarie; Stummer, Harald; Kautzky-Willer, Alexandra

2018-03-01

According to the European Agency for Safety and Health at Work (EU-OSHA), hospitals represent a work environment with high job strain. Prolonged perceived occupational stress may result in symptoms of burnout, such as emotional exhaustion (EE), depersonalisation (DP) and reduced personal accomplishment (PA). Understanding which factors may reduce vulnerability for burnout is an important requirement for well-targeted occupational stress prevention in mental hospital staff. To identify the influence of gender, age, working field, family structure, education, voluntarily occupational training during holidays and length of stay on job on occupational stress perception. In a cross-sectional design, 491 employees (311 female, 180 male) of an Austrian mental health centre participated in the study. The extent of perceived occupational stress was assessed by the Maslach Burnout Inventory (MBI) with the scales for emotional exhaustion, depersonalisation and personal accomplishment. Participants were divided according to their working field in those working with/without patients. Prevalence of emotional exhaustion was higher in women working with patients compared to men working with patients (25% vs. 18%, p = 0.003). Age above 45 years was significantly associated with decreased vulnerability for burnout in men (EE p = 0.040, DP p = 0.010, PA p = 0.007), but not in women. A lower level of education had a significant impact on depersonalisation in both sexes (p = 0.001 for men, p = 0.048 for women). Length of stay on job showed a significant influence on emotional exhaustion. No significant relationship was found between family structure and vulnerability for burnout. Gender had a differential effect on perceived occupational stress indicating a need for gender-tailored preventive strategies. Age, working field, education, voluntarily occupational training during holidays and length of stay on job affect vulnerability for burnout in mental hospital staff. © 2017 Nordic College of Caring Science.

Socially Vulnerable Young People in Flemish Sports Clubs: Investigating Youth Experiences

ERIC Educational Resources Information Center

Haudenhuyse, Reinhard; Theeboom, Marc; Nols, Zeno; Coussée, Filip

2014-01-01

Sport appears to present a powerful tool for engaging socially vulnerable youth in an organised context, which offers an opportunity to work with them. However, we have little understanding regarding participation of socially vulnerable young people in the "traditional" sport sector (i.e. sports clubs). Nor do we have sufficient insights…

Daytime Sleep Disturbance in Night Shift Work and the Role of PERIOD3.

PubMed

Cheng, Philip; Tallent, Gabriel; Burgess, Helen J; Tran, Kieulinh Michelle; Roth, Thomas; Drake, Christopher L

2018-03-15

Recent evidence indicates that daytime sleep disturbance associated with night shift work may arise from both circadian misalignment and sleep reactivity to stress. This presents an important clinical challenge because there are limited means of predicting and distinguishing between the two mechanisms, and the respective treatments differ categorically; however, there is support that a polymorphism in the PERIOD3 gene ( PER3 ) may indicate differences in vulnerability to daytime sleep disturbance in shift workers. We recruited 30 fixed night shift workers for laboratory assessments of circadian misalignment (dim light melatonin onset), sleep reactivity to stress (Ford Insomnia Response to Stress Test), daytime sleep disturbance (daytime Insomnia Severity Index), and PER3 genotype ( PER3 4/4 , PER3 5 /- ). The two mechanisms for daytime sleep disturbance (circadian misalignment and sleep reactivity to stress) were compared between PER3 genotypes. Disturbed daytime sleep in the PER3 4/4 group was more likely related to sleep reactivity to stress, whereas disturbed sleep in the PER3 5 /- group was more likely related to circadian misalignment. Exploratory analyses also revealed a blunted melatonin amplitude in the PER3 4/4 genotype group. This study provides further evidence for multiple mechanisms (ie, circadian misalignment versus sleep reactivity to stress) associated with daytime sleep disturbances in shift workers. Additionally, it provides the new finding that PER3 genotype may play an important role in individual vulnerability to the different mechanisms of daytime sleep disturbance in night shift workers. © 2018 American Academy of Sleep Medicine.

'You should at least ask'. The expectations, hopes and fears of rare disease patients on large-scale data and biomaterial sharing for genomics research.

PubMed

McCormack, Pauline; Kole, Anna; Gainotti, Sabina; Mascalzoni, Deborah; Molster, Caron; Lochmüller, Hanns; Woods, Simon

2016-10-01

Within the myriad articles about participants' opinions of genomics research, the views of a distinct group - people with a rare disease (RD) - are unknown. It is important to understand if their opinions differ from the general public by dint of having a rare disease and vulnerabilities inherent in this. Here we document RD patients' attitudes to participation in genomics research, particularly around large-scale, international data and biosample sharing. This work is unique in exploring the views of people with a range of rare disorders from many different countries. The authors work within an international, multidisciplinary consortium, RD-Connect, which has developed an integrated platform connecting databases, registries, biobanks and clinical bioinformatics for RD research. Focus groups were conducted with 52 RD patients from 16 countries. Using a scenario-based approach, participants were encouraged to raise topics relevant to their own experiences, rather than these being determined by the researcher. Issues include wide data sharing, and consent for new uses of historic samples and for children. Focus group members are positively disposed towards research and towards allowing data and biosamples to be shared internationally. Expressions of trust and attitudes to risk are often affected by the nature of the RD which they have experience of, as well as regulatory and cultural practices in their home country. Participants are concerned about data security and misuse. There is an acute recognition of the vulnerability inherent in having a RD and the possibility that open knowledge of this could lead to discrimination.

‘You should at least ask'. The expectations, hopes and fears of rare disease patients on large-scale data and biomaterial sharing for genomics research

PubMed Central

McCormack, Pauline; Kole, Anna; Gainotti, Sabina; Mascalzoni, Deborah; Molster, Caron; Lochmüller, Hanns; Woods, Simon

2016-01-01

Within the myriad articles about participants' opinions of genomics research, the views of a distinct group – people with a rare disease (RD) – are unknown. It is important to understand if their opinions differ from the general public by dint of having a rare disease and vulnerabilities inherent in this. Here we document RD patients' attitudes to participation in genomics research, particularly around large-scale, international data and biosample sharing. This work is unique in exploring the views of people with a range of rare disorders from many different countries. The authors work within an international, multidisciplinary consortium, RD-Connect, which has developed an integrated platform connecting databases, registries, biobanks and clinical bioinformatics for RD research. Focus groups were conducted with 52 RD patients from 16 countries. Using a scenario-based approach, participants were encouraged to raise topics relevant to their own experiences, rather than these being determined by the researcher. Issues include wide data sharing, and consent for new uses of historic samples and for children. Focus group members are positively disposed towards research and towards allowing data and biosamples to be shared internationally. Expressions of trust and attitudes to risk are often affected by the nature of the RD which they have experience of, as well as regulatory and cultural practices in their home country. Participants are concerned about data security and misuse. There is an acute recognition of the vulnerability inherent in having a RD and the possibility that open knowledge of this could lead to discrimination. PMID:27049302

Mobile Phones and Psychosocial Therapies with Vulnerable People: a First State of the Art

PubMed Central

Sexto, Carlos Ferrás; Rocha, Álvaro; Aguilera, Adrián

2017-01-01

Mobile phones are becoming a communication tool commonly used by people all over the world; and they are started to be adopted in psychosocial therapies involving vulnerable people. We are herein presenting the results of an academic literature review. We identified scientific papers published between 2006 and 2015 resorting to academic databases available on the Internet, applying a systematic selection method based on quality criteria. Secondly, we analysed contents, highlighting the scarcity of research involving vulnerable people. The available literature specialized in psychosocial therapies offers investigation results which involve mobile phones and patients in general, focusing particularly on the clinical psychology field and, to a lesser extent, on the social work field. Particularly significant are the investigation works developed in the United States. In the present paper we introduce a first “state of the art”, identifying opportunities and also the limitations surrounding the use of mobile phones in psychosocial therapies targeting the vulnerable. Issues concerning privacy and data confidentiality, and the access of vulnerable people to mobile phones and how they use them, pose significant challenges; but they offer the opportunity to reach isolated or impoverished populations, or even to facilitate access to social and healthcare services. We close this paper formulating possible orientations, hypotheses and goals to design new investigation works involving vulnerable populations. PMID:27194134

Poverty and working status in changes of unmet health care need in old age.

PubMed

Park, Sojung; Kim, BoRin; Kim, Soojung

2016-06-01

This study examined relationships between socioeconomic disadvantage and unmet health care needs among older adults in Korea adjusting for predisposing and health need factors. We examined how older adults' low-income status and working status affect unmet needs for healthcare over time, and how the association varies by reason for unmet needs (i.e. financial or non-financial). We used three waves of data (2009, 2011, 2012) from the Korea Health Panel (KHP) survey and a multinomial logistic mixed model to analyze how low socioeconomic disadvantages affects changes in unmet healthcare needs independently and in combination. Results showed that near-poor elders were more likely to experience increased risk of unmet need due to non-financial constraints over time. When working, near-poor elders risk of unmet healthcare needs due to financial and non-financial factors increases substantially over time. Across societies, different subgroups of older adults may be at risk of unmet healthcare needs, contingent on healthcare policies. Our finding suggests that in Korea, near-poor working elders are the vulnerable subgroup at highest risk of unmet healthcare needs. This finding provides much-needed evidence of heterogeneity of vulnerability in unmet healthcare needs and can be used to design more affordable and accessible programs and services for this group. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Respiratory morbidity among street sweepers working at Hanumannagar Zone of Nagpur Municipal Corporation, Maharashtra.

PubMed

Yogesh, Sabde D; Zodpey, Sanjay P

2008-01-01

Due to the occupational exposure street sweepers are very much vulnerable to develop the chronic diseases of respiratory system. Therefore this study was undertaken to find out the proportion of chronic respiratory morbidity among the street sweepers and the role of various associated risk factors. The study included two groups: study group i.e. street sweepers and comparison group (Class IV workers working in the office buildings). Various risk factors studied were age, sex, socioeconomic status, length of service, smoking habit, type of house, area of residence, cooking fuel and pets. Proportion of chronic respiratory morbidity (chronic bronchitis, asthma and bronchiectasis) was higher (8.1%) among street sweepers compared to comparison group (2.1%), the difference being statistically significant. Unconditional multivariate logistic regression revealed that risk of having chronic respiratory morbidity among street sweepers was 4.24 (95% CI of OR = 1.24 to 14.50) times higher than that in the comparison group and the risk increased significantly with increasing length of service (OR = 1.75, 95 % CI = 1.09 to 2.81).

Suicide Mortality Across Broad Occupational Groups in Greece: A Descriptive Study.

PubMed

Alexopoulos, Evangelos C; Kavalidou, Katerina; Messolora, Fani

2016-03-01

Several studies have investigated the relationship between specific occupations and suicide mortality, as suicide rates differ by profession. The aim of this study was to investigate suicide mortality ratios across broad occupational groups in Greece for both sexes in the period 2000-2009. Data of suicide deaths were retrieved from the Hellenic Statistical Authority and comparative mortality ratios were calculated. Occupational classification was based on the International Classification of Occupations (ISCO-88) and the coding for Intentional self-harm (X60-X84) was based on the international classification of diseases (ICD-10). Male dominant occupations, mainly armed forces, skilled farmers and elementary workers, and female high-skilled occupations were seen as high risk groups for suicide in a period of 10 years. The age-productive group of 30-39 years in Greek male elementary workers and the 50-59 age-productive group of Greek professional women proved to have the most elevated number of suicide deaths. Further research is needed into the work-related stressors of occupations with high suicide mortality risk and focused suicide prevention strategies should be applied within vulnerable working age populations.

Older Women and Poverty. Lifecycle Learning Sheet.

ERIC Educational Resources Information Center

Regina Univ. (Saskatchewan). Univ. Extension. Seniors Education Centre.

Statistics reveal that 61% of older Canadian women who are unattached to a male partner live in poverty. Two primary factors why women are especially vulnerable to poverty are their financially dependent status and their inequality in the work force. Even women who have worked outside the home are more vulnerable to poverty in old age than their…

Eldercare work, migrant care workers, affective care and subjective proximity.

PubMed

Lovelock, Kirsten; Martin, Greg

2016-08-01

To document and explore the experience of migrant care workers providing health and social care to the elderly in institutional care settings and in the homes of the elderly in the community in New Zealand with a particular focus on the affective components of care work. This qualitative study involved conducting face-to-face, open-ended, semi-structured interviews with 29 migrant care workers in the eldercare sector in the cities of Auckland and Wellington, New Zealand. Participants were recruited through various agencies focusing on aged care and engaged with migrant eldercare workers and snowballing through participant referral. Sample size was determined when saturation was reached. The interviews were audio recorded, transcribed verbatim, themes were identified and then analysed drawing on a body of theoretical work in the fields of emotional anthropology and moral geography and the international empirical literature addressing migrant eldercare workers. As with the international research in this field we found that these workers were vulnerable to exploitation, the workforce is largely feminised and stereotypical understandings of racial groups and national characteristics informed recruitment and the workplace experience. Here attributing gradients of affect to particular migrant groups in the workforce was the main mechanism employed to establish worker worth and difference. Identifying with these gradients of affect enabled these eldercare workers to demonstrate that they met the moral and ethical requirements of permanent residency and ultimately citizenship. Eldercare workers in the home were vulnerable to 'blurred emotional boundaries' and care recipient demand for greater emotional commitment. The migrant eldercare workers in this study all shared vulnerable residential status and many feared they would never obtain permanent residency or citizenship. All had family who remained in the Philippines and towards whom they had an obligation to substitute care support. Central to understanding how this labour force issue is experienced by both caregivers and the elderly is the notion of subjective proximity and how emotional and moral trajectories serve to mediate the connection between the eldercare worker and workplace, the Filipino migrant eldercare relationship with employers, agencies and institutions; and, the transnational nature of this mobility and social and actual citizenship.

An integrated framework for assessing vulnerability to climate change and developing adaptation strategies for coffee growing families in Mesoamerica.

PubMed

Baca, María; Läderach, Peter; Haggar, Jeremy; Schroth, Götz; Ovalle, Oriana

2014-01-01

The Mesoamerican region is considered to be one of the areas in the world most vulnerable to climate change. We developed a framework for quantifying the vulnerability of the livelihoods of coffee growers in Mesoamerica at regional and local levels and identify adaptation strategies. Following the Intergovernmental Panel on Climate Change (IPCC) concepts, vulnerability was defined as the combination of exposure, sensitivity and adaptive capacity. To quantify exposure, changes in the climatic suitability for coffee and other crops were predicted through niche modelling based on historical climate data and locations of coffee growing areas from Mexico, Guatemala, El Salvador and Nicaragua. Future climate projections were generated from 19 Global Circulation Models. Focus groups were used to identify nine indicators of sensitivity and eleven indicators of adaptive capacity, which were evaluated through semi-structured interviews with 558 coffee producers. Exposure, sensitivity and adaptive capacity were then condensed into an index of vulnerability, and adaptation strategies were identified in participatory workshops. Models predict that all target countries will experience a decrease in climatic suitability for growing Arabica coffee, with highest suitability loss for El Salvador and lowest loss for Mexico. High vulnerability resulted from loss in climatic suitability for coffee production and high sensitivity through variability of yields and out-migration of the work force. This was combined with low adaptation capacity as evidenced by poor post harvest infrastructure and in some cases poor access to credit and low levels of social organization. Nevertheless, the specific contributors to vulnerability varied strongly among countries, municipalities and families making general trends difficult to identify. Flexible strategies for adaption are therefore needed. Families need the support of government and institutions specialized in impacts of climate change and strengthening of farmer organizations to enable the adjustment of adaptation strategies to local needs and conditions.

An Integrated Framework for Assessing Vulnerability to Climate Change and Developing Adaptation Strategies for Coffee Growing Families in Mesoamerica

PubMed Central

Baca, María; Läderach, Peter; Haggar, Jeremy; Schroth, Götz; Ovalle, Oriana

2014-01-01

The Mesoamerican region is considered to be one of the areas in the world most vulnerable to climate change. We developed a framework for quantifying the vulnerability of the livelihoods of coffee growers in Mesoamerica at regional and local levels and identify adaptation strategies. Following the Intergovernmental Panel on Climate Change (IPCC) concepts, vulnerability was defined as the combination of exposure, sensitivity and adaptive capacity. To quantify exposure, changes in the climatic suitability for coffee and other crops were predicted through niche modelling based on historical climate data and locations of coffee growing areas from Mexico, Guatemala, El Salvador and Nicaragua. Future climate projections were generated from 19 Global Circulation Models. Focus groups were used to identify nine indicators of sensitivity and eleven indicators of adaptive capacity, which were evaluated through semi-structured interviews with 558 coffee producers. Exposure, sensitivity and adaptive capacity were then condensed into an index of vulnerability, and adaptation strategies were identified in participatory workshops. Models predict that all target countries will experience a decrease in climatic suitability for growing Arabica coffee, with highest suitability loss for El Salvador and lowest loss for Mexico. High vulnerability resulted from loss in climatic suitability for coffee production and high sensitivity through variability of yields and out-migration of the work force. This was combined with low adaptation capacity as evidenced by poor post harvest infrastructure and in some cases poor access to credit and low levels of social organization. Nevertheless, the specific contributors to vulnerability varied strongly among countries, municipalities and families making general trends difficult to identify. Flexible strategies for adaption are therefore needed. Families need the support of government and institutions specialized in impacts of climate change and strengthening of farmer organizations to enable the adjustment of adaptation strategies to local needs and conditions. PMID:24586328

[The vulnerability of the human atrium. I. Correlations between vulnerability, sinus node recovery time and intraatrial conduction time (author's transl)].

PubMed

Pop, T; Fleischmann, D; Effert, S

1976-09-01

Using the extrastimulus method in 100 patients, premature impulses were applied during the relative refractory period of the right atrium. Depending on the atrial response to these impulses we divided our patients in the following 3 groups: Group A: no repetitive firing (61 patients); group B: 1 to 5 additional atrial extrasystoles with a total duration of maximum 1.5 s (27 patients); group C: runs of atrial flutter or fibrilation for at least 8 s (12 patients). The statistical analysis of the following parameters: age, PA interval, absolute and corrected sinus node recovery time did not show any significant difference between the 3 groups. These results suggest that the investigated parameters are of no great importance in the genesis of the atrial vulnerability.

Informality and employment vulnerability: application in sellers with subsistence work

PubMed Central

Garzón-Duque, María Osley; Cardona-Arango, María Doris; Rodríguez-Ospina, Fabio León; Segura-Cardona, Angela María

2017-01-01

ABSTRACT OBJECTIVE To describe the origin, evolution, and application of the concept of employment vulnerability in workers who subsist on street sales. METHODS We have carried out an analysis of the literature in database in Spanish, Portuguese, and English, without restriction by country. This is a review of the gray literature of government reports, articles, and documents from Latin America and the Caribbean. We have analyzed information on the informal economy, social-employment vulnerability, and subsistence workers. RESULTS AND CONCLUSIONS The concept of informal economy is dispersed and suggested as synonymous with employment vulnerability. As a polysemic term, it generates confusion and difficulty in identifying defined profiles of employment vulnerability in informal subsistence workers, who sell their products on the streets and sidewalks of cities. The lack of a clear concept and profile of employment vulnerability for this type of workers generates a restriction on defined actions to reduce employment vulnerability. The profiles could facilitate access to the acquisition of assets that support their structure of opportunities, facilitating and mediating in the passage from vulnerability to social mobility with opportunities. We propose as a concept of employment vulnerability for subsistence workers in the informal sector, the condition of those who must work by day to eat at night, who have little or no ownership of assets, and who have a minimum structure of opportunities to prevent, face, and resist the critical situations that occur daily, putting at risk their subsistence and that of the persons who are their responsibility, thus making the connection between social and employment vulnerability. PMID:29020122

The impact of shift and night work on health related quality of life of working women: findings from the Korea Health Panel.

PubMed

Kim, Woorim; Kim, Tae Hyun; Lee, Tae-Hoon; Choi, Jae Woo; Park, Eun-Cheol

2016-11-28

Night and shift work status has been associated with health related quality of life (HRQoL) in economically active women. This study aimed to investigate the association between night or shift work status and HRQoL of economically active women and to further analyze how marital status interplays in the objected relationship. Data were from the Korea Health Panel, 2011 to 2013. A total of 2238 working women were included for analysis. Work status was categorized into day work, night work, and rotating shift work and its association with HRQoL, measured using the EuroQol-5D (EQ-5D) index, was investigated using the generalized estimating equation (GEE) model. Compared to the day work reference group, the night work group (β: -0.9757, P = 0.0202) and the rotating shift work group (β: -0.7947, P = 0.0363) showed decreases in EQ-5D scores. This trend was maintained regardless of marital status, although decreases in health related quality of life were particularly pronounced among night shift workers with a spouse. Night and rotating shift work status was associated with HRQoL of economically active women as individuals working night and rotating shifts showed decreases in EQ-5D scores compared to individuals working day shifts. The findings of this study signify the importance of monitoring the HRQoL status of women working night and rotating shifts as these individuals may be comparatively vulnerable to reduced HRQoL.

'They bring AIDS to us and say we give it to them': Socio-structural context of female sex workers' vulnerability to HIV infection in Ibadan, Nigeria.

PubMed

Muñoz, Jennifer; Adedimeji, Adebola; Alawode, Olayemi

2010-08-01

The aim of the study was to examine and describe the individual and structural-environmental factors that shape the vulnerability of brothel-based female sex workers (FSWs) in Ibadan, southwest Nigeria to HIV infection. A descriptive qualitative research design was utilised to elicit data, using in-depth interviews and focus group discussions, from 60 randomly selected participants in four brothels. A thematic analysis of data was undertaken following transcription and validation of interviews. Five themes emerged from the data: (i) flawed knowledge and fatalistic attitudes; (ii) the psychosocial and economic context of sex work; (iii) religious beliefs, stigma and risk taking; (iv) barriers to HIV testing; and (v) legal and policy constraints to sex work. We describe the complex interaction between these themes and how they combine to increase the risk of HIV infection among FSWs. The impact of previous interventions to reduce the risk of HIV infection among FSWs has been limited by personal and structural factors; hence we recommend that new strategies that recognise the practical constraints to HIV prevention among FSWs are urgently needed to make the environment of commercial work safer for FSWs, their clients, and by extension the general population.

Assessing intrinsic and specific vulnerability models ability to indicate groundwater vulnerability to groups of similar pesticides: A comparative study

USGS Publications Warehouse

Douglas, Steven; Dixon, Barnali; Griffin, Dale W.

2018-01-01

With continued population growth and increasing use of fresh groundwater resources, protection of this valuable resource is critical. A cost effective means to assess risk of groundwater contamination potential will provide a useful tool to protect these resources. Integrating geospatial methods offers a means to quantify the risk of contaminant potential in cost effective and spatially explicit ways. This research was designed to compare the ability of intrinsic (DRASTIC) and specific (Attenuation Factor; AF) vulnerability models to indicate groundwater vulnerability areas by comparing model results to the presence of pesticides from groundwater sample datasets. A logistic regression was used to assess the relationship between the environmental variables and the presence or absence of pesticides within regions of varying vulnerability. According to the DRASTIC model, more than 20% of the study area is very highly vulnerable. Approximately 30% is very highly vulnerable according to the AF model. When groundwater concentrations of individual pesticides were compared to model predictions, the results were mixed. Model predictability improved when concentrations of the group of similar pesticides were compared to model results. Compared to the DRASTIC model, the AF model more accurately predicts the distribution of the number of contaminated wells within each vulnerability class.

Validation of a social vulnerability index in context to river-floods in Germany

NASA Astrophysics Data System (ADS)

Fekete, A.

2009-03-01

Social vulnerability indices are a means for generating information about people potentially affected by disasters that are e.g. triggered by river-floods. The purpose behind such an index is in this study the development and the validation of a social vulnerability map of population characteristics towards river-floods covering all counties in Germany. This map is based on a composite index of three main indicators for social vulnerability in Germany - fragility, socio-economic conditions and region. These indicators have been identified by a factor analysis of selected demographic variables obtained from federal statistical offices. Therefore, these indicators can be updated annually based on a reliable data source. The vulnerability patterns detected by the factor analysis are verified by using an independent second data set. The interpretation of the second data set shows that vulnerability is revealed by a real extreme flood event and demonstrates that the patterns of the presumed vulnerability match the observations of a real event. It comprises a survey of flood-affected households in three federal states. By using logistic regression, it is demonstrated that the theoretically presumed indications of vulnerability are correct and that the indicators are valid. It is shown that indeed certain social groups like the elderly, the financially weak or the urban residents are higher risk groups.

The VCOP Scale: A Measure of Overprotection in Parents of Physically Vulnerable Children.

ERIC Educational Resources Information Center

Wright, Logan; And Others

1993-01-01

Developed Vulnerable Child/Overprotecting Parent Scale to measure overprotecting versus optimal developmental stimulation tendencies for parents of physically vulnerable children. Items were administered to parents whose parenting techniques had been rated as either highly overprotective or as optimal by group of physicians and other…

Assessment of groundwater vulnerability to pollution: a combination of GIS, fuzzy logic and decision making techniques

NASA Astrophysics Data System (ADS)

Gemitzi, Alexandra; Petalas, Christos; Tsihrintzis, Vassilios A.; Pisinaras, Vassilios

2006-03-01

The assessment of groundwater vulnerability to pollution aims at highlighting areas at a high risk of being polluted. This study presents a methodology, to estimate the risk of an aquifer to be polluted from concentrated and/or dispersed sources, which applies an overlay and index method involving several parameters. The parameters are categorized into three factor groups: factor group 1 includes parameters relevant to the internal aquifer system’s properties, thus determining the intrinsic aquifer vulnerability to pollution; factor group 2 comprises parameters relevant to the external stresses to the system, such as human activities and rainfall effects; factor group 3 incorporates specific geological settings, such as the presence of geothermal fields or salt intrusion zones, into the computation process. Geographical information systems have been used for data acquisition and processing, coupled with a multicriteria evaluation technique enhanced with fuzzy factor standardization. Moreover, besides assigning weights to factors, a second set of weights, i.e., order weights, has been applied to factors on a pixel by pixel basis, thus allowing control of the level of risk in the vulnerability determination and the enhancement of local site characteristics. Individual analysis of each factor group resulted in three intermediate groundwater vulnerability to pollution maps, which were combined in order to produce the final composite groundwater vulnerability map for the study area. The method has been applied in the region of Eastern Macedonia and Thrace (Northern Greece), an area of approximately 14,000 km2. The methodology has been tested and calibrated against the measured nitrate concentration in wells, in the northwest part of the study area, providing results related to the aggregation and weighting procedure.

Social vulnerability assessment: a growing practice in Europe?

NASA Astrophysics Data System (ADS)

Tapsell, S.; McC arthy, S.

2012-04-01

This paper builds upon work on social vulnerability from the CapHaz-Net consortium, an ongoing research project funded by the European Commission in its 7th Framework Programme. The project focuses on the social dimensions of natural hazards, as well as on regional practices of risk prevention and management, and aims at improving the resilience of European societies to natural hazards, paying particular attention to social capacity building. The topic of social vulnerability is one of seven themes being addressed in the project. There are various rationales for examining the relevance of social vulnerability to natural hazards. Vulnerability assessment has now been accepted as a requirement for the effective development of emergency management capability, and assessment of social vulnerability has been recognised as being integral to understanding the risk to natural hazards. The aim of our research was to examine social vulnerability, how it might be understood in the context of natural hazards in Europe, and how social vulnerability can be addressed to increase social capacity. The work comprised a review of research on social vulnerability to different natural hazards within Europe and included concepts and definitions of social vulnerability (and related concepts), the purpose of vulnerability assessment and who decides who is vulnerable, different approaches to assessing or measuring social vulnerability (such as the use of 'classical' quantitative vulnerability indicators and qualitative community-based approaches, along with the advantages and disadvantages of both), conceptual frameworks for assessing social vulnerability and three case studies of social vulnerability studies within Europe: flash floods in the Italian Alps, fluvial flooding in Germany and heat waves in Spain. The review reveals variable application of social vulnerability analysis across Europe and there are indications why this might be the case. Reasons could range from the scale of country policy and the particular risk management focus to the smaller scale risk management perceptions of the analysis techniques employed being to resource expensive, difficult to interpret or to operationalise. This paper will provide a context with some empirical examples to perhaps explain the growing popularity of concepts such as resilience and capacity building which lie more comfortably with policy makers and risk managers as concepts which focus on the solution rather than identifying a problem by assessing social vulnerability.

Talking about sexuality, STI and AIDS with poor adolescents.

PubMed

Murakami, Juliana Kelli; Petrilli Filho, José Fernando; Telles Filho, Paulo Celso Prado

2007-01-01

This study aimed to report an educative action experience on sexuality/STI/Aids in an adolescent group living in a poor context. The study site was a Family Health Unit located in a city in the interior of São Paulo, Brazil. Six female adolescents participated in the educative actions, and each of the five meetings took 70 minutes on the average. The educative action allowed for knowledge/action based on a network of interlaced gestures, words and affections, permeating new constructions. Thus, new meanings emerged, not only for the adolescents, who discovered the power of being in the group, but also for the researchers, who managed to visualize other horizons for the work with highly vulnerable groups in society.

Imbalanced spontaneous brain activity in orbitofrontal-insular circuits in individuals with cognitive vulnerability to depression.

PubMed

Zhang, Xiaocui; Di, Xin; Lei, Hui; Yang, Juan; Xiao, Jing; Wang, Xiang; Yao, Shuqiao; Rao, Hengyi

2016-07-01

The hopelessness theory of depression posits that individuals with negative cognitive styles are at risk of developing depression following negative life events. The purpose of this work was to examine whether individuals with cognitive vulnerability to depression (CVD) exhibit similar spontaneous brain activity patterns as compared to patients with major depressive disorder (MDD). Subjects with CVD (N=32), drug-naïve first-episode patients with major depressive disorder (N=32), and sex-, age- and education-matched healthy controls (HCs; N=35) were subjected to resting state functional magnetic resonance imaging (RS-fMRI) and amplitudes of low-frequency fluctuation (ALFF) was compared between the groups. Pearson correlation analysis was performed between regional ALFFs and psychometric scores, namely the Cognitive Style Questionnaire (CSQ) and the Center for Epidemiologic Studies Depression (CES-D) scale scores. Significant group differences in ALFF values were observed bilaterally in the orbitofrontal cortex (OFC) and insular cortex (IC), and in the left fusiform gyrus (FFG). Compared to HCs, CVD subjects had reduced ALFFs in the bilateral OFC and increased ALFF in the bilateral IC and the left FFG, which were similar to the differences observed between the HCs and MDD patients. Compared to MDD patients, CVD subjects showed significant reduced ALFF values in right IC. Additionally, CSQ scores for the CVD group correlated with ALFF values in the left IC. We did not conduct a longitudinal study. Our findings were limited in cross-sectional analysis. A hypoactive OFC and hyperactive IC in a resting-state may underlie an imbalance in the spontaneous brain activity in orbitofrontal-insular circuits, and these differences may represent a trait-related marker of vulnerability to depression. Copyright © 2016 Elsevier B.V. All rights reserved.

Ranking terrestrial vertebrate species for utility in biomonitoring and vulnerability to environmental contaminants

USGS Publications Warehouse

Golden, N.H.; Rattner, B.A.

2003-01-01

The measurement of contaminant tissue concentrations or exposure-related effects in biota has been used extensively to monitor pollution and environmental health. Terrestrial vertebrates have historically been an important group of species in such evaluations, not only because many are excellent sentinels of environmental contamination, but also because they are valued natural resources in their own right that may be adversely affected by toxicant exposure. Selection of appropriate vertebrates for biomonitoring studies frequently relies on expert opinion, although a few rigorous schemes are in use for predicting vulnerability of birds to the adverse effects of petroleum crude oil. A Utility Index that ranks terrestrial vertebrate species as potential sentinels of contaminants in a region, and a Vulnerability Index that assesses the threat of specific groups of contaminants to these species, have been developed to assist decision makers in risk assessments of persistent organic pollutants, cholinesterase-inhibiting pesticides, petroleum crude oil, mercury, and lead shot. Twenty-five terrestrial vertebrate species commonly found in Atlantic Coast estuarine habitat were ranked for their utility as biomonitors of contamination and their vulnerability to pollutants in this region. No single species, taxa or class of vertebrates was found to be an ideal sentinel for all groups of contaminants. Although birds have overwhelmingly been used to monitor contaminants compared to other terrestrial vertebrate classes, the non-migratory nature and dietary habits of the snapping turtle and mink consistently resulted in ranking these species excellent sentinels as well. Vulnerability of Atlantic Coast populations of these species varied considerably among groups of contaminants. Usually a particular species was found to be at high risk to only one or two groups of contaminants, although a noteworthy exception is the bald eagle that is highly vulnerable to all five of the contaminant groups examined. This index could be further enhanced by generation of additional comparative toxicity data to facilitate interspecific extrapolations. The Utility and Vulnerability Indices have application to many types of habitat types in addition to estuaries, and are of value to natural resource and risk managers that routinely conduct local, regional or national environmental quality assessments.

Early intervention and recovery among children with failure to thrive: follow-up at age 8.

PubMed

Black, Maureen M; Dubowitz, Howard; Krishnakumar, Ambika; Starr, Raymond H

2007-07-01

We sought to examine the impact of a randomized, controlled trial of home visiting among infants with failure to thrive on growth, academic/cognitive performance, and home/classroom behavior at age 8. Infants with failure to thrive (N = 130) or adequate growth (N = 119) were recruited from pediatric primary care clinics serving low-income, urban communities. Eligibility criteria included age <25 months, gestational age >36 weeks, birth weight >2500 g, and no significant medical conditions. Evaluation included anthropometries, Bayley scales, maternal anthropometries, demographics, negative affect, IQ, and the Home Observation for Measurement of the Environment scale. Infants with failure to thrive were treated in an interdisciplinary growth and nutrition clinic and randomized into clinical-intervention-plus-home-intervention or clinical-care-only groups. The home-visiting curriculum promoted maternal sensitivity, parent-infant relationships, and child development. Follow-up visits were conducted by evaluators who were unaware of the children's growth or intervention history. At age 8, the evaluation included anthropometries, the Wechsler Intelligence Scale for Children III, and the Wide Range Achievement Test, Revised. Mothers completed the Child Behavior Checklist and teachers completed the Teacher Report Form. Multivariate analyses of variance were used to examine differences in growth, cognitive/academic performance, and home/school behavior, adjusted by maternal education, public assistance, and, when appropriate, infant Bayley score, maternal BMI, height, negative affect, IQ, and Home Observation for Measurement of the Environment scores. Retention was 74% to 78%. Children in the adequate-growth group were significantly taller, heavier, and had better arithmetic scores than the clinical-intervention-only group, with the clinical-intervention-plus-home-intervention group intermediate. There were no group differences in IQ, reading, or mother-reported behavior problems. Children in the clinical-intervention-plus-home-intervention group had fewer teacher-reported internalizing problems and better work habits than the clinical-intervention-only group. Early failure to thrive increased children's vulnerability to short stature, poor arithmetic performance, and poor work habits. Home visiting attenuated some of the negative effects of early failure to thrive, possibly by promoting maternal sensitivity and helping children build strong work habits that enabled them to benefit from school. Findings provide evidence for early intervention programs for vulnerable infants.

The Future of Risk Analysis: Operationalizing Living Vulnerability Assessments from the Cloud to the Street (and Back)

NASA Astrophysics Data System (ADS)

Tellman, B.; Schwarz, B.; Kuhn, C.; Pandey, B.; Schank, C.; Sullivan, J.; Mahtta, R.; Hammet, L.

2016-12-01

21 million people are exposed to flooding every year, and that number is expected to more than double by 2030 due to climate, land use, and demographic change. Cloud to Street, a mission driven science organization, is working to make big and real time data more meaningful to understand both biophysical and social vulnerability to flooding in this changing world. This talk will showcase the science and practice we have built of integrated social and biophysical flood vulnerability assessments based on our work in Uttarakhand, India and Senegal, in conjunction with nonprofits and development banks. We will show developments of our global historical flood database, detected from MODIS and Landsat satellites, used to power machine learning flood exposure models in Google Earth Engine's API. Demonstrating the approach, we will also showcase new approaches in social vulnerability science, from developing data-driven social vulnerability indices in India, to deriving predictive models that explain the social conditions that lead to disproportionate flood damage and fatality in the US. While this talk will draw on examples of completed vulnerability assessments, we will also discuss the possible future for place-based "living" flood vulnerability assessments that are updated each time satellites circle the earth or people add crowd-sourced observations about flood events and social conditions.

Self-efficacy as a unifying construct in nursing-social work collaboration with vulnerable populations.

PubMed

Washington, Olivia G M; Moxley, David P

2013-03-01

The authors consider self-efficacy practice as an organizing construct guiding nursing-social work action research in partnership with older homeless and formerly homeless African-American women. The authors, both academics who together have worked with members of this vulnerable population for a decade and a half, report on their unifying action research perspective immersed in self-efficacy theory. We examine how our adaptations of Bandura's classic four sources of self-efficacy form a distinctive intervention practice designed to help older African-American women emerge from homelessness. We amplify the incorporation of the four sources (vicarious experience and exposure to powerful role models, emotional arousal and accompanying catharsis, verbal persuasion, and role performance) into a grand strategy useful in working collaboratively with members of vulnerable populations, so they can achieve outcomes that improve their functional health, well-being and ultimately their quality of life. © 2012 Blackwell Publishing Ltd.

Exploring an Activist Approach of Working with Boys from Socially Vulnerable Backgrounds in a Sport Context

ERIC Educational Resources Information Center

Luguetti, Carla; Oliver, Kimberly L.; Kirk, David; Dantas, Luiz

2017-01-01

This study explores an activist approach for co-creating a prototype pedagogical model of sport for working with boys from socially vulnerable backgrounds. This paper addresses the key features that emerged when we identified what facilitated and hindered the boys' engagement in sport. This study was an activist research project that was conducted…

Safe Spaces, Support, Social Capital: A Critical Analysis of Artists Working with Vulnerable Young People in Educational Contexts

ERIC Educational Resources Information Center

Sellman, Edward

2015-01-01

This article provides a critical and thematic analysis of three research projects involving artists working with vulnerable young people in educational contexts. It argues that artists create safe spaces in contrast to traditional educational activities but it will also raise questions about what constitutes such a space for participants. It will…

Psychological Effects of the Threat of Nuclear War

PubMed Central

Kiraly, S. J.

1986-01-01

Systematic studies are emerging on the prevailing harmful psychological effect of the threat of nuclear war. The most recent surveys have identified populations which are particularly vulnerable. Anxiety was found to be a factor in criminal behavior, and threat of nuclear war to be a factor in anxiety. Psychiatric morbidity has been correlated with work deprivation and threat of annihilation. Many studies have focused on children, finding that anxiety about social issues is high, but that cynicism and apathy set in rapidly. Conclusions from such studies show that denial and avoidance are some of the worst results, since they are a barrier to meaningful reaction. The most vulnerable groups are children, adolescents, the unemployed, and those responsible for the welfare of others. Appropriate action is seen to be acknowledgement of fear and disillusionment as valid feelings, education towards a stronger sense of reality, and mobilization of goal-directed activity. PMID:21274254

Cognitive reactivity as outcome and working mechanism of mindfulness-based cognitive therapy for recurrently depressed patients in remission.

PubMed

Cladder-Micus, M B; van Aalderen, J; Donders, A R T; Spijker, J; Vrijsen, J N; Speckens, A E M

2018-03-01

Major depressive disorder is a prevalent condition with high relapse rates. There is evidence that cognitive reactivity is an important vulnerability factor for the recurrence of depression. Mindfulness-based interventions are designed to reduce relapse rates, with cognitive reactivity as one of the proposed working mechanisms. In a randomised controlled trial we compared the effect of mindfulness-based cognitive therapy (MBCT) with treatment-as-usual (TAU) on cognitive reactivity in recurrently depressed patients (N = 115). Depressive symptoms, cognitive reactivity, and mindfulness skills were assessed pre and post treatment. Patients in the MBCT group reported a significantly greater reduction in cognitive reactivity than those in the TAU group (d = .51). The reduction of cognitive reactivity appeared to mediate the association between MBCT/TAU and decrease of depressive symptoms, using pre and post scores. The current study provides evidence that MBCT reduces cognitive reactivity and preliminary evidence that cognitive reactivity is a working mechanism of MBCT.

Vulnerability of Coastal Communities from Storm Surge and Flood Disasters

PubMed Central

Bathi, Jejal Reddy; Das, Himangshu S.

2016-01-01

Disasters in the form of coastal storms and hurricanes can be very destructive. Preparing for anticipated effects of such disasters can help reduce the public health and economic burden. Identifying vulnerable population groups can help prioritize resources for the most needed communities. This paper presents a quantitative framework for vulnerability measurement that incorporates both socioeconomic and flood inundation vulnerability. The approach is demonstrated for three coastal communities in Mississippi with census tracts being the study unit. The vulnerability results are illustrated as thematic maps for easy usage by planners and emergency responders to assist in prioritizing their actions to vulnerable populations during storm surge and flood disasters. PMID:26907313

Populations of concern: Chapter 9

USGS Publications Warehouse

Gamble, Janet; Balbus, John; Berger, Martha; Bouye, Karen; Campbell, Vince; Chief, Karletta; Conlon, K.; Crimmins, Allison; Flanagan, Barry; Gonzalez-Maddux, C.; Hallisey, E.; Hutchins, S.; Jantarasami, L.; Khoury, S.; Kiefer, M.; Kolling, J.; Lynn, K.; Manangan, A.; McDonald, M.; Morello-Frosch, R.; Hiza, Margaret; Sheffield, P.; Thigpen Tart, K.; Watson, J.; Whyte, K.P.; Wolkin, A.F.

2016-01-01

Climate change is already causing, and is expected to continue to cause, a range of health impacts that vary across different population groups in the United States. The vulnerability of any given group is a function of its sensitivity to climate change related health risks, its exposure to those risks, and its capacity for responding to or coping with climate variability and change. Vulnerable groups of people, described here as populations of concern, include those with low income, some communities of color, immigrant groups (including those with limited English proficiency), Indigenous peoples, children and pregnant women, older adults, vulnerable occupational groups, persons with disabilities, and persons with preexisting or chronic medical conditions. Planners and public health officials, politicians and physicians, scientists and social service providers are tasked with understanding and responding to the health impacts of climate change. Collectively, their characterization of vulnerability should consider how populations of concern experience disproportionate, multiple, and complex risks to their health and well-being in response to climate change. Some groups face a number of stressors related to both climate and non-climate factors. For example, people living in impoverished urban or isolated rural areas, floodplains, coastlines, and other at-risk locations are more vulnerable not only to extreme weather and persistent climate change but also to social and economic stressors. Many of these stressors can occur simultaneously or consecutively. Over time, this “accumulation” of multiple, complex stressors is expected to become more evident1 as climate impacts interact with stressors associated with existing mental and physical health conditions and with other socioeconomic and demographic factors.

Peer-led Aboriginal parent support: Program development for vulnerable populations with participatory action research.

PubMed

Munns, Ailsa; Toye, Christine; Hegney, Desley; Kickett, Marion; Marriott, Rhonda; Walker, Roz

2017-10-01

Participatory action research (PAR) is a credible, culturally appropriate methodology that can be used to effect collaborative change within vulnerable populations. This PAR study was undertaken in a Western Australian metropolitan setting to develop and evaluate the suitability, feasibility and effectiveness of an Aboriginal peer-led home visiting programme. A secondary aim, addressed in this paper, was to explore and describe research methodology used for the study and provide recommendations for its implementation in other similar situations. PAR using action learning sets was employed to develop the parent support programme and data addressing the secondary, methodological aim were collected through focus groups using semi-structured and unstructured interview schedules. Findings were addressed throughout the action research process to enhance the research process. The themes that emerged from the data and addressed the methodological aim were the need for safe communication processes; supportive engagement processes and supportive organisational processes. Aboriginal peer support workers (PSWs) and community support agencies identified three important elements central to their capacity to engage and work within the PAR methodology. This research has provided innovative data, highlighting processes and recommendations for child health nurses to engage with the PSWs, parents and community agencies to explore culturally acceptable elements for an empowering methodology for peer-led home visiting support. There is potential for this nursing research to credibly inform policy development for Aboriginal child and family health service delivery, in addition to other vulnerable population groups. Child health nurses/researchers can use these new understandings to work in partnership with Aboriginal communities and families to develop empowering and culturally acceptable strategies for developing Aboriginal parent support for the early years. Impact Statement Child health nurses and Aboriginal communities can collaborate through participatory action research to develop peer-led support for the early years. Indigenous Australian peoples are people who identify as Aboriginal or Torres Strait Islander. Respectfully, throughout this paper, they will be described as Aboriginal.

Participation and influence of migrant workers on working conditions: a qualitative approach.

PubMed

López-Jacob, María J; Safont, Eva Canaleta; García, Ana M; Garí, Aitana; Agudelo-Suárez, Andrés; Gil, Angel; Benavides, Fernando G

2010-01-01

Workers participation in the management of employment and working conditions is an important determinant of both positive and negative effects of work on human health. Through a qualitative approach, this study analyzes the degree of control and influence that migrant workers in different Spanish cities have over their own working conditions (Immigration, Work, and Health [ITSAL] Project). Results showed that migrant workers had little influence on employment and working conditions. Immigrant workers are mostly interested in issues such as salaries, hiring, and hours of work. Fear of dismissal makes immigrant workers reluctant to demand improved working conditions. We received limited information about immigrant workers' understanding of their rights and their perceptions of the possibilities to influence working conditions through trade union activity. Informal social networks play an essential role in disseminating information on workers' rights, although the effect is not always positive. Unions need to increase attention to and adapt measures for this particularly vulnerable group of workers.

Spent Fuel Working Group Report. Volume 1

DOE Office of Scientific and Technical Information (OSTI.GOV)

O`Toole, T.

1993-11-01

The Department of Energy is storing large amounts of spent nuclear fuel and other reactor irradiated nuclear materials (herein referred to as RINM). In the past, the Department reprocessed RINM to recover plutonium, tritium, and other isotopes. However, the Department has ceased or is phasing out reprocessing operations. As a consequence, Department facilities designed, constructed, and operated to store RINM for relatively short periods of time now store RINM, pending decisions on the disposition of these materials. The extended use of the facilities, combined with their known degradation and that of their stored materials, has led to uncertainties about safety.more » To ensure that extended storage is safe (i.e., that protection exists for workers, the public, and the environment), the conditions of these storage facilities had to be assessed. The compelling need for such an assessment led to the Secretary`s initiative on spent fuel, which is the subject of this report. This report comprises three volumes: Volume I; Summary Results of the Spent Fuel Working Group Evaluation; Volume II, Working Group Assessment Team Reports and Protocol; Volume III; Operating Contractor Site Team Reports. This volume presents the overall results of the Working Group`s Evaluation. The group assessed 66 facilities spread across 11 sites. It identified: (1) facilities that should be considered for priority attention. (2) programmatic issues to be considered in decision making about interim storage plans and (3) specific vulnerabilities for some of these facilities.« less

Experiential avoidance in the vulnerability to depression among adolescent females.

PubMed

Mellick, William; Vanwoerden, Salome; Sharp, Carla

2017-01-15

Although various mechanisms in the maternal transmission of Major Depressive Disorder (MDD) have been investigated, it is unknown whether experiential avoidance (EA) is a vulnerability factor in the development of depression or a consequence of the illness. The present study utilized a high-risk design to determine if EA indeed poses vulnerability to adolescent MDD. Secondly, we examined the means by which adolescent EA may come to pose vulnerability, namely that it explains the relation between maternal EA and adolescent depressive symptoms. One-hundred and forty-six biological mother/adolescent daughter dyads comprised three diagnostic groups: mothers with a history of MDD and their depressed daughters (MDD; n=21), mothers with a history of MDD and their never-depressed daughters (high-risk, HR; n=69), and healthy controls (HCs; n=56). Groups differed on daughter EA such that the MDD group reported greater EA than the HR group, which in turn reported greater EA than HCs. Daughter EA mediated the relation between maternal EA and daughter depressive symptoms after controlling for maternal depressive symptoms. Strengths aside, this study included a relatively small group of depressed mother-daughter dyads and relied on cross-sectional self-report data. EA appears to serve as a vulnerability factor for adolescent MDD, and the mechanistic role of daughter EA highlights the significance of intergenerational EA in the maternal transmission of depression. Therapeutic approaches may therefore consider reducing the transmission of EA from mothers to daughters. Copyright © 2016 Elsevier B.V. All rights reserved.

Health-Related Quality of Life, Self-Efficacy and Enjoyment Keep the Socially Vulnerable Physically Active in Community-Based Physical Activity Programs: A Sequential Cohort Study

PubMed Central

Herens, Marion; Bakker, Evert Jan; van Ophem, Johan; Wagemakers, Annemarie; Koelen, Maria

2016-01-01

Physical inactivity is most commonly found in socially vulnerable groups. Dutch policies target these groups through community-based health-enhancing physical activity (CBHEPA) programs. As robust evidence on the effectiveness of this approach is limited, this study investigated whether CBHEPA programs contribute to an increase in and the maintenance of physical activity in socially vulnerable groups. In four successive cohorts, starting at a six-month interval, 268 participants from 19 groups were monitored for twelve months in seven CBHEPA programs. Data collection was based on repeated questionnaires. Socio-economic indicators, program participation and coping ability were measured at baseline. Physical activity, health-related quality of life and on-going program participation were measured three times. Self-efficacy and enjoyment were measured at baseline and at twelve months. Statistical analyses were based on a quasi-RCT design (independent t-tests), a comparison of participants and dropouts (Mann-Whitney test), and multilevel modelling to assess change in individual physical activity, including group level characteristics. Participants of CBHEPA programs are socially vulnerable in terms of low education (48.6%), low income (52.4%), non-Dutch origin (64.6%) and health-related quality of life outcomes. Physical activity levels were not below the Dutch average. No increase in physical activity levels over time was observed. The multilevel models showed significant positive associations between health-related quality of life, self-efficacy and enjoyment, and leisure-time physical activity over time. Short CBHEPA programs (10–13 weeks) with multiple trainers and gender-homogeneous groups were associated with lower physical activity levels over time. At twelve months, dropouts' leisure-time physical activity levels were significantly lower compared to continuing participants, as were health-related quality of life, self-efficacy and enjoyment outcomes. BMI and care consumption scored significantly higher among dropouts. In conclusion, Dutch CBHEPA programs reach socially vulnerable, but not necessarily inactive, groups in terms of socio-economic and health-related quality of life outcomes. Our findings suggest that CBHEPA programs particularly contribute to physical activity maintenance in socially vulnerable groups, rather than to an increase in physical activity behaviour over time. PMID:26909696

Health-Related Quality of Life, Self-Efficacy and Enjoyment Keep the Socially Vulnerable Physically Active in Community-Based Physical Activity Programs: A Sequential Cohort Study.

PubMed

Herens, Marion; Bakker, Evert Jan; van Ophem, Johan; Wagemakers, Annemarie; Koelen, Maria

2016-01-01

Physical inactivity is most commonly found in socially vulnerable groups. Dutch policies target these groups through community-based health-enhancing physical activity (CBHEPA) programs. As robust evidence on the effectiveness of this approach is limited, this study investigated whether CBHEPA programs contribute to an increase in and the maintenance of physical activity in socially vulnerable groups. In four successive cohorts, starting at a six-month interval, 268 participants from 19 groups were monitored for twelve months in seven CBHEPA programs. Data collection was based on repeated questionnaires. Socio-economic indicators, program participation and coping ability were measured at baseline. Physical activity, health-related quality of life and on-going program participation were measured three times. Self-efficacy and enjoyment were measured at baseline and at twelve months. Statistical analyses were based on a quasi-RCT design (independent t-tests), a comparison of participants and dropouts (Mann-Whitney test), and multilevel modelling to assess change in individual physical activity, including group level characteristics. Participants of CBHEPA programs are socially vulnerable in terms of low education (48.6%), low income (52.4%), non-Dutch origin (64.6%) and health-related quality of life outcomes. Physical activity levels were not below the Dutch average. No increase in physical activity levels over time was observed. The multilevel models showed significant positive associations between health-related quality of life, self-efficacy and enjoyment, and leisure-time physical activity over time. Short CBHEPA programs (10-13 weeks) with multiple trainers and gender-homogeneous groups were associated with lower physical activity levels over time. At twelve months, dropouts' leisure-time physical activity levels were significantly lower compared to continuing participants, as were health-related quality of life, self-efficacy and enjoyment outcomes. BMI and care consumption scored significantly higher among dropouts. In conclusion, Dutch CBHEPA programs reach socially vulnerable, but not necessarily inactive, groups in terms of socio-economic and health-related quality of life outcomes. Our findings suggest that CBHEPA programs particularly contribute to physical activity maintenance in socially vulnerable groups, rather than to an increase in physical activity behaviour over time.

Risk-Reduction Strategies to Expand Radon Care Planning with Vulnerable Groups

PubMed Central

Larsson, Laura S.

2016-01-01

Objectives Radon is the second leading cause of lung cancer in the United States and the leading cause of lung cancer among nonsmokers. Residential radon is the cause of approximately 21,000 U.S. lung cancer deaths each year. Dangerous levels of radon are just as likely to be found in low-rise apartments and townhomes as single-family homes in the same area. The preferred radon mitigation strategy can be expensive and requires structural modifications to the home. The public health nurse (PHN) needs a collection of low-cost alternatives when working with low-income families or families who rent their homes. Method A review of the literature was performed to identify evidence-based methods to reduce radon risk with vulnerable populations. Results Fourteen recommendations for radon risk reduction were categorized into four strategies. Nine additional activities for raising awareness and increasing testing were also included. Discussion The results pair the PHN with practical interventions and the underlying rationale to develop radon careplans with vulnerable families across housing types. The PHN has both the competence and the access to help families reduce their exposure to this potent carcinogen. PMID:24547763

Nutritional vulnerability seen within asylum seekers in Australia.

PubMed

O'Reilly, Sharleen; O'Shea, Tess; Bhusumane, Sibusiso

2012-04-01

To examine the extent of nutritional vulnerability seen in a cohort of asylum seekers in Australia. Twenty-one asylum seekers (15 males, 6 females) that used a food bank were interviewed over a 6 week period at the Melbourne based Asylum Seeker Resource Centre about foods consumed in the previous 24-h and any non food bank foods obtained. A basket audit was conducted after participants accessed the food bank on the day of interview, Participants obtained significantly less than the minimum requirements for the Australian Guide to Healthy Eating in the vegetables and legumes (P < .001, 95% CI -3.5, -1.7) fruits (P < .001, 95% CI -1.7, -.1.2), dairy (P < .001, 95% CI -1.8, -1.5) and meat and meat alternatives core food groups (P = .001, 95% CI -0.8, -0.3) using foods accessed from the food bank, their primary or sole food source. A high level of nutritional vulnerability was seen in this cohort due to their inability to meet minimum nutritional requirements from their primary food access point. Health professionals working with asylum seeker populations need to be aware of this issue and the resulting potential for longer term ill health as a consequence.

Risk-reduction strategies to expand radon care planning with vulnerable groups.

PubMed

Larsson, Laura S

2014-01-01

Radon is the second leading cause of lung cancer in the United States and the leading cause of lung cancer among nonsmokers. Residential radon is the cause of approximately 21,000 U.S. lung cancer deaths each year. Dangerous levels of radon are just as likely to be found in low-rise apartments and townhomes as single-family homes in the same area. The preferred radon mitigation strategy can be expensive and requires structural modifications to the home. The public health nurse (PHN) needs a collection of low-cost alternatives when working with low-income families or families who rent their homes. A review of the literature was performed to identify evidence-based methods to reduce radon risk with vulnerable populations. Fourteen recommendations for radon risk reduction were categorized into four strategies. Nine additional activities for raising awareness and increasing testing were also included. The results pair the PHN with practical interventions and the underlying rationale to develop radon careplans with vulnerable families across housing types. The PHN has both the competence and the access to help families reduce their exposure to this potent carcinogen. © 2014 Wiley Periodicals, Inc.

Locating Spatial Variation in the Association Between Wildland Fire Risk and Social Vulnerability Across Six Southern States

NASA Astrophysics Data System (ADS)

Poudyal, Neelam C.; Johnson-Gaither, Cassandra; Goodrick, Scott; Bowker, J. M.; Gan, Jianbang

2012-03-01

Wildland fire in the South commands considerable attention, given the expanding wildland urban interface (WUI) across the region. Much of this growth is propelled by higher income retirees and others desiring natural amenity residential settings. However, population growth in the WUI increases the likelihood of wildfire fire ignition caused by people, as humans account for 93% of all wildfires fires in the South. Coexisting with newly arrived, affluent WUI populations are working class, poor or otherwise socially vulnerable populations. The latter groups typically experience greater losses from environmental disasters such as wildfire because lower income residents are less likely to have established mitigation programs in place to help absorb loss. We use geographically weighted regression to examine spatial variation in the association between social vulnerability (SOVUL) and wildfire risk. In doing so, we identify "hot spots" or geographical clusters where SOVUL varies positively with wildfire risk across six Southern states—Alabama, Arkansas, Florida, Georgia, Mississippi, and South Carolina. These clusters may or may not be located in the WUI. These hot spots are most prevalent in South Carolina and Florida. Identification of these population clusters can aid wildfire managers in deciding which communities to prioritize for mitigation programming.

Spatial-explicit modeling of social vulnerability to malaria in East Africa

PubMed Central

2014-01-01

Background Despite efforts in eradication and control, malaria remains a global challenge, particularly affecting vulnerable groups. Despite the recession in malaria cases, previously malaria free areas are increasingly confronted with epidemics as a result of changing environmental and socioeconomic conditions. Next to modeling transmission intensities and probabilities, integrated spatial methods targeting the complex interplay of factors that contribute to social vulnerability are required to effectively reduce malaria burden. We propose an integrative method for mapping relative levels of social vulnerability in a spatially explicit manner to support the identification of intervention measures. Methods Based on a literature review, a holistic risk and vulnerability framework has been developed to guide the assessment of social vulnerability to water-related vector-borne diseases (VBDs) in the context of changing environmental and societal conditions. Building on the framework, this paper applies spatially explicit modeling for delineating homogeneous regions of social vulnerability to malaria in eastern Africa, while taking into account expert knowledge for weighting the single vulnerability indicators. To assess the influence of the selected indicators on the final index a local sensitivity analysis is carried out. Results Results indicate that high levels of malaria vulnerability are concentrated in the highlands, where immunity within the population is currently low. Additionally, regions with a lack of access to education and health services aggravate vulnerability. Lower values can be found in regions with relatively low poverty, low population pressure, low conflict density and reduced contributions from the biological susceptibility domain. Overall, the factors characterizing vulnerability vary spatially in the region. The vulnerability index reveals a high level of robustness in regard to the final choice of input datasets, with the exception of the immunity indicator which has a marked impact on the composite vulnerability index. Conclusions We introduce a conceptual framework for modeling risk and vulnerability to VBDs. Drawing on the framework we modeled social vulnerability to malaria in the context of global change using a spatially explicit approach. The results provide decision makers with place-specific options for targeting interventions that aim at reducing the burden of the disease amongst the different vulnerable population groups. PMID:25127688

Salmon and Sagebrush: The Shoshone-Bannock Tribes Collaborative Approach to Adaptation Planning

NASA Astrophysics Data System (ADS)

Petersen, A.; Nasser, E.; Stone, D.; Krosby, M.; Whitley-Binder, L.; Morgan, H.; Rupp, D. E.; Dello, K.; Dalton, M. M.; Fox, M.; Rodgers, K.

2017-12-01

The Shoshone-Bannock Tribes reside in the Upper Snake River Watershed in southeast Idaho. Their lives and culture are intertwined with the lands where they live; lands which continue to sustain the Tribes cultural, spiritual, dietary and economic needs. Climate change presents a new threat to the region requiring innovative approaches to prepare for changes as well as to protect the natural resources within the region. As a critical first step in building climate resilience, the Tribes worked with Adaptation International, the University of Washington's Climate Impacts Group (CIG) and the Oregon Climate Change Research Institute (OCCRI) to complete a collaborative climate change vulnerability assessment and adaptation planning process. This presentation provides an overview of collaborative process, shares the results of the project, and includes a 3-minute video presentation. The project started with the identification of 34 plant and animal species to focus the vulnerability assessment. OCCRI analyzed detailed downscaled climate projections for two key climate scenarios (RCP 4.5 and RCP 8.5) and timescales (2050s and 2080s). CIG then used NatureServe's Climate Change Vulnerability Index (CCVI) to develop initial relative vulnerability results for these species. A core team of Tribal staff members from various departments refined these results, drawing upon and integrating rich local and traditional knowledges of the natural environmental and cultural resources. The adaptation planning phase of the project continued in a similar collaborative manner with the project team identifying promising adaptation actions and working directly with Tribal staff to refine and customize these strategies. Tailoring the actions to the local context provides a framework for action that the Tribes can continue to build on in the future. By engaging in these efforts to identify vulnerable species and adaptation strategies and actions to minimize the negative effects of climate change, the Tribes have demonstrated their continued commitment to protecting their vital natural resources. The Tribes will continue to implement projects across landscapes in the near term and utilize the information co-produced as part of this project to develop long-term strategies and projects to build resilience.

Cultural knowledge and local vulnerability in African American communities

NASA Astrophysics Data System (ADS)

Miller Hesed, Christine D.; Paolisso, Michael

2015-07-01

Policymakers need to know what factors are most important in determining local vulnerability to facilitate effective adaptation to climate change. Quantitative vulnerability indices are helpful in this endeavour but are limited in their ability to capture subtle yet important aspects of vulnerability such as social networks, knowledge and access to resources. Working with three African American communities on Maryland’s Eastern Shore, we systematically elicit local cultural knowledge on climate change and connect it with a scientific vulnerability framework. The results of this study show that: a given social-ecological factor can substantially differ in the way in which it affects local vulnerability, even among communities with similar demographics and climate-related risks; and social and political isolation inhibits access to sources of adaptive capacity, thereby exacerbating local vulnerability. These results show that employing methods for analysing cultural knowledge can yield new insights to complement those generated by quantitative vulnerability indices.

Improving interprofessional practice for vulnerable older people: gaining a better understanding of vulnerability.

PubMed

Abley, Clare; Bond, John; Robinson, Louise

2011-09-01

A key focus for professionals working with older people in the community is on those who are vulnerable, although this vulnerability is not well defined. This study sought the views of health and social care professionals and older people on vulnerability, identifying significant differences between professional and older people's perspectives. It found that for older people, vulnerability is an emotional response to being in a specific situation, whereas for professionals, the vulnerability of those on their case loads relates to them having certain or a combination of characteristics (physical, psychological and social). The paper concludes that interprofessional care for older people in the community could be improved firstly by asking older people if they ever feel vulnerable and if so, in what situations and secondly by focusing team efforts on addressing the issues raised by older people in response to these questions.

Building relations with women's organisations in relief work.

PubMed

Gell, F

1997-02-01

An Oxfam Emergency Team arrived in Ingushetia in the Northern Caucasus region of the former Soviet Union in August 1996 to set up a program of shelter, rehabilitation, and relief in response to the large influx of people displaced by conflicts in the neighboring republics of Chechnya and North Ossetia. The team was also tasked with contacting community organizations such as women's groups and developing a relationship with them through joint relief work. The Chechen population was comprised of mainly women, children, and the elderly. The internally displaced population of 100,000 people is now scattered throughout the republic in collective centers and host families. Small committees of women were formed to help identify the most vulnerable residents and to distribute winter clothing. It was found during the relief work that fledgling women's groups are establishing themselves as vehicles for change, increasingly open to work with and learn from international organizations such as Oxfam. The Chechen branch of the Union of North Caucasian Women and the Ingushetian ALMOS played leading roles in peacemaking, human rights observance, and humanitarian relief.

Lack of evidence on mental health and well-being impacts of individual-level interventions for vulnerable adolescents: systematic mapping review.

PubMed

Vojt, G; Skivington, K; Sweeting, H; Campbell, M; Fenton, C; Thomson, H

2018-05-30

To review empirical evaluations of individual-level interventions intended to improve mental health or well-being for vulnerable adolescents. This is a systematic mapping review. Thirteen databases covering academic and gray literature were searched for published reviews and randomised controlled trials, and gray literature (2005-2016) and the results quality-assessed to prioritise best available evidence. We aimed to identify well-conducted systematic reviews and trials that evaluated individual-level interventions, for mental health/well-being outcomes, where the population was adolescents aged 10-24 years in any of 12 vulnerable groups at high risk of poor health outcomes (e.g. homeless, offenders, 'looked after', carers). Thirty systematic reviews and 16 additional trials were identified. There was insufficient evidence to identify promising individual-level interventions that improve the mental health/well-being of any of the vulnerable groups. Despite Western policy to promote health and well-being among vulnerable young people, the dearth of evidence suggests a lack of interest in evaluating interventions targeting these groups in respect of their mental health/well-being outcomes. Copyright © 2018 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Psychosocial Vulnerability Among Patients Contacting a Norwegian Sexual Assault Center.

PubMed

Vik, Bjarte Frode; Nöttestad, Jim Aage; Schei, Berit; Rasmussen, Kirsten; Hagemann, Cecilie Therese

2016-07-01

In this study, the objective was to assess the occurrence of specific vulnerability factors among adult and adolescent females attending a Norwegian sexual assault center (SAC). We also explored assault characteristics and investigated whether these characteristics differed between the group of patients with vulnerability factors compared with the group without such factors. We conducted a retrospective descriptive study of 573 women ≥ 12 years of age attending the SAC at St. Olavs Hospital, Trondheim, Norway, between July 1, 2003 and December 31, 2010. A patient was considered vulnerable if at least one of the following features was present: intellectual or physical disability; history of present/former mental health problems; history of present/former alcohol/substance abuse; or former sexual assault. At least one vulnerability factor was present in 59% of the cases. More than one vulnerability factor was present in 29%. Reporting at least one vulnerability factor was associated with a higher patient age, unemployment, a higher frequency of reported light/moderate physical violence, and the documentation of minor body injury. In contrast, those without vulnerability more often were students assaulted during night time, by a casual or stranger assailant and reporting a higher intake of alcohol prior to the assault. There are obvious patterns of differences in the nature of sexual assaults reported among victims with specific vulnerability factors compared with victims without these factors. Future research should address these differences and possible solutions for better protection of especially vulnerable individuals against sexual offenses, such as those with mental health and substance abuse difficulties.

Tensions of network security and collaborative work practice: understanding a single sign-on deployment in a regional hospital.

PubMed

Heckle, Rosa R; Lutters, Wayne G

2011-08-01

Healthcare providers and their IT staff, working in an effort to balance appropriate accessibility with stricter security mandates, are considering the use of a single network sign-on approach for authentication and password management. Single sign-on (SSO) promises to improve usability of authentication for multiple-system users, increase compliance, and help curb system maintenance costs. However, complexities are introduced when SSO is placed within a collaborative environment. These complexities include unanticipated workflow implications that introduce greater security vulnerability for the individual user. OBJECTIVES AND METHODOLOGY: In this work, we examine the challenges of implementing a single sign-on authentication technology in a hospital environment. The aim of the study was to document the factors that affected SSO adoption within the context of use. The ultimate goal is to better inform the design of usable authentication systems within collaborative healthcare work sites. The primary data collection techniques used are ethnographically informed - observation, contextual interviews, and document review. The study included a cross-section of individuals from various departments and varying rolls. These participants were a mix of both clinical and administrative staff, as well as the Information Technology group. The field work revealed fundamental mis-matches between the technology and routine work practices that will significantly impact its effective adoption. While single sign-on was effective in the administrative offices, SSO was not a good fit for collaborative areas. The collaborative needs of the clinical staff unearthed tensions in its implementation. An analysis of the findings revealed that the workflow, activities, and physical environment of the clinical areas create increased security vulnerabilities for the individual user. The clinical users were cognizant of these vulnerabilities and this created resistance to the implementation due to a concern for privacy. From a preliminary analysis of our on-going field study at a community hospital, there appears to be a number of mismatches between the SSO vision and the realities of routine work. While we cannot conclusively say if a SSO adoption will be effective in meeting its goals in a hospital environment, we do know that it will affect the work practice and that will make the management of the SSO system problematic. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

IPCC Working Group II: Impacts and Adaptation Part I

NASA Astrophysics Data System (ADS)

Pulwarty, R. S.

2007-12-01

The IPCC (as opposed to the UN Framework Convention) defines climate change as" any change in climate over time, whether due to natural variability or as a result of human activity". The IPCC Working Group II (Impacts, Adaptation, Vulnerability) was charged with assessing the scientific, technical, environmental, economic, and social aspects of vulnerability to climate change, and, the negative and positive consequences for ecological systems, socio-economic sectors, and human health. The Working Group II report focused on the following issues for different sectors and regions (e.g. water, agriculture, biodiversity) and communities (coastal, island, etc.): · The role of adaptation in reducing vulnerability and impacts, · Assessment of adaptation capacity, options and constraints, and · Enhancing adaptation practice and operations. This presentation will address the following questions in the context of the results of the IPCC Fourth Assessment Report WG II: · What are the barriers, knowledge gaps, and opportunities for impacts assessments? · How are decisions about adaptation being made, and what types of adaptation strategies are being undertaken? · What are good adaptation practices and how are they learned over time? Examples will be drawn from the freshwater resources, small islands and adaptation chapters to which the presenter contributed. Many lessons have been identified but few have been implemented or evaluated over time. Adaptation occurs in the context of multiple stresses. Adaptation will be important in coping with early impacts in the near-term and continue to be important as our climate changes, regardless of how that change is derived. It is important to note that unmitigated climate change could, in the long term, exceed the capacity of different natural, managed and human systems to adapt. The assessment leads to the following conclusions: · Adaptation to climate change is already taking place, but on a limited basis · Adaptation measures are seldom undertaken in response to climate change alone · Many adaptations can be implemented at low cost, but comprehensive estimates of adaptation costs and benefits are currently lacking · Adaptive capacity is uneven across and within societies Adaptive capacity to manage as climate changes can be increased by introducing adaptation measures into development planning and operations (sometimes termed 'mainstreaming'). This can be achieved by including adaptation measures in land-use planning and infrastructure design, or by including measures to reduce vulnerability in existing disaster preparedness programs (such as introducing drought warning systems based on actual management needs). The major barriers to implementing adaptive management measures are that adaptation to climate change is not as yet a high priority, and the validity of local manifestations of global climate change remains in question. Coping with the uncertainties associated with estimates of future climate change and the impacts on economic and environmental resources means management measures must be robust enough to apply to a range of potential scenarios, some as yet undefined Greenhouse gas mitigation is not enough to reduce climatic risks, nor does identifying the need for adaptations translate into actions that reduce vulnerability. By implementing mainstreaming initiatives, adaptation to climate change will become part of, or will be consistent with, other well- established programs to increase societal resilience, particularly environmental impacts assessments, adaptive management

How sex work becomes an option: Experiences of female sex workers in Kerman, Iran.

PubMed

Karamouzian, Mohammad; Foroozanfar, Zohre; Ahmadi, Azal; Haghdoost, Ali Akbar; Vogel, Joanna; Zolala, Farzaneh

2016-01-01

Sex work is rarely an occupation of choice for Iranian women and is often described as a last resort. While several factors play a role in creating an environment where individuals become involved in sex work, female sex workers' experiences regarding entry into sex work in Iran are poorly understood. In this qualitative study, a convenience sample of 24 participants was recruited from a drop-in centre for vulnerable women in Kerman, Iran. Through in-depth interviews, participants were asked about their personal lived experiences of initiating sex work. Grounded theory was used to analyse findings from this research. We learned that major factors impacting on women's initiation into sex work circulated around their vulnerability and chronic poverty. Participants continued to sell sex due to their limited opportunities, drug dependence and financial needs. Improving sex workers' economic status could be a vital intervention in providing vulnerable women with options other than sex work. Female sex workers should be provided with government support and educational programmes delivered through special centres. Despite the illegal status of their work, sex workers' needs should be recognised across all aspects of policy and legislation.

Biofeedback Training in Crisis Managers: A Randomized Controlled Trial.

PubMed

Janka, A; Adler, C; Brunner, B; Oppenrieder, S; Duschek, S

2017-06-01

Working in crisis environments represents a major challenge, especially for executive personnel engaged in directing disaster operations, i.e. crisis managers. Crisis management involves operating under conditions of extreme stress resulting, for instance, from high-level decision-making, principal responsibility for personnel, multitasking or working under conditions of risk and time pressure. The present study aimed to investigate the efficacy of a newly developed biofeedback training procedure based on electrodermal activity, especially designed for the target group of crisis managers. The training comprised exercises promoting acquisition of control over sympathetic arousal under resting conditions and during exposure to visual, acoustic and cognitive stressors resembling situations related to crisis management. In a randomized controlled design, 36 crisis managers were assigned to either a biofeedback training group or waiting list control group. Subjective stress was assessed using the Perceived Stress Scale. In the training group, stress level markedly decreased; the decrease remained stable at follow-up 2 months after the training. The results indicate that biofeedback training in crisis management is an effective method for stress management that may help to reduce vulnerability to stress-related performance decline and stress-related disease.

[Vulnerability and health problems while traveling: the viewpoint of the tourist in the city of Rio de Janeiro].

PubMed

Matos, Vanina; Barcellos, Christovam; Camargo, Luiz Octávio de Lima

2013-01-01

This article examines how a group of tourists perceives health issues related to safety, prevention and health care during their travels. Interviews were conducted with Brazilian tourists visiting the city of Rio de Janeiro, as well as local residents leaving the city on trips. The interviews were analyzed in accordance with the dimensions of vulnerability, information, prevention and health care, from which vulnerability emerged as a category of analysis. The reports of the trajectory of the tourists made it possible to identify problems and opportunities that could be used by the health sector for actions of prevention and promotion. The means of transport determines the trajectory of tourists and their security alternatives. Traveling in groups and visiting tourist attractions are seen as protective factors, which reinforces the role of information and social support networks as resources used by tourists in the absence of specific policies geared to this highly mobile and vulnerable population group.

Earthquake Vulnerability Assessment for Hospital Buildings Using a Gis-Based Group Multi Criteria Decision Making Approach: a Case Study of Tehran, Iran

NASA Astrophysics Data System (ADS)

Delavar, M. R.; Moradi, M.; Moshiri, B.

2015-12-01

Nowadays, urban areas are threatened by a number of natural hazards such as flood, landslide and earthquake. They can cause huge damages to buildings and human beings which necessitates disaster mitigation and preparation. One of the most important steps in disaster management is to understand all impacts and effects of disaster on urban facilities. Given that hospitals take care of vulnerable people reaction of hospital buildings against earthquake is vital. In this research, the vulnerability of hospital buildings against earthquake is analysed. The vulnerability of buildings is related to a number of criteria including age of building, number of floors, the quality of materials and intensity of the earthquake. Therefore, the problem of seismic vulnerability assessment is a multi-criteria assessment problem and multi criteria decision making methods can be used to address the problem. In this paper a group multi criteria decision making model is applied because using only one expert's judgments can cause biased vulnerability maps. Sugeno integral which is able to take into account the interaction among criteria is employed to assess the vulnerability degree of buildings. Fuzzy capacities which are similar to layer weights in weighted linear averaging operator are calculated using particle swarm optimization. Then, calculated fuzzy capacities are included into the model to compute a vulnerability degree for each hospital.

Characterization of Vulnerable and Resilient Spanish Adolescents in Their Developmental Contexts

PubMed Central

Moreno, Carmen; García-Moya, Irene; Rivera, Francisco; Ramos, Pilar

2016-01-01

Research on resilience and vulnerability can offer very valuable information for optimizing design and assessment of interventions and policies aimed at fostering adolescent health. This paper used the adversity level associated with family functioning and the positive adaptation level, as measured by means of a global health score, to distinguish four groups within a representative sample of Spanish adolescents aged 13–16 years: maladaptive, resilient, competent and vulnerable. The aforementioned groups were compared in a number of demographic, school context, peer context, lifestyles, psychological and socioeconomic variables, which can facilitate or inhibit positive adaptation in each context. In addition, the degree to which each factor tended to associate with resilience and vulnerability was examined. The majority of the factors operated by increasing the likelihood of good adaptation in resilient adolescents and diminishing it in vulnerable ones. Overall, more similarities than differences were found in the factors contributing to explaining resilience or vulnerability. However, results also revealed some differential aspects: psychological variables showed a larger explicative capacity in vulnerable adolescents, whereas factors related to school and peer contexts, especially the second, showed a stronger association with resilience. In addition, perceived family wealth, satisfaction with friendships and breakfast frequency only made a significant contribution to the explanation of resilience. The current study provides a highly useful characterization of resilience and vulnerability phenomena in adolescence. PMID:27458397

Cognitive style, personality and vulnerability to postnatal depression.

PubMed

Jones, Lisa; Scott, Jan; Cooper, Caroline; Forty, Liz; Smith, Katherine Gordon; Sham, Pak; Farmer, Anne; McGuffin, Peter; Craddock, Nick; Jones, Ian

2010-03-01

Only some women with recurrent major depressive disorder experience postnatal episodes. Personality and/or cognitive styles might increase the likelihood of experiencing postnatal depression. To establish whether personality and cognitive style predicts vulnerability to postnatal episodes over and above their known relationship to depression in general. We compared personality and cognitive style in women with recurrent major depressive disorder who had experienced one or more postnatal episodes (postnatal depression (PND) group, n=143) with healthy female controls (control group, n=173). We also examined parous women with recurrent major depressive disorder who experienced no perinatal episodes (non-postnatal depression (NPND) group, n=131). The PND group had higher levels of neuroticism and dysfunctional beliefs, and lower self-esteem than the control group. However, there were no significant differences between the PND and NPND groups. Established personality and cognitive vulnerabilities for depression were reported by women with a history of postnatal depression, but there was no evidence that any of these traits or styles confer a specific risk for the postnatal onset of episodes.

Collecting data to evaluate the effect of health policies on vulnerable populations.

PubMed

Bindman, A B; Grumbach, K; Keane, D; Lurie, N

1993-02-01

Public health policies often have disproportionate effects on the poor and other vulnerable groups. Standard survey techniques are often difficult to apply to these vulnerable populations, and many data bases systematically omit such individuals. The purpose of this paper is to review our experience in collecting primary survey data from public hospital, mentally ill, HIV-infected, and non-English-speaking patients. Important issues in conducting research on these populations include proper selection of subjects and comparison groups and difficulties involved in recruitment and enrollment of subjects. Maintaining longitudinal data on these populations is difficult and often requires tracking, secondary contacts, home visits and community outreach, and the use of organizations, institutions, and networks. Investigators must also pay careful attention to ethical issues involved in conducting research on vulnerable populations.

Depression vulnerable and nonvulnerable smokers after a failure experience: examining cognitive self-regulation and motivation.

PubMed

Scott, Walter D; Beevers, Christopher G; Mermelstein, Robin J

2008-07-01

The present study extended previous tests of cognitive priming theories of depression by examining cognitive self-regulatory, motivational, and affective functioning of depression-vulnerable and nonvulnerable individuals after a failure experience. Participants were enrolled in a clinic-based smoking cessation program that consisted of seven group meetings. Major findings show that compared to the nonvulnerable group, depression-vulnerable individuals were less motivated to quit and experienced more negative affect, but only after a failure to quit smoking. However, after controlling for actual smoking rate, depression-vulnerable individuals did not evaluate their success any more negatively, nor did they indicate lower self-efficacy for quitting. Results are discussed in terms of cognitive self-regulatory and affect temperament models of motivation and depression.

Meta-Synthesis of Literacy for the Empowerment of Vulnerable Groups

ERIC Educational Resources Information Center

Camilli-Trujillo, Celia; Römer-Pieretti, Max

2017-01-01

The vulnerability translates in concrete human groups that, although they know what occurs around them in a digital matter, by his own social and cultural condition they are alienated and, in this sense, away of the exercise of the information right. The aim has been to analyze the critical, media and digital literacy for the empowerment of…

Gendered depression: Vulnerability or exposure to work and family stressors?

PubMed

Marchand, Alain; Bilodeau, Jaunathan; Demers, Andrée; Beauregard, Nancy; Durand, Pierre; Haines, Victor Y

2016-10-01

Research has shown that employed women are more prone to depression than men, but the pathways linking gender to depression remain poorly understood. The aim of this study was to examine how work and family conditions operated as potentially gendered antecedents of depression. It evaluated more specifically how differences in depressive symptoms in women and men could be explained by their differential vulnerability and exposure to work and family conditions, as well as by the mediating role of work-to-family conflict (WFC) and family-to-work conflict (FWC). Data were collected in 2009-2012 from a sample of 1935 employees (48.9% women) nested in 63 workplaces in the province of Quebec (Canada). Data were analyzed with multilevel path analysis models to test for the differential exposure hypothesis, and stratified by gender to test for the differential vulnerability hypothesis. Results supported both hypothesizes, but only WFC played a mediating role between work-family stressors and depression. Regarding the vulnerability hypothesis, WFC was more strongly associated with women depressive symptoms, and the magnitude of the association between family income and WFC was stronger for women. Overall, the differential exposure hypothesis seemed to reach a greater empirical support. After accounting for work and family stressors as well as WFC, differences in depressive symptoms in women and men were no longer significantly, as WFC, working hours, irregular work schedule and skill utilization acted as mediators. WFC associated with higher depressive symptoms and skill utilization with lower depressive symptoms. WFC related to higher working hours and irregular work schedule. Compared to men, women reported higher WFC, but lower working hours, less irregular work schedule and lower skill utilization at work. Women's higher rate of depression is intrinsically linked to their different social experiences as shaped by a gendered social structure and gendered organizations. Copyright © 2016 Elsevier Ltd. All rights reserved.

Racial and Ethnic Differences in Factors Related to Work Place Violence Victimization

PubMed Central

Sabri, Bushra; St. Vil, Noelle M.; Campbell, Jacquelyn C.; Fitzgerald, Sheila; Kub, Joan; Agnew, Jacqueline

2014-01-01

Work place violence (WPV) is a significant public health concern affecting all racial or ethnic groups. This study examined whether different racial/ethnic groups differed in vulnerability to WPV exposure and utilization of resources at the workplace. This cross sectional research focused on White, Black and Asian nursing employees (N=2033) employed in four health care institutions in a Mid-Atlantic US metropolitan area. While childhood physical abuse was significantly related to risk for WPV among workers from all racial/ethnic backgrounds, intimate partner abuse was a significant factor for Asians and Whites. Blacks and Asians were found to be less likely than Whites to be knowledgeable about WPV resources or use resources to address WPV. Services to address past trauma, and education and training opportunities for new workers may reduce risk for WPV and promote resource utilization among minority workers. PMID:24658287

Do Work Characteristics Predict Health Deterioration Among Employees with Chronic Diseases?

PubMed

de Wind, Astrid; Boot, Cécile R L; Sewdas, Ranu; Scharn, Micky; van den Heuvel, Swenne G; van der Beek, Allard J

2018-06-01

Purpose In our ageing workforce, the increasing numbers of employees with chronic diseases are encouraged to prolong their working lives. It is important to prevent health deterioration in this vulnerable group. This study aims to investigate whether work characteristics predict health deterioration over a 3-year period among employees with (1) chronic diseases, and, more specifically, (2) musculoskeletal and psychological disorders. Methods The study population consisted of 5600 employees aged 45-64 years with a chronic disease, who participated in the Dutch Study on Transitions in Employment, Ability and Motivation (STREAM). Information on work characteristics was derived from the baseline questionnaire. Health deterioration was defined as a decrease in general health (SF-12) between baseline and follow-up (1-3 years). Crude and adjusted logistic regression analyses were performed to investigate prediction of health deterioration by work characteristics. Subgroup analyses were performed for employees with musculoskeletal and psychological disorders. Results At follow-up, 19.2% of the employees reported health deterioration (N = 1075). Higher social support of colleagues or supervisor predicted health deterioration in the crude analyses in the total group, and the groups with either musculoskeletal or psychological disorders (ORs 1.11-1.42). This effect was not found anymore in the adjusted analyses. The other work characteristics did not predict health deterioration in any group. Conclusions This study did not support our hypothesis that work characteristics predict health deterioration among employees with chronic diseases. As our study population succeeded continuing employment to 45 years and beyond, it was probably a relatively healthy selection of employees.

Repercussions of violence on the mental health of workers of the Family Health Program.

PubMed

Lancman, Selma; Ghirardi, Maria Isabel Garcez; Castro, Eliane Dias de; Tuacek, Tatiana Amodeo

2009-08-01

To describe forms of external and indirect violence that affect the mental health of workers of the Programa Saúde da Família (Family Health Program), as well as the strategies developed by these workers to enable their work and to be psychologically protected. Qualitative study on the Programa Saúde da Família work process, performed in the cities of São Paulo, Ribeirão Preto and Embu (Southeastern Brazil) in 2005. Theoretical approach of psychodynamics of work, which proposes the formation of reflection groups with workers, was employed. Subjective aspects of work, situations of psychological suffering and strategies used by workers to deal with suffering and continue to work were sought to be identified. The Program's work organization exposed workers to the following: situations of violence, invisible at times; feeling of impotence in the face of precarious situations; lack of acknowledgement of efforts made; lack of borders between professional and personal aspects; intense experiences of social and domestic violence; fear of risk of exposure; feeling of moral and physical integrity being threatened; and fear of reprisal. Situations of psychological suffering resulting from violence in the workplace were observed. These became more intense in the Programa Saúde da Família due to regular contact with situations of violence that cause fear and a feeling of vulnerability. Psychological repercussions caused by violence in the workplace, not always expressed in the form of psychological disorders, were observed in situations of intense suffering. Workers develop strategies to minimize suffering, protect themselves psychologically and continue to work; and seek to create solidarity and protection networks with the population, aiming to reduce vulnerability. With the experience gained, they learn to detect high-risk situations, avoiding those they believe to be threatening.

Sexual and physical violence against female sex workers in Kenya: a qualitative enquiry.

PubMed

Okal, Jerry; Chersich, Matthew F; Tsui, Sharon; Sutherland, Elizabeth; Temmerman, Marleen; Luchters, Stanley

2011-05-01

Few studies in Africa provide detailed descriptions of the vulnerabilities of female sex workers (FSW) to sexual and physical violence, and how this impacts on their HIV risk. This qualitative study documents FSW's experiences of violence in Mombasa and Naivasha, Kenya. Eighty-one FSW who obtained clients from the streets, transportation depots, taverns, discos and residential areas were recruited through local sex workers trained as peer counsellors to participate in eight focus-group discussions. Analysis showed the pervasiveness of sexual and physical violence among FSW, commonly triggered by negotiation around condoms and payment. Pressing financial needs of FSW, gender-power differentials, illegality of trading in sex and cultural subscriptions to men's entitlement for sex sans money underscore much of this violence. Sex workers with more experience had developed skills to avoid threats of violence by identifying potentially violent clients, finding safer working areas and minimising conflict with the police. Addressing violence and concomitant HIV risks and vulnerabilities faced by FSW should be included in Kenya's national HIV/AIDS strategic plan. This study indicates the need for multilevel interventions, including legal reforms so that laws governing sex work promote the health and human rights of sex workers in Kenya.

Health and Occupational Outcomes Among Injured, Nonstandard Shift Workers.

PubMed

Wong, Imelda S; Smith, Peter M; Mustard, Cameron A; Gignac, Monique A M

2015-11-01

This study compares health and occupational outcomes following a work-related injury for nonstandard and day-shift workers. National Population Health Survey data were used to explore outcomes 2 years post-work injury. Retrospective-matched cohort analyses examined main effects and interactions of shift schedule and work injury with changes in health, shift schedule, and labor force status. Models were adjusted for respondent characteristics, baseline health status, and occupational strength requirements. Injured nonstandard shift workers reported lower health utility index scores, compared with uninjured and injured daytime workers and uninjured nonstandard-shift workers. No significant interactions between shift and injury were found with schedule change and leaving the labor force. Injured nonstandard-shift workers are as likely to remain employed as other groups, but may be vulnerable in terms of diminished health.

Malcolm MacLachlan: International Humanitarian Award.

PubMed

2014-11-01

The International Humanitarian Award recognizes extraordinary humanitarian services and activism by psychologists, including professional and volunteer work conducted primarily in the field with under-served populations. Award recipients are psychologists who, by their extraordinary service at a difficult time, improve the lives and contribute to the well-being of people in a large or small geographic area anywhere in the world. The 2014 recipient is Malcolm MacLachlan. "Focused on the rights and empowerment of vulnerable and marginalized groups, Malcolm MacLachlan's work synthesizes health, rehabilitation, and organizational and political psychology to promote social inclusion and global health." MacLachlan's award citation, biography, and selected bibliography are presented here. PsycINFO Database Record (c) 2014 APA, all rights reserved.

How Researchers Define Vulnerable Populations in HIV/AIDS Clinical Trials

PubMed Central

Lo, Bernard; Strauss, Ronald P.; Eron, Joseph; Gifford, Allen L.

2010-01-01

In this study, we interviewed researchers, asking them to define vulnerable populations in HIV/AIDS clinical trials, and provide feedback on the federal regulations for three vulnerable populations. Interview data informed a conceptual framework, and were content analyzed to identify acceptability or disagreement with the regulations. Beginning with several characteristics of vulnerable enrollees identified by researchers, the conceptual framework illustrates possible scenarios of how enrollees could be considered vulnerable in clinical research. Content analysis identified barriers affecting HIV/AIDS researchers’ ability to conduct clinical trials with pregnant women, prisoners, and children, for which the regulations specify additional protections. This study challenges current thinking about federal regulations’ group-based approach to defining vulnerable populations. PMID:20721614

THE IMPACT OF CONSTRUCTION AND GENTRIFICATION ON AN OUTDOOR TRANS SEX WORK ENVIRONMENT: VIOLENCE, DISPLACEMENT AND POLICING.

PubMed

Lyons, Tara; Krüsi, Andrea; Pierre, Leslie; Small, Will; Shannon, Kate

2017-12-01

The objective of this study was to investigate how environmental and structural changes to a trans outdoor work environment impacted sex workers in Vancouver, Canada. The issue of changes to the work area arose during qualitative interviews with 33 trans sex workers. In response, ethnographic walks that incorporated photography were undertaken with trans sex workers. Changes to the work environment were found to increase vulnerabilities to client violence, displace trans sex workers, and affect policing practices. Within a criminalized context, construction and gentrification enhanced vulnerabilities to violence and harassment from police and residents.

Larval ecomorphology of 13 Libellulidae (Anisoptera, Odonata) of the Middle Rio Doce Valley, Minas Gerais, Brazil.

PubMed

Giacomini, H C; De Marco, P

2008-02-01

In the lakes of the Middle Rio Doce, Minas Gerais (MG), two groups of larval Libellulidae are distinguished by preferences of habitat use: one uses mainly aquatic macrophytes and the other uses the bottom substrate. The goal of this work was to verify if there is a morphological distinction between the two groups of species. Thirteen body measures were taken from the larvae and analyzed. No difference was found between the two groups of species regarding the body size, but shape differences were observed for two morphological variables. The species that use mainly macrophytes tend to have larger relative measures of the labium and smaller measures of the abdomen width. Advantages in resource obtainment and in vulnerability to predation are probably the explanations for the morphological divergence among these larval groups.

Physical, Structural and Operational Vulnerability of Critical Facilities in Valle de Chalco Solidaridad, Estado de Mexico, Mexico. Case of study: Avándaro, San Isidro and El Triunfo

NASA Astrophysics Data System (ADS)

Garcia Payne, D. G.; Novelo-Casanova, D. A.; Ponce-Pacheco, A. B.; Espinosa-Campos, O.; Huerta-Parra, M.; Reyes-Pimentel, T.; Rodriguez, F.; Benitez-Olivares, I.

2010-12-01

Valle de Chalco Solidaridad is located in Mexico City Metropolitan Area in Estado de Mexico, Mexico. In this town there is a sewage canal called “La Compañía”. A wall of this canal collapsed on February 5, 2010 due to heavy rains creating the flooding of four surrounding communities. It is important to point out that this area is frequently exposed to floods. In this work, we consider a critical facility as an essential structure for performance, health care and welfare within a community or/and as a place that can be used as shelter in case of emergency or disaster. Global vulnerability (the sum of the three measured vulnerabilities) of the 25 critical facilities identified in the locations of Avándaro, San Isidro and El Triunfo was assessed using the Community Vulnerability Assessment Tool developed by the National Oceanic and Atmospheric Administration (NOAA). For each critical facility we determined its operational, structural and physical vulnerabilities. For our analysis, we considered the four main natural hazards to which Valle de Chalco is exposed: earthquakes, floods, landslides and sinking. We considered five levels of vulnerability using a scale from 1 to 5, where values range from very low to very high vulnerability, respectively. A critical facilities database was generated by collecting general information for three categories: schools, government and church. Each facility was evaluated considering its location in relation to identified high-risk areas. Our results indicate that in average, the global vulnerability of all facilities is low, however, there are particular cases in which this global vulnerability is high. The average operational vulnerability of the three communities is moderate. The global structural vulnerability (sum of the structural vulnerability for the four analyzed hazards) is moderate. In particular, the structural vulnerability to earthquakes is low, to landslides is very low, to flooding is moderate and to sinking is low. Due to the location of the critical facilities, its global physical vulnerability (sum of the physical vulnerability to the four analyzed hazards) is moderate. Only three facilities have very high physical vulnerability to floods. Churches (six facilities) have the highest operational vulnerability, whereas its structural vulnerability is the lowest. Schools (13 facilities) have the lowest operational vulnerability, nevertheless, there are two schools with very high vulnerability. Regarding the six government facilities, we identified that their structural vulnerability range from moderate to high. As a result of this work, we believe in the importance of strengthening the culture of civil protection within the critical facilities of the communities of Valle de Chalco.

Environmental Health Related Socio-Spatial Inequalities: Identifying “Hotspots” of Environmental Burdens and Social Vulnerability

PubMed Central

Shrestha, Rehana; Flacke, Johannes; Martinez, Javier; van Maarseveen, Martin

2016-01-01

Differential exposure to multiple environmental burdens and benefits and their distribution across a population with varying vulnerability can contribute heavily to health inequalities. Particularly relevant are areas with high cumulative burdens and high social vulnerability termed as “hotspots”. This paper develops an index-based approach to assess these multiple burdens and benefits in combination with vulnerability factors at detailed intra-urban level. The method is applied to the city of Dortmund, Germany. Using non-spatial and spatial methods we assessed inequalities and identified “hotspot” areas in the city. We found modest inequalities burdening higher vulnerable groups in Dortmund (CI = −0.020 at p < 0.05). At the detailed intra-urban level, however, inequalities showed strong geographical patterns. Large numbers of “hotspots” exist in the northern part of the city compared to the southern part. A holistic assessment, particularly at a detailed local level, considering both environmental burdens and benefits and their distribution across the population with the different vulnerability, is essential to inform environmental justice debates and to mobilize local stakeholders. Locating “hotspot” areas at this detailed spatial level can serve as a basis to develop interventions that target vulnerable groups to ensure a health conducive equal environment. PMID:27409625

Recognizing Risk and Vulnerability in Research Ethics: Imagining the "What Ifs?"

PubMed

Peter, Elizabeth; Friedland, Judith

2017-04-01

Research ethics committees (RECs) may misunderstand the vulnerability of participants, given their distance from the field. What RECs identify as the vulnerabilities that were not adequately recognized in protocols and how they attempt to protect the perceived vulnerability of participants and mitigate risks were examined using the response letters sent to researchers by three university-based RECs. Using a critical qualitative method informed by feminist ethics, we identified an overarching theme of recognizing and responding to cascading vulnerabilities and four subthemes: identifying vulnerable groups, recognizing potentially risky research, imagining the "what ifs," and mitigating perceived risks. An ethics approach that is up-close, as opposed to distant, is needed to foster closer relationships among participants, researchers, and RECs and to understand participant vulnerability and strength better.

Mining Bug Databases for Unidentified Software Vulnerabilities

DOE Office of Scientific and Technical Information (OSTI.GOV)

Dumidu Wijayasekara; Milos Manic; Jason Wright

2012-06-01

Identifying software vulnerabilities is becoming more important as critical and sensitive systems increasingly rely on complex software systems. It has been suggested in previous work that some bugs are only identified as vulnerabilities long after the bug has been made public. These vulnerabilities are known as hidden impact vulnerabilities. This paper discusses the feasibility and necessity to mine common publicly available bug databases for vulnerabilities that are yet to be identified. We present bug database analysis of two well known and frequently used software packages, namely Linux kernel and MySQL. It is shown that for both Linux and MySQL, amore » significant portion of vulnerabilities that were discovered for the time period from January 2006 to April 2011 were hidden impact vulnerabilities. It is also shown that the percentage of hidden impact vulnerabilities has increased in the last two years, for both software packages. We then propose an improved hidden impact vulnerability identification methodology based on text mining bug databases, and conclude by discussing a few potential problems faced by such a classifier.« less

Legal physician-assisted dying in Oregon and the Netherlands: evidence concerning the impact on patients in "vulnerable" groups.

PubMed

Battin, Margaret P; van der Heide, Agnes; Ganzini, Linda; van der Wal, Gerrit; Onwuteaka-Philipsen, Bregje D

2007-10-01

Debates over legalisation of physician-assisted suicide (PAS) or euthanasia often warn of a "slippery slope", predicting abuse of people in vulnerable groups. To assess this concern, the authors examined data from Oregon and the Netherlands, the two principal jurisdictions in which physician-assisted dying is legal and data have been collected over a substantial period. The data from Oregon (where PAS, now called death under the Oregon Death with Dignity Act, is legal) comprised all annual and cumulative Department of Human Services reports 1998-2006 and three independent studies; the data from the Netherlands (where both PAS and euthanasia are now legal) comprised all four government-commissioned nationwide studies of end-of-life decision making (1990, 1995, 2001 and 2005) and specialised studies. Evidence of any disproportionate impact on 10 groups of potentially vulnerable patients was sought. Rates of assisted dying in Oregon and in the Netherlands showed no evidence of heightened risk for the elderly, women, the uninsured (inapplicable in the Netherlands, where all are insured), people with low educational status, the poor, the physically disabled or chronically ill, minors, people with psychiatric illnesses including depression, or racial or ethnic minorities, compared with background populations. The only group with a heightened risk was people with AIDS. While extralegal cases were not the focus of this study, none have been uncovered in Oregon; among extralegal cases in the Netherlands, there was no evidence of higher rates in vulnerable groups. Where assisted dying is already legal, there is no current evidence for the claim that legalised PAS or euthanasia will have disproportionate impact on patients in vulnerable groups. Those who received physician-assisted dying in the jurisdictions studied appeared to enjoy comparative social, economic, educational, professional and other privileges.

Mental health and parenting characteristics of caregivers of children with spina bifida.

PubMed

Malm-Buatsi, Elizabeth; Aston, Christopher E; Ryan, Jamie; Tao, Yeun; Palmer, Blake W; Kropp, Bradley P; Klein, Jake; Wisniewski, Amy B; Frimberger, Dominic

2015-04-01

Within the chronic medical illness literature, associations exist between caring for an affected child and parent mental health. The few studies examining both mothers and fathers provide mixed results. The purpose of this study is to examine associations between caregiver anxiety, depression, and parenting variables in caregivers of youth with SB as these relate to marital status, age, education, household income, work status, and child's severity of SB. The aim of this study is to examine associations between anxiety, depression, and parenting variables in caregivers of youth with spina bifida and how they relate to demographic and disease variables. Exploratory analyses examined the relationship between participation in support activities and depressive and anxious symptomatology and parenting characteristics. Eighty-four primary caregivers (49 mothers) of 51 youth with spina bifida completed measures of depressive and anxious symptomology, parenting stress, parent overprotection, and perceived child vulnerability. There were differences between mothers and fathers on several parenting characteristics; however, these were related more to marital status and employment than to gender of the caretaker per se. In the 33 married/remarried couples for whom both spouses participated, stress for the mothers was correlated with stress for the fathers. This correlation was strongest in the 12 married couples in which the mother works. Higher perceived vulnerability scores were reported in parents of SB patients in the younger age group, especially preschoolers (0-4 years). Parents of children with shunts reported more anxiety, depression and perceived child vulnerability. Both male and female caregivers of younger children reported significantly higher protectiveness scores. Involvement in recreational activities with other families affected by SB was associated with more positive parenting characteristics for mothers. Stress and protectiveness were found to be positively correlated (r > 0.6); depression, anxiety, and perceived vulnerability were not (0.3 < r < -0.3). Overall, mothers reported more stress and anxiety than fathers. Higher perceived vulnerability scores were reported in parents of SB patients in the younger age group, especially preschoolers (0-4 years). Parents of children with shunts reported more anxiety, depression and perceived child vulnerability. Both male and female caregivers of younger children reported significantly higher protectiveness scores compared to caregivers of older children. Involvement in recreational activities with other families affected by SB was associated with more positive parenting characteristics for mothers. There were differences between mothers and fathers on several parenting characteristics; however, these were related more to marital status and employment than to gender of the caretaker per se. Limitations to the current study qualify our results and conclusions. Associations do not prove causation. Our measure of parent protection had a lower Cronbach's alpha score for male caregivers (0.68) than female caregivers (0.83), consistent with an examination of the factor structure of the PPS that found the measure to have a poor factor structure and limited reliability in samples with a chronic medical condition. Anxiety, depression, and parenting characteristics were differentially impacted by variables such as caregiver and child age, shunt status, and employment status/income for parents of youth with SB. Interventions to improve parenting skills and mental health of these caregivers can be designed to target specific needs of parents. Groups such as the Greater Oklahoma Disabled Sports Association (GODSA) offer real-world support to improve the lives of caregivers of SB children, and should be studied further to optimize outcomes for children. Copyright © 2015 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

Navigator Approach to Improve Quality of Care for Vulnerable Populations in Mexico.

PubMed

Ramos, Rebeca; Ferreira-Pinto, João; Loza, Oralia

2015-01-01

For nearly 30 years, Programa Compañeros Inc (Compañeros) has worked in Ciudad Juarez, Chihuahua, Mexico, to ensure that vulnerable populations can exercise their rights to receive HIV and substance abuse prevention and treatment services. Compañeros staff has worked to ameliorate the negative results that limit access to care to the most vulnerable individuals: those who are poor, homeless, sex workers, addicted, and others whose life context put them at greater risk for being infected with HIV. With support from the MAC AIDS Foundation, Compañeros has expanded its capacity to deliver services to persons living with HIV/AIDS (PLWHA) and to HIV-vulnerable populations. This short communication describes findings from an internal evaluation conducted to investigate the effectiveness of the MAC AIDS-funded navigator-based program implemented at Compañeros. © The Author(s) 2015.

U.S. Government and Partners: Working Together on a Comprehensive, Coordinated and Effective Response to Highly Vulnerable Children. Third Annual Report to Congress on Public Law 109-95, the Assistance for Orphans and Other Vulnerable Children in Developing Countries Act of 2005

ERIC Educational Resources Information Center

US Agency for International Development, 2009

2009-01-01

Public Law 109-95, the Assistance for Orphans and Other Vulnerable Children in Developing Countries Act of 2005 (hereinafter, referred to as PL 109-95), was signed into law four years ago to respond to the global orphans and vulnerable children crisis. It calls for the U.S. Government (USG) response to the crisis to be comprehensive, coordinated…

'People insult her as a sexy woman': sexuality, stigma and vulnerability among widowed and divorced women in Oromiya, Ethiopia.

PubMed

Newton-Levinson, Anna; Winskell, Kate; Abdela, Berissa; Rubardt, Marcie; Stephenson, Rob

2014-01-01

Widowed and divorced women, sometimes referred to as 'female heads of household', are one of the most impoverished and marginalised groups in the world. Widowed and divorced women are often overlooked in the literature or are seen primarily as economically or socially marginalised beings; their sexuality is rarely addressed. In an effort to understand the experiences and challenges faced by such women, we conducted and analysed four focus-group discussions, seven in-depth interviews and four interactive activities with 32 widowed and divorced women and with 25 other community members in Oromiya, Ethiopia. Findings indicate that women experienced high levels of community stigma in relation to their sexuality. Participants' fear of community stigma, and the actions they took to avert it, further served to marginalise them within their community and had negative impact on their economic, social and health support systems and, ultimately, on their overall well-being. Future interventions need to acknowledge sexual stigma as a driving force in the many challenges these women face. Further programmatic work is needed to reduce stigma related to widowed and divorced women's sexuality and to decrease their vulnerability to rape.

Bipolar disorder: a neural network perspective on a disorder of emotion and motivation.

PubMed

Wessa, Michèle; Kanske, Philipp; Linke, Julia

2014-01-01

Bipolar disorder (BD) is a severe, chronic disease with a heritability of 60-80%. BD is frequently misdiagnosed due to phenomenological overlap with other psychopathologies, an important issue that calls for the identification of biological and psychological vulnerability and disease markers. Altered structural and functional connectivity, mainly between limbic and prefrontal brain areas, have been proposed to underlie emotional and motivational dysregulation in BD and might represent relevant vulnerability and disease markers. In the present laboratory review we discuss functional and structural neuroimaging findings on emotional and motivational dysregulation from our research group in BD patients and healthy individuals at risk to develop BD. As a main result of our studies, we observed altered orbitofrontal and limbic activity and reduced connectivity between dorsal prefrontal and limbic brain regions, as well as reduced integrity of fiber tracts connecting prefrontal and subcortical brain structures in BD patients and high-risk individuals. Our results provide novel insights into pathophysiological mechanisms of bipolar disorder. The current laboratory review provides a specific view of our group on altered brain connectivity and underlying psychological processes in bipolar disorder based on our own work, integrating relevant findings from others. Thereby we attempt to advance neuropsychobiological models of BD.

Adaptation strategies to climate change in the Arctic: a global patchwork of reactive community-scale initiatives

NASA Astrophysics Data System (ADS)

Loboda, Tatiana V.

2014-11-01

Arctic regions have experienced and will continue to experience the greatest rates of warming compared to any other region of the world. The people living in the Arctic are considered among most vulnerable to the impacts of environmental change ranging from decline in natural resources to increasing mental health concerns (IPCC 2014 Climate Change 2014: Impacts, Adaptation and Vulnerability. Contribution of Working Group II to the Fifth Assessment Report of the Intergovernmental Panel on Climate Change (Cambridge: Cambridge University Press)). A meta-analysis study by Ford et al (2014 Environ. Res. Lett. 9 104005) has assessed the volume, scope and geographic distribution of reported in the English language peer-reviewed literature initiatives for adaptation to climate change in the Arctic. Their analysis highlights the reactive nature of the adopted policies with a strong emphasis on local and community-level policies mostly targeting indigenous population in Canada and Alaska. The study raises concerns about the lack of monitoring and evaluation mechanism to track the success rate of the existing policies and the need for long-term strategic planning in adaption policies spanning international boundaries and including all groups of population.

Defining HIV Risk and Determining Responsibility in Postsocialist Poland

PubMed Central

Owczarzak, Jill

2014-01-01

Drawing on 15 months of ethnographic research on HIV prevention programs in Poland, I explore the consequences of the shift from models of HIV prevention that emphasize “risk groups” and AIDS blame, to models that focus on “risky behaviors” and universal risk. The centrality of choice making and individual risk management in these models suggests objective risk assessment free from moralizing arguments. The Polish national prevention strategy shifted to focus on choice making, address all risk groups, and include concrete prevention strategies. This shift created a backlash that resulted in the reassertion of moral arguments about risk and risk groups that positioned those most vulnerable to HIV outside the purview of prevention efforts. AIDS organizations working with marginalized, “morally problematic” populations used the label “at risk” to legitimize claims to resources. They enacted a model of risk reduction in which the relevant actor is the individual buffeted by social forces, and behavior change, and therefore HIV risk reduction, is a long process because of myriad forms of vulnerability clients face. Despite efforts to reconceptualize risk, organizations positioned the individual as the locus of HIV prevention interventions, rather than attempting to address the social context that shapes risk. PMID:20092052

Social support and vulnerability: state of the art in relation to families and children.

PubMed

MacElveen-Hoehn, P; Eyres, S J

1984-01-01

The purpose of this presentation is to review the concepts of social support and vulnerable families and children, propose a theoretical model on coping and adaptation, and ascertain any significant implications for the delivery of health care services and future research. The review of the literature indicates that major problems persist in the classification, conceptualization, empirical investigation, and clinical application of social support due to a lack of clarity regarding the definition of social support and how it works. Related perspectives such as bonding, child development, and child rearing also reaffirm the need for and the utilization of social support. High-risk factors, such as low maternal age, poverty, single parenthood, and long-term health problems, increase the vulnerability of families and children. This literature strongly suggests that the interactions of adults and children with supportive members of their social networks are important in the development of essential cognitive and social skills, as well as for the promotion of security and comfort. Supports from individuals, families, and groups also are associated with more successful adaptation and favorable outcomes. Despite numerous articles and research projects, however, questions concerning how social support works to assist vulnerable children and families remain. Seven factors are proposed as a theoretical model to identify threatening situations and coping difficulties so that appropriate support can be provided. These factors are surprise, experience, confusion, perceived effectiveness, perceived allies, perceived uniqueness of threat, and overload. Additional testing is required for this model so that a more meaningful investigation and utilization of social support can be established. Additional research also is indicated to determine the specific types of support needed in the presence of certain factors, network style preferences, the supply and demand for support over the life span, and cultural aspects of coping and support processes. The position that appropriate social support will promote mastery and self-determination has significant implications for health professionals.

Seaside, Oregon, Tsunami Vulnerability Assessment Pilot Study

NASA Astrophysics Data System (ADS)

Dunbar, P. K.; Dominey-Howes, D.; Varner, J.

2006-12-01

The results of a pilot study to assess the risk from tsunamis for the Seaside-Gearhart, Oregon region will be presented. To determine the risk from tsunamis, it is first necessary to establish the hazard or probability that a tsunami of a particular magnitude will occur within a certain period of time. Tsunami inundation maps that provide 100-year and 500-year probabilistic tsunami wave height contours for the Seaside-Gearhart, Oregon, region were developed as part of an interagency Tsunami Pilot Study(1). These maps provided the probability of the tsunami hazard. The next step in determining risk is to determine the vulnerability or degree of loss resulting from the occurrence of tsunamis due to exposure and fragility. The tsunami vulnerability assessment methodology used in this study was developed by M. Papathoma and others(2). This model incorporates multiple factors (e.g. parameters related to the natural and built environments and socio-demographics) that contribute to tsunami vulnerability. Data provided with FEMA's HAZUS loss estimation software and Clatsop County, Oregon, tax assessment data were used as input to the model. The results, presented within a geographic information system, reveal the percentage of buildings in need of reinforcement and the population density in different inundation depth zones. These results can be used for tsunami mitigation, local planning, and for determining post-tsunami disaster response by emergency services. (1)Tsunami Pilot Study Working Group, Seaside, Oregon Tsunami Pilot Study--Modernization of FEMA Flood Hazard Maps, Joint NOAA/USGS/FEMA Special Report, U.S. National Oceanic and Atmospheric Administration, U.S. Geological Survey, U.S. Federal Emergency Management Agency, 2006, Final Draft. (2)Papathoma, M., D. Dominey-Howes, D.,Y. Zong, D. Smith, Assessing Tsunami Vulnerability, an example from Herakleio, Crete, Natural Hazards and Earth System Sciences, Vol. 3, 2003, p. 377-389.

High-resolution magnetic resonance imaging of carotid atherosclerotic plaques - a correlation study with histopathology.

PubMed

Xia, Zhangyong; Yang, Hua; Yuan, Xiaochun; Wang, Jiyue; Zhang, Shigang; Zhang, Liyong; Qu, Yang; Chen, Jun; Jiao, Liqun; Wang, Le-Xin; Du, Yifeng

2017-07-01

This study aimed to utilize high-resolution magnetic resonance imaging (MRI) to investigate the characteristics of stable and vulnerable carotid arteriosclerotic plaques, with correlations to histopathological findings. High-resolution MRI was performed in 817 patients, using three-dimensional magnetic resonance angiography. Plaque composition was evaluated by measuring the areas occupied by calcification, a lipid-rich necrotic core, intra-plaque haemorrhage, and fibrous cap rupture. Plaque morphology was analysed by measuring vessel wall area, thickness, and luminal area at the bifurcation of the common carotid artery. Plaque tissues were sampled during carotid endarterectomy and examined using haematoxylin-eosin, Oil Red O, Masson trichrome staining, and immunohistochemical staining for CD68. Patients were divided into stable plaque group (n = 462) and vulnerable plaque group (n = 355), based on intraoperative observations and postoperative histopathological findings. Compared to the stable plaque group, the vulnerable plaque group exhibited increased vessel wall areas and thickness, and decreased mean luminal areas (P < 0.001). The vulnerable plaque group also had a lower collagen content, a higher lipid content, and higher CD68 expression in plaque tissues on histological examinations (P < 0.01). Incidences of lipid-rich necrotic core (38.1 % vs. 34.3 %), intra-plaque haemorrhage (26.9 % vs. 22.8 %), plaque calcification (45.2 % vs. 40.9 %), and fibrous cap rupture (36.0 % vs 39.8 %) in the plaques were concordant with MRI observations and histopathological findings (p > 0.05). Stable and vulnerable carotid plaques had different morphologies and compositions. High-resolution MRI can assess such differences qualitatively and quantitatively in vivo and provide guidance for risk stratification and management.

Functional magnetic resonance imaging of working memory and response inhibition in children with mild traumatic brain injury.

PubMed

Krivitzky, Lauren S; Roebuck-Spencer, Tresa M; Roth, Robert M; Blackstone, Kaitlin; Johnson, Chad P; Gioia, Gerard

2011-11-01

The current pilot study examined functional magnetic resonance imaging (fMRI) activation in children with mild traumatic brain injury (mTBI) during tasks of working memory and inhibitory control, both of which are vulnerable to impairment following mTBI. Thirteen children with symptomatic mTBI and a group of controls completed a version of the Tasks of Executive Control (TEC) during fMRI scanning. Both groups showed greater prefrontal activation in response to increased working memory load. Activation patterns did not differ between groups on the working memory aspects of the task, but children with mTBI showed greater activation in the posterior cerebellum with the addition of a demand for inhibitory control. Children with mTBI showed greater impairment on symptom report and "real world" measures of executive functioning, but not on traditional "paper and pencil" tasks. Likewise, cognitive testing did not correlate significantly with imaging results, whereas increased report of post-concussive symptoms were correlated with increased cerebellar activation. Overall, results provide some evidence for the utility of symptom report as an indicator of recovery and the hypothesis that children with mTBI may experience disrupted neural circuitry during recovery. Limitations of the study included a small sample size, wide age range, and lack of in-scanner accuracy data.

An assessment of vulnerability to HIV infection of boatmen in Teknaf, Bangladesh

PubMed Central

Gazi, Rukhsana; Mercer, Alec; Wansom, Tanyaporn; Kabir, Humayun; Saha, Nirod Chandra; Azim, Tasnim

2008-01-01

Background Mobile population groups are at high risk for contracting HIV infection. Many factors contribute to this risk including high prevalence of risky behavior and increased risk of violence due to conflict and war. The Naf River serves as the primary border crossing point between Teknaf, Bangladesh and Mynamar [Burma] for both official and unofficial travel of people and goods. Little is known about the risk behavior of boatmen who travel back and forth between Teknaf and Myanmar. However, we hypothesize that boatmen may act as a bridging population for HIV/AIDS between the high-prevalence country of Myanmar and the low-prevalence country of Bangladesh. Methods Methods included initial rapport building with community members, mapping of boatmen communities, and in-depth qualitative interviews with key informants and members from other vulnerable groups such as spouses of boatmen, commercial female sex workers, and injecting drug users. Information from the first three stages was used to create a cross-sectional survey that was administered to 433 boatmen. Results Over 40% of the boatmen had visited Myanmar during the course of their work. 17% of these boatmen had sex with CSW while abroad. There was a significant correlation found between the number of nights spent in Myanmar and sex with commercial sex workers. In the past year, 19% of all boatmen surveyed had sex with another man. 14% of boatmen had participated in group sex, with groups ranging in size from three to fourteen people. Condom use was rare {0 to 4.7% during the last month}, irrespective of types of sex partners. Regression analysis showed that boatmen who were 25 years and older were statistically less likely to have sexual intercourse with non- marital female partners in the last year compared to the boatmen aged less than 25 years. Similarly deep-sea fishing boatmen and non-fishing boatmen were statistically less likely to have sexual intercourse with non- marital female partners in the last year compared to the day long fishing boatmen adjusting for all other variables. Boatmen's knowledge regarding HIV transmission and personal risk perception for contracting HIV was low. Conclusion Boatmen in Teknaf are an integral part of a high-risk sexual behaviour network between Myanmar and Bangladesh. They are at risk of obtaining HIV infection due to cross border mobility and unsafe sexual practices. There is an urgent need for designing interventions targeting boatmen in Teknaf to combat an impending epidemic of HIV among this group. They could be included in the serological surveillance as a vulnerable group. Interventions need to address issues on both sides of the border, other vulnerable groups, and refugees. Strong political will and cross border collaboration is mandatory for such interventions. PMID:18341696

Service and sales workers, are they vulnerable to smoking cessation?

PubMed

Cho, Youn-Mo; Myong, Jun-Pyo; Kim, Hyoung-Ryoul; Lee, HyeEun; Koo, Jung-Wan

2017-10-07

The aim of the present study was to evaluate the association between failed smoking cessation and occupation by age stratification among Korean males and provide quantitative evidence of factors associated with failed smoking cessation. The study comprised 3,127 male workers who had attempted smoking cessation during their life time. Data were obtained from the Korea National Health and Nutrition Examination Survey from 2010 to 2012. Participants were stratified by age into two subgroups comprising a younger group (19-40 yr) and an older group (41-60 yr). Multiple logistic regression analyses were used to estimate odds ratios (ORs) for failed smoking cessation. In the younger group, failed smoking cessation was related to the occupational fields "service and sales" and "manual work" compared to "office work" (OR: 2.10, 95% confidence interval (CI): 1.34-3.29; and OR: 1.47, 95% CI: 1.02-2.12, respectively). In the older group, the ORs of failed smoking cessation occupational categories "service and sales" and "manual work" [ref: office workers] were 0.58 (0.40-0.85) and 0.90 (0.66-1.24), respectively. Failed smoking cessation is associated with occupational categories and age stratification. Policy makers need to create tailored anti-smoking policy considering the occupation and the age of the subjects.

Suicide Mortality Across Broad Occupational Groups in Greece: A Descriptive Study

PubMed Central

Alexopoulos, Evangelos C.; Kavalidou, Katerina; Messolora, Fani

2015-01-01

Background Several studies have investigated the relationship between specific occupations and suicide mortality, as suicide rates differ by profession. The aim of this study was to investigate suicide mortality ratios across broad occupational groups in Greece for both sexes in the period 2000–2009. Methods Data of suicide deaths were retrieved from the Hellenic Statistical Authority and comparative mortality ratios were calculated. Occupational classification was based on the International Classification of Occupations (ISCO-88) and the coding for Intentional self-harm (X60–X84) was based on the international classification of diseases (ICD-10). Results Male dominant occupations, mainly armed forces, skilled farmers and elementary workers, and female high-skilled occupations were seen as high risk groups for suicide in a period of 10 years. The age-productive group of 30–39 years in Greek male elementary workers and the 50–59 age-productive group of Greek professional women proved to have the most elevated number of suicide deaths. Conclusion Further research is needed into the work-related stressors of occupations with high suicide mortality risk and focused suicide prevention strategies should be applied within vulnerable working age populations. PMID:27014484

Experiences of structural vulnerability among exotic dancers in Baltimore, Maryland: co-occurring social and economic antecedents of HIV/STI risk

PubMed Central

Brantley, Meredith L.; Footer, Katherine; Lim, Sahnah; Kerrigan, Deanna; Sherman, Susan G.

2017-01-01

Women who grow up in an environment of economic scarcity often face limited opportunities for upward mobility, as a result of challenges securing stable housing, quality education, and high-paying, steady employment. Chronically unstable women often also have reduced capacity to protect themselves against HIV/STI related harm when engaging in sexual activity or illicit drug use. Characterizing and targeting the structural contexts that facilitate HIV/STI risk are critical to effective design and implementation of drug and sexual harm reduction interventions. This study explores the nature and progression of structural vulnerability experienced by female exotic dancers during their early lives through the initial months of exotic dancing. We also examine the roles of drug use and social relationships regarding experiences of structural vulnerability and engagement in sexual risk behavior. We conducted semi-structured in-depth interviews with exotic dancers working in Baltimore City and County exotic dance clubs during July 2014 and May 2015. Using thematic analysis, interviews revealed important individual, social, and economic effects of structural vulnerability. Many dancers depicted early experiences of residential transience, violence, and independence, and were raised in an environment of social and economic scarcity. The accumulation of chronic, overlapping social and economic disadvantage continued upon entry into dancing. Substance use emerged as an important issue for the majority of women, operating cyclically as both precursor to and product of accumulating social and economic hardship. Dancers also revealed social strategies that buffered the effects of structural vulnerability and minimized exposure to workplace-related drug and sexual risks. This study provides insight on an understudied group of at-risk women with a unique demographic profile. Findings illustrate how the effects of structural vulnerability, substance abuse, social strategies, and opportunities for economic gain through sexual services in the workplace converge to produce varying levels of HIV/STI risk among exotic dancers. PMID:29040840

Wyoming freight movement system vulnerabilities and ITS.

DOT National Transportation Integrated Search

2013-12-01

This report summarizes the work performed during the second phase of a two-phase : research project. The first phase focused on two main areas: freight safety and wind : vulnerability, and the identification of critical infrastructure. Phase I also t...

Decreasing Human Trafficking through Sex Work Decriminalization.

PubMed

Albright, Erin; D'Adamo, Kate

2017-01-01

In order to decrease human trafficking, health care workers should support the full decriminalization of prostitution. Similar to trafficking in other forms of labor, preventing trafficking in the sex trade requires addressing the different forms of marginalization that create vulnerable communities. By removing punitive laws that prevent reporting of exploitation and abuse, decriminalization allows sex workers to work more safely, thereby reducing marginalization and vulnerability. Decriminalization can also help destigmatize sex work and help resist political, social, and cultural marginalization of sex workers. © 2017 American Medical Association. All Rights Reserved.

"Show me the money": vulnerability to gambling moderates the attractiveness of money versus suspense.

PubMed

Hahn, Cheryl; Wilson, Timothy D; McRae, Kaichen; Gilbert, Daniel T

2013-10-01

Do people take risks to obtain rewards or experience suspense? We hypothesized that people vulnerable to gambling are motivated more by the allure of winning money whereas people less vulnerable to gambling are motivated more by the allure of suspense. Consistent with this hypothesis, participants with high scores on a subscale of the Gambling Attitudes and Beliefs Survey--a measure of vulnerability to gambling--reported more of a motivation to earn money (pilot study), were more likely to accept a certain or near-certain amount of money than to gamble for that same amount (Studies 1-2), and worked harder to earn money (Study 3). People vulnerable to gambling also made more accurate predictions about how much they would gamble. People less vulnerable to gambling, in contrast, gambled more than people vulnerable to gambling, but did not know that they would.

Construction of road network vulnerability evaluation index based on general travel cost

NASA Astrophysics Data System (ADS)

Leng, Jun-qiang; Zhai, Jing; Li, Qian-wen; Zhao, Lin

2018-03-01

With the development of China's economy and the continuous improvement of her urban road network, the vulnerability of the urban road network has attracted increasing attention. Based on general travel cost, this work constructs the vulnerability evaluation index for the urban road network, and evaluates the vulnerability of the urban road network from the perspective of user generalised travel cost. Firstly, the generalised travel cost model is constructed based on vehicle cost, travel time, and traveller comfort. Then, the network efficiency index is selected as an evaluation index of vulnerability: the network efficiency index is composed of the traffic volume and the generalised travel cost, which are obtained from the equilibrium state of the network. In addition, the research analyses the influence of traffic capacity decrease, road section attribute value, and location of road section, on vulnerability. Finally, the vulnerability index is used to analyse the local area network of Harbin and verify its applicability.

Spatial-Sequential Working Memory in Younger and Older Adults: Age Predicts Backward Recall Performance within Both Age Groups

PubMed Central

Brown, Louise A.

2016-01-01

Working memory is vulnerable to age-related decline, but there is debate regarding the age-sensitivity of different forms of spatial-sequential working memory task, depending on their passive or active nature. The functional architecture of spatial working memory was therefore explored in younger (18–40 years) and older (64–85 years) adults, using passive and active recall tasks. Spatial working memory was assessed using a modified version of the Spatial Span subtest of the Wechsler Memory Scale – Third Edition (WMS-III; Wechsler, 1998). Across both age groups, the effects of interference (control, visual, or spatial), and recall type (forward and backward), were investigated. There was a clear effect of age group, with younger adults demonstrating a larger spatial working memory capacity than the older adults overall. There was also a specific effect of interference, with the spatial interference task (spatial tapping) reliably reducing performance relative to both the control and visual interference (dynamic visual noise) conditions in both age groups and both recall types. This suggests that younger and older adults have similar dependence upon active spatial rehearsal, and that both forward and backward recall require this processing capacity. Linear regression analyses were then carried out within each age group, to assess the predictors of performance in each recall format (forward and backward). Specifically the backward recall task was significantly predicted by age, within both the younger and older adult groups. This finding supports previous literature showing lifespan linear declines in spatial-sequential working memory, and in working memory tasks from other domains, but contrasts with previous evidence that backward spatial span is no more sensitive to aging than forward span. The study suggests that backward spatial span is indeed more processing-intensive than forward span, even when both tasks include a retention period, and that age predicts backward spatial span performance across the adult lifespan, within both younger and older adulthood. PMID:27757096

Spatial-Sequential Working Memory in Younger and Older Adults: Age Predicts Backward Recall Performance within Both Age Groups.

PubMed

Brown, Louise A

2016-01-01

Working memory is vulnerable to age-related decline, but there is debate regarding the age-sensitivity of different forms of spatial-sequential working memory task, depending on their passive or active nature. The functional architecture of spatial working memory was therefore explored in younger (18-40 years) and older (64-85 years) adults, using passive and active recall tasks. Spatial working memory was assessed using a modified version of the Spatial Span subtest of the Wechsler Memory Scale - Third Edition (WMS-III; Wechsler, 1998). Across both age groups, the effects of interference (control, visual, or spatial), and recall type (forward and backward), were investigated. There was a clear effect of age group, with younger adults demonstrating a larger spatial working memory capacity than the older adults overall. There was also a specific effect of interference, with the spatial interference task (spatial tapping) reliably reducing performance relative to both the control and visual interference (dynamic visual noise) conditions in both age groups and both recall types. This suggests that younger and older adults have similar dependence upon active spatial rehearsal, and that both forward and backward recall require this processing capacity. Linear regression analyses were then carried out within each age group, to assess the predictors of performance in each recall format (forward and backward). Specifically the backward recall task was significantly predicted by age, within both the younger and older adult groups. This finding supports previous literature showing lifespan linear declines in spatial-sequential working memory, and in working memory tasks from other domains, but contrasts with previous evidence that backward spatial span is no more sensitive to aging than forward span. The study suggests that backward spatial span is indeed more processing-intensive than forward span, even when both tasks include a retention period, and that age predicts backward spatial span performance across the adult lifespan, within both younger and older adulthood.

Differences in health care utilization between parents who perceive their child as vulnerable versus overprotective parents.

PubMed

Thomasgard, M; Metz, W P

1996-06-01

While a parental perception of child vulnerability to illness/injury is often used interchangeably with parental overprotection, research suggests that they are independent constructs. We hypothesized more frequent pediatric nonwell-child visits for perceived child vulnerability, but not for parental overprotection. The parents of 300 children, ages 2-5 years, enrolled in a health maintenance organization, were sampled. For children without medical conditions, there were no differences in nonwell-child care visits between the high perceived vulnerability and high parental protection groups (Wilcoxon Rank Sum Test, WRST, P = .31). As expected, high parental protection was not significantly associated with increased nonwell-child care visits compared with the low parental protection group (WRST, P = .14). These findings suggest that markers other than health care utilization are required to identify these forms of parent-child relationship disorders.

Vulnerable Children's Access to Examinations at Key Stage 4. Research Report RR639

ERIC Educational Resources Information Center

Kendall, Sally; Johnson, Annie; Martin, Kerry; Kinder; Kay

2005-01-01

This research project was commissioned by the Department for Education and Skills (DfES) in 2004 to examine barriers to vulnerable children accessing examinations at the end of key stage 4 and to identify strategies employed to overcome these barriers. Key groups of vulnerable children identified by the DfES included: (1) Looked-after children;…

Enhancing Defense Support of Civil Authorities within the National Capital Region

DTIC Science & Technology

2011-04-04

tenorist organizations center of gravity, critical capabilities, critical requirements, and critical vulnerabilities. For example, to execute the...London Underground bombings ( critical capability), the group (center of gravity) needed money ( critical requirement! critical vulnerability). 8 Usually...the movement of large amounts of money through banks, the internet, or via credit cards creates a critical vulnerability because law enforcement

Vulnerability to alcohol-related problems: a policy brief with implications for the regulation of alcohol marketing.

PubMed

Babor, Thomas F; Robaina, Katherine; Noel, Jonathan K; Ritson, E Bruce

2017-01-01

The concern that alcohol advertising can have detrimental effects on vulnerable viewers has prompted the development of codes of responsible advertising practices. This paper evaluates critically the concept of vulnerability as it applies to (1) susceptibility to alcohol-related harm and (2) susceptibility to the effects of marketing, and describes its implications for the regulation of alcohol marketing. We describe the findings of key published studies, review papers and expert reports to determine whether these two types of vulnerability apply to population groups defined by (1) age and developmental history; (2) personality characteristics; (3) family history of alcoholism; (4) female sex and pregnancy risk; and (5) history of alcohol dependence and recovery status. Developmental theory and research suggest that groups defined by younger age, incomplete neurocognitive development and a history of alcohol dependence may be particularly vulnerable because of the disproportionate harm they experience from alcohol and their increased susceptibility to alcohol marketing. Children may be more susceptible to media imagery because they do not have the ability to compensate for biases in advertising portrayals and glamorized media imagery. Young people and people with a history of alcohol dependence appear to be especially vulnerable to alcohol marketing, warranting the development of new content and exposure guidelines focused on protecting those groups to improve current self-regulation codes promoted by the alcohol industry. If adequate protections cannot be implemented through this mechanism, statutory regulations should be considered. © 2016 Society for the Study of Addiction.

Resistance and vulnerability to stigmatization in abortion work.

PubMed

O'Donnell, Jenny; Weitz, Tracy A; Freedman, Lori R

2011-11-01

The stigma surrounding abortion in the United States commonly permeates the experience of both those seeking this health service as well as those engaged in its provision. Annually there are approximately 1.2 million abortions performed in the United States; despite that existing research shows that abortion services are highly utilized, women rarely disclose their use of these services. In 2005 only 1787 facilities that offer abortion services remained, a drop of almost 40 percent since 1982 (Jones, Zolna, Henshaw, & Finer, 2008). While it has been acknowledged that all professionals working in abortion are labeled to some degree as different, no published research has explored stigmatization as a process experienced by the range of individuals that comprise the abortion-providing workforce in the USA. Using qualitative data from a group of healthcare professionals doing abortion work in a Western state, this study begins to fill that gap, providing evidence of how the experience of stigma can vary and is managed within interactions in the workplace, in professional circles, among family and friends, and among strangers. The analysis shows that the experience of stigma for those providing abortion care is not a static or fixed loss of status. It is a dynamic situation in which those vulnerable to stigmatization can avoid, resist, or transform the stigma that would attach to them by varying degrees within selective contexts. Copyright © 2011 Elsevier Ltd. All rights reserved.

When Sex Work Becomes Your Everything: The Complex Linkages Between Economy and Affection Among Male Sex Workers in Peru.

PubMed

Bayer, Angela M; Garvich, Mijail; Díaz, David A; Sánchez, Hugo; García, Patricia J; Coates, Thomas J

2014-09-01

In Peru, there are few studies on male sex workers (MSWs), and existing studies explore limited subgroups or offer limited information about MSWs' perspectives. This study provides in-depth perspectives from 40 MSWs who work in downtown Lima (Cercado) and in surrounding urban neighborhoods (non-Cercado) through interviews on their identities, lives, and HIV/STI (sexually transmitted infection) risks and vulnerabilities. Findings are that entry into sex work links economy and affection, particularly among Cercado MSWs. Continued sex work cements this link, making it difficult to exit sex work and establish goals. Ties between economics and affections influence MSWs' perceived HIV/STI risks, vulnerabilities, and prevention practices. Although Cercado MSWs report higher HIV/STI risks and vulnerabilities than non-Cercado peers, they report fewer prevention practices given inability to buy condoms and acceptance of client offers of higher payment, especially clients they feel affection for. MSWs need support to strengthen their self-perceptions and define and pursue their goals in order to improve their HIV/STI prevention practices, health, and well-being. © The Author(s) 2013.

[Medical research and vulnerable subjects: unemployed people].

PubMed

Niebrój, Lesław

2006-01-01

Although the importance of medical research for the diagnosis and treatment of human diseases is unquestionable, the use of human subjects, however, still presents a complex ethical problem. Moral difficulties occur in particular when the medical research deals with vulnerable subjects. Vulnerable individuals are defined as those who experience diminished actual autonomy. Among the groups which should be considered as being vulnerable are usually listed the following: children, pregnant women, mentally or emotionally disabled, physically disabled, homeless, and institutionalized people. This study addresses key concerns that gave rise to the question of whether unemployed people had to be recognized as vulnerable subjects. The term "vulnerability" was clarified and it was assumed that the "vulnerability" of medical research subjects' had to be understood as a form of continuum from potential, through the circumstantial, temporal, episodic, permanent to inevitable vulnerability. The conclusion was drawn that unemployed people were, at least, potentially vulnerable subjects. Research involving unemployed people presents important moral challenges to researchers and should be undertaken very carefully, following special ethical guidelines.

Not the usual suspects: addressing layers of vulnerability.

PubMed

Luna, Florencia; Vanderpoel, Sheryl

2013-07-01

This paper challenges the traditional account of vulnerability in healthcare which conceptualizes vulnerability as a list of identifiable subpopulations. This list of 'usual suspects', focusing on groups from lower resource settings, is a narrow account of vulnerability. In this article we argue that in certain circumstances middle-class individuals can be also rendered vulnerable. We propose a relational and layered account of vulnerability and explore this concept using the case study of cord blood (CB) banking. In the first section, two different approaches to 'vulnerability' are contrasted: categorical versus layered. In the second section, we describe CB banking and present a case study of CB banking in Argentina. We examine the types of pressure that middle-class pregnant women feel when considering CB collection and storage. In section three, we use the CB banking case study to critique the categorical approach to vulnerability: this model is unable to account for the ways in which these women are vulnerable. A layered account of vulnerability identifies several ways in which middle-class women are vulnerable. Finally, by utilizing the layered approach, this paper suggests how public health policies could be designed to overcome vulnerabilities. © 2013 John Wiley & Sons Ltd.

Science Center Public Forums: Engaging Lay-Publics in Resilience Deliberations Through Informal Science Education

NASA Astrophysics Data System (ADS)

Sittenfeld, D.; Choi, F.; Farooque, M.; Helmuth, B.

2017-12-01

Because climate hazards present a range of potential impacts and considerations for different kinds of stakeholders, community responses to increase resilience are best considered through the inclusion of diverse, informed perspectives. The Science Center Public Forums project has created multifaceted modules to engage diverse publics in substantive deliberations around four hazards: heat waves, drought, extreme precipitation, and sea level rise. Using a suite of background materials including visualization and narrative components, each of these daylong dialogues engage varied groups of lay-participants at eight US science centers in learning about hazard vulnerabilities and tradeoffs of proposed strategies for building resilience. Participants listen to and consider the priorities and perspectives of fellow residents and stakeholders, and work together to formulate detailed resilience plans reflecting both current science and informed public values. Deliverables for the project include visualizations of hazard vulnerabilities and strategies through immersive planetarium graphics and Google Earth, stakeholder perspective narratives, and detailed background materials for each project hazard. This session will: communicate the process for developing the hazard modules with input from subject matter experts, outline the process for iterative revisions based upon findings from formative focus groups, share results generated by participants of the project's first two pilot forums, and describe plans for broader implementation. These activities and outcomes could help to increase the capacity of informal science education institutions as trusted conveners for informed community dialogue by educating residents about vulnerabilities and engaging them in critical thinking about potential policy responses to critical climate hazards while sharing usable public values and priorities with civic planners.

Leadership, Literacy, and Translational Expertise in Genomics: Challenges and Opportunities for Social Work.

PubMed

Werner-Lin, Allison; McCoyd, Judith L M; Doyle, Maya H; Gehlert, Sarah J

2016-08-01

The transdisciplinary field of genomics is revolutionizing conceptualizations of health, mental health, family formation, and public policy. Many professions must rapidly acquire genomic expertise to maintain state-of-the-art knowledge in their practice. Calls for social workers to build genomic capacity come regularly, yet social work education has not prepared practitioners to join the genomics workforce in providing socially just, ethically informed care to all clients, particularly those from vulnerable and marginalized groups. The authors suggest a set of action steps for bringing social work skills and practice into the 21st century. They propose that good genomic practice entails bringing social work values, skills, and behaviors to genomics. With education and training, social workers may facilitate socially just dissemination of genomic knowledge and services across practice domains. Increased genomic literacy will support the profession's mission to address disparities in health, health care access, and mortality. © 2016 National Association of Social Workers.

Leadership, Literacy, and Translational Expertise in Genomics: Challenges and Opportunities for Social Work

PubMed Central

Werner-Lin, Allison; McCoyd, Judith L. M.; Doyle, Maya H.; Gehlert, Sarah J.

2016-01-01

The transdisciplinary field of genomics is revolutionizing conceptualizations of health, mental health, family formation, and public policy. Many professions must rapidly acquire genomic expertise to maintain state-of-the-art knowledge in their practice. Calls for social workers to build genomic capacity come regularly, yet social work education has not prepared practitioners to join the genomics workforce in providing socially just, ethically informed care to all clients, particularly those from vulnerable and marginalized groups. The authors suggest a set of action steps for bringing social work skills and practice into the 21st century. They propose that good genomic practice entails bringing social work values, skills, and behaviors to genomics. With education and training, social workers may facilitate socially just dissemination of genomic knowledge and services across practice domains. Increased genomic literacy will support the profession’s mission to address disparities in health, health care access, and mortality. PMID:29206948

Long-term effect of early-life stress from earthquake exposure on working memory in adulthood.

PubMed

Li, Na; Wang, Yumei; Zhao, Xiaochuan; Gao, Yuanyuan; Song, Mei; Yu, Lulu; Wang, Lan; Li, Ning; Chen, Qianqian; Li, Yunpeng; Cai, Jiajia; Wang, Xueyi

2015-01-01

The present study aimed to investigate the long-term effect of 1976 Tangshan earthquake exposure in early life on performance of working memory in adulthood. A total of 907 study subjects born and raised in Tangshan were enrolled in this study. They were divided into three groups according to the dates of birth: infant exposure (3-12 months, n=274), prenatal exposure (n=269), and no exposure (born at least 1 year after the earthquake, n=364). The prenatal group was further divided into first, second, and third trimester subgroups based on the timing of exposure during pregnancy. Hopkins Verbal Learning Test-Revised and Brief Visuospatial Memory Test-Revised (BVMT-R) were used to measure the performance of working memory. Unconditional logistic regression analysis was used to analyze the influential factors for impaired working memory. The Hopkins Verbal Learning Test-Revised scores did not show significant difference across the three groups. Compared with no exposure group, the BVMT-R scores were slightly lower in the prenatal exposure group and markedly decreased in the infant exposure group. When the BVMT-R scores were analyzed in three subgroups, the results showed that the subjects whose mothers were exposed to earthquake in the second and third trimesters of pregnancy had significantly lower BVMT-R scores compared with those in the first trimester. Education level and early-life earthquake exposure were identified as independent risk factors for reduced performance of visuospatial memory indicated by lower BVMT-R scores. Infant exposure to earthquake-related stress impairs visuospatial memory in adulthood. Fetuses in the middle and late stages of development are more vulnerable to stress-induced damage that consequently results in impaired visuospatial memory. Education and early-life trauma can also influence the performance of working memory in adulthood.

From vulnerability to passion in the end-of-life care: The lived experience of nurses.

PubMed

Liu, Ying-Chun; Chiang, Hsien-Hsien

2017-12-01

End-of-life (EOL) care is considered to be inherently difficult and vulnerable for patients and nurses. It also seems hard to develop passion for care during these problematic times. This study elucidates how EOL nurses interpret their care experience and how they transform their experience and mindset. This study was conducted by organizing a reflective group based on the concept of group analysis for oncology and hospice nurses to share their experience. Thirteen registered nurses were enrolled from a medical center in northern Taiwan. Data drawn from the group dialogue was derived from six digitally recorded sessions and then analysed alone with the researcher's diaries and participants' feedback sheets. Interpretative Phenomenological Analysis (IPA) was used to analyze the data. The results showed that nurses who provide EOL care actually experience suffering by witnessing patients' suffering. However, the suffering authentically drives the nurses to encounter their own inner selves, to induce the shift of mindset, and then allow them to continuously provide and maintain the passion in EOL care. This study provides a new viewpoint for understanding of EOL nurses' experiences, indicating that this line of work may be recognized as a privilege. We recommend that the setting of a nurse reflective group is important and it may be considered in providing EOL care training for nurses. Hopefully the study results could shed lights for future policies regarding EOL care. Copyright © 2017 Elsevier Ltd. All rights reserved.

Neuropsychological characteristics of child and adolescent offspring of patients with bipolar disorder.

PubMed

de la Serna, Elena; Vila, Monserrat; Sanchez-Gistau, Vanessa; Moreno, Dolores; Romero, Soledad; Sugranyes, Gisela; Baeza, Immaculada; Llorente, Cloe; Rodriguez-Toscano, Elisa; Sánchez-Gutierrez, Teresa; Castro-Fornieles, Josefina

2016-02-04

Bipolar disorder (BD) is a severe mental disorder with a strong genetic component. The assessment of child and adolescent offspring of patients diagnosed with BD (BDoff) provides an opportunity to investigate vulnerability factors and the first abnormalities associated with the disorder. Previous literature in child and adolescent BDoff is scarce and controversial. However, some studies concur in identifying significant impairment in executive functions, memory and attention. The present study aims to compare global neuropsychological characteristics of child and adolescent offspring of patients with bipolar disorder with a group of offspring of parentswith no history of psychotic disorder, and to assess the influence of psychopathology on neuropsychological performance. This research was part of The Bipolar and Schizophrenia Young Offspring Study (BASYS). A group of BDoff (N= 90) and a group of offspring of parents with no history of psychotic disorder (CC) (N = 107) were assessed with a complete neuropsychological battery. Intellectual quotient, working memory, processing speed, verbal memory and learning, visual memory, attention and executive functions were included in the cognitive assessment. BDoff showed significantly worse performance in processing speed and immediate recall of visual memory relative to CC. When the presence of any lifetime psychopathology was analysed, the results showed that belonging to the BDoff group was the main explicative factor for the scores obtained in both processing speed and visual memory immediate recall, regardless of the presence of psychopathology. These findings suggest that processing speed and visualmemory should be taken into consideration in future research on vulnerability markers of BD.

Designing and implementing a parenting resource center for pregnant teens.

PubMed

Broussard, Anne B; Broussard, Brenda S

2009-01-01

The Resource Center for Young Parents-To-Be is a longstanding and successful grant-funded project that was initiated as a response to an identified community need. Senior-level baccalaureate nursing students and their maternity-nursing instructors are responsible for staffing the resource center's weekly sessions, which take place at a public school site for pregnant adolescents. Childbirth educators interested in working with this population could assist in replicating this exemplary clinical project in order to provide prenatal education to this vulnerable and hard-to-reach group.

Sensitive Interviewing in Qualitative Research.

PubMed

Dempsey, Laura; Dowling, Maura; Larkin, Philip; Murphy, Kathy

2016-12-01

In this paper we focus on important considerations when planning and conducting qualitative interviews on sensitive topics. Drawing on experiences of conducting interviews with dementia caregivers, a framework of essential elements in qualitative interviewing was developed to emphasize study participants' needs while also providing guidance for researchers. Starting with a definition of sensitive research, the framework includes preparing for interviews, interacting with gatekeepers of vulnerable groups, planning for interview timing, and location, building relationships and conducting therapeutic interactions, protecting ethically vulnerable participants, and planning for disengagement. This framework has the potential to improve the effectiveness of sensitive interviewing with vulnerable groups. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

A new approach for computing a flood vulnerability index using cluster analysis

NASA Astrophysics Data System (ADS)

Fernandez, Paulo; Mourato, Sandra; Moreira, Madalena; Pereira, Luísa

2016-08-01

A Flood Vulnerability Index (FloodVI) was developed using Principal Component Analysis (PCA) and a new aggregation method based on Cluster Analysis (CA). PCA simplifies a large number of variables into a few uncorrelated factors representing the social, economic, physical and environmental dimensions of vulnerability. CA groups areas that have the same characteristics in terms of vulnerability into vulnerability classes. The grouping of the areas determines their classification contrary to other aggregation methods in which the areas' classification determines their grouping. While other aggregation methods distribute the areas into classes, in an artificial manner, by imposing a certain probability for an area to belong to a certain class, as determined by the assumption that the aggregation measure used is normally distributed, CA does not constrain the distribution of the areas by the classes. FloodVI was designed at the neighbourhood level and was applied to the Portuguese municipality of Vila Nova de Gaia where several flood events have taken place in the recent past. The FloodVI sensitivity was assessed using three different aggregation methods: the sum of component scores, the first component score and the weighted sum of component scores. The results highlight the sensitivity of the FloodVI to different aggregation methods. Both sum of component scores and weighted sum of component scores have shown similar results. The first component score aggregation method classifies almost all areas as having medium vulnerability and finally the results obtained using the CA show a distinct differentiation of the vulnerability where hot spots can be clearly identified. The information provided by records of previous flood events corroborate the results obtained with CA, because the inundated areas with greater damages are those that are identified as high and very high vulnerability areas by CA. This supports the fact that CA provides a reliable FloodVI.

Reducing inequalities in health and access to health care in a rural Indian community: an India-Canada collaborative action research project.

PubMed

Haddad, Slim; Narayana, Delampady; Mohindra, Ks

2011-11-08

Inadequate public action in vulnerable communities is a major constraint for the health of poor and marginalized groups in low and middle-income countries (LMICs). The south Indian state of Kerala, known for relatively equitable provision of public resources, is no exception to the marginalization of vulnerable communities. In Kerala, women's lives are constrained by gender-based inequalities and certain indigenous groups are marginalized such that their health and welfare lag behind other social groups. The goal of this socially-engaged, action-research initiative was to reduce social inequalities in access to health care in a rural community. Specific objectives were: 1) design and implement a community-based health insurance scheme to reduce financial barriers to health care, 2) strengthen local governance in monitoring and evidence-based decision-making, and 3) develop an evidence base for appropriate health interventions. Health and social inequities have been masked by Kerala's overall progress. Key findings illustrated large inequalities between different social groups. Particularly disadvantaged are lower-caste women and Paniyas (a marginalized indigenous group), for whom inequalities exist across education, employment status, landholdings, and health. The most vulnerable populations are the least likely to receive state support, which has broader implications for the entire country. A community based health solidarity scheme (SNEHA), under the leadership of local women, was developed and implemented yielding some benefits to health equity in the community-although inclusion of the Paniyas has been a challenge. The Canadian-Indian action research team has worked collaboratively for over a decade. An initial focus on surveys and data analysis has transformed into a focus on socially engaged, participatory action research. Adapting to unanticipated external forces, maintaining a strong team in the rural village, retaining human resources capable of analyzing the data, and encouraging Paniya participation in the health insurance scheme were challenges. Successes were at least partially enabled by the length of the funding (this was a two-phase project over an eight year period).

The Naïve nurse: revisiting vulnerability for nursing

PubMed Central

2012-01-01

Background Nurses in the Western world have given considerable attention to the concept of vulnerability in recent decades. However, nurses have tended to view vulnerability from an individualistic perspective, and have rarely taken into account structural or collective dimensions of the concept. As the need grows for health workers to engage in the global health agenda, nurses must broaden earlier works on vulnerability, noting that conventional conceptualizations and practical applications on the notion of vulnerability warrant extension to include more collective conceptualizations thereby making a more complete understanding of vulnerability in nursing discourse. Discussion The purpose of this paper is to examine nursing contributions to the concept of vulnerability and consider how a broader perspective that includes socio-political dimensions may assist nurses to reach beyond the immediate milieu of the patient into the dominant social, political, and economic structures that produce and sustain vulnerability. Summary By broadening nurse’s conceptualization of vulnerability, nurses can obtain the consciousness needed to move beyond a peripheral role of nursing that has been dominantly situated within institutional settings to contribute in the larger arena of social, economic, political and global affairs. PMID:22520841

Test Program for Assessing Vulnerability of Industrial Equipment to Nuclear Air Blast.

DTIC Science & Technology

1983-10-01

PROJECT. TASK 4Scientific Servic, Inc. AREA & WORK UNIT NUMBERS 517 East Bayshore Work Unit 1124F Redwood City, CA 94063___ __________ 11. CONTROLLING ...vulnerability, but perhaps less expensive, to be selected and substituted, with an eye to cost control . 5. MODELING AND SCALING CONSIDERATIONS Reiterating...behavior and properties of the test items and Interfaces that control behavior (e4g., test objects/flow field, test objects/interfacing surface of

Social identity and support for counteracting tobacco company marketing that targets vulnerable populations

PubMed Central

Baig, Sabeeh A.; Pepper, Jessica K.; Morgan, Jennifer C.; Brewer, Noel T.

2017-01-01

Rationale Tobacco companies use advertising to target vulnerable populations, including youth, racial/ethnic minorities, and sexual minorities. Objective We sought to examine how personal identity affects support for population-specific anti-smoking advertisements that could serve as countermeasures to industry practices. Methods In 2014–2015, we surveyed probability phone samples of adults and adolescents (n = 6,139) and an online convenience sample of adults (n = 4,137) in the United States. We experimentally varied the description of tobacco industry marketing practices (no description, general, or specific to a target group). The four prevention target groups were teens; African Americans; Latinos; and gays, lesbians, and bisexuals (GLBs). Participants were either members or non-members of their prevention target group. Results Support was highest for anti-smoking advertisements targeting teens, moderate for Latinos and African Americans, and lowest for GLBs. In-group members expressed higher support than out-group members when anti-smoking advertisements targeted African Americans, Latinos, and GLBs (all p < .05). However, when teens were the target prevention group, in-group members expressed lower support than out-group members (p < .05). The description of industry marketing practices did not have an effect. Results were similar across the phone and online studies. Conclusions Our findings suggest that the public strongly supports advertisements to prevent smoking among teens, but support for similar efforts among other vulnerable populations is comparatively low. Anti-smoking campaigns for vulnerable populations may benefit from a greater understanding of the role of social identity in shaping public support for such campaigns. PMID:28427731

Work and Health among Latina Mothers in Farmworker Families

PubMed Central

Arcury, Thomas A.; Trejo, Grisel; Suerken, Cynthia K.; Grzywacz, Joseph G.; Ip, Edward H.; Quandt, Sara A.

2014-01-01

Background Work organization is important for the health of vulnerable workers, particularly women. This analysis describes work organization for Latinas in farmworker families and delineates the associations of work organization with health indicators. Methods 220 Latino women in farmworker families completed interviews from October 2012 - July 2013. Interviews addressed job structure, job demand, job control, and job support. Health measures included stress, depressive symptoms, physical activity, family conflict, and family economic security. Results Three-fifths of the women were employed. Several work organization dimensions, including shift, psychological demand, work safety climate, and benefits, were associated with participant health as expected, based on the work organization and job demands-control-support models. Conclusions Research should address women's health and specific work responsibilities. Occupational safety policy must consider the importance of work organization in the health of vulnerable workers. PMID:25742536

Accessibility and use of Primary Health Care: how conclusive is the social-economical situation in Antwerp?

PubMed

Philips, H; Rotthier, P; Meyvis, L; Remmen, R

2015-04-01

The percentage of households that delays medical assistance due to financial reasons is slowly increasing. Moreover, some groups of the population do not ever find their way to primary health care and end up unnecessarily in the emergency department or with specialists. This study wants to examine how primary health care can be made accessible to these groups. In this study, we aim to discover whether in a city such as Antwerp primary health care is accessible to everyone. The statistics were collected from the Health Care Survey done by the Welfare Services Antwerp in cooperation with the City of Antwerp. The questions were asked in three different ways: a postal questionnaire, a telephone questionnaire and a face-to-face interview. We determined that people who live on social welfare delay medical help due to financial reasons more frequently than the global Antwerp population. They often do not have a regular general practitioner (GP). Especially single parents, house-wives and house-husbands, job-seekers, incapacitated people unable to work, unskilled workers and foreigners are among the vulnerable groups where accessibility to primary health care is a concern. If we hope to improve the accessibility of primary health care, we must first and foremost inform the above-mentioned groups of the insurability and how this is applied. When this is fulfilled, it will be easier for the GP to receive this vulnerable group within the primary care system, so that the help of specialized care, which is often unnecessary, can be reduced.

Relational Factors of Vulnerability and Protection for Adolescent Pregnancy: A Cross-Sectional Comparative Study of Portuguese Pregnant and Nonpregnant Adolescents of Low Socioeconomic Status

ERIC Educational Resources Information Center

Pereira, Ana I. F.; Canavarro, Maria C.; Cardoso, Margarida F.; Mendonca, Denisa

2005-01-01

This study explores multiple relational contexts that promote vulnerability and protection against early pregnancy in a potential risk group of Portuguese adolescents. A comparative analysis was made between two groups of female adolescents of low socioeconomic status: pregnant adolescents (n = 57) and adolescents without a history of pregnancy (n…

A pragmatic analysis of vulnerability in clinical research.

PubMed

Wendler, David

2017-09-01

Identifying which subjects are vulnerable, and implementing safeguards to protect them, is widely regarded as essential to clinical research. Commentators have endorsed a number of responses to these challenges and have thereby made significant progress in understanding vulnerability in clinical research. At the same time, this literature points to a central contradiction which calls into question its potential to protect vulnerable subjects in practice. Specifically, analysis suggests that all human subjects are vulnerable and vulnerability in clinical research is comparative and context dependent, in the sense that individuals are vulnerable relative to others and in some contexts only. Yet, if everyone is vulnerable, there seems to be no point in citing the vulnerability of some individuals. Moreover, the conclusion that everyone is vulnerable seems inconsistent with the claims that vulnerability is comparative and context dependent, raising concern over whether it will be possible to develop a comprehensive account of vulnerability that is internally consistent. The solution to this dilemma lies in recognition of the fact that the practical significance of claims regarding vulnerability depends on the context in which they are used. The claims that appear to lead to the central contradiction are in fact accurate conclusions that follow from different uses of the term 'vulnerability'. The present manuscript describes this 'pragmatic' approach to vulnerability in clinical research and considers its implications for ensuring that subjects receive appropriate protection. Published 2017. This article is a U.S. Government work and is in the public domain in the USA.

Core concepts of human rights and inclusion of vulnerable groups in the mental health policies of Malawi, Namibia, and Sudan

PubMed Central

2013-01-01

Background One of the most crucial steps towards delivering judicious and comprehensive mental health care is the formulation of a policy and plan that will navigate mental health systems. For policy-makers, the challenges of a high-quality mental health system are considerable: the provision of mental health services to all who need them, in an equitable way, in a mode that promotes human rights and health outcomes. Method EquiFrame, a novel policy analysis framework, was used to evaluate the mental health policies of Malawi, Namibia, and Sudan. The health policies were assessed in terms of their coverage of 21 predefined Core Concepts of human rights (Core Concept Coverage), their stated quality of commitment to said Core Concepts (Core Concept Quality), and their inclusion of 12 Vulnerable Groups (Vulnerable Group Coverage). In relation to these summary indices, each policy was also assigned an Overall Summary Ranking, in terms of it being of High, Moderate, or Low quality. Results Substantial variability was identified across EquiFrame’s summary indices for the mental health policies of Malawi, Namibia, and Sudan. However, all three mental health policies scored high on Core Concept Coverage. Particularly noteworthy was the Sudanese policy, which scored 86% on Core Concept Coverage, and 92% on Vulnerable Group Coverage. Particular deficits were evident in the Malawian mental health policy, which scored 33% on Vulnerable Group Coverage and 47% on Core Concept Quality, and was assigned an Overall Summary Ranking of Low accordingly. The Overall Summary Ranking for the Namibian Mental Health Policy was High; for the Sudanese Mental Health Policy was Moderate; and for the Malawian Mental Health Policy was Low. Conclusions If human rights and equity underpin policy formation, it is more likely that they will be inculcated in health service delivery. EquiFrame may provide a novel and valuable tool for mental health policy analysis in relation to core concepts of human rights and inclusion of vulnerable groups, a key practical step in the successful realization of the Millennium Development Goals. PMID:23406583

Research should not ignore the power of elite groups.

PubMed

Gregory, Robert J

2002-02-01

For a long time, public health research has focused on many and diverse types of vulnerable groups in society. Whether drug abusers, prison inmates, smokers, poverty-stricken, mentally ill, HIV positive, or any number of other ailments, the public health system and, in particular, researchers have addressed and reported on people and populations with so-called deficits. Research on these vulnerable groups has been designed, conducted, reported, discussed and analysed, but vulnerable groups continue and, in fact, appear to be increasing in number, size, and range. An alternative approach that begins with entirely different questions is possible and advisable. Public health research could, and in the author's point of view, should, examine the lifestyles and, specifically, decision-making by members of elite groups. Studying up the economic and political ladder calls for examination of how a few reap enormous benefits for themselves, leaving the rest of us to our misfortune. Such decisions as the elite groups make affects resource allocation, use of information, and results in the public health and other social, economic, military, and political sectors in society.

Natural and environmental vulnerability analysis through remote sensing and GIS techniques: a case study of Indigirka River basin, Eastern Siberia, Russia

NASA Astrophysics Data System (ADS)

Boori, Mukesh S.; Choudhary, Komal; Kupriyanov, Alexander; Sugimoto, Atsuko; Evers, Mariele

2016-10-01

The aim of this research work is to understand natural and environmental vulnerability situation and its cause such as intensity, distribution and socio-economic effect in the Indigirka River basin, Eastern Siberia, Russia. This paper identifies, assess and classify natural and environmental vulnerability using landscape pattern from multidisciplinary approach, based on remote sensing and Geographical Information System (GIS) techniques. A model was developed by following thematic layers: land use/cover, vegetation, wetland, geology, geomorphology and soil in ArcGIS 10.2 software. According to numerical results vulnerability classified into five levels: low, sensible, moderate, high and extreme vulnerability by mean of cluster principal. Results are shows that in natural vulnerability maximum area covered by moderate (29.84%) and sensible (38.61%) vulnerability and environmental vulnerability concentrated by moderate (49.30%) vulnerability. So study area has at medial level vulnerability. The results found that the methodology applied was effective enough in the understanding of the current conservation circumstances of the river basin in relation to their environment with the help of remote sensing and GIS. This study is helpful for decision making for eco-environmental recovering and rebuilding as well as predicting the future development.

How diet modification challenges are magnified in vulnerable or marginalized people with diabetes and heart disease: a systematic review and qualitative meta-synthesis.

PubMed

Vanstone, M; Giacomini, M; Smith, A; Brundisini, F; DeJean, D; Winsor, S

2013-01-01

Diet modification is an important part of self-management for patients with diabetes and/or heart disease (including coronary artery disease, heart failure, and atrial fibrillation). Many health care providers and community-based programs advise lifestyle and diet modification as part of care for people with these conditions. This report synthesizes qualitative information on how patients respond differently to the challenges of diet modification. Qualitative and descriptive evidence can illuminate challenges that may affect the success and equitable impact of dietary modification interventions. To (a) examine the diet modification challenges faced by diabetes and/or heart disease patients; and (b) compare and contrast the challenges faced by patients who are members of vulnerable and nonvulnerable groups as they change their diet in response to clinical recommendations. This report synthesizes 65 primary qualitative studies on the topic of dietary modification challenges encountered by patients with diabetes and/or heart disease. Included papers were published between 2002 and 2012 and studied adult patients in North America, Europe, and Australia/New Zealand. Qualitative meta-synthesis was used to integrate findings across primary research studies. Analysis identified 5 types of challenges that are common to both vulnerable and nonvulnerable patients: self-discipline, knowledge, coping with everyday stress, negotiating with family members, and managing the social significance of food. Vulnerable patients may experience additional barriers, many of which can magnify or exacerbate those common challenges. While qualitative insights are robust and often enlightening for understanding experiences and planning services in other settings, they are not intended to be generalizable. The findings of the studies reviewed here--and of this synthesis--do not strictly generalize to the Ontario (or any specific) population. This evidence must be interpreted and applied carefully, in light of expertise and the experiences of the relevant community. Diet modification is not simply a matter of knowing what to eat and making the rational choice to change dietary practices. Rather, diet and eating practices should be considered as part of the situated lives of patients, requiring an individualized approach that is responsive to the conditions in which each patient is attempting to make a change. Common challenges include self-discipline, knowledge, coping with everyday stress, negotiating with family members, and managing the social significance of food. An individualized approach is particularly important when working with patients who have vulnerabilities. Health care providers often encourage people with diabetes and/or heart disease to change their diet. They advise people with diabetes to eat less sugar, starch, and fat. They advise people with heart disease to eat less fat and salt. However, many patients find it difficult to change what they eat. This report examines the challenges people may face when making such changes. It also examines the special challenges faced by people who are vulnerable due to other factors, such as poverty, lack of education, and difficulty speaking English. Five themes were common to all people who make diet changes: self-discipline, knowledge, coping with stress, negotiating with family members, and managing the social aspect of food. Members of vulnerable groups also reported other challenges, such as affording fresh fruit and vegetables or understanding English instructions. This report may help health care providers work with patients more effectively to make diet changes.

How Diet Modification Challenges Are Magnified in Vulnerable or Marginalized People With Diabetes and Heart Disease

PubMed Central

Vanstone, M; Giacomini, M; Smith, A; Brundisini, F; DeJean, D; Winsor, S

2013-01-01

Background Diet modification is an important part of self-management for patients with diabetes and/or heart disease (including coronary artery disease, heart failure, and atrial fibrillation). Many health care providers and community-based programs advise lifestyle and diet modification as part of care for people with these conditions. This report synthesizes qualitative information on how patients respond differently to the challenges of diet modification. Qualitative and descriptive evidence can illuminate challenges that may affect the success and equitable impact of dietary modification interventions. Objectives To (a) examine the diet modification challenges faced by diabetes and/or heart disease patients; and (b) compare and contrast the challenges faced by patients who are members of vulnerable and nonvulnerable groups as they change their diet in response to clinical recommendations. Data Sources This report synthesizes 65 primary qualitative studies on the topic of dietary modification challenges encountered by patients with diabetes and/or heart disease. Included papers were published between 2002 and 2012 and studied adult patients in North America, Europe, and Australia/New Zealand. Review Methods Qualitative meta-synthesis was used to integrate findings across primary research studies. Results Analysis identified 5 types of challenges that are common to both vulnerable and nonvulnerable patients: self-discipline, knowledge, coping with everyday stress, negotiating with family members, and managing the social significance of food. Vulnerable patients may experience additional barriers, many of which can magnify or exacerbate those common challenges. Limitations While qualitative insights are robust and often enlightening for understanding experiences and planning services in other settings, they are not intended to be generalizable. The findings of the studies reviewed here—and of this synthesis—do not strictly generalize to the Ontario (or any specific) population. This evidence must be interpreted and applied carefully, in light of expertise and the experiences of the relevant community. Conclusions Diet modification is not simply a matter of knowing what to eat and making the rational choice to change dietary practices. Rather, diet and eating practices should be considered as part of the situated lives of patients, requiring an individualized approach that is responsive to the conditions in which each patient is attempting to make a change. Common challenges include self-discipline, knowledge, coping with everyday stress, negotiating with family members, and managing the social significance of food. An individualized approach is particularly important when working with patients who have vulnerabilities. Plain Language Summary Health care providers often encourage people with diabetes and/or heart disease to change their diet. They advise people with diabetes to eat less sugar, starch, and fat. They advise people with heart disease to eat less fat and salt. However, many patients find it difficult to change what they eat. This report examines the challenges people may face when making such changes. It also examines the special challenges faced by people who are vulnerable due to other factors, such as poverty, lack of education, and difficulty speaking English. Five themes were common to all people who make diet changes: self-discipline, knowledge, coping with stress, negotiating with family members, and managing the social aspect of food. Members of vulnerable groups also reported other challenges, such as affording fresh fruit and vegetables or understanding English instructions. This report may help health care providers work with patients more effectively to make diet changes. PMID:24228077

Current Simulation Methods in Military Systems Vulnerability Assessment

DTIC Science & Technology

1990-11-01

Weapons * 1990: JASON Review of the Army Approach to Vulnerability Testing Many of the suggestions and recommendations made by these committees concern...damage vectors. Ongoing work by the JASONs 29 is also targeted to developing statistical methods for LF-test/SQuASH-model comparisons in Space 2]. We...Technical Report BRL-TR-3113, June 1990. 28. L. Tonnessen, A. Fries , L. Starkey and A. Stein, Live Fire Testing in the Evaluation of the Vulnerability of

Working memory training in children with neuropsychiatric disorders and mild to borderline intellectual functioning, the role of coaching; a double-blind randomized controlled trial.

PubMed

Roording-Ragetlie, Sammy; Klip, Helen; Buitelaar, Jan; Slaats-Willemse, Dorine

2017-03-28

Working memory training (WMT) has been shown to offer therapeutic benefits to both patients with Attention-Deficit Hyperactivity Disorder (ADHD) and patients with mild to borderline Intellectual Disabilities (MBID; 60 < IQ < 85). However, robust evidence for transfer effects and treatment benefits of WMT over placebo training are lacking. Owing to the nature of double-blind research designs in RCTs, children have received non-specific coaching not based on their actual training performance. Active coaching based on individual training results (such as in clinical practice) might enhance the efficacy of Cogmed WMT. Furthermore, clinical experience and the general treatment approach to these vulnerable children has shown that the intensity and duration of WMT is often too stressful. This study therefore investigated the efficacy of a less intensive, but more prolonged Cogmed WMT (including active personalized coaching and feedback) in reducing behavioral symptoms and improving neurocognitive functioning and academic achievements in children with MBID and neuropsychiatric disorders. A double-blind RCT with children (age 10.0-13.11) with neuropsychiatric disorders (ADHD and/or autism spectrum disorder (ASD)) and MBID (IQ: 60 < IQ < 85). Two groups (each n = 26) will receive Cogmed WMT (version R/M) at home or at school for 8 weeks, 4 days a week, at 30 min a day. One group will receive active personalized coaching and feedback based on their actual individual performance during Cogmed training. The other group will only receive general non-personalized coaching (i.e. no receive personalized coaching and feedback). Both groups will undergo a neurocognitive assessment (working memory, executive functioning, academic achievements) before and after training and complete several questionnaires (behavioral problems, parenting style) with a 6 months follow-up. This study will add to the literature since the role of coaching in Cogmed WMT has not been studied before. It will also provide opportunities to investigate an alternative version of WMT in a large group of vulnerable children, for whom few evidence-based treatments are available. Ultimately, this will allow us to advise mental health care professionals and special education schools about the use of this type of intervention for children with MBID and neuropsychiatric disorders. Dutch Trial Register. NTR5223 . Registration date 06-09-2015.

DEMONSTRATING APPLICATIONS OF REGIONAL VULNERABILITY ASSESSMENT

EPA Science Inventory

This task is designed to respond to 2 Congressional earmarks of $1,000,000 to the Canaan Valley Institute (CVI) to work in close coordination with the Regional Vulnerability Assessment (ReVA) initiative to develop research and educational tools using integrative technologies to p...

Preventing Childhood Malaria in Africa by Protecting Adults from Mosquitoes with Insecticide-Treated Nets

PubMed Central

Killeen, Gerry F; Smith, Tom A; Ferguson, Heather M; Mshinda, Hassan; Abdulla, Salim; Lengeler, Christian; Kachur, Steven P

2007-01-01

Background Malaria prevention in Africa merits particular attention as the world strives toward a better life for the poorest. Insecticide-treated nets (ITNs) represent a practical means to prevent malaria in Africa, so scaling up coverage to at least 80% of young children and pregnant women by 2010 is integral to the Millennium Development Goals (MDG). Targeting individual protection to vulnerable groups is an accepted priority, but community-level impacts of broader population coverage are largely ignored even though they may be just as important. We therefore estimated coverage thresholds for entire populations at which individual- and community-level protection are equivalent, representing rational targets for ITN coverage beyond vulnerable groups. Methods and Findings Using field-parameterized malaria transmission models, we show that high (80% use) but exclusively targeted coverage of young children and pregnant women (representing <20% of the population) will deliver limited protection and equity for these vulnerable groups. In contrast, relatively modest coverage (35%–65% use, with this threshold depending on ecological scenario and net quality) of all adults and children, rather than just vulnerable groups, can achieve equitable community-wide benefits equivalent to or greater than personal protection. Conclusions Coverage of entire populations will be required to accomplish large reductions of the malaria burden in Africa. While coverage of vulnerable groups should still be prioritized, the equitable and communal benefits of wide-scale ITN use by older children and adults should be explicitly promoted and evaluated by national malaria control programmes. ITN use by the majority of entire populations could protect all children in such communities, even those not actually covered by achieving existing personal protection targets of the MDG, Roll Back Malaria Partnership, or the US President's Malaria Initiative. PMID:17608562

Protecting water quality in the watershed

DOE Office of Scientific and Technical Information (OSTI.GOV)

James, C.R.; Johnson, K.E.; Stewart, E.H.

1994-08-01

This article highlights the water quality component of a watershed management plan being developed for the San Francisco (CA) Water Department. The physical characteristics of the 63,000-acre watersheds were analyzed for source and transport vulnerability for five groups of water quality parameters--particulates, THM precursors, microorganisms (Giardia and cryptosporidium), nutrients (nitrogen and phosphorus), and synthetic organic chemicals--and vulnerability zones were mapped. Mapping was achieved through the use of an extensive geographic information system (GIS) database. Each water quality vulnerability zone map was developed based on five watershed physical characteristics--soils, slope, vegetation, wildlife concentration, and proximity to water bodies--and their relationships tomore » each of the five groups of water quality parameters. An approach to incorporate the watershed physical characteristics information into the five water quality vulnerability zone maps was defined and verified. The composite approach was based in part on information gathered from existing watershed management plans.« less

Using internet-based approaches to collect qualitative data from vulnerable groups: reflections from the field.

PubMed

Neville, Stephen; Adams, Jeffery; Cook, Catherine

2016-12-01

Undertaking qualitative research with vulnerable populations is a complex and challenging process for researchers. Traditional and common modes of collecting qualitative data with these groups have been via face-to-face recorded interviews. This article reports on three internet-based data collection methods; email and synchronous online interviews, as well as online qualitative survey. The key characteristics of using email, sychronous online interviews and an online qualitative survey including the strengths and limitations of each are presented. Reflections and insights on the use of these internet-based data collection methods are provided to encourage researchers to embrace technology and move away from using traditional face-to-face interviews when researching with vulnerable populations. Using the internet to collect qualitative data offers additional ways to gather qualitative data over traditional data collection methods. The use of alternative interview methods may encourage participation of vulnerable participants.

African American adolescent perceptions of vulnerability and resilience to HIV.

PubMed

Glenn, Betty L; Wilson, Kathleen P

2008-07-01

HIV/AIDS is growing at a disproportional rate among African American adolescents. This trend has occurred despite the fact that 89% of schools have educational programs on HIV/AIDS. Barriers to effective HIV prevention may be related to a failure to develop educational programs based on the cultural competencies of vulnerable populations such as adolescents who are at risk for HIV. The purpose of this qualitative study was to explore African American adolescent perceptions of vulnerability and resilience to HIV/AIDS within a cultural competency paradigm. A group of 8 adolescents at an African American church participated in a focus group to discuss vulnerability and resilience to HIV. To facilitate discussion, the adolescents developed collages from pictures in African American magazines. Content analysis was used to identify themes. The themes revealed were confidence, safe social activities, innocence, image, music/drug culture, and peer pressure.

Education in Sustainable Development: How Can Science Education Contribute to the Vulnerability Perception?

NASA Astrophysics Data System (ADS)

Lange, J. M.

2012-01-01

Education for human development within the constraints of sustainability is problematic for schools. On one hand, it is a political idea that continues to evolve with successive compromises between social groups with differing or even conflicting interests. ESD is therefore inherently `non-disciplinary' and cannot be the basis of a single school subject if we wish to keep the creativity that results from the dynamics at work. On the other hand, SD leads us to think collectively about solutions that ensure a future of our choosing that preserves the biological capacity of the planet and to reduce our vulnerability. The sciences thus have a key role: their ability to question the world and to model the consequences of collective and individual choices. But there is a risk of technocratic drift and SD leads us to think about society's values and aims. A new link is established between sciences and humanities with a democratic model in sight. This paper presents what is possible out of the prospective scenarios method within general and compulsory education by seeking, through an empirical approach, to determine its feasibility, its contributions, its limits, and to locate the place of science education in the elaboration of the perception of "vulnerability". Both primary and secondary schools are concerned.

An approach to developing local climate change environmental public health indicators, vulnerability assessments, and projections of future impacts.

PubMed

Houghton, Adele; English, Paul

2014-01-01

Environmental public health indicators (EPHIs) are used by local, state, and federal health agencies to track the status of environmental hazards; exposure to those hazards; health effects of exposure; and public health interventions designed to reduce or prevent the hazard, exposure, or resulting health effect. Climate and health EPHIs have been developed at the state, federal, and international levels. However, they are also needed at the local level to track variations in community vulnerability and to evaluate the effectiveness of interventions designed to enhance community resilience. This review draws on a guidance document developed by the U.S. Council of State and Territorial Epidemiologists' State Environmental Health Indicators Collaborative climate change working group to present a three-tiered approach to develop local climate change EPHIs. Local climate change EPHIs can assist local health departments (LHDs) in implementing key steps of the 10 essential public health services and the U.S. Centers for Disease Control and Prevention's Building Resilience Against Climate Effects framework. They also allow LHDs to incorporate climate-related trends into the larger health department planning process and can be used to perform vulnerability assessments which can be leveraged to ensure that interventions designed to address climate change do not exacerbate existing health disparities.

An Approach to Developing Local Climate Change Environmental Public Health Indicators, Vulnerability Assessments, and Projections of Future Impacts

PubMed Central

2014-01-01

Environmental public health indicators (EPHIs) are used by local, state, and federal health agencies to track the status of environmental hazards; exposure to those hazards; health effects of exposure; and public health interventions designed to reduce or prevent the hazard, exposure, or resulting health effect. Climate and health EPHIs have been developed at the state, federal, and international levels. However, they are also needed at the local level to track variations in community vulnerability and to evaluate the effectiveness of interventions designed to enhance community resilience. This review draws on a guidance document developed by the U.S. Council of State and Territorial Epidemiologists' State Environmental Health Indicators Collaborative climate change working group to present a three-tiered approach to develop local climate change EPHIs. Local climate change EPHIs can assist local health departments (LHDs) in implementing key steps of the 10 essential public health services and the U.S. Centers for Disease Control and Prevention's Building Resilience Against Climate Effects framework. They also allow LHDs to incorporate climate-related trends into the larger health department planning process and can be used to perform vulnerability assessments which can be leveraged to ensure that interventions designed to address climate change do not exacerbate existing health disparities. PMID:25349621

Masculinity, sexuality and vulnerability in ‘working’ with young men in South African contexts: ‘you feel like a fool and an idiot … a loser’

PubMed Central

Shefer, Tamara; Kruger, Lou-Marie; Schepers, Yeshe

2015-01-01

South Africa has seen a rapid increase in scholarship and programmatic interventions focusing on gender and sexuality, and more recently on boys, men and masculinities. In this paper, we argue that a deterministic discourse on men's sexuality and masculinity in general is inherent in many current understandings of adolescent male sexuality, which tend to assume that young women are vulnerable and powerless and young men are sexually powerful and inevitably also the perpetrators of sexual violence. Framed within a feminist, social constructionist the oretical perspective, the current research looked at how the masculinity and sexuality of South African young men is constructed, challenged or maintained. Focus groups were conducted with young men between the ages of 15 and 20 years from five different schools in two regions of South Africa, the Western and Eastern Cape. Data were analysed using Gilligan's listening guide method. Findings suggest that participants in this study have internalised the notion of themselves as dangerous, but were also exploring other possible ways of being male and being sexual, demonstrating more complex experiences of manhood. We argue for the importance of documenting and highlighting the precariousness, vulnerability and uncertainty of young men in scholarly and programmatic work on masculinities. PMID:25803702

Interactive exploration of the vulnerability of the human infrastructure: an approach using simultaneous display of similar locations

NASA Astrophysics Data System (ADS)

Ceré, Raphaël; Kaiser, Christian

2015-04-01

Currently, three quarters of the Swiss population is living in urban areas. The total population is still increasing, and urbanized space is increasing event faster. Consequently, the intensity of use has decreased but the exposure of the urban space to natural events has grown along with the cost related to the impact of hazards. In line with this fact, during the 20th century there has been a noticeable increase of natural disasters accompanied by the rapid increase of the world population, leading to higher costs. Additionally to the fact that more people are exposed to natural hazards, the value of goods globally has increased more than proportionally. Consequently, the vulnerability of urban space is, more than ever before, a major issue for socio-economic development. Here, vulnerability is defined as the potential human loss or loss of infrastructure caused by a hazardous event. It encompasses factors of urban infrastructure, population and the environment, which increase the susceptibility of a location to the impact of hazards. This paper describes a novel method for improving the interactive use of exploratory data analysis in the context of minimizing vulnerability and disaster risk by prevention or mitigation. This method is used to assess the similarity between different locations with respect to several characteristics relevant to vulnerability at different scales, allowing for automatic display of multiple locations similar to the one under investigation by an expert. Visualizing vulnerability simultaneously for several locations allows for analyzing and comparing of metric characteristics between multiple places and at different scales. The interactivity aspect is also useful for understanding vulnerability patterns and it facilitates disaster risk management and decisions on global preventive measures in urban spaces. Metrics for vulnerability assessment can be extracted from extensive geospatial datasets such as high-resolution digital elevation models (DEM) or individual building vector layers. Morphological properties can be calculated for different scales using different moving window sizes. Multi-scale measures such as fractal or lacunarity can be integrated into the analysis. Other properties such as different densities and ratios are also easy to calculate and include. Based on a rather extensive set of properties or features, a feature selection or extraction method such as Principal Component Analysis can be used to obtain a subset of relevant properties. In a second step, an unsupervised classification algorithm such as Self-Organizing Maps can be used to group similar locations together, and criteria such as the intra-group distance and geographic distribution can be used for selecting relevant locations to be displayed in an interactive data exploration interface along with a given main location. A case study for a part of Switzerland illustrates the presented approach within a working interactive tool, showing the feasibility and allowing for an investigation of the usefulness of our method.

Creating a Flood Risk Index to Improve Community Resilience

NASA Astrophysics Data System (ADS)

Klima, K.; El Gammal, L.

2017-12-01

While flood risk reduction is an existent discourse and agenda in policy and insurance, vulnerabilities vary between communities; some communities may have aging infrastructure, or an older/poorer population less able to absorb a flood, putting them at increased risk from the hazards. As a result, some are considering environmental justice aspects of flood risk reduction. To date, catastrophe models have focused on creating floodmaps (e.g., NOAA's Sea Level Rise Viewer, Climate Central's Surging Seas), or on linking hydrological models to economic loss models (e.g., HEC-RAS + HAZUS). However, this approach may be highly inequitable between areas of different income (as well as other demographics). Some have begun work on combining hydrology with vulnerability information (e.g., USACE's North Atlantic Comprehensive Coastal Study). To our knowledge, no one has tried to adapt the more advanced known heat risk theory to water risk by combining hydrology information (e.g., HEC-RAS, floodplain maps) with the social vulnerability (e.g., Cutter et al.) of the residents. This project will create a method to combine water hazard data with a derived water vulnerability index to help a community understand their current and future water risk. We will use the case study area of Pittsburgh, PA, which faces severe precipitation and riverine flooding hazards. Building on present literature of factors influencing water vulnerability contextualized to the Pittsburgh region, we will identify, quantify, and map the top factors impacting water vulnerability. We will combine these with flood maps to identify the geospatial distribution of water risk. This work will allow policy makers to identify location-specific aspects of water vulnerability and risk in any community, thus promoting environmental justice. It is possible that this type of original research would create maps of relative water risk that may prove as understandable to the general public as other flood maps, and may also help to promote "just resilience". This presentation will present a method to combine water hazard data with a derived water vulnerability index to present work on the geospatial distribution of water risk in Pittsburgh, PA.

Addressing vulnerabilities of female sex workers in an HIV prevention intervention in Mumbai and Thane: experiences from the Aastha project.

PubMed

Ranebennur, Virupax; Gaikwad, Sanjeevsingh; Ramesh, Sowmya; Bhende, Amrita

2014-01-01

It is important for targeted interventions to consider vulnerabilities of female sex workers (FSWs) such as poverty, work-related mobility, and literacy, for effective human immunodeficiency virus (HIV) prevention. This paper describes and examines the association of the Aastha HIV/sexually transmitted infection (STI) prevention project in Mumbai and Thane, India, on the relationship between vulnerability and behavioral outcomes. Data were drawn from the Behavioural Tracking Survey, a cross-sectional behavioral study conducted in 2010 with 2,431 FSWs recruited in Mumbai and Thane. The key independent measures used were program exposure and "vulnerability index", a composite index of literacy, factors of dependence (alternative livelihood options, current debt, and children), and aspects of sex work (mobility and duration in sex work). Dependent measures included service uptake, self-confidence, self-identity, and individual agency. Logistic regression analysis was used to examine the study objectives. Of the analytical sample of 2,431 FSWs, 1,295 (53.3%) were categorized as highly vulnerable. Highly vulnerable FSWs who were associated with the Aastha program for more than a year were more likely to have accessed crisis-response services in the past 6 months (adjusted odds ratio [AOR] 2.2, 95% confidence interval [CI] 1.4-3.6; P<0.001), to have visited a clinic to get a checkup for STI symptoms (AOR 2.4, 95% CI 1.2-4.8; P<0.015), not to be ashamed to disclose identity as an FSW to health workers (AOR 2.1, 95% CI 1.2-3.5; P<0.008), and to be confident in supporting a fellow FSW in crisis (AOR 1.7, 95% CI 1.0-2.8, P<0.033) compared to those less vulnerable with similar exposure to the Aastha program. It is critical for HIV/STI interventions to consider vulnerabilities of FSWs at project inception and address them with focused strategies, including a segmented service-delivery model and community involvement, in order to strengthen the structural response to HIV prevention.

Addressing vulnerabilities of female sex workers in an HIV prevention intervention in Mumbai and Thane: experiences from the Aastha project

PubMed Central

Ranebennur, Virupax; Gaikwad, Sanjeevsingh; Ramesh, Sowmya; Bhende, Amrita

2014-01-01

Background It is important for targeted interventions to consider vulnerabilities of female sex workers (FSWs) such as poverty, work-related mobility, and literacy, for effective human immunodeficiency virus (HIV) prevention. This paper describes and examines the association of the Aastha HIV/sexually transmitted infection (STI) prevention project in Mumbai and Thane, India, on the relationship between vulnerability and behavioral outcomes. Materials and methods Data were drawn from the Behavioural Tracking Survey, a cross-sectional behavioral study conducted in 2010 with 2,431 FSWs recruited in Mumbai and Thane. The key independent measures used were program exposure and “vulnerability index”, a composite index of literacy, factors of dependence (alternative livelihood options, current debt, and children), and aspects of sex work (mobility and duration in sex work). Dependent measures included service uptake, self-confidence, self-identity, and individual agency. Logistic regression analysis was used to examine the study objectives. Results Of the analytical sample of 2,431 FSWs, 1,295 (53.3%) were categorized as highly vulnerable. Highly vulnerable FSWs who were associated with the Aastha program for more than a year were more likely to have accessed crisis-response services in the past 6 months (adjusted odds ratio [AOR] 2.2, 95% confidence interval [CI] 1.4–3.6; P<0.001), to have visited a clinic to get a checkup for STI symptoms (AOR 2.4, 95% CI 1.2–4.8; P<0.015), not to be ashamed to disclose identity as an FSW to health workers (AOR 2.1, 95% CI 1.2–3.5; P<0.008), and to be confident in supporting a fellow FSW in crisis (AOR 1.7, 95% CI 1.0–2.8, P<0.033) compared to those less vulnerable with similar exposure to the Aastha program. Conclusion It is critical for HIV/STI interventions to consider vulnerabilities of FSWs at project inception and address them with focused strategies, including a segmented service-delivery model and community involvement, in order to strengthen the structural response to HIV prevention. PMID:24600249

What constitutes 'support' for the role of the Aboriginal and Torres Strait Islander child health workforce?

PubMed

Watson, Karen; Young, Jeanine; Barnes, Margaret

2013-02-01

As well as providing primary health care services, Aboriginal and Torres Strait Islander health workers are known to significantly contribute to the overall acceptability, access and use of health services through their role of cultural brokerage in the communities within which they work. As such they are uniquely positioned to positively influence health improvements for this vulnerable population. This study sought to identify key areas that both Aboriginal and Torres Strait Islander and non-Indigenous health professionals working within Indigenous communities felt were important in providing support for their roles. This group of workers require support within their roles particularly in relation to cultural awareness and capability, resource provision, educational opportunities, collaboration with colleagues and peers, and professional mentorship.

A Reflection on the Work of an Educational Psychologist in Providing Supervision for a Team of Community Based Support Workers, Supporting Families with Vulnerable Adolescents at Risk of Exclusion from School

ERIC Educational Resources Information Center

Maxwell, Tim

2013-01-01

The evolving role of the educational psychologist (EP) is discussed with an emphasis on the supervision provided for a team of support workers for vulnerable adolescents, working within a Local Service Team. This development is considered in the context of the Every Child Matters (DfES, 2004) agenda and the Farrell, Woods, Lewis, Rooney, Squire…

Review Article: A comparison of flood and earthquake vulnerability assessment indicators

NASA Astrophysics Data System (ADS)

de Ruiter, Marleen C.; Ward, Philip J.; Daniell, James E.; Aerts, Jeroen C. J. H.

2017-07-01

In a cross-disciplinary study, we carried out an extensive literature review to increase understanding of vulnerability indicators used in the disciplines of earthquake- and flood vulnerability assessments. We provide insights into potential improvements in both fields by identifying and comparing quantitative vulnerability indicators grouped into physical and social categories. Next, a selection of index- and curve-based vulnerability models that use these indicators are described, comparing several characteristics such as temporal and spatial aspects. Earthquake vulnerability methods traditionally have a strong focus on object-based physical attributes used in vulnerability curve-based models, while flood vulnerability studies focus more on indicators applied to aggregated land-use classes in curve-based models. In assessing the differences and similarities between indicators used in earthquake and flood vulnerability models, we only include models that separately assess either of the two hazard types. Flood vulnerability studies could be improved using approaches from earthquake studies, such as developing object-based physical vulnerability curve assessments and incorporating time-of-the-day-based building occupation patterns. Likewise, earthquake assessments could learn from flood studies by refining their selection of social vulnerability indicators. Based on the lessons obtained in this study, we recommend future studies for exploring risk assessment methodologies across different hazard types.

An assessment of sex work in Swaziland: barriers to and opportunities for HIV prevention among sex workers.

PubMed

Chipamaunga, Shalote; Muula, Adamson S; Mataya, Ronald

2010-10-01

The HIV situation in virtually all southern African countries is a generalised epidemic. Despite the fact that almost all adult age and social groups have high HIV prevalence estimates, sex workers are disproportionally affected, with prevalence estimates higher than the general population. In a qualitative study of 61 male and female sex workers in Swaziland, we found that while poverty drove many into sex work, others reported motivations of pleasure or "sensation seeking", and freedoms from the burden of marriage as perceived benefits of sex work. We also found that penile-vaginal sex was not universal in male-female sexual encounters; and motivation by sex workers for non-condom use included intention to earn more money from unprotected sex, desire for sexual pleasure, and not having time to use condoms. Many sex workers expressed doubts over an alternative lifestyle, even if that change afforded them money to meet their daily necessities. The findings from this study suggest that treating sex workers as a homogenous group that is driven into, or maintain sex work only because of poverty may be problematic, and could hamper HIV-relevant interventions aimed at reducing their vulnerability to sexually transmitted infections.

Narrowing the Gap in Outcomes for Vulnerable Groups: Overview and Analysis of Available Datasets on Vulnerable Groups and the Five ECM Outcomes. Executive Summary

ERIC Educational Resources Information Center

Morris, Marian

2007-01-01

This summary presents the main findings from a data mapping and analysis study commissioned by the Local Government Association (LGA) from the National Foundation for Educational Research (NFER) as part of a two-year development and research programme, Narrowing the Gap. This programme seeks to make a significant difference in "narrowing the…

Specialized science.

PubMed

Casadevall, Arturo; Fang, Ferric C

2014-04-01

As the body of scientific knowledge in a discipline increases, there is pressure for specialization. Fields spawn subfields that then become entities in themselves that promote further specialization. The process by which scientists join specialized groups has remarkable similarities to the guild system of the middle ages. The advantages of specialization of science include efficiency, the establishment of normative standards, and the potential for greater rigor in experimental research. However, specialization also carries risks of monopoly, monotony, and isolation. The current tendency to judge scientific work by the impact factor of the journal in which it is published may have roots in overspecialization, as scientists are less able to critically evaluate work outside their field than before. Scientists in particular define themselves through group identity and adopt practices that conform to the expectations and dynamics of such groups. As part of our continuing analysis of issues confronting contemporary science, we analyze the emergence and consequences of specialization in science, with a particular emphasis on microbiology, a field highly vulnerable to balkanization along microbial phylogenetic boundaries, and suggest that specialization carries significant costs. We propose measures to mitigate the detrimental effects of scientific specialism.

Specialized Science

PubMed Central

Fang, Ferric C.

2014-01-01

As the body of scientific knowledge in a discipline increases, there is pressure for specialization. Fields spawn subfields that then become entities in themselves that promote further specialization. The process by which scientists join specialized groups has remarkable similarities to the guild system of the middle ages. The advantages of specialization of science include efficiency, the establishment of normative standards, and the potential for greater rigor in experimental research. However, specialization also carries risks of monopoly, monotony, and isolation. The current tendency to judge scientific work by the impact factor of the journal in which it is published may have roots in overspecialization, as scientists are less able to critically evaluate work outside their field than before. Scientists in particular define themselves through group identity and adopt practices that conform to the expectations and dynamics of such groups. As part of our continuing analysis of issues confronting contemporary science, we analyze the emergence and consequences of specialization in science, with a particular emphasis on microbiology, a field highly vulnerable to balkanization along microbial phylogenetic boundaries, and suggest that specialization carries significant costs. We propose measures to mitigate the detrimental effects of scientific specialism. PMID:24421049

High-ACE Low Wage Workers: Occupational Health Nursing Research and Praxis Through a Trauma-Informed Lens.

PubMed

Rosemberg, Marie-Anne; Gultekin, Laura; Pardee, Michelle

2018-05-01

Individuals with a history of adverse childhood experiences (ACEs) disproportionately have poor mental and physical health outcomes. These experiences affect individuals across the life span extending beyond health with deleterious impact on work-related outcomes. Low-wage workers are particularly at risk. Social service and health organizations are becoming aware of the extent to which the populations they serve have been affected by these experiences. Employment support programs may serve high-ACE individuals but likely are unaware of their histories and the developmental or health deficits that result and can impinge on successful employment. Occupational health nurses may be well-positioned not only to implement trauma-informed care in workplaces but also to influence the ways in which employment services for this vulnerable group are delivered. The purpose of this article is to consider how ACEs could affect vulnerable workers. The need for trauma-informed research and praxis to advance occupational health nursing is discussed.

Need for a Comprehensive Sex and Relationship Education Programme for Adults with Learning Disability.

PubMed

Enow, Humphrey; Nagalingam, Priya; Singh, Ranbir; Thalitaya, Madhusudan Deepak

2015-09-01

Most people with learning disabilities (PWLD) have little understanding of the concept of sex and relationship. PWLD are vulnerable and more likely to be victims of sexual offending. Currently, the only formal access to sex and relationship education that PWLD have is in special need schools. The right to express their sexuality is frequently restricted or denied by restricted policies, negative attitudes and lack of awareness of their needs. To provide a Comprehensive Sex and Relationship Education programme for PWLD. These group/individual sessions will led by a sexuality support worker with experience in working with PWLD. They will be supported by members of the multidisciplinary team including, psychiatrist, psychologist, occupational therapists etc. Providing sex and relationship education PWLD would help them achieve a fulfilling and rewarding sexual experience and make them less vulnerable to sexual abuse. There should be greater emphasis to be placed on sex and relationship education in PWLD; preferably by qualified professionals.

Seismic vulnerability of existing bridge substructures supporting the I-55 undercrossing at MS-302 (Goodman Road).

DOT National Transportation Integrated Search

2002-10-01

As part of a work assignment issued by the Mississippi Department of Transportation, : Bridge Division, the following report has been prepared to document results of an : investigation of seismic vulnerability of the primary structural elements suppo...

Food security and nutritional outcomes among urban poor orphans in Nairobi, Kenya.

PubMed

Kimani-Murage, Elizabeth W; Holding, Penny A; Fotso, Jean-Christophe; Ezeh, Alex C; Madise, Nyovani J; Kahurani, Elizabeth N; Zulu, Eliya M

2011-06-01

The study examines the relationship between orphanhood status and nutritional status and food security among children living in the rapidly growing and uniquely vulnerable slum settlements in Nairobi, Kenya. The study was conducted between January and June 2007 among children aged 6-14 years, living in informal settlements of Nairobi, Kenya. Anthropometric measurements were taken using standard procedures and z scores generated using the NCHS/WHO reference. Data on food security were collected through separate interviews with children and their caregivers, and used to generate a composite food security score. Multiple regression analysis was done to determine factors related to vulnerability with regards to food security and nutritional outcomes. The results show that orphans were more vulnerable to food insecurity than non-orphans and that paternal orphans were the most vulnerable orphan group. However, these effects were not significant for nutritional status, which measures long-term food deficiencies. The results also show that the most vulnerable children are boys, those living in households with lowest socioeconomic status, with many dependants, and female-headed and headed by adults with low human capital (low education). This study provides useful insights to inform policies and practice to identify target groups and intervention programs to improve the welfare of orphans and vulnerable children living in urban poor communities.

Do we have a moral responsibility to compensate for vulnerable groups? A discussion on the right to health for LGBT people.

PubMed

Ekmekci, Perihan Elif

2017-09-01

Vulnerability is a broad concept widely addressed in recent scholarly literature. Lesbian, gay, bisexual, and transgender (LGBT) people are among the vulnerable populations with significant disadvantages related to health and the social determinants of health. Medical ethics discourse tackles vulnerability from philosophical and political perspectives. LGBT people experience several disadvantages from both perspectives. This article aims to justify the right to health for LGBT people and their particular claims regarding healthcare because they belong to a vulnerable group. Rawls' theory of justice and Norman Daniels' normal functioning approach will be discussed in this context. Despite the fact that the right to health can be justified by Daniels' normal functioning approach, there is still a theoretical gap in justifying the right to health for particular vulnerable populations such as LGBT peopleand discussing society's duty to compensate for these disadvantages. In search of solid theoretical grounds for the justification of the right to health for LGBT people, the present author takes the opportunity to utilize Daniels' flexible definition of normal functioning to show that normal functioning not only varies by age but also by different states of human existence, including sexual orientation and gender identity, and to propose replacing the life span approach with normal states of human existence.

Fleshing out vulnerability.

PubMed

Tavaglione, Nicolas; Martin, Angela K; Mezger, Nathalie; Durieux-Paillard, Sophie; François, Anne; Jackson, Yves; Hurst, Samia A

2015-02-01

In the literature on medical ethics, it is generally admitted that vulnerable persons or groups deserve special attention, care or protection. One can define vulnerable persons as those having a greater likelihood of being wronged - that is, of being denied adequate satisfaction of certain legitimate claims. The conjunction of these two points entails what we call the Special Protection Thesis. It asserts that persons with a greater likelihood of being denied adequate satisfaction of their legitimate claims deserve special attention, care or protection. Such a thesis remains vague, however, as long as we do not know what legitimate claims are. This article aims at dispelling this vagueness by exploring what claims we have in relation to health care - thus fleshing out a claim-based conception of vulnerability. We argue that the Special Protection Thesis must be enriched as follows: If individual or group X has a greater likelihood of being denied adequate satisfaction of some of their legitimate claims to (i) physical integrity, (ii) autonomy, (iii) freedom, (iv) social provision, (v) impartial quality of government, (vi) social bases of self-respect or (vii) communal belonging, then X deserves special attention, care or protection. With this improved understanding of vulnerability, vulnerability talk in healthcare ethics can escape vagueness and serve as an adequate basis for practice. © 2013 John Wiley & Sons Ltd.

Unified communication to reach vulnerable mothers.

PubMed

Tezcan, B; Von Rege, I; Henkson, H; Oteng-Ntim, E

2011-01-01

The feasibility of using a mobile text to reach vulnerable patient groups was assessed in this study. A total of 121 pregnant or postnatal women were randomly asked to complete a questionnaire. The questionnaire was given to them in the antenatal clinic, postnatal ward, antenatal ward or in the day assessment unit at St Thomas' Hospital, London. The forms were collected and analysed using an Excel database. The results of this survey show that mobile technology is readily available for 97% of the obstetric population. In mothers from vulnerable groups and in mothers from deprived areas, 61% possessed 3rd generation mobile technology. The majority of mothers surveyed wanted their care supplemented by the use of their mobile phones.

Does psychosocial competency training for junior physicians working in pediatric medicine improve individual skills and perceived job stress.

PubMed

Bernburg, Monika; Baresi, Lisa; Groneberg, David; Mache, Stefanie

2016-12-01

Pediatricians' job performance, work engagement, and job satisfaction are essential for both the individual physician and quality of care for their little patients and parents. Therefore, it is important to maintain or possibly augment pediatricians' individual and professional competencies. In this study, we developed and implemented a psychosocial competency training (PCT) teaching different psychosocial competencies and stress coping techniques. We investigated (1) the influence of the PCT on work-related characteristics: stress perception, work engagement, job satisfaction and (2) explored pediatricians' outcomes and satisfaction with PCT. Fifty-four junior physicians working in pediatric hospital departments participated in the training and were randomized in an intervention (n = 26) or a control group (n = 28). In the beginning, at follow-up 1 and 2, both groups answered a self-rated questionnaire on perceived training outcomes and work-related factors. The intervention group showed that their job satisfaction significantly increased while perceived stress scores decreased after taking part in the PCT. No substantial changes were observed with regard to pediatricians' work engagement. Participating physicians evaluated PCT with high scores for training design, content, received outcome, and overall satisfaction with the training. Professional psychosocial competency training could improve junior pediatricians' professional skills, reduce stress perception, increase their job satisfaction, and psychosocial skills. In addition, this study indicates that the PCT is beneficial to be implemented as a group training program for junior pediatricians at work. What is Known: • Junior pediatricians often report experiencing high levels of job strain and little supervisory support. • High levels of job demands make pediatricians vulnerable for mental health problems and decreased work ability. What is New: • Development, implementation, and evaluation of a psychosocial competency training for junior pediatricians working in clinical settings • Psychosocial competency training has the potential to improve pediatricians' psychosocial skills and perceptions of perceived work-related stress and job satisfaction.

Group decision-making approach for flood vulnerability identification using the fuzzy VIKOR method

NASA Astrophysics Data System (ADS)

Lee, G.; Jun, K. S.; Chung, E.-S.

2015-04-01

This study proposes an improved group decision making (GDM) framework that combines the VIKOR method with data fuzzification to quantify the spatial flood vulnerability including multiple criteria. In general, GDM method is an effective tool for formulating a compromise solution that involves various decision makers since various stakeholders may have different perspectives on their flood risk/vulnerability management responses. The GDM approach is designed to achieve consensus building that reflects the viewpoints of each participant. The fuzzy VIKOR method was developed to solve multi-criteria decision making (MCDM) problems with conflicting and noncommensurable criteria. This comprising method can be used to obtain a nearly ideal solution according to all established criteria. This approach effectively can propose some compromising decisions by combining the GDM method and fuzzy VIKOR method. The spatial flood vulnerability of the southern Han River using the GDM approach combined with the fuzzy VIKOR method was compared with the spatial flood vulnerability using general MCDM methods, such as the fuzzy TOPSIS and classical GDM methods (i.e., Borda, Condorcet, and Copeland). As a result, the proposed fuzzy GDM approach can reduce the uncertainty in the data confidence and weight derivation techniques. Thus, the combination of the GDM approach with the fuzzy VIKOR method can provide robust prioritization because it actively reflects the opinions of various groups and considers uncertainty in the input data.

Perceived risks and benefits of sex work among transgender women of color in San Francisco.

PubMed

Sausa, Lydia A; Keatley, JoAnne; Operario, Don

2007-12-01

Prior research has shown that male-to-female (MTF) transgender women of color in the United States have a high rate of HIV infection and often engage in sex work for economic survival. With the exception of studies on HIV prevalence and behavioral risk, little research exists to elucidate the social context and determinants of sex work and related health risks among these women. Through a qualitative analysis of seven focus groups with 48 transgender women of color, we examined why and how participants became involved in sex work, documented risks associated with sex work, and explored what motivated participants to remain in sex work. Participants reported on how social networks and cultural norms, immigration issues, and experiences of racism, sexism, and transphobia influenced their decisions to enter and the risks encountered in sex work. Findings revealed that transgender women of color who engage in sex work have unique needs and experiences that must be addressed through structural and social network-based interventions to minimize their vulnerability to social and public health harms.

[Fundamental principles of social work--(also) a contribution to public health ethics].

PubMed

Lob-Hüdepohl, A

2009-05-01

Social work and public health are different but mutually connected. Both are professions with their own ethical foundations. Despite all differences, they have the same goal: to protect and to enhance the well-being of people. This is, in part, why the fundamental ethical principles of social work are salient for developing public health ethics. As a human rights profession, social work respects the personal autonomy of clients, supports solidarity-based relationships in families, groups or communities, and attempts to uphold social justice in society. Social workers need to adopt special professional attitudes: sensibility for the vulnerabilities of clients, care and attentiveness for their resources and strengths, assistance instead of paternalistic care and advocacy in decision making for clients' well-being when clients are not able to decide for themselves. These fundamental ethical principles are the basis for discussion of special topics of social work ethics as public health ethics, for example, in justifying intervention in individual lifestyles by public services without the participation or consent of the affected persons.

Identifying Two Groups of Entitled Individuals: Cluster Analysis Reveals Emotional Stability and Self-Esteem Distinction.

PubMed

Crowe, Michael L; LoPilato, Alexander C; Campbell, W Keith; Miller, Joshua D

2016-12-01

The present study hypothesized that there exist two distinct groups of entitled individuals: grandiose-entitled, and vulnerable-entitled. Self-report scores of entitlement were collected for 916 individuals using an online platform. Model-based cluster analyses were conducted on the individuals with scores one standard deviation above mean (n = 159) using the five-factor model dimensions as clustering variables. The results support the existence of two groups of entitled individuals categorized as emotionally stable and emotionally vulnerable. The emotionally stable cluster reported emotional stability, high self-esteem, more positive affect, and antisocial behavior. The emotionally vulnerable cluster reported low self-esteem and high levels of neuroticism, disinhibition, conventionality, psychopathy, negative affect, childhood abuse, intrusive parenting, and attachment difficulties. Compared to the control group, both clusters reported being more antagonistic, extraverted, Machiavellian, and narcissistic. These results suggest important differences are missed when simply examining the linear relationships between entitlement and various aspects of its nomological network.

Contexts, Mechanisms, and Outcomes That Matter in Dutch Community-Based Physical Activity Programs Targeting Socially Vulnerable Groups.

PubMed

Herens, Marion; Wagemakers, Annemarie; Vaandrager, Lenneke; van Ophem, Johan; Koelen, Maria

2017-09-01

This article presents a practitioner-based approach to identify key combinations of contextual factors (C) and mechanisms (M) that trigger outcomes (O) in Dutch community-based health-enhancing physical activity (CBHEPA) programs targeting socially vulnerable groups. Data were collected in six programs using semi-structured interviews and focus groups using a timeline technique. Sessions were recorded, anonymized, and transcribed. A realist synthesis protocol was used for data-driven and thematic analysis of CMO configurations. CMO configurations related to community outreach, program sustainability, intersectoral collaboration, and enhancing participants' active lifestyles. We have refined the CBHEPA program theory by showing that actors' passion for, and past experiences with, physical activity programs trigger outcomes, alongside their commitment to socially vulnerable target groups. Project discontinuity, limited access to resources, and a trainer's stand-alone position were negative configurations. The authors conclude that local governance structures appear often to lack adaptive capacity to accommodate multilevel processes to sustain programs.

Detection of Vulnerable Atherosclerotic Plaques in Experimental Atherosclerosis with the USPIO-Enhanced MRI.

PubMed

Qi, Chun-Mei; Du, Lili; Wu, Wei-Heng; Li, Dong-Ye; Hao, Ji; Gong, Lei; Deng, Liangrong; Zhang, Tao; Zhang, Chao; Zhang, Yu

2015-11-01

This study's goal was to assess the diagnostic value of the USPIO-(ultra-small superparamagnetic iron oxide) enhanced magnetic resonance imaging (MRI) in detection of vulnerable atherosclerotic plaques in abdominal aorta in experimental atherosclerosis. Thirty New Zealand rabbits were randomly divided into two groups, Group A and Group B. Each group comprised 15 animals which were fed with high cholesterol diet for 8 weeks and then subjected to balloon-induced endothelial injury of the abdominal aorta. After another 8 weeks, animals in Group B received adenovirus carrying p53 gene that was injected through a catheter into the aortic segments rich in plaques. Two weeks later, all rabbits were challenged with the injection of Chinese Russell's viper venom and histamine. Pre-contrast images and USPIO-enhanced MRI images were obtained after pharmacological triggering with injection of USPIO for 5 days. Blood specimens were taken for biochemical and serological tests at 0 and 18 weeks. Abdominal aorta was histologically studied. The levels of serum ICAM-1 and VCAM-1 were quantified by ELISA. Vulnerable plaques appeared as a local hypo-intense signal on the USPIO-enhanced MRI, especially on T2*-weighted sequences. The signal strength of plaques reached the peak at 96 h. Lipid levels were significantly (p < 0.05) higher in both Group A and B compared with the levels before the high cholesterol diet. The ICAM-1 and VCAM-1 levels were significantly (p < 0.05) higher in Group B compared with Group A. The USPIO-enhanced MRI efficiently identifies vulnerable plaques due to accumulation of USPIO within macrophages in abdominal aorta plaques.

Social identity and support for counteracting tobacco company marketing that targets vulnerable populations.

PubMed

Baig, Sabeeh A; Pepper, Jessica K; Morgan, Jennifer C; Brewer, Noel T

2017-06-01

Tobacco companies use advertising to target vulnerable populations, including youth, racial/ethnic minorities, and sexual minorities. We sought to examine how personal identity affects support for population-specific anti-smoking advertisements that could serve as countermeasures to industry marketing practices. In 2014-2015, we surveyed probability phone samples of adults and adolescents (n = 6,139) and an online convenience sample of adults (n = 4,137) in the United States. We experimentally varied the description of tobacco industry marketing practices (no description, general, or specific to a target group). The four prevention target groups were teens; African Americans; Latinos; and gays, lesbians, and bisexuals (GLBs). Participants were either members or non-members of their prevention target group. Support was highest for anti-smoking advertisements targeting teens, moderate for Latinos and African Americans, and lowest for GLBs. In-group members expressed higher support than out-group members when anti-smoking advertisements targeted African Americans, Latinos, and GLBs (all p < 0.05). However, when teens were the target prevention group, in-group members expressed lower support than out-group members (p < 0.05). The description of industry marketing practices did not have an effect. Results were similar across the phone and online studies. Our findings suggest that the public strongly supports advertisements to prevent smoking among teens, but support for similar efforts among other vulnerable populations is comparatively low. Anti-smoking campaigns for vulnerable populations may benefit from a greater understanding of the role of social identity in shaping public support for such campaigns. Copyright © 2017 Elsevier Ltd. All rights reserved.

Vulnerable subjects? The case of nonhuman animals in experimentation.

PubMed

Johnson, Jane

2013-12-01

The concept of vulnerability is deployed in bioethics to, amongst other things, identify and remedy harms to participants in research, yet although nonhuman animals in experimentation seem intuitively to be vulnerable, this concept and its attendant protections are rarely applied to research animals. I want to argue, however, that this concept is applicable to nonhuman animals and that a new taxonomy of vulnerability developed in the context of human bioethics can be applied to research animals. This taxonomy does useful explanatory work, helping to pinpoint the limitations of the 3Rs/welfare approach currently adopted in the context of animal experimentation. On this account, the 3Rs/welfare approach fails to deliver for nonhuman animals in experimentation because it effectively addresses only one element of their vulnerability (inherent) and paradoxically through the institution of Animal Ethics Committees intended to protect experimental animals in fact generates new vulnerabilities that exacerbate their already precarious situation.

Climate Compatible Development in the Mongolia Steppe: analysis of vulnerability and adaptation response to global changes

NASA Astrophysics Data System (ADS)

Ojima, D. S.; Togtokh, C.; Galvin, K. A.

2015-12-01

INTRODUCTION: Climate change and variability, market and policy changes are shaping pastoral communities' decisions on what pathways their future livelihoods will take and how the steppe landscapes and river basins, are managed. Recent droughts and damaging winter storms (zuds) of the past two decades have exacerbated the situation and undermined the natural capital on which the pastoral livelihoods depend upon. River basins are critical natural resources well-being of social-ecological systems in Mongolia. River basins provide the ecosystem services which support pastoral communities and industrial and urban development. Green development strategies are strongly dependent on water resources. Consequently, integrated planning of river basin management is needed to maintain these critical ecosystem services to meet the multiple needs of livelihoods of communities in these basins and to support sustainable development activities within the basins. For this study our team worked in nine sums (i.e., county level administrative areas) in three river basins in two provinces (aimags) to collect household data from 144 households. We also collected census data from the aimags and national level to understand trends at the level of ecosystems and river basins. We have selected 3 sums in each river basis, representing forest steppe, steppe and desert steppe regions for comparison across river basins and ecological zones. FINDINGS: Integrated planning efforts would be enhanced through, one, use of a social-ecological framework and, two, the development of a cross-ministerial working group to address natural resource considerations. Across the three basins agriculture, pastoral, industrial, and urban needs vie for similar ecosystem services. The natural capital and ecosystem services of these basins need to be assessed to understand the vulnerability and capacity of the resources. The most frequently listed "best coping strategy" across all ecosystem types was for herders to have better cooperation, both among themselves and with administrators. They frequently expressed the idea that people working alone can't accomplish anything in comparison to when they work together. Development of cross ministry and cross-sectoral working groups were viewed as one such mechanism.

"It's all about making a life": poverty, HIV, violence, and other vulnerabilities faced by young female sex workers in Kumasi, Ghana.

PubMed

Onyango, Monica Adhiambo; Adu-Sarkodie, Yaw; Agyarko-Poku, Thomas; Asafo, Mabel Kissiwah; Sylvester, Joy; Wondergem, Peter; Green, Kimberly; Wambugu, Samuel; Brennan, Alana T; Beard, Jennifer

2015-03-01

This study aimed to identify social, economic, structural, and individual-level vulnerabilities of female adolescents who sell sex in Kumasi, Ghana. Twenty-four in-depth interviews and 4 focus group discussions were conducted with female sex workers of age 18-20 years who had been involved in sex work for at least 2 years. Total sample size was 48. One-third of participants started sex work before age 15. Knowledge of HIV was accurate and most reported having intentions to use condoms consistently with clients; however, factors such as higher payments, drug and/or alcohol use, fear of violence, and police harassment affected condom use. They perceived violence and rape at the hands of clients as their greatest risk. They also reported abuse and exploitation by police. Respondents voiced strong concerns that girls and teens involved in sex work are at higher risk of unsafe sex, exploitation, and abuse than their older and more experienced counterparts. Unprotected sex with boyfriends was also common. The pathway to sex work followed a similar pattern for many study participants who left their rural homes for Kumasi in search of economic opportunity. While adolescents who sell sex appear to be abundant in Kumasi, they have been missed by HIV prevention and harm reduction programming. The findings from this study informed the design and implementation of a young female sex worker peer educator pilot program. Key elements of that program are presented, and recommendations for future program evaluation are made.

The development and interaction of terrorist and fanatic groups

NASA Astrophysics Data System (ADS)

Camacho, Erika T.

2013-11-01

Through the mathematical study of two models we quantify some of the theories of co-development and co-existence of focused groups in the social sciences. This work attempts to develop the mathematical framework behind the social sciences of community formation. By using well developed theories and concepts from ecology and epidemiology we hope to extend the theoretical framework of organizing and self-organizing social groups and communities, including terrorist groups. The main goal of our work is to gain insight into the role of recruitment and retention in the formation and survival of social organizations. Understanding the underlining mechanisms of the spread of ideologies under competition is a fundamental component of this work. Here contacts between core and non-core individuals extend beyond its physical meaning to include indirect interaction and spread of ideas through phone conversations, emails, media sources and other similar mean. This work focuses on the dynamics of formation of interest groups, either ideological, economical or ecological and thus we explore the questions such as, how do interest groups initiate and co-develop by interacting within a common environment and how do they sustain themselves? Our results show that building and maintaining the core group is essential for the existence and survival of an extreme ideology. Our research also indicates that in the absence of competitive ability (i.e., ability to take from the other core group or share prospective members) the social organization or group that is more committed to its group ideology and manages to strike the right balance between investment in recruitment and retention will prevail. Thus under no cross interaction between two social groups a single trade-off (of these efforts) can support only a single organization. The more efforts that an organization implements to recruit and retain its members the more effective it will be in transmitting the ideology to other vulnerable individuals and thus converting them to believers.

Symbolic capital and health: the case of women's sex work in Antananarivo, Madagascar.

PubMed

Stoebenau, Kirsten

2009-06-01

Public health research on sex work has been criticized both for representing sex work as a monolithic entity and for focusing only on individual behavioral determinants of health. When broader determinants are acknowledged, they are often described in solely economic terms (ie, comparing health risks of higher class versus lower class sex workers). Drawing from Pierre Bourdieu, I describe women's sex work in Antananarivo, Madagascar as a social 'field' and demonstrate that this field is both highly complex and highly structured. Fourteen months of ethnographic fieldwork (December 2002-December 2003; May-June 2004) in Antananarivo with women sex workers (n approximately 60) and community members (n approximately 85) informed a description of the community's understanding of the sex work field and its contrast to the lived experience of key informant sex workers. Women who sell sex were categorized by their communities into three social positions--ambony (high), antonony (middle) and ambany (low)--which were differentiated by economic capital (earnings per sexual exchange) and symbolic capital (prestige associated with race, ethnicity and moral demeanor). Women who occupied the antonony social position held the greatest volumes of symbolic capital both because they were identified as belonging to the local dominant ethnic group, and because they demonstrated discretion and shame in their sex work practice. Alternatively, women who occupied the ambony and ambany positions openly practiced their sex work and were associated with ethnic or racial minority identities, contributing to their lower volumes of symbolic capital. Symbolic capital influenced unique health vulnerabilities, such as to sexually transmitted disease, by social position through mechanisms operating from the institutional to the interpersonal level. This analysis illustrates the value of examining sex work as a social field, specifically the importance of capturing more than economic capital in order to understand sex workers' unique health vulnerabilities and concerns.

Uncertainty of trial timing enhances acquisition of conditioned eyeblinks in anxiety vulnerable individuals.

PubMed

Allen, M T; Myers, C E; Servatius, R J

2016-05-01

Recent work has found that behaviorally inhibited (BI) individuals exhibit enhanced eyeblink conditioning in omission and yoked training as well as with schedules of partial reinforcement. We hypothesized that spacing CS-US paired trials over a longer period of time by extending and varying the inter-trial interval (ITI) would facilitate learning. All participants completed the Adult Measure of Behavioural Inhibition (AMBI) and were grouped as behaviorally inhibited (BI) and non-behaviorally inhibited (NI) based on a median split score of 15.5. All participants received 3 US alone trials and 30CS-US paired trials for acquisition training and 20CS alone trials for extinction training in one session. Conditioning stimuli were a 500 ms tone conditioned stimulus (CS) and a 50-ms air puff unconditional stimulus (US). Participants were randomly assigned to receive a short ITI (mean=30+/- 5s), a long ITI (mean=57+/- 5s) or a variable long ITI (mean=57 s, range 25-123 s). No significant ITI effects were observed for acquisition or extinction. Overall, anxiety vulnerable individuals exhibited enhanced conditioned eyeblink responses as compared to non-vulnerable individuals. This enhanced acquisition of CRs was significant in spaced training with a variable long ITI, but not the short or long ITI. There were no significant effects of ITI or BI on extinction. These findings are interpreted based on the idea that uncertainty plays a role in anxiety and can enhance associative learning in anxiety vulnerable individuals. Copyright © 2016 Elsevier B.V. All rights reserved.

Communication Vulnerabilities in Working-age Australians with Musculoskeletal Conditions: A Cross-sectional Analysis.

PubMed

Lowe, Dianne B; Taylor, Michael J; Hill, Sophie J

2015-08-01

To estimate the prevalence of communication vulnerability (CV) and its association with various health measures among working-age Australians with musculoskeletal conditions (MSK). The various vulnerability characteristics may lead to inadequate communication between consumers and healthcare professionals. Prevalence of CV among 18-64 year olds, with or without MSK, was analyzed using the Australian Bureau of Statistics' National Health Survey 2007-08 data. Associations between CV and measures of health complexity (accumulating multimorbidity and risk factors) and health burden (poorer self-rated health, psychological distress, and pain restricting work) in the MSK population were estimated using logistic regression. Further analyses were conducted for each vulnerability characteristic to determine the degree of association (crude and adjusted) with measures of interest. CV were more prevalent in working-age Australians with MSK (65%) than those without (51%). Adjusted for age and sex among working-age Australians with at least 1 MSK, those with 1 or more CV were more likely to have multimorbidity [adjusted OR (aOR) = 1.8, 95% CI 1.5-2.2], lifestyle risk factors (aOR = 2.1, 95% CI 1.5-2.8), poorer self-rated health (aOR = 3.4, 95% CI 2.7-4.2), greater psychological distress (aOR = 2.9, 95% CI 2.3-3.7), and pain restricting employment (aOR = 1.7, 95% CI 1.4-2.1) compared with those without CV. For working-age people, there is an association between MSK and CV. For those with MSK, CV were associated with increased likelihood of health complexity and burden. These findings have policy and clinical relevance. Research is needed to determine whether interventions that address these specific CV characteristics reduce the burden of disease within these populations.

Syntactic Structural Assignment in Brazilian Portuguese-Speaking Children With Specific Language Impairment

PubMed Central

Fortunato-Tavares, Talita; de Andrade, Claudia R. F.; Befi-Lopes, Debora M.; Hestvik, Arild; Epstein, Baila; Tornyova, Lidiya; Schwartz, Richard G.

2013-01-01

Purpose In this study, the authors examined the comprehension of sentences with predicates and reflexives that are linked to a nonadjacent noun as a test of the hierarchical ordering deficit (HOD) hypothesis. That hypothesis and more modern versions posit that children with specific language impairment (SLI) have difficulty in establishing nonadjacent (hierarchical) relations among elements of a sentence. The authors also tested whether additional working memory demands in constructions containing reflexives affected the extent to which children with SLI incorrectly structure sentences as indicated by their picture-pointing comprehension responses. Method Sixteen Brazilian Portuguese-speaking children (8;4–l 0;6 [years;months]) with SLI and 16 children with typical language development (TLD) matched for age (±3 months), gender, and socioeconomic status participated in 2 experiments (predicate and reflexive interpretation). In the reflexive experiment, the authors also manipulated working memory demands. Each experiment involved a 4-choice picture selection sentence comprehension task. Results Children with SLI were significantly less accurate on all conditions. Both groups made more hierarchical syntactic construction errors in the long working memory condition than in the short working memory condition. Conclusion The HOD hypothesis was not confirmed. For both groups, syntactic factors (structural assignment) were more vulnerable than lexical factors (prepositions) to working memory effects in sentence miscomprehension. PMID:22232402

Family vulnerability index to disability and dependence (FVI-DD), by social and health conditions.

PubMed

Amendola, Fernanda; Alvarenga, Márcia Regina Martins; Latorre, Maria do Rosário Dias de Oliveira; Oliveira, Maria Amélia de Campos

2017-06-01

The Family Vulnerability Index to Disability and Dependence (FVI-DD) aims to summarize the dimensions of vulnerability to disability and dependence using family data monitored by Family Health Strategy (ESF) teams. This study aims to analyze the FVI-DD according to the social and health vulnerability, to validate and extract a cutoff point for each dimension. The FVI-DD was built with a sample of 248 families living in a region of São Paulo. The dimension related to health conditions was validated with good internal consistency, with respect to the Katz Index and the Lawton Scale, whereas the dimension related to social conditions was only validated in relation to Lawton Scale. Thus, a vulnerable family was defined as one with 15 or more points in the Total FVI-DD, and a vulnerable family in health conditions that with a score of 6 or more points in that dimension. Therefore, it is possible to classify families as not vulnerable, vulnerable in the social aspects, vulnerable in the health aspects and the more vulnerable family (social and health) using social indicators of empowerment and wear and health indicators related not only to the biological sphere, but also in the access to health services, health self-assessment and existing vulnerable groups.

Resourceful masculinities: exploring heterosexual Black men's vulnerability to HIV in Ontario, Canada.

PubMed

Husbands, Winston; Oakes, Wesley; Mbulaheni, Tola; Ongoïba, Fanta; Pierre-Pierre, Valérie; Luyombya, Henry

2017-10-29

Heterosexually active Black men are alleged to endorse masculine norms that increase their and their female partners' vulnerability to HIV. These norms include Black men's inability or reluctance to productively engage their own health-related personal and interpersonal vulnerabilities. We draw on data from the iSpeak research study in Ontario, Canada, to assess whether and how heterosexual Black men cope with personal and inter-personal vulnerability, namely that heterosexual Black men: avoid emotionally supportive relationships with other men (and women), which diminishes their capacity to productively acknowledge and resolve their health-related challenges; are reticent to productively acknowledge and address HIV and health on a personal level; and are pathologically secretive about their health, which compounds their vulnerability and precipitates poor health outcomes. iSpeak was implemented in 2011 to 2013, and included two focus groups with HIV-positive and HIV-negative self-identified heterosexual men (N = 14) in Toronto and London, a focus group with community-based health promotion practitioners who provide HIV-related services to Black communities in Ontario (N = 6), and one-on-one interviews with four researchers distinguished for their scholarship with/among Black communities in Toronto. Participants in the men's focus group were recruited discretely through word-of-mouth. Focus groups were audiotaped and transcribed verbatim. Team members independently read the transcripts, and then met to identify, discuss and agree on the emerging themes. We demonstrate that iSpeak participants (a) engage their personal and interpersonal vulnerabilities creatively and strategically, (b) complicate and challenge familiar interpretations of Black men's allegedly transgressive masculinity through their emotional and practical investment in their health, and (c) demonstrate a form of resourceful masculinity that ambiguously aligns with patriarchy. We conclude with a range of actionable recommendations to strengthen the discursive framework for understanding heterosexual Black men in relation to HIV and health, and substantively engaging them in community responses to HIV.

Intervention mapping for development of a participatory return-to-work intervention for temporary agency workers and unemployed workers sick-listed due to musculoskeletal disorders

PubMed Central

Vermeulen, Sylvia J; Anema, Johannes R; Schellart, Antonius JM; van Mechelen, Willem; van der Beek, Allard J

2009-01-01

Background In the past decade in activities aiming at return-to-work (RTW), there has been a growing awareness to change the focus from sickness and work disability to recovery and work ability. To date, this process in occupational health care (OHC) has mainly been directed towards employees. However, within the working population there are two vulnerable groups: temporary agency workers and unemployed workers, since they have no workplace/employer to return to, when sick-listed. For this group there is a need for tailored RTW strategies and interventions. Therefore, this paper aims to describe the structured and stepwise process of development, implementation and evaluation of a theory- and practise-based participatory RTW program for temporary agency workers and unemployed workers, sick-listed due to musculoskeletal disorders (MSD). This program is based on the already developed and cost-effective RTW program for employees, sick-listed due to low back pain. Methods The Intervention Mapping (IM) protocol was used to develop a tailor-made RTW program for temporary agency workers and unemployed workers, sick-listed due to MSD. The Attitude-Social influence-self-Efficacy (ASE) model was used as a theoretical framework for determinants of behaviour regarding RTW of the sick-listed worker and development of the intervention. To ensure participation and facilitate successful adoption and implementation, important stakeholders were involved in all steps of program development and implementation. Results of semi-structured interviews and 'fine-tuning' meetings were used to design the final participatory RTW program. Results A structured stepwise RTW program was developed, aimed at making a consensus-based RTW implementation plan. The new program starts with identifying obstacles for RTW, followed by a brainstorm session in which the sick-listed worker and the labour expert of the Social Security Agency (SSA) formulate solutions/possibilities for suitable (therapeutic) work. This process is guided by an independent RTW coordinator to achieve consensus. Based on the resulting RTW implementation plan, to create an actual RTW perspective, a vocational rehabilitation agency is assigned to find a matching (therapeutic) workplace. The cost-effectiveness of this participatory RTW program will be evaluated in a randomised controlled trial. Conclusion IM is a promising tool for the development of tailor-made OHC interventions for the vulnerable working population. PMID:19573229

History of sex trafficking, recent experiences of violence, and HIV vulnerability among female sex workers in coastal Andhra Pradesh, India

PubMed Central

Gupta, Jhumka; Reed, Elizabeth; Kershaw, Trace; Blankenship, Kim M.

2011-01-01

Synopsis Findings from female sex workers in southern India indicate that women who enter sex work via trafficking are exposed to unique HIV vulnerabilities. Objectives To estimate the prevalence of sex trafficking as a mode of entry into sex work, and to examine associations between sex trafficking and recent violence experiences and HIV vulnerability among female sex workers (FSWs). Methods In a cross-sectional study in 2006 in coastal Andhra Pradesh, India, 812 FSWs were recruited via respondent-driven sampling to take part in an oral survey of their experiences in sex work. Results One in 5 (19.3%) FSWs met the UN definition of sex trafficking. Women trafficked into sex work were more likely than other FSWs to report recent violence experiences (adjusted odds ratio [AOR], 1.93; 95% confidence interval [CI], 1.32–2.81), more clients per week (AOR, 1.63; 95% CI, 1.11–2.41), and more days of sex work per week (AOR, 1.76; 95% CI, 1.18–2.63), and were less likely to report use of FSW-focused services (AOR, 0.60; 95% CI, 0.42–0.86). No significant differences emerged regarding HIV knowledge or consistent condom use. Conclusion There was a high prevalence of sex trafficking. A history of sex trafficking was associated with a greater vulnerability to recent violence and HIV risk behaviors, underscoring the need for increased attention to the public health needs of trafficked populations. PMID:21620402

Men and women--still far apart on HIV/AIDS.

PubMed

Frasca, Tim

2003-11-01

What could be more logical than a gay-feminist alliance to respond to the AIDS epidemic in Latin America? However, drawing on published articles and the author's experience in HIV/AIDS work in Chile, this paper argues that such an alliance is more rhetorical than real. Instead, both groups tend to stick to their respective niches and view the epidemic through the prism of the particular needs and concerns of their target constituencies, rather than learn from and support each other. Feminist rhetoric sometimes suggests that AIDS is a problem only because it affects women. The African paradigm of vulnerable women is inexactly applied, given the predominantly male and homosexual nature of the epidemic in most Latin American countries. Both women and homosexually active men are highly vulnerable to HIV infection, and little is gained by competing for the top slot on the "tragedy honour roll". Latin American gay men's groups, torn between AIDS and gay rights activism, often resist both protagonism by women and women's issues. Although the fight for access to antiretroviral treatment has obscured this conflict, it resurfaces in associations of HIV-positive people and may increase along with heterosexual transmission in the region. Discussion and exchanges should be encouraged to overcome these largely hidden divisions.

Developing an audit checklist to assess outdoor falls risk

PubMed Central

Curl, Angela; Thompson, Catharine Ward; Aspinall, Peter; Ormerod, Marcus

2016-01-01

Falls by older people (aged 65+) are linked to disability and a decrease in mobility, presenting a challenge to active ageing. As such, older fallers represent a vulnerable road user group. Despite this there is little research into the causes and prevention of outdoor falls. This paper develops an understanding of environmental factors causing falls or fear of falling using a walk-along interview approach with recent fallers to explore how older people navigate the outdoor environment and which aspects of it they perceived facilitate or hinder their ability to go outdoors and fear of falling. While there are a number of audit checklists focused on assessing the indoor environment for risk or fear of falls, nothing exists for the outdoor environment. Many existing street audit tools are focused on general environmental qualities and have not been designed with an older population in mind. We present a checklist that assesses aspects of the environment most likely to encourage or hinder those who are at risk of falling outdoors, developed through accounting for the experiences and navigational strategies of elderly individuals. The audit checklist can assist occupational therapists and urban planners, designers and managers in working to reduce the occurrence of outdoor falls among this vulnerable user group. PMID:27166968

Developing an audit checklist to assess outdoor falls risk.

PubMed

Curl, Angela; Thompson, Catharine Ward; Aspinall, Peter; Ormerod, Marcus

2016-06-01

Falls by older people (aged 65+) are linked to disability and a decrease in mobility, presenting a challenge to active ageing. As such, older fallers represent a vulnerable road user group. Despite this there is little research into the causes and prevention of outdoor falls. This paper develops an understanding of environmental factors causing falls or fear of falling using a walk-along interview approach with recent fallers to explore how older people navigate the outdoor environment and which aspects of it they perceived facilitate or hinder their ability to go outdoors and fear of falling. While there are a number of audit checklists focused on assessing the indoor environment for risk or fear of falls, nothing exists for the outdoor environment. Many existing street audit tools are focused on general environmental qualities and have not been designed with an older population in mind. We present a checklist that assesses aspects of the environment most likely to encourage or hinder those who are at risk of falling outdoors, developed through accounting for the experiences and navigational strategies of elderly individuals. The audit checklist can assist occupational therapists and urban planners, designers and managers in working to reduce the occurrence of outdoor falls among this vulnerable user group.

Discussing the Notion of Decent Work: Senses of Working for a Group of Brazilian Workers without College Education

PubMed Central

Ribeiro, Marcelo A.; Silva, Fabiano F.; Figueiredo, Paula M.

2016-01-01

Despite recent stability and socioeconomic development, Brazil’s history is marked by social inequality, informality, precarious work, and psychosocial vulnerability, with little opportunity for decent and meaningful work, as recommended by the International Labour Office (ILO), for people in the country. Nevertheless, based on a social constructionist view, the hypothesis can be raised that there is no substantive definition of decent work, but rather a psychosocial one, constructed based on the discourse, narratives, and practices produced through the relational processes which grant sense and meaning to work. Therefore, the examination of narratives and discourses is an important methodological strategy to understand the socio-occupational reality of Brazil. Thus, this study aims to understand the senses attributed to working through content analysis of the narratives produced by a set of 20 urban workers and contrast them with the ILO definition of decent work, in an effort to analyze the relationships, similarities, and differences between an established collective social discourse and the interviewees’ singular narratives. The main results point out that the participants look for working with fair wages, social protection, safety, and personal development opportunities, as the ILO recommends. The main difference is that these characteristics do not derive from the State’s actions, as in the employment and formal qualification model, but come from informal sources, such as family and community relationship networks. The informal relationship networks produce job opportunities as well as social protection; qualification takes place through practical learning from more experienced colleagues; the opportunity to be able to keep working (employed or working informally) leads to success and safety; and the possibility to make choices and have control over one’s life translates into personal and occupational development. In conclusion, the participants searched for working according to the principles recommended by the ILO. Nevertheless, in contexts of vulnerability and with restricted support from the State, these principles are constructed in the community and not offered by the public power, which generates distinguished forms of decent work. PMID:26941678

Discussing the Notion of Decent Work: Senses of Working for a Group of Brazilian Workers without College Education.

PubMed

Ribeiro, Marcelo A; Silva, Fabiano F; Figueiredo, Paula M

2016-01-01

Despite recent stability and socioeconomic development, Brazil's history is marked by social inequality, informality, precarious work, and psychosocial vulnerability, with little opportunity for decent and meaningful work, as recommended by the International Labour Office (ILO), for people in the country. Nevertheless, based on a social constructionist view, the hypothesis can be raised that there is no substantive definition of decent work, but rather a psychosocial one, constructed based on the discourse, narratives, and practices produced through the relational processes which grant sense and meaning to work. Therefore, the examination of narratives and discourses is an important methodological strategy to understand the socio-occupational reality of Brazil. Thus, this study aims to understand the senses attributed to working through content analysis of the narratives produced by a set of 20 urban workers and contrast them with the ILO definition of decent work, in an effort to analyze the relationships, similarities, and differences between an established collective social discourse and the interviewees' singular narratives. The main results point out that the participants look for working with fair wages, social protection, safety, and personal development opportunities, as the ILO recommends. The main difference is that these characteristics do not derive from the State's actions, as in the employment and formal qualification model, but come from informal sources, such as family and community relationship networks. The informal relationship networks produce job opportunities as well as social protection; qualification takes place through practical learning from more experienced colleagues; the opportunity to be able to keep working (employed or working informally) leads to success and safety; and the possibility to make choices and have control over one's life translates into personal and occupational development. In conclusion, the participants searched for working according to the principles recommended by the ILO. Nevertheless, in contexts of vulnerability and with restricted support from the State, these principles are constructed in the community and not offered by the public power, which generates distinguished forms of decent work.

Geology for Global Development: Training young geoscientists to communicate and do effective disaster risk reduction in the developing world

NASA Astrophysics Data System (ADS)

Gill, J. C.

2012-04-01

Geoscientists have a crucial role to play in improving disaster risk reduction and supporting communities to build resilience and reduce vulnerability. Across the world millions live in severe poverty, without access to many of the basic needs that are often taken for granted - a clean water supply, a reliable food source, safe shelter and suitable infrastructure. This lack of basic needs results in communities being particularly vulnerable to devastating natural hazards, such as floods, earthquakes, volcanic eruptions and landslides. Here we discuss two major gaps which can limit the engagement of geoscience students and recent graduates in the serious debates surrounding resilience and effective disaster risk reduction: (i) Geoscience undergraduate and postgraduate courses rarely give students the opportunity to engage with issues such as vulnerability, sustainability, knowledge exchange and cross-cultural communication. (ii) There are very few opportunities for geoscience students to gain experience in this sector through UK or overseas placements. Geology for Global Development (GfGD), established in 2011, is starting to work with UK students and recent graduates to fill these gaps. GfGD aims to inspire and engage young geoscientists, supporting them to apply their interdisciplinary knowledge and skills to generate solutions and resources which support NGOs, empower communities and help build resilience to natural hazards. This is being and will be done through: (i) active university groups hosting seminars and discussion groups; (ii) blog articles; (iii) opportunities to contribute to technical papers; (iv) workshops and conferences; and (v) UK and overseas placements. GfGD seeks to play a key role in the training and development of geoscience graduates with the necessary 'soft-skills' and opportunities to make an important contribution to improving disaster risk reduction, fighting poverty and improving people's lives.

Factors influencing to earthquake caused economical losses on urban territories

NASA Astrophysics Data System (ADS)

Nurtaev, B.; Khakimov, S.

2005-12-01

Questions of assessment of earthquake economical losses on urban territories of Uzbekistan, taking into account damage forming factors, which are increqasing or reducing economical losses were discussed in the paper. Buildings and facilities vulnerability factors were classified. From total value (equal to 50) were selected most important ones. Factors ranging by level of impact and weight function in loss assessment were ranged. One group of damage forming factors includs seismic hazard assessment, design, construction and maintenance of building and facilities. Other one is formed by city planning characteristics and includes : density of constructions and population, area of soft soils, existence of liquefaction susceptible soils and etc. To all these factors has been given weight functions and interval values by groups. Methodical recomendations for loss asessment taking into account above mentioned factors were developed. It gives possibility to carry out preventive measures for protection of vulnerable territories, to differentiate cost assessment of each region in relation with territory peculiarity and damage value. Using developed method we have ranged cities by risk level. It has allowed to establish ratings of the general vulnerability of urban territories of cities and on their basis to make optimum decisions, oriented to loss mitigation and increase of safety of population. Besides the technique can be used by insurance companies for estimated zoning of territory, development of effective utilization schema of land resources, rational town-planning, an economic estimation of used territory for supply with information of the various works connected to an estimation of seismic hazard. Further improvement of technique of establishment of rating of cities by level of damage from earthquakes will allow to increase quality of construction, rationality of accommodation of buildings, will be an economic stimulator for increasing of seismic resistance of building.

BEACH GRASS INVASIONS AND COASTAL FLOOD PROTECTION: FORECASTING THE EFFECTS OF CLIMATE CHANGE ON COASTAL VULNERABILITY

EPA Science Inventory

Our work will yield an increased general understanding of interactions among the alteration of coastal ecosystem, species invasions, climate change, and human risk in coastal environments. In addition, we will conduct a quantitative vulnerability assessment of a specific coast...

Exploring Faculty Perceptions toward Working with Academically Vulnerable College Students

ERIC Educational Resources Information Center

Quick, Robin L.

2013-01-01

This study is an exploratory study of faculty members' knowledge and perceptions toward of with academically vulnerable college students who are specifically experiencing reading and writing difficulties. Data were gathered from 174 college faculty at six higher education institutions throughout northwestern Pennsylvania via an online electronic…

Martial Arts and Socially Vulnerable Youth. An Analysis of Flemish Initiatives

ERIC Educational Resources Information Center

Theeboom, Marc; De Knop, Paul; Wylleman, Paul

2008-01-01

Notwithstanding the lack of empirical support for its positive socio-psychological effects, numerous educators and welfare workers make use of martial arts in their work with socially vulnerable youth. Using qualitative methodology, the aims, approaches and personal experiences were analysed of teachers and co-ordinators involved in specific…

Obsessional and Eating Disorder-related Intrusive Thoughts: Differences and Similarities Within and Between Individuals Vulnerable to OCD or to EDs.

PubMed

Belloch, Amparo; Roncero, María; Perpiñá, Conxa

2016-11-01

Unwanted intrusive cognitions constitute the normal variant of clinically significant intrusive cognitions found in disorders such as obsessive-compulsive disorder (OCD) and eating disorders (EDs). This study investigates whether individuals who are vulnerable to OCD or EDs experience more intrusions than people with no vulnerability to these disorders, and it examines the consequences of obsessional (OITs) and eating disorder (EDITs) intrusions in the same individuals, taking into account their susceptibility to OCD, EDs or neither of the two. From a sample of 922 participants, three groups were formed: risk of OCD (n = 92), risk of EDs (n = 41) and a no-risk group (n = 100). EDITs were more frequent than OITs in the two risk groups. Within-group comparisons showed that in the OCD-risk group, the OIT had more negative consequences (interference, emotional distress, dysfunctional appraisals and neutralizing strategies) than the EDIT, whereas in the ED-risk group, the OIT and the EDIT instigated similar negative consequences. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association.

"I feel like I am less than other people": Health-related vulnerabilities of male migrants travelling alone on their journey to Europe.

PubMed

Arsenijević, Jovana; Burtscher, Doris; Ponthieu, Aurelie; Severy, Nathalie; Contenta, Andrea; Moissaing, Stephane; Argenziano, Stefano; Zamatto, Federica; Zachariah, Rony; Ali, Engy; Venables, Emilie

2018-07-01

During 2015 and 2016, an unprecedented flow of approximately 800,000 migrants coming from Turkey towards Western Europe crossed the Balkans. Male migrants are perceived as being less vulnerable compared to other migrants and they are not given priority in service and support provision. This qualitative study examines the self-perceived vulnerabilities of male migrants travelling alone along the Balkan route to Europe. Twenty-four individual in-depth interviews, two group interviews and participant observation were conducted with male migrants in Belgrade, Serbia in 2017. Data was coded manually, and analysed thematically. Male migrants traveling alone face the cumulative vulnerability of various traumatic events and migration-related contextual circumstances. Three main themes emerged: the ongoing desperate journey, the better treatment of 'traditionally' well recognised vulnerable sub-groups and the impact of the continuous stress on mental health. Deterrence measures imposed for border control purposes in the form of push-backs, expulsions, detention and degrading, inhumane treatment amplify the psychological distress of male migrants. Feelings of hopelessness, desperation, lack of self-value and self-esteem were reported. 'Traditionally vulnerable' populations were said to have had better treatment throughout the journey from smugglers, border state authorities, governmental officials, civil society and international organizations. The devastating experiences of male migrants, as well as the better treatment offered to other groups of migrants like women and children, results in a perceived neglect of the needs of men in humanitarian response, rendering them vulnerable and exposing them to further health and protection risks. In a context where needs are unmet and people's dignity and health are at risk, specific strategies should be developed to include men in the assistance and protection offered, particularly in relation to exposure to violence. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

Diabetes and work: 12-year national follow-up study of the association of diabetes incidence with socioeconomic group, age, gender and country of origin.

PubMed

Poulsen, Kjeld; Cleal, Bryan; Willaing, Ingrid

2014-12-01

To investigate the extent and socioeconomic distribution of incident diabetes among the Danish working-age population. The Danish National Diabetes Register was linked with socioeconomic and population-based registers covering the entire population. We analysed the 12-year diabetes incidence using multivariate Poisson regression for 2,086,682 people, adjusting for gender, 10-year age groups, main population groups defined by country of origin, and seven socioeconomic groups: professionals, managers, technicians, workers skilled at basic level, unskilled workers, unemployed and pensioners. The crude 12-year incidence of diabetes was 5.8%. The saturated multivariate model, adjusted for gender, age, country of origin and socioeconomic status; showed a relative risk (RR) for diabetes incidence of 1.44 for male (reference: female), 3.95 for the age range of 50-59 years (reference: 30-39 years), 2.07 for unskilled workers (reference: professionals) and 2.15 for people from countries of 'non-Western origin' (reference: Danish origin). Diabetes incidence increases with age, male gender and low socioeconomic status; and also among people from countries of 'non-Western origin'. The results indicate that getting a more senior workforce will substantially increase the proportion of workers with diabetes, especially among already vulnerable groups. © 2014 the Nordic Societies of Public Health.

Prenatal tobacco prevention and cessation interventions for women in low- and middle-income countries.

PubMed

Oncken, Cheryl A; Dietz, Patricia M; Tong, Van T; Belizán, José M; Tolosa, Jorge E; Berghella, Vincenzo; Goldenberg, Robert L; Lando, Harry A; Samet, Jonathan M; Bloch, Michele H

2010-01-01

Although the prevalence of tobacco use is decreasing in many high-income countries, it is increasing in many low- and middle-income countries. The health and economic burden of increasing tobacco use and dependence is predictable and will have devastating effects in countries with limited resources, particularly for vulnerable populations such as pregnant women. We sought to review effective tobacco prevention and intervention strategies for decreasing tobacco use and secondhand smoke exposure before and during pregnancy in high-, middle-, and low-income countries. We reviewed several types of interventions, including population-level efforts (increasing tobacco prices, implementing tobacco control policies), community interventions, clinical interventions, and pharmacological treatments. A second purpose of this report is to present findings of an international expert working group that was convened to review the evidence and to establish research priorities in the following areas: (a) preventing the uptake and reducing tobacco use among girls and women of reproductive age; and (b) reducing tobacco use and secondhand smoke exposure among pregnant women. The working group considered the evidence on existing interventions in terms of burden of disease, intervention impact, intervention costs, feasibility of integration into existing services, uniqueness of the contribution, and overall feasibility. Finally, we present the working group's recommendations for intervention research priorities.

Country watch: South-East Asia.

PubMed

Bagasao, T M

1996-01-01

Nongovernmental organizations (NGO) and community-based groups working on HIV/AIDS in Thailand, Sri Lanka, the Philippines, Malaysia, and other countries participated in a February 1991 workshop during which they recognized that human rights are inextricably linked with HIV prevention, the provision of services, and improving the quality of life of people living with HIV/AIDS and other vulnerable, marginalized groups. They also noted how rarely environments were supportive with respect to either legal structures or sociocultural norms. The groups resolved to act as a watchdog, an advocacy and lobbying group to monitor legislation, provide public information, and empower people with HIV/AIDS as visible and active partners. Meeting again in 1993 to assess progress, the groups found few gains in addressing human rights violations such as the denial of medical services to people with HIV/AIDS and the deportation of HIV-positive migrant workers. The Asia Pacific Council of AIDS Service Organizations (APCASO) responded by developing a pilot documentation, monitoring, and reporting system in the region to record HIV-related human rights violations. That system is described.

Do Children Orphaned by AIDS Experience Distress Over Time? A Latent Growth Curve Analysis of Depressive Symptoms

PubMed Central

Chi, Peilian; Li, Xiaoming; Barnett, Douglas; Zhao, Junfeng; Zhao, Guoxiang

2014-01-01

This longitudinal study aimed to examine the enduring effects of parental HIV/AIDS on children's psychological well-being in Asia. A sample of 1625 children aged from 6 to 18 years old were assessed annually for their depressive symptoms over three years. Latent growth curve modeling (LGCM) was used to examine the trajectories of depressive symptoms among AIDS orphans and vulnerable children in comparison with children from HIV-free families. AIDS orphans demonstrated the highest initial level of depressive symptoms among the three groups. On average, children's depressive symptoms scores can be expected to realize an approximate 25% decrease for AIDS orphans, 19% decrease for vulnerable children and 15% decrease for comparison children over a 3-year period. Individual differences within the groups showed that children with higher initial level of depressive symptoms can be expected to decrease slower over time. Multiple group LGCM showed that the three groups of children demonstrated significantly different trajectories of depressive symptoms. Among the key demographic factors, only age exerted an effect on the trajectory of depressive symptoms of vulnerable children, indicating that the younger children showed higher level of initial depressive symptoms and lower rate of decrease than the older children. The current study enriched our knowledge on the longitudinal effect of parental HIV/AIDS on children's emotional distress. Future psychological support might take the children's developmental stages and cultural appropriateness into consideration and deliver service for the most vulnerable group of children affected by HIV/AIDS. PMID:24090100

Safety of union home care aides in Washington State.

PubMed

Schoenfisch, Ashley L; Lipscomb, Hester; Phillips, Leslie E

2017-09-01

A rate-based understanding of home care aides' adverse occupational outcomes related to their work location and care tasks is lacking. Within a 30-month, dynamic cohort of 43 394 home care aides in Washington State, injury rates were calculated by aides' demographic and work characteristics. Injury narratives and focus groups provided contextual detail. Injury rates were higher for home care aides categorized as female, white, 50 to <65 years old, less experienced, with a primary language of English, and working through an agency (versus individual providers). In addition to direct occupational hazards, variability in workload, income, and supervisory/social support is of concern. Policies should address the roles and training of home care aides, consumers, and managers/supervisors. Home care aides' improved access to often-existing resources to identify, manage, and eliminate occupational hazards is called for to prevent injuries and address concerns related to the vulnerability of this needed workforce. © 2017 Wiley Periodicals, Inc.

Wide-ranging impacts reported by NZ cancer survivors: is supporting cancer survivor resilience a health sector role?

PubMed

O'Brien, Inga; Signal, Louise; Sarfati, Diana

2018-04-01

Cancer survivor numbers are on the rise but little is known about New Zealand (NZ) survivors' experiences with management of cancer-related impacts and vulnerability. This study explored the experiences and resilience of NZ cancer survivors and the experiences of healthcare practitioners who work with cancer survivors. There is a focus on indigenous Māori survivors. This study used qualitative methods to explore survivors and healthcare practitioners' views on cancer-related impact and management strategies. Two focus groups were conducted with mainly colorectal cancer survivors residing in the central regions of NZ. There was one Māori-only group (n = 6 participants) and one multicultural group (n = 18 participants). The Māori-only focus group was purposefully organised to provide a culturally safe setting for the research. In addition, 12 in-depth interviews were conducted with healthcare practitioners between October 2011 and March 2012. Wide-ranging survivorship impacts were described by survivors across physical, emotional, spiritual and social domains. Shame resilience and relationships, particularly with healthcare practitioners, were indicated as useful supports. Healthcare practitioners' time constraints and role priorities were identified as barriers to their ability to provide survivorship support. This study generated qualitative data on survivorship impacts and components of survivor resilience in NZ. It also provided insights into the need for better strategies and pathways to help the NZ health system be more responsive to both Māori and non-Māori survivors. Survivor impacts create vulnerabilities that are experienced and described differently by individuals and groups in NZ. Tailored survivor support that can enhance resilience and support relationships is needed in NZ.

Vulnerability assessments as a political creation: tsunami management in Portugal.

PubMed

Pronk, Maartje; Maat, Harro; Crane, Todd A

2017-10-01

Vulnerability assessments are a cornerstone of contemporary disaster research. This paper shows how research procedures and the presentation of results of vulnerability assessments are politically filtered. Using data from a study of tsunami risk assessment in Portugal, the paper demonstrates that approaches, measurement instruments, and research procedures for evaluating vulnerability are influenced by institutional preferences, lines of communication, or lack thereof, between stakeholder groups, and available technical expertise. The institutional setting and the pattern of stakeholder interactions form a filter, resulting in a particular conceptualisation of vulnerability, affecting its operationalisation via existing methods and technologies and its institutional embedding. The Portuguese case reveals a conceptualisation that is aligned with perceptions prevalent in national government bureaucracies and the exclusion of local stakeholders owing to selected methodologies and assessment procedures. The decisions taken by actors involved in these areas affect how vulnerability is assessed, and ultimately which vulnerability reduction policies will be recommended in the appraisal. © 2017 The Author(s). Disasters © Overseas Development Institute, 2017.

Differential exposure and differential vulnerability as counteracting forces linking the psychosocial work environment to socioeconomic health differences.

PubMed

Vanroelen, C; Levecque, K; Louckx, F

2010-10-01

In this article, the link between (1) psychosocial working conditions (job demands, job autonomy, task variation, social support), (2) self-reported health (persistent fatigue, musculoskeletal complaints, emotional well-being) and (3) socioeconomic position (skill levels, occupational status) is explored. The two theoretical pathways linking the psychosocial work environment to socioeconomic differences in health are explored: differential exposure and differential vulnerability. Previously, the focus has often been on social inequalities in exposure to the stressors. The pathway of differential vulnerability in different socioeconomic positions is often neglected. In a representative cross-sectional sample of 11,099 Flemish (Belgian) wage earners, 16-65 years of age (47.5% women), logit modelling is applied. Higher exposure to psychosocial occupational stressors is associated with a higher prevalence of adverse health outcomes. Lower skill levels and subordinate occupational positions show a higher prevalence of musculoskeletal complaints, but not of persistent fatigue or emotional well-being. High demands, job strain and iso-strain are more common in higher-skilled, supervisory and managerial positions, but have the strongest health-damaging effects in lower socioeconomic positions. Low control is more prevalent in lower-skilled and subordinate positions, while having stronger adverse health effects in higher socioeconomic positions-the same holds for social support, although it has no clear socioeconomic distribution. Differential exposure and differential vulnerability constitute two counteracting forces in constituting the association between the psychosocial work environment and socioeconomic differences in self-reported health complaints among wage earners.

Psychological Vulnerability and Problem Gambling: The Mediational Role of Cognitive Distortions.

PubMed

Lévesque, David; Sévigny, Serge; Giroux, Isabelle; Jacques, Christian

2018-01-03

Despite numerous studies demonstrating the influence of cognitive distortions on gambling problem severity, empirical data regarding the role of psychological vulnerability on the latter is limited. Hence, this study assesses the mediating effect of cognitive distortions between psychological vulnerability (personality and mood), and gambling problem severity. It also verifies whether the relationships between these variables differs according to the preferred gambling activity. The sample is composed of 272 male gamblers [191 poker players; 81 video lottery terminal (VLT) players] aged between 18 and 82 years (M = 35.2). Bootstrap analysis results revealed that cognitive distortions mediate the effect of narcissism on gambling problem severity for both groups. The level of depression for VLT players significantly predicted gambling problem severity, both directly and indirectly via the mediating effect of cognitive distortions. Mediation analyses also indicated that narcissism had an indirect impact on problem gambling through cognitive distortions for both groups. These findings suggest that certain vulnerabilities related to personality and mood may influence cognitive distortion intensity and gambling problem severity. In addition, psychological vulnerabilities could differ based on preferred gambling activity. These results may be useful for prevention policies, identifying high risk gamblers and planning psychological interventions.

Global Vulnerability Assessment in Santa María Tixmadeje, Estado de México, México

NASA Astrophysics Data System (ADS)

Monroy Salazar, S.; Novelo-Casanova, D. A.

2010-12-01

Santa María Tixmadejé (SMT), Estado de México, Mexico is a town located very close to the Acambay-Tixmadejé fault. This fault is located in the middle of the Trans Volcanic Belt in the center of the Mexican territory and generated a large seismic event in 1912 with magnitude 6.9 which combined with the local vulnerability, caused a disaster. In this work we measure the different vulnerabilities of the SMT community: structural, economical, social and educational. In addition, we determinate the total vulnerability, by summing all estimated vulnerabilities, for the critical facilities identified in this town. Vulnerability was determined using the methodology proposed by National Oceanic Atmospheric Administration (NOAA) and by Disaster Prevention National Center (CENAPRED). Besides, we considered a minimum sample statistically significant of the total houses with a random sampling for our survey. Our results indicate that 50% of the critical facilities have high and very high and the other 50% between low and moderate level of total vulnerability. The results for independent vulnerabilities are as follows: (1) Near to 75% of the community has high and very high level of social vulnerability and the range for the another 25% is between low and moderate; (2) About 43% of the community has high and very high economical vulnerability and 57% low and moderate; (3) Approximately 38% of the population has high and very high educational vulnerability. The 62% present low and moderate vulnerability; and (4) About 42% of the community has very high structural vulnerability and 58% between low and moderate.

Access to genetic testing and genetic counseling in vulnerable populations: the d/Deaf and hard of hearing population.

PubMed

Cooke-Hubley, Sandra; Maddalena, Victor

2011-09-01

Genetic testing holds great potential for preventing morbidities and mortalities for a number of diseases through early detection and effective intervention. As the number of genetic tests expand, so will public demand for these services. Therefore, it is essential to evaluate access to genetic testing and genetic services to ensure that all Canadians, including vulnerable groups, have equitable access to all forms of health care, in keeping with the mandate of the Canadian Health Act. The purpose of this paper is to examine the literature to determine if and how the Deaf community, as a vulnerable group, is at an increased risk of inequitable access to genetic services in Canada and to discuss how those who are deaf and hard of hearing are subject to the same risks. First, we define vulnerability and describe why the Deaf community, as a social group, can be considered a vulnerable group, followed by a description of the benefits of genetic testing. Second, we describe the barriers to accessing genetic testing, and how the d/Deaf and hard of hearing population experience additional barriers. Third, we examine the difficulties incorporating genetic testing into medical practice, and how this creates additional barriers to those already at risk. Finally, we discuss the steps necessary to promote equitable access to genetic testing among the d/Deaf and hard of hearing populations within Canada, and provide recommendations for further research in this topic area. Lastly, we comment on how barriers to genetic testing vary among the d/Deaf and hard of hearing is dependent upon the type of health care system available (whether public or private).

Caught between a rock and a hard place: mental health of migrant live-in caregivers in Canada.

PubMed

Vahabi, Mandana; Wong, Josephine Pui-Hing

2017-05-23

Canada depends on Temporary Foreign Workers (TFWs), also known as migrant workers, to fill labour shortage in agriculture, hospitality, construction, child/senior care, and other low-skilled occupations. Evidence shows that TFWs, especially women live-in caregivers (LC), constitute a vulnerable population. Their health is compromised by the precarious and harsh working and living conditions they encounter. There is a paucity of research on the mental health of LCs, their support systems and access to mental health services. In this community-based exploratory study, we used mixed methods of survey and focus groups to explore the work related experiences and mental health of migrant live-in caregivers in the Greater Toronto Area in Ontario, Canada. Convenience and snowball sampling were used to recruit participants. The inclusion criteria were: being 18 years or older, initially migrated to Canada as TFWs under LC program, resided in the Greater Toronto Area, and able to understand and converse in English based on self-report. This paper reports on the focus group results derived from inductive thematic analysis. A total of 30 women LCs participated in the study. Most of them were from the Philippines. A number of key themes emerged from the participants' narratives: (1) precarious migration-employment status (re)produces exploitation; (2) deskilling and downward social mobility reinforce alienation; (3) endurance of hardship for family back home; (4) double lives of public cheerfulness and private anguish; and (4) unrecognized mental health needs. The study results reflected gross injustices experienced by these women. A multi-faceted approach is required to improve the working and living conditions of this vulnerable group and ultimately their health outcomes. We recommend the following: government inspection to ensure employer compliance with the labour standards and provision of safe working and living conditions; change immigration policy to allow migrant caregivers to apply for permanent residence upon arrival; the TFWs Program to establish fair wages and subsidized housing so that caregivers can truly access the live-out option; and local ethno-specific, settlement and faith organizations be leveraged to provide TFWs with social support as well as information about their rights and how to access health and social care.

The use of incentives in vulnerable populations for a telephone survey: a randomized controlled trial.

PubMed

Knoll, Megan; Soller, Lianne; Ben-Shoshan, Moshe; Harrington, Daniel; Fragapane, Joey; Joseph, Lawrence; La Vieille, Sebastien; St-Pierre, Yvan; Wilson, Kathi; Elliott, Susan; Clarke, Ann

2012-10-19

Poor response rates in prevalence surveys can lead to nonresponse bias thereby compromising the validity of prevalence estimates. We conducted a telephone survey of randomly selected households to estimate the prevalence of food allergy in the 10 Canadian provinces between May 2008 and March 2009 (the SCAAALAR study: Surveying Canadians to Assess the Prevalence of Common Food Allergies and Attitudes towards Food LAbeling and Risk). A household response rate of only 34.6% was attained, and those of lower socioeconomic status, lower education and new Canadians were underrepresented. We are now attempting to target these vulnerable populations in the SPAACE study (Surveying the Prevalence of Food Allergy in All Canadian Environments) and are evaluating strategies to increase the response rate. Although the success of incentives to increase response rates has been demonstrated previously, no studies have specifically examined the use of unconditional incentives in these vulnerable populations in a telephone survey. The pilot study will compare response rates between vulnerable Canadian populations receiving and not receiving an incentive. Randomly selected households were randomly assigned to receive either a $5 incentive or no incentive. The between group differences in response rates and 95% confidence intervals (CIs) were calculated. The response rates for the incentive and non-incentive groups were 36.1% and 28.7% respectively, yielding a between group difference of 7.4% (-0.7%, 15.6%). Although the wide CI precludes definitive conclusions, our results suggest that unconditional incentives are effective in vulnerable populations for telephone surveys.

Extension of the behavioral model of healthcare utilization with ethnically diverse, low-income women.

PubMed

Keenan, Lisa A; Marshall, Linda L; Eve, Susan

2002-01-01

Psychosocial vulnerabilities were added to a model of healthcare utilization. This extension was tested among low-income women with ethnicity addressed as a moderator. Structured interviews were conducted at 2 points in time, approximately 1 year apart. The constructs of psychosocial vulnerability, demographic predisposing, barriers, and illness were measured by multiple indicators to allow use of Structural Equation Modeling to analyze results. The models were tested separately for each ethnic group. Community office. African-American (N = 266), Euro-American (N = 200), and Mexican-American (N = 210) women were recruited from the Dallas Metropolitan area to participate in Project Health Outcomes of Women, a multi-year, multi-wave study. Face-to-face interviews were conducted with this sample. Participants had been in heterosexual relationships for at least 1 year, were between 20 and 49 years of age, and had incomes less than 200% of the national poverty level. Healthcare utilization, defined as physician visits and general healthcare visits. Illness mediated the effect of psychosocial vulnerability on healthcare utilization for African Americans and Euro-Americans. The model for Mexican Americans was the most complex. Psychosocial vulnerability on illness was partially mediated by barriers, which also directly affected utilization. Psychosocial vulnerabilities were significant utilization predictors for healthcare use for all low-income women in this study. The final models for the 2 minority groups, African Americans and Mexican Americans, were quite different. Hence, women of color should not be considered a homogeneous group in comparison to Euro-Americans.

Linking degradation status with ecosystem vulnerability to environmental change

USGS Publications Warehouse

Angeler, David G.; Baho, Didier L.; Allen, Craig R.; Johnson, Richard K.

2015-01-01

Environmental change can cause regime shifts in ecosystems, potentially threatening ecosystem services. It is unclear if the degradation status of ecosystems correlates with their vulnerability to environmental change, and thus the risk of future regime shifts. We assessed resilience in acidified (degraded) and circumneutral (undegraded) lakes with long-term data (1988–2012), using time series modeling. We identified temporal frequencies in invertebrate assemblages, which identifies groups of species whose population dynamics vary at particular temporal scales. We also assessed species with stochastic dynamics, those whose population dynamics vary irregularly and unpredictably over time. We determined the distribution of functional feeding groups of invertebrates within and across the temporal scales identified, and in those species with stochastic dynamics, and assessed attributes hypothesized to contribute to resilience. Three patterns of temporal dynamics, consistent across study lakes, were identified in the invertebrates. The first pattern was one of monotonic change associated with changing abiotic lake conditions. The second and third patterns appeared unrelated to the environmental changes we monitored. Acidified and the circumneutral lakes shared similar levels and patterns of functional richness, evenness, diversity, and redundancy for species within and across the observed temporal scales and for stochastic species groups. These similar resilience characteristics suggest that both lake types did not differ in vulnerability to the environmental changes observed here. Although both lake types appeared equally vulnerable in this study, our approach demonstrates how assessing systemic vulnerability by quantifying ecological resilience can help address uncertainty in predicting ecosystem responses to environmental change across ecosystems.

Coping capacity among women with abusive partners.

PubMed

Nurius, P S; Furrey, J; Berliner, L

1992-01-01

Coping capacity, although increasingly implicated as a mediating force in how individuals respond to personal threat, is an underrecognized factor in work with women of abusive partners. To explore the utility of coping capacity as a multivariable set to guide intervention with women of abusive partners, findings are reported comparing four groups of women: those whose partners do not engage in abuse, are abusive toward them, are sex offenders of children for whom the woman is a parent, or are offenders of children for whom the woman is not a parent. Three variable sets were included: vulnerability factors that may negatively influence appraisals of threat and ability to cope with abuse; coping responses that include cognitive, emotional, and behavioral reactions to the abuse; and coping resources expected to mediate effects of vulnerability factors and to influence the mobilization (of lack thereof) of coping responses. There were significant differences in coping capacity profiles across the four groups. These appeared to be a continuum of coping capacity, with women who were most directly threatened showing the lowest and women who were least directly threatened showing the highest levels of coping capacity. In order from the lowest to the highest levels of coping capacity were (1) battered women, (2) women whose partners are offenders against their children, (3) women whose partners are offenders against children of whom they are not the parent, and (4) control group women. The paper ends with a conceptual interpretation of the mediating functions of coping resources and implications for intervention and further study.

Flood Risk Vulnerability Assessment: What are the Main Factors? Hierarchization of The Main Factors at a Regional Scale

NASA Astrophysics Data System (ADS)

Jouannic, G.; Kolli, Z.; Legendre, T.; Marchetti, M.; Gastaud, P.; Gargani, J.; Lermet, R.; Augeard, C.; Felts, D.; Arki, F.

2015-12-01

Recent studies have shown that the national flood risk exposure is high in France, with one fourth of the total population and a third of jobs located in risk areas. In this context, a global vulnerability assessment methodology is currently being developed in France to bring adequate tools for local territories to manage flood risk. This study addresses the question of the quantification, the qualification and the choice of these vulnerability indicators for a given territory. This work aims to propose a classification of nearly 40 of these indicators in terms of their relative impacts on the risk level estimated on two territories: Chalon-sur-Saône (Saône river) Garonne estuary (Garonne and Dordogne rivers, and Atlantic ocean) Through these cases study, 3 different spatial scales have been compared: the Prés-Saint-Jean district inside Chalon (0.6 km²), the city of Ambès (28.8 km²) and Chalon with its suburbs (72.2 km²). A principal component analysis (PCA) was applied and indicated a threshold in terms of urban impacts between the different flood scenarios. On Chalon, the PCA discriminates 2 groups of flood and highlighted a threshold between T20 and T50. A partial least-square regression (PLS) was computed to make predictions on vulnerability indicators values modelled on new flood scenarios. Their results were is useful to identify the most relevant vulnerability indicators as a function of their flood exposure. These statistical analysis aims to highlight the relationship between a variable of exposure level (hydrologic impact: water levels and flow velocity) with spatialized vulnerability indicators in a 100 m grid (e.g., population, job, etc.). Finally, to get a hierarchy of variables depending on their impact on the risk level, an ANOVA was computed. The selection of variables was performed with a stepwise selection to assess contributions of each dependant variable on the F-statistic as they are added to or removed from the model.

The Vulnerable Worker? A Labor Law Challenge for WIL and Work Experience

ERIC Educational Resources Information Center

Cameron, Craig

2013-01-01

The Fair Work Act (2009) in Australia deregulates "work" in work-integrated learning (WIL) by distinguishing "vocational placement" from "employee". Following concerns about the legal position of WIL and work experience, the Fair Work Ombudsman (FWO) published a fact sheet and commenced a joint research project into…

Involving Communities in the Targeting of Cash Transfer Programs for Vulnerable Children: Opportunities and Challenges☆

PubMed Central

Robertson, Laura; Mushati, Phyllis; Skovdal, Morten; Eaton, Jeffrey W.; Makoni, Jeremiah C.; Crea, Tom; Mavise, Gideon; Dumba, Lovemore; Schumacher, Christina; Sherr, Lorraine; Nyamukapa, Constance; Gregson, Simon

2014-01-01

Summary We used baseline data, collected in July–September 2009, from a randomized controlled trial of a cash transfer program for vulnerable children in eastern Zimbabwe to investigate the effectiveness, coverage, and efficiency of census- and community-based targeting methods for reaching vulnerable children. Focus group discussions and in-depth interviews with beneficiaries and other stakeholders were used to explore community perspectives on targeting. Community members reported that their participation improved ownership and reduced conflict and jealousy. However, all the methods failed to target a large proportion of vulnerable children and there was poor agreement between the community- and census-based methods. PMID:24748713

[Occupational stress in assembly line workers in electronics manufacturing service and related influencing factors].

PubMed

Ji, Y Q; Li, S; Wang, C; Wang, J; Liu, X M

2016-10-20

Objective: To investigate occupational stress in assembly line workers in electronics manu-facturing service (EMS) and related influencing factors. Methods: From June to October, 2015, a cross-sectional survey was performed for 5 944 assembly line workers in EMS (observation group) and 6 270 workers from other posts (non-assembly line workers and management personnel; control group) using the self-made questionnaire for basic information, job demand-control (JDC) model questionnaire, and effort-reward imbalance (ERI) model questionnaire to collect respondents' basic information and occupational stress. Results: The observation group had significantly lower work autonomy, social support, and work reward scores than the control group (2.72 ± 0.63/3.64 ± 0.68/4.06 ± 0.80 vs 3.00 ± 0.67/3.83 ± 0.68/4.24 ± 0.75, t =23.53, 15.41, and 12.70, all P <0.05) , as well as significantly higher work effort and job involvement scores than the control group (2.34±0.78/2.48±0.78 vs 2.21±0.80/2.33±0.77, t =-9.08 and-10.90, both P <0.05). The observation group had significantly higher proportions of workers with occupational stress determined by JDC and ERI models than the control group (64.5%/12.7% vs 52.6%/9.9%, χ 2 =182.26 and 23.41, both P <0.05). Female sex, migrant workers, working time >60 hours/week, and sleeping time <7 hours/day were major risk factors for occupational stress in JDC model; education background of Bachelor's degree or above, working time >60 hours/week, and sleeping time<7 hours/day were major risk factors for occupational stress in ERI model, while female sex and a high monthly income reduced the risk of occupational stress in ERI model. Conclusion: Assembly line workers in EMS are a relatively vulnerable group and have a high degree of occupational stress. Working time >60 hours/week and sleeping time <7 hours/day are major risk factors for occupational stress.

A contribution to the selection of tsunami human vulnerability indicators: conclusions from tsunami impacts in Sri Lanka and Thailand (2004), Samoa (2009), Chile (2010) and Japan (2011)

NASA Astrophysics Data System (ADS)

González-Riancho, P.; Aliaga, B.; Hettiarachchi, S.; González, M.; Medina, R.

2014-12-01

After several tsunami events with disastrous consequences around the world, coastal countries have realized the need to be prepared to minimize human mortality and damage to coastal infrastructures, livelihoods and resources. The international scientific community is striving to develop and validate methodologies for tsunami hazard and vulnerability and risk assessments. The vulnerability of coastal communities is usually assessed through the definition of sets of indicators based on previous literature and/or post-tsunami reports, as well as on the available data for the study site. The aim of this work is to validate in light of past tsunami events the indicators currently proposed by the scientific community to measure human vulnerability, to improve their definition and selection as well as to analyse their validity for different country development profiles. The events analyzed are the 2011 Great Tohoku tsunami, the 2010 Chilean tsunami, the 2009 Samoan tsunami and the 2004 Indian Ocean tsunami. The results obtained highlight the need for considering both permanent and temporal human exposure, the former requiring some hazard numerical modelling while the latter is related to site-specific livelihoods, cultural traditions and gender roles. The most vulnerable age groups are the elderly adults and the children, the former having much higher mortality rates. Female mortality is not always higher than male and not always related to dependency issues. Higher numbers of disabled people do not always translate into higher numbers of victims. Besides, it is clear that mortality is not only related to the characteristics of the population but also the buildings. A high correlation has been found between the affected buildings and the number of victims, being very high for completely damaged buildings. Distance to the sea, building materials and expected water depths are highly determining factors regarding the type of damage in buildings.

A contribution to the selection of tsunami human vulnerability indicators: conclusions from tsunami impacts in Sri Lanka and Thailand (2004), Samoa (2009), Chile (2010) and Japan (2011)

NASA Astrophysics Data System (ADS)

González-Riancho, P.; Aliaga, B.; Hettiarachchi, S.; González, M.; Medina, R.

2015-07-01

After several tsunami events with disastrous consequences around the world, coastal countries have realized the need to be prepared to minimize human mortality and damage to coastal infrastructures, livelihoods and resources. The international scientific community is striving to develop and validate methodologies for tsunami hazard and vulnerability and risk assessments. The vulnerability of coastal communities is usually assessed through the definition of sets of indicators based on previous literature and/or post-tsunami reports, as well as on the available data for the study site. The aim of this work is to validate, in light of past tsunami events, the indicators currently proposed by the scientific community to measure human vulnerability, to improve their definition and selection as well as to analyse their validity for different country development profiles. The events analysed are the 2011 Great Tohoku tsunami, the 2010 Chilean tsunami, the 2009 Samoan tsunami and the 2004 Indian Ocean tsunami. The results obtained highlight the need for considering both permanent and temporal human exposure, the former requiring some hazard numerical modelling, while the latter is related to site-specific livelihoods, cultural traditions and gender roles. The most vulnerable age groups are the elderly and children, the former having much higher mortality rates. Female mortality is not always higher than male mortality and not always related to dependency issues. Higher numbers of disabled people do not always translate into higher numbers of victims. Besides, it is clear that mortality is not only related to the characteristics of the population but also of the buildings. A high correlation has been found between the affected buildings and the number of victims, being very high for completely damaged buildings. Distance to the sea, building materials and expected water depths are important determining factors regarding the type of damage to buildings.

Vulnerability Discovery: Bridging the Gap Between Analysis and Engineering

DTIC Science & Technology

2006-01-01

work in selected technologies © 2006 Carnegie Mellon University 16 An Easy Target: ActiveX 1995 – OLE 2  COM  ActiveX 2000 – CERT/CC... ActiveX Security Workshop 2005 – VU#680526  New vector for exploiting COM vulnerabilities via Internet Explorer discovered 2006 – Dranzer, the COM Object

Working Vulnerability: Agency of Caring Children and Children's Rights

ERIC Educational Resources Information Center

Wihstutz, Anne

2011-01-01

A growing number of empirical studies deal with children's participation in care relationships in the family. Based on a review of empirical findings in the UK and Germany, this article discusses care-giving children in terms of vulnerability and agency. The focus is set on understandings of family life as interdependent and reciprocal…

Use of the NatureServe Climate Change Vulnerability Index as an Assessment Tool for Reptiles and Amphibians: Lessons Learned.

PubMed

Tuberville, Tracey D; Andrews, Kimberly M; Sperry, Jinelle H; Grosse, Andrew M

2015-10-01

Climate change threatens biodiversity globally, yet it can be challenging to predict which species may be most vulnerable. Given the scope of the problem, it is imperative to rapidly assess vulnerability and identify actions to decrease risk. Although a variety of tools have been developed to assess climate change vulnerability, few have been evaluated with regard to their suitability for certain taxonomic groups. Due to their ectothermic physiology, low vagility, and strong association with temporary wetlands, reptiles and amphibians may be particularly vulnerable relative to other groups. Here, we evaluate use of the NatureServe Climate Change Vulnerability Index (CCVI) to assess a large suite of herpetofauna from the Sand Hills Ecoregion of the southeastern United States. Although data were frequently lacking for certain variables (e.g., phenological response to climate change, genetic variation), sufficient data were available to evaluate all 117 species. Sensitivity analyses indicated that results were highly dependent on size of assessment area and climate scenario selection. In addition, several ecological traits common in, but relatively unique to, herpetofauna are likely to contribute to their vulnerability and need special consideration during the scoring process. Despite some limitations, the NatureServe CCVI was a useful tool for screening large numbers of reptile and amphibian species. We provide general recommendations as to how the CCVI tool's application to herpetofauna can be improved through more specific guidance to the user regarding how to incorporate unique physiological and behavioral traits into scoring existing sensitivity factors and through modification to the assessment tool itself.

Use of the NatureServe Climate Change Vulnerability Index as an Assessment Tool for Reptiles and Amphibians: Lessons Learned

NASA Astrophysics Data System (ADS)

Tuberville, Tracey D.; Andrews, Kimberly M.; Sperry, Jinelle H.; Grosse, Andrew M.

2015-10-01

Climate change threatens biodiversity globally, yet it can be challenging to predict which species may be most vulnerable. Given the scope of the problem, it is imperative to rapidly assess vulnerability and identify actions to decrease risk. Although a variety of tools have been developed to assess climate change vulnerability, few have been evaluated with regard to their suitability for certain taxonomic groups. Due to their ectothermic physiology, low vagility, and strong association with temporary wetlands, reptiles and amphibians may be particularly vulnerable relative to other groups. Here, we evaluate use of the NatureServe Climate Change Vulnerability Index (CCVI) to assess a large suite of herpetofauna from the Sand Hills Ecoregion of the southeastern United States. Although data were frequently lacking for certain variables (e.g., phenological response to climate change, genetic variation), sufficient data were available to evaluate all 117 species. Sensitivity analyses indicated that results were highly dependent on size of assessment area and climate scenario selection. In addition, several ecological traits common in, but relatively unique to, herpetofauna are likely to contribute to their vulnerability and need special consideration during the scoring process. Despite some limitations, the NatureServe CCVI was a useful tool for screening large numbers of reptile and amphibian species. We provide general recommendations as to how the CCVI tool's application to herpetofauna can be improved through more specific guidance to the user regarding how to incorporate unique physiological and behavioral traits into scoring existing sensitivity factors and through modification to the assessment tool itself.

An ergonomic approach to reorganize parking inspection agents' work productivity, health and safety in São Paulo, Brazil.

PubMed

Gonçalves, R M A; Lancman, S; Trudel, L; Jardim, T A; Sznelwar, L I; Santos, M C; Freeman, Andrew

2010-01-01

The Traffic Engineering Company of the City of São Paulo (Brazil) observed a decrease in productivity, and an increase in sick leave, accidents and psychological distress among their parking inspection agents. To document this situation, qualitative research was undertaken to obtain an in-depth comprehension of work activity. Workers, managers and health and safety professionals contributed to the documentation of the problem and to the proposal of possible solutions. Ergonomic work analysis focusing on real work activity, as well as interviews with individual or groups of stakeholders, were conducted. This research revealed that political-economic factors gradually contributed to: 1) an increasing work load; 2) growing fatigue throughout the day, increasing the workers' vulnerability to incidents and accidents and their tendency to react inappropriately to violence experienced on the street; and 3) excessive individual responsibility to manage dangerous situations. Recommendations to ameliorate the situation are proposed. These suggestions are discussed in terms of feasibility given the impact of macro social factors upon micro work activity, and the associated potential expansion of the ergonomist's role.

Age-related patterns in work-related injury claims from older New Zealanders, 2009-2013: Implications of injury for an aging workforce.

PubMed

Lilley, Rebbecca; Jaye, Chrystal; Davie, Gabrielle; Keeling, Sally; Waters, Debra; Egan, Richard

2018-01-01

This study describes the incidence, nature and cause of work-related injuries in older New Zealand workers to understand the risks of work-related injury in this rapidly aging population. Data for the period 2009-2013 from 25,455 injured workers aged 55-79 years, extracted from national work-related injury entitlement claims, were stratified by age group and analysed by sex, industry, injury type and cause. Age-specific claims rates were calculated by year, sex and ethnicity. Patterns of injury differed by age: 70-79 year olds had the highest injury rates and proportion of claims due to falls (45%), for the self-employed (32%), for the agriculture sector (24%), and for fatal injuries (5%). The burden of work-related injuries in older workers, particularly in those aged over 70, will increase with their increasing participation in work. Workplace injury prevention strategies and interventions need to consider the specific characteristics and vulnerabilities of older workers. Copyright © 2017 Elsevier Ltd. All rights reserved.

Health needs and nursing care.

PubMed

Petersen, Cristina Buischi; Lima, Regina Aparecida Garcia de; Boemer, Magali Roseira; Rocha, Semiramis Melani Melo

2016-01-01

to present the concept of needs according to different approaches to discuss the possibility of health care that incorporates a broader view of human vulnerabilities in health services. the arguments are founded on nursing theorists who worked on the construction of frameworks relevant to care, based on needs and on philosophers who show the possibility of identifying the vulnerabilities of human beings, defending art as a therapeutic instrument that can promote health care. although care can acquire a new dimension with the introduction of art, according to certain perspectives, philosophical studies on ethics and aesthetics should be resumed to identify human vulnerabilities that can in fact be compensated by sensible understanding of the outer world. To incorporate art in nursing care requires studies from theorists to be recovered, deepening concepts and working on empirical investigations for their adequate use.

Improving vulnerability models: lessons learned from a comparison between flood and earthquake assessments

NASA Astrophysics Data System (ADS)

de Ruiter, Marleen; Ward, Philip; Daniell, James; Aerts, Jeroen

2017-04-01

In a cross-discipline study, an extensive literature review has been conducted to increase the understanding of vulnerability indicators used in both earthquake- and flood vulnerability assessments, and to provide insights into potential improvements of earthquake and flood vulnerability assessments. It identifies and compares indicators used to quantitatively assess earthquake and flood vulnerability, and discusses their respective differences and similarities. Indicators have been categorized into Physical- and Social categories, and further subdivided into (when possible) measurable and comparable indicators. Physical vulnerability indicators have been differentiated to exposed assets such as buildings and infrastructure. Social indicators are grouped in subcategories such as demographics, economics and awareness. Next, two different vulnerability model types have been described that use these indicators: index- and curve-based vulnerability models. A selection of these models (e.g. HAZUS) have been described, and compared on several characteristics such as temporal- and spatial aspects. It appears that earthquake vulnerability methods are traditionally strongly developed towards physical attributes at an object scale and used in vulnerability curve models, whereas flood vulnerability studies focus more on indicators applied to aggregated land-use scales. Flood risk studies could be improved using approaches from earthquake studies, such as incorporating more detailed lifeline and building indicators, and developing object-based vulnerability curve assessments of physical vulnerability, for example by defining building material based flood vulnerability curves. Related to this, is the incorporation of time of the day based building occupation patterns (at 2am most people will be at home while at 2pm most people will be in the office). Earthquake assessments could learn from flood studies when it comes to the refined selection of social vulnerability indicators. Based on the lessons obtained in this study, we recommend future studies to further explore cross-hazard studies.

A concept analysis of women's vulnerability during pregnancy, birth and the postnatal period.

PubMed

Briscoe, Lesley; Lavender, Tina; McGowan, Linda

2016-10-01

To report an analysis of the concept of vulnerability associated with pregnancy, birth and the postnatal period. The concept of vulnerability during childbirth is complex and the term, 'to be vulnerable' frequently attains a vague application. Analysis about vulnerability is needed to guide policy, practice, education and research. Clarity around the concept has the potential to improve outcomes for women. Concept analysis. Searches were conducted in CINAHL, EMBASE, PubMed, Psychinfo, MEDLINE, MIDIRS and ASSIA and limited to between January 2000 - June 2014. Data were collected over 12 months during 2014. This concept analysis drew on Morse's qualitative methods. Vulnerability during pregnancy, birth and the postnatal period can be defined by three main attributes: (a) Threat; (b) Barrier; and (c) Repair. Key attributes have the potential to influence outcome for women. Inseparable sub-attributes such as mother and baby attachment, the woman's free will and choice added a level of complexity about the concept. This concept analysis has clarified how the term vulnerability is currently understood and used in relation to pregnancy, birth and the postnatal period. Vulnerability should be viewed as a complex phenomenon rather than a singular concept. A 'vulnerability journey plan' has the potential to identify how reparative interventions may develop the woman's capacity for resilience and influence the degree of vulnerability experienced. Methodology based around complex theory should be explored in future work about vulnerability. © 2016 John Wiley & Sons Ltd.

Legal physician-assisted suicide in Oregon and The Netherlands: evidence concerning the impact on patients in vulnerable groups--another perspective on Oregon's data.

PubMed

Finlay, I G; George, R

2011-03-01

Battin et al examined data on deaths from physician-assisted suicide (PAS) in Oregon and on PAS and voluntary euthanasia (VE) in The Netherlands. This paper reviews the methodology used in their examination and questions the conclusions drawn from it-namely, that there is for the most part 'no evidence of heightened risk' to vulnerable people from the legalisation of PAS or VE. This critique focuses on the evidence about PAS in Oregon. It suggests that vulnerability to PAS cannot be categorised simply by reference to race, gender or other socioeconomic status and that the impetus to seek PAS derives from factors, including emotional state, reactions to loss, personality type and situation and possibly to PAS contagion, all factors that apply across the social spectrum. It also argues, on the basis of official reports from the Oregon Health Department on the working of the Oregon Death with Dignity Act since 2008, that, contrary to the conclusions drawn by Battin et al, the highest resort to PAS in Oregon is among the elderly and, on the basis of research published since Battin et al reported, that there is reason to believe that some terminally ill patients in Oregon are taking their own lives with lethal drugs supplied by doctors despite having had depression at the time when they were assessed and cleared for PAS.

Subchronic administration of atomoxetine causes an enduring reduction in context-induced relapse to cocaine seeking without affecting impulsive decision making.

PubMed

Broos, Nienke; Loonstra, Rhianne; van Mourik, Yvar; Schetters, Dustin; Schoffelmeer, Anton N M; Pattij, Tommy; De Vries, Taco J

2015-07-01

Previous work has established a robust relationship between impulsivity and addiction, and revealed that impulsive decision making predisposes the vulnerability to cocaine-seeking behavior in rats. An important next step is to assess whether elevated relapse vulnerability can be treated via the reduction of impulsive decision making. Therefore, this study explored whether subchronic atomoxetine treatment can reduce relapse vulnerability by reducing impulsive decision making. Rats were trained in the delayed reward task and were subjected to 3 weeks of cocaine self-administration. Following drug self-administration, animals were divided to different experimental groups and received the noradrenaline transporter inhibitor and attention-deficit/hyperactivity disorder drug atomoxetine or vehicle subchronically for 20 days. On days 1 and 10 after treatment cessation, a context-induced reinstatement test was performed. Throughout the entire experiment, changes in impulsive decision making were continuously monitored. Subchronic treatment with atomoxetine reduced context-induced reinstatement both 1 and 10 days after treatment cessation, only in animals receiving no extinction training. Interestingly, neither subchronic nor acute atomoxetine treatments affected impulsive decision making. Our data indicate that the enduring reduction in relapse sensitivity by atomoxetine occurred independent of a reduction in impulsive decision making. Nonetheless, repeated atomoxetine administration seems a promising pharmacotherapeutical strategy to prevent relapse to cocaine seeking in abstinent drug-dependent subjects. © 2014 Society for the Study of Addiction.

The association between long work hours and leisure-time physical activity and obesity.

PubMed

Cook, Miranda A; Gazmararian, Julie

2018-06-01

Obesity affects approximately one-third of all U.S. adults, presenting a large economic and public health burden. Long work hours may be contributing to the rising obesity problem by reducing time for physical activity, particularly for individuals working in sedentary occupations. This study sought to investigate the association between long work hours, leisure-time physical activity (LTPA), and obesity across levels of occupational activity in order to identify potentially vulnerable groups. Cross sectional analysis was performed in 2017 using data from the 2015 Georgia Behavioral Risk Factor Surveillance System and prevalence ratios were estimated across work hour and occupational activity groups. Ability to meet guidelines for LTPA did not differ significantly across work hour categories overall. Those working in low activity occupations were more likely to meet aerobic guidelines for LTPA compared to those in intermediate and high activity occupations (χ 2 : 19.3; P -value: <0.01). Results of interaction assessment demonstrate that the effects of work hours on obesity risk and meeting aerobic guidelines are significantly different across OA categories, indicating OA to be an effect modifier of the relationship between long work hours and obesity (χ 2 : 13.33; P -value: <0.001; χ 2 : 4.42; P -value: <0.05). Employees in intermediate activity occupations working long hours were found to be at the greatest risk for obesity. Further research is required to better understand the mechanisms impacting the relationship between long work hours, domains of physical activity, and obesity risk as well as to identify effective intervention and prevention programs for employees in intermediate activity occupations.

Economic vulnerability to health shocks and coping strategies: evidence from Andhra Pradesh, India.

PubMed

Dhanaraj, Sowmya

2016-07-01

Empirical research has shown that households in developing countries are unable to sustain current levels of consumption during and after severe health crises due to substantial increase in medical expenditure and/or loss of income. Health events are also found to have an adverse impact on nutritional status and educational attainment of household members. Thus, in this study, we investigate: who are vulnerable to welfare loss from health shocks, what are the household responses to cope with the economic burden of health shocks and if policy responses like state health insurance schemes are effective in reducing the economic vulnerability. We use self-reported measures of health shocks and coping strategies from the longitudinal survey of the ongoing Young Lives project in India [Andhra Pradesh (AP)] to identify the characteristics of vulnerable groups and perform three-level random intercept logistic regression that takes into account contextual or environmental factors. What emerges is socioeconomic status of household (determined by education, wealth, occupation and caste/religious group) and its demographic characteristics like gender of the household head and proportion of elderly and disabled members matter for outcomes related to health events. Households adopt different strategies to cope with the economic costs of ill-health; borrowing is the most widely used strategy. For credit, majority of households rely on informal sources (moneylenders, friends, relatives, etc.) and have little or no access to formal sources. However, health shock to main breadwinner leads to households adopting costly strategies like reducing consumption or sending children to work. We found no evidence that the state health insurance scheme reduced the household welfare loss from health shocks and their coping strategies. The results suggest that health insurance schemes have to be complemented with access to micro-credit and social security schemes for self-employed persons/workers in informal sector to reduce the economic burden faced by households due to health shocks. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

ISIBINDI, creating circles of care for orphans and vulnerable children in South Africa: post-programme outcomes.

PubMed

Visser, Maretha; Zungu, Nompumelelo; Ndala-Magoro, Nkateko

2015-01-01

This paper presents the evaluation of post-programme outcomes of the ISIBINDI model, a community-based intervention to promote physical and psychosocial well-being of orphans and vulnerable children (OVC) in South Africa. A mixed methods quasi-experimental design was used to investigate the differences between former ISIBINDI participants (18 years and older) and a control group of similar background. ISIBINDI ex-participants at 12 sites (n=427) and a control group of non-participants (n=177) completed a questionnaire which explored level of education and employment, psychosocial well-being and HIV risk behaviour. Focus group discussions were conducted with various stakeholders. Ex-participants reported higher self-esteem and problem-solving abilities, family support and lower HIV risk behaviour than the control group. High levels of unemployment especially in rural areas resulted in unemployment of out-of-school OVC which creates new forms of vulnerability. The benefits of the programme may be compromised by the lack of community resources. An effective exit strategy is needed to contribute to financial independence of OVC after exiting the programme.

Me, us, or them: who is more conformist? Perception of conformity and political orientation.

PubMed

Cavazza, Nicoletta; Mucchi-Faina, Angelica

2008-06-01

Research has shown that people perceive others as more vulnerable than themselves to media communication, and their political out-group as more vulnerable than their political in-group. In the present study, the authors predicted that the same two biases would appear with respect to another kind of influence--conformity--but that participants' judgments would display a different pattern according to their political orientations. Right-wing and left-wing university students were asked to evaluate conformity and to estimate how conformist they, their political in-group, their political out-group, and other groups are. As hypothesized, right-wingers expressed more ambivalence toward conformity and viewed it less negatively than did left-wingers. Political orientation had no impact on the discrepancy between self and others, but it did moderate the in-group-out-group discrepancy.

The etemic model of Gypsy Roma Traveller community vulnerability: is it time to rethink our understanding of vulnerability?

PubMed

Heaslip, Vanessa; Hean, Sarah; Parker, Jonathan

2016-08-09

To present a new etemic model of vulnerability. Despite vulnerability being identified as a core consequence of health and health experiences, there has been little research exploring the meaning of vulnerability as a concept. Yet, being vulnerable is known to have dire physical/mental health consequences. It is therefore a fundamental issue for nurses to address. To date, the meaning of the term vulnerability has been influenced by the work of Spiers (Journal of Advanced Nursing, 31, 2000, 715, The Essential Concepts of Nursing: Building Blocks for Practice, 2005, Elsevier, London). Spiers identified two aspects of vulnerability: the etic (external judgment of another persons' vulnerability) and the emic (internal lived experience of vulnerability). This approach has led to a plethora of research which has explored the etic (external judgment) of vulnerability and rendered the internal lived (or emic) experience invisible. Consequences of this, for marginalised communities such as Gypsy Roma Travellers include a lack of culturally sensitive services compounding health inequalities. Position paper. Drawing upon a qualitative phenomenological research study exploring the lived experience of vulnerability from a Gypsy Roma Travelling community (published previously), this paper presents a new model of vulnerability. This etemic model of vulnerability values both external and internal dimensions of vulnerability and argues for a fusion of these two opposing perspectives. If nurses and other health- and social care professionals wish to develop practice that is successful in engaging with Gypsy Roma Travellers, then there is a need to both understand and respect their community. This can be achieved through an etemic approach to understanding their vulnerability achieved by eliciting lived experience alongside the appreciation of epidemiological studies. If nurses and health practitioners used this etemic approach to practice then it would enable both the development and delivery of culturally sensitive services facilitating health access to this community. Only then, will their poor health status be successfully addressed. © 2016 John Wiley & Sons Ltd.

Bullying and Cyberbullying in Minorities: Are They More Vulnerable than the Majority Group?

PubMed

Llorent, Vicente J; Ortega-Ruiz, Rosario; Zych, Izabela

2016-01-01

Inclusion in education of all the children is necessary for the success, equality and peace among individuals and societies. In this context, special attention needs to be paid to the minorities. These groups might encounter additional difficulties which make them more vulnerable to be involved in bullying and cyberbullying. The current study was conducted with the objective of describing the involvement in bullying and cyberbullying of students from the majority group and also from sexual and ethnic-cultural minorities. The second objective was to explore if the implication is predicted by the interaction with gender, grade and the size of the population where the schools are located. It is an ex post facto transversal descriptive study with a survey on a representative sample of adolescents enrolled in the Compulsory Secondary Education in the south of Spain (Andalusia). The survey was answered by 2139 adolescents (50.9% girls) in 22 schools. These participants were selected through the random multistage cluster sampling with the confidence level of 95% and a sampling error of 2.1%. The results show that the minority groups, especially sexual minorities, are more involved in bullying and cyberbullying. Regression analyses show that being in the majority or a minority group predicts a small but significant percentage of variance of being involved in bullying and cyberbullying. Results are discussed taking into account the social vulnerability of being a part of a minority group and the need of designing educational programs which would prevent this vulnerability thorough the inclusion in education. There is a need for an educational policy that focuses on convivencia and ciberconvivencia which would promote the social and educational development of all the students.

Bullying and Cyberbullying in Minorities: Are They More Vulnerable than the Majority Group?

PubMed Central

Llorent, Vicente J.; Ortega-Ruiz, Rosario; Zych, Izabela

2016-01-01

Inclusion in education of all the children is necessary for the success, equality and peace among individuals and societies. In this context, special attention needs to be paid to the minorities. These groups might encounter additional difficulties which make them more vulnerable to be involved in bullying and cyberbullying. The current study was conducted with the objective of describing the involvement in bullying and cyberbullying of students from the majority group and also from sexual and ethnic-cultural minorities. The second objective was to explore if the implication is predicted by the interaction with gender, grade and the size of the population where the schools are located. It is an ex post facto transversal descriptive study with a survey on a representative sample of adolescents enrolled in the Compulsory Secondary Education in the south of Spain (Andalusia). The survey was answered by 2139 adolescents (50.9% girls) in 22 schools. These participants were selected through the random multistage cluster sampling with the confidence level of 95% and a sampling error of 2.1%. The results show that the minority groups, especially sexual minorities, are more involved in bullying and cyberbullying. Regression analyses show that being in the majority or a minority group predicts a small but significant percentage of variance of being involved in bullying and cyberbullying. Results are discussed taking into account the social vulnerability of being a part of a minority group and the need of designing educational programs which would prevent this vulnerability thorough the inclusion in education. There is a need for an educational policy that focuses on convivencia and ciberconvivencia which would promote the social and educational development of all the students. PMID:27803677

Pretreatment Clinical and Risk Correlates of Substance Use Disorder Patients With Primary Depression*

PubMed Central

Cohn, Amy M.; Epstein, Elizabeth E.; McCrady†, Barbara S.; Jensen, Noelle; Hunter-Reel, Dorian; Green, Kelly E.; Drapkin, Michelle L.

2011-01-01

Objective: The current study examined the distinction between primary and secondary depression among substance use patients to test whether the primary depressed subgroup presents to treatment with a unique profile of clinical and vulnerability characteristics. Method: The heterogeneous sample comprised 286 individuals (76% male) with alcohol and/or drug abuse or dependence (according to criteria from the Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised) across four treatment outcome studies conducted at the alcohol research center at the Rutgers University Center of Alcohol Studies. Participants were classified as having comorbid lifetime history of primary depression (21%), secondary depression (24%), or no depression (55%). Results: Participants in the primary depression and secondary depression groups were comparable in severity of substance use, and both of these groups had more severe substance use problems than the no-depression group. The primary depression group presented with more severe depression histories, higher levels of current depressive symptoms, and higher rates of additional Axis I comorbidity at treatment entry. In terms of vulnerability indices, the primary depression subgroup had a uniquely high family history risk for major depressive disorder; underlying personality vulnerability to depression was also evident in the primary depression group, with higher neuroticism and lower ex-traversion relative to secondary depression patients. Conclusions: The findings suggest that careful assessment of lifetime depression symptoms vis-à-vis substance use history and severity yields important information identifying the primary depression subtype of substance use patients as a group with a unique and more severely affected clinical presentation of depression and other Axis I psychopathology relative to secondary depression patients. Effectiveness of substance use interventions may be augmented with depression treatment for primary depression patients, given their more severe clinical presentation and vulnerability characteristics. PMID:21138705

Parental overprotection, perceived child vulnerability, and parenting stress: a cross-illness comparison.

PubMed

Hullmann, Stephanie E; Wolfe-Christensen, Cortney; Ryan, Jamie L; Fedele, David A; Rambo, Philip L; Chaney, John M; Mullins, Larry L

2010-12-01

The current study sought to investigate differences in parenting capacity variables across four disease groups. Parents (N = 425), the majority of whom were mothers, of children with either cancer, asthma, Type 1 diabetes, or cystic fibrosis, completed measures of parental overprotection, perceived child vulnerability, and parenting stress. After controlling for significant demographic variables, parents of children with cystic fibrosis and asthma reported higher perceived child vulnerability than parents of children with either diabetes or cancer, while parents of children with asthma and diabetes reported higher parenting stress than parents of children with cancer or cystic fibrosis. No differences between disease groups were found for parental overprotection. The current study provides support for an illness-specific approach to understanding parenting capacity variables in the context of childhood chronic illnesses.

Saving Children, Saving Haiti? Child Vulnerability and Narratives of the Nation

ERIC Educational Resources Information Center

Hoffman, Diane M

2012-01-01

Long before the earthquake in Haiti on 12 January 2010, but particularly since, international media and humanitarian groups have drawn attention to the "vulnerable child" in Haiti, a child often portrayed as needing "saving". Focusing in particular on the "restavek" (child domestic laborer), this article first…

American Indian Adolescent Girls: Vulnerability to Sex Trafficking, Intervention Strategies

ERIC Educational Resources Information Center

Pierce, Alexandra

2012-01-01

The Minnesota Indian Women's Resource Center offers harm reduction programming to at-risk adolescent American Indian girls, including outreach, case management, advocacy, healthy sexuality education, and support groups. To evaluate program impact, participants are assessed at intake and every 6 months afterward for current vulnerability to…

International Student-Workers in Australia: A New Vulnerable Workforce

ERIC Educational Resources Information Center

Nyland, Chris; Forbes-Mewett, Helen; Marginson, Simon; Ramia, Gaby; Sawir, Erlenawati; Smith, Sharon

2009-01-01

In the period immediately preceding the 2007 Australian election, much attention was accorded to the impact of the nation's labour laws on vulnerable employees. This debate centred on specific groups including women, youth, migrants and workers on individual employment contracts. International students, by contrast, were ignored in the debate.…

[Peer group influence and illicit drug use among adolescent students in Brazil: a cross-sectional study].

PubMed

Jorge, Kelly Oliva; Ferreira, Raquel Conceição; Ferreira, Efigênia Ferreira E; Kawachi, Ichiro; Zarzar, Patrícia Maria; Pordeus, Isabela Almeida

2018-03-08

The aim of the present cross-sectional study was to examine illicit drug use and associations with socioeconomic factors as well as peer group influence among Brazilian adolescents aged 15 to 19 years. Two-stage cluster sampling was adopted, involving the random selection of public and private schools from the nine administrative districts of a Brazilian state capital and the random selection of classrooms at each school. Illicit drug use was the outcome and was measured through the question: "Have you ever used any illicit drugs (marijuana, inhalants, hypnotics, cocaine/crack, hallucinogens, amphetamines and opioids) in your life?". The most important group of friends was ranked as school, family, religious activities and sports/culture. The area-based Health Vulnerability Index (HVI) was used to assess socioeconomic status. Data from 891 adolescents were analyzed using the chi-squared test and logistic regression. The overall rate of illicit drug use was 15.2%. Gender heterogeneity within groups (OR = 3.14; 95%CI: 1.63-6.06), religion-based friendships (OR = 0.36; 95%CI: 0.17-0.75) and sports/culture-based friendships (OR = 0.44; 95%CI: 0.22-0.87) remained significantly associated with illicit drug use. Adolescents who lived in less vulnerable areas had higher chance of drug use in comparison with those living in more vulnerable areas. Religion-based and sports/culture-based friendships seem to demonstrate a protective effect against lifetime illicit drug use. Gender heterogeneity within groups and residing in a less vulnerable area increased the chances of adolescents reporting illicit drug use.

Participatory Research Revealing the Work and Occupational Health Hazards of Cooperative Recyclers in Brazil

PubMed Central

Gutberlet, Jutta; Baeder, Angela M.; Pontuschka, Nídia N.; Felipone, Sonia M. N.; dos Santos, Tereza L. F.

2013-01-01

Although informal waste collectors are sometimes organized in cooperatives, their working conditions remain extremely precarious and unsafe. The paper discusses the findings of action oriented, participatory qualitative research with several recycling groups in the metropolitan region of São Paulo, Brazil. During workshops with the recyclers mapping, acting, and drawing methods helped reveal health hazards from collection, separation and transportation of recyclable materials. Major health problems relate to chemical and biological hazards, musculoskeletal damage, mechanical trauma and poor emotional wellbeing. The recent federal legislation on solid waste management opens new avenues for the inclusion of recycling cooperatives in selective waste collection. Nevertheless, we express the need to consider the distinctive characteristics and vulnerabilities of recycling groups, when developing safer work environments in these social businesses. We also suggest that the workspace be ergonomically organized and that public awareness campaigns about selective waste collection are conducted regularly to increase the quality of source separation. The introduction of electric hand pushed carts can further reduce health strains. This research has produced a better understanding of the work of the recyclers and related health risks. The interactive qualitative research methodology has allowed for the co-creation and mobilization of specific knowledge on health and safety in recycling cooperatives. PMID:24084672

Participatory research revealing the work and occupational health hazards of cooperative recyclers in Brazil.

PubMed

Gutberlet, Jutta; Baeder, Angela M; Pontuschka, Nídia N; Felipone, Sonia M N; Dos Santos, Tereza L F

2013-09-27

Although informal waste collectors are sometimes organized in cooperatives, their working conditions remain extremely precarious and unsafe. The paper discusses the findings of action oriented, participatory qualitative research with several recycling groups in the metropolitan region of São Paulo, Brazil. During workshops with the recyclers mapping, acting, and drawing methods helped reveal health hazards from collection, separation and transportation of recyclable materials. Major health problems relate to chemical and biological hazards, musculoskeletal damage, mechanical trauma and poor emotional wellbeing. The recent federal legislation on solid waste management opens new avenues for the inclusion of recycling cooperatives in selective waste collection. Nevertheless, we express the need to consider the distinctive characteristics and vulnerabilities of recycling groups, when developing safer work environments in these social businesses. We also suggest that the workspace be ergonomically organized and that public awareness campaigns about selective waste collection are conducted regularly to increase the quality of source separation. The introduction of electric hand pushed carts can further reduce health strains. This research has produced a better understanding of the work of the recyclers and related health risks. The interactive qualitative research methodology has allowed for the co-creation and mobilization of specific knowledge on health and safety in recycling cooperatives.

Circadian type, chronic fatigue, and serum IgM in the shift workers of an industrial organization

PubMed Central

Khaleghipour, Shahnaz; Masjedi, Mohsen; Kelishadi, Roya

2015-01-01

Background: Night shift workers are more vulnerable to immune-related diseases. Immunoglobulin M (IgM) is a potent activator of complement, and complement has a crucial role in defense against bacterial infections. Circadian type is known as an effective agent on vulnerability and adaptation with shift work due to non-compliance with shift stress. The objective of this study was to investigate the correlation of circadian type and chronic fatigue with the serum concentration of IgM in a group of shift workers. Materials and Methods: This cross-sectional study was performed in an industrial organization in Isfahan, Iran. The study population consisted of 221 male employees working at night shifts who were selected by random cluster sampling. The following questionnaires were used: composite morningness (Torsvall and Akerstedt), circadian type (Folkard), and chronic fatigue (Barton and colleagues). The serum concentration of IgM was measured by the nephelometric method. The data were analyzed with the Pearson coefficient correlation and the path analysis for finding the pattern of the structural equations to evaluate the direct and indirect relationships between variables, using the SPSS 15 and LISREL 8.5 statistical software. Results: Significant correlation was documented between morningness, flexibility, languidness, and chronic fatigue with the serum concentration of IgM (P < 0.01). Conclusion: The results showed that the shift workers with morningness and languidness experienced more problems during the working hours due to more tiredness, and had decreased serum concentration of IgM. Correct management of shift work may attenuate fatigue in workers and also improve many health issues experienced by the shift workers. PMID:25802830

Recruiting vulnerable populations into research: a systematic review of recruitment interventions.

PubMed

UyBico, Stacy J; Pavel, Shani; Gross, Cary P

2007-06-01

Members of vulnerable populations are underrepresented in research studies. To evaluate and synthesize the evidence regarding interventions to enhance enrollment of vulnerable populations into health research studies. Studies were identified by searching MEDLINE, the Web of Science database, personal sources, hand searching of related journals, and article references. Studies that contained data on recruitment interventions for vulnerable populations (minority, underserved, poor, rural, urban, or inner city) and for which the parent study (study for which recruitment was taking place) was an intervention study were included. A total of 2,648 study titles were screened and 48 articles met inclusion criteria, representing 56 parent studies. Two investigators extracted data from each study. African Americans were the most frequently targeted population (82% of the studies), while 46% targeted Hispanics/Latinos. Many studies assessed 2 or more interventions, including social marketing (82% of studies), community outreach (80%), health system recruitment (52%), and referrals (28%). The methodologic rigor varied substantially. Only 40 studies (71%) incorporated a control group and 21% used statistical analysis to compare interventions. Social marketing, health system, and referral recruitment were each found to be the most successful intervention about 35-45% of the studies in which they were attempted, while community outreach was the most successful intervention in only 2 of 16 studies (13%) in which it was employed. People contacted as a result of social marketing were no less likely to enroll than people contacted through other mechanisms. Further work with greater methodologic rigor is needed to identify evidence-based strategies for increasing minority enrollment in research studies; community outreach, as an isolated strategy, may be less successful than other strategies.

Recruiting Vulnerable Populations into Research: A Systematic Review of Recruitment Interventions

PubMed Central

UyBico, Stacy J.; Pavel, Shani

2007-01-01

Background Members of vulnerable populations are underrepresented in research studies. Objective To evaluate and synthesize the evidence regarding interventions to enhance enrollment of vulnerable populations into health research studies. Data sources Studies were identified by searching MEDLINE, the Web of Science database, personal sources, hand searching of related journals, and article references. Studies that contained data on recruitment interventions for vulnerable populations (minority, underserved, poor, rural, urban, or inner city) and for which the parent study (study for which recruitment was taking place) was an intervention study were included. A total of 2,648 study titles were screened and 48 articles met inclusion criteria, representing 56 parent studies. Two investigators extracted data from each study. Results African Americans were the most frequently targeted population (82% of the studies), while 46% targeted Hispanics/Latinos. Many studies assessed 2 or more interventions, including social marketing (82% of studies), community outreach (80%), health system recruitment (52%), and referrals (28%). The methodologic rigor varied substantially. Only 40 studies (71%) incorporated a control group and 21% used statistical analysis to compare interventions. Social marketing, health system, and referral recruitment were each found to be the most successful intervention about 35–45% of the studies in which they were attempted, while community outreach was the most successful intervention in only 2 of 16 studies (13%) in which it was employed. People contacted as a result of social marketing were no less likely to enroll than people contacted through other mechanisms. Conclusions Further work with greater methodologic rigor is needed to identify evidence-based strategies for increasing minority enrollment in research studies; community outreach, as an isolated strategy, may be less successful than other strategies. PMID:17375358

Exploring the impact of underage sex work among female sex workers in two Mexico-U.S. border cities

PubMed Central

Goldenberg, Shira M; Rangel, Gudelia; Vera, Alicia; Patterson, Thomas L; Abramovitz, Daniela; Silverman, Jay G; Raj, Anita; Strathdee, Steffanie A

2011-01-01

Although sex work and younger age increase HIV vulnerability, empirical data regarding the impacts of underage sex work are lacking. We explored associations between features of the risk environment, sex work and drug use history, and underage sex work entry among 624 female sex workers(FSWs) in Tijuana and Ciudad Juarez, Mexico. Forty-one percent (n=253) of women began sex work as minors, among whom HIV and any STI/HIV prevalence were 5.2% and 60.7%. Factors independently associated with increased odds of underage sex work were inhalants as the first drug used, forced first injection, number of drug treatment attempts, and recent receptive syringe-sharing. Number of recent condom negotiation attempts with steady partners and depression as a reason for first injecting were negatively associated with underage entry. These results underscore the importance of efforts to prevent underage sex work and the wider factors contributing to HIV risk among vulnerable youth and underage FSWs. PMID:22012147

Exploring the impact of underage sex work among female sex workers in two Mexico-US border cities.

PubMed

Goldenberg, Shira M; Rangel, Gudelia; Vera, Alicia; Patterson, Thomas L; Abramovitz, Daniela; Silverman, Jay G; Raj, Anita; Strathdee, Steffanie A

2012-05-01

Although sex work and younger age increase HIV vulnerability, empirical data regarding the impacts of underage sex work are lacking. We explored associations between features of the risk environment, sex work, and drug use history, and underage sex work entry among 624 female sex workers (FSWs) in Tijuana and Ciudad Juarez, Mexico. Forty-one percent (n = 253) of women began sex work as minors, among whom HIV and any STI/HIV prevalence were 5.2 and 60.7%. Factors independently associated with increased odds of underage sex work were inhalants as the first drug used, forced first injection, number of drug treatment attempts, and recent receptive syringe sharing. Number of recent condom negotiation attempts with steady partners and depression as a reason for first injecting were negatively associated with underage entry. These results underscore the importance of efforts to prevent underage sex work and the wider factors contributing to HIV risk among vulnerable youth and underage FSWs.

Changing Work and Work-Family Conflict: Evidence from the Work, Family, and Health Network*

PubMed Central

Kelly, Erin L.; Moen, Phyllis; Oakes, J. Michael; Fan, Wen; Okechukwu, Cassandra; Davis, Kelly D.; Hammer, Leslie; Kossek, Ellen; King, Rosalind Berkowitz; Hanson, Ginger; Mierzwa, Frank; Casper, Lynne

2013-01-01

Schedule control and supervisor support for family and personal life are work resources that may help employees manage the work-family interface. However, existing data and designs have made it difficult to conclusively identify the effects of these work resources. This analysis utilizes a group-randomized trial in which some units in an information technology workplace were randomly assigned to participate in an initiative, called STAR, that targeted work practices, interactions, and expectations by (a) training supervisors on the value of demonstrating support for employees’ personal lives and (b) prompting employees to reconsider when and where they work. We find statistically significant, though modest, improvements in employees’ work-family conflict and family time adequacy and larger changes in schedule control and supervisor support for family and personal life. We find no evidence that this intervention increased work hours or perceived job demands, as might have happened with increased permeability of work across time and space. Subgroup analyses suggest the intervention brings greater benefits to employees more vulnerable to work-family conflict. This study advances our understanding of the impact of social structures on individual lives by investigating deliberate organizational changes and their effects on work resources and the work-family interface with a rigorous design. PMID:25349460

Changing Work and Work-Family Conflict: Evidence from the Work, Family, and Health Network*

PubMed

Kelly, Erin L; Moen, Phyllis; Oakes, J Michael; Fan, Wen; Okechukwu, Cassandra; Davis, Kelly D; Hammer, Leslie; Kossek, Ellen; King, Rosalind Berkowitz; Hanson, Ginger; Mierzwa, Frank; Casper, Lynne

2014-06-01

Schedule control and supervisor support for family and personal life are work resources that may help employees manage the work-family interface. However, existing data and designs have made it difficult to conclusively identify the effects of these work resources. This analysis utilizes a group-randomized trial in which some units in an information technology workplace were randomly assigned to participate in an initiative, called STAR, that targeted work practices, interactions, and expectations by (a) training supervisors on the value of demonstrating support for employees' personal lives and (b) prompting employees to reconsider when and where they work. We find statistically significant, though modest, improvements in employees' work-family conflict and family time adequacy and larger changes in schedule control and supervisor support for family and personal life. We find no evidence that this intervention increased work hours or perceived job demands, as might have happened with increased permeability of work across time and space. Subgroup analyses suggest the intervention brings greater benefits to employees more vulnerable to work-family conflict. This study advances our understanding of the impact of social structures on individual lives by investigating deliberate organizational changes and their effects on work resources and the work-family interface with a rigorous design.

Nutritional status and parasitic infestation among working children in a village in Egypt: a comparative study.

PubMed

Shoman, Ahmed E; Mostafa, Nayera S; Musslem, Amira A

2015-06-01

Work poses potential threats to the physical, emotional, economic, and academic health of teenagers. Like their adult coworkers, teenagers face exposure to a variety of health and safety hazards that can lead to injury and illness. Children's increased vulnerability puts them at a high risk of work-related health problems. The aim of this study was to compare growth parameters of working children in contrast to nonworking students, and to compare the frequency of anemia and parasitic infestations among the two groups. A comparative cross-sectional study among 75 working boys in small industrial workshops in Arab Gohaina village in Qaliuobia governorate and 75 students of the same residence was conducted. All children were interviewed and were subjected to physical examination. Their BMI and hemoglobin were measured, and stool samples were examined for parasites. Only 11 and 15% of the workers working children eat vegetables and fruits on daily basis compared with 25 and 49% of students respectively (P<0.001). Mean BMI of the working group was 21.62±2.56 compared with 23.29±3.09 among the students. Students showed more frequency of obesity and overweight than the working group (13.33 and 29.33% compared with 2.67 and 20%, respectively, P=0.009). The hemoglobin level of working children (10.27±0.53 g/dl) was less than that of students (11.31±0.75 g/dl, P<0.001). The frequency of having parasitic infestations among working children was significantly higher than the students (P<0.001). Labor was a factor that negatively affected the health of children. More working children in this village had anemia and parasitic infestations than nonworking ones. It is recommended to pay more attention to health problems among working children, with controlling child labor, especially in hazardous occupations and performing periodic medical examination to monitor their health and development.

Vulnerabilities to Health Disparities and Statin Use in the REGARDS (Reasons for Geographic and Racial Differences in Stroke) Study.

PubMed

Schroff, Praful; Gamboa, Christopher M; Durant, Raegan W; Oikeh, Asikhame; Richman, Joshua S; Safford, Monika M

2017-08-28

Statins may be underutilized in certain vulnerable populations, but the effect of cumulative vulnerabilities within 1 individual is not well described. We sought to determine the likelihood of receiving statins with an increasing number of vulnerabilities in an individual, after controlling for factors known to influence health services utilization. We identified 18 216 participants from the REGARDS (Reasons for Geographic and Racial Differences in Stroke) study who had a statin indication or who were taking statins, as verified by pill bottle review. Statin use was assessed with respect to 5 major vulnerability domains alone and in combination: older age, black race, female sex, high area-level poverty, and lack of health insurance. The study included 5286 white men, 4180 black men, 2791 white women, and 4194 black women; 5.6% of the sample had no vulnerabilities, 20.6% had 1 vulnerability, 29.2% had 2 vulnerabilities, 27.3% had 3 vulnerabilities, and 17.3% had 4 or 5 vulnerabilities. All race-sex groups were less likely than white men to use statins; prevalence of use was 0.80 in black women with reference to white men ( P <0.0001). In both unadjusted and adjusted models, as the number of vulnerabilities increased, statin use steadily decreased. After adjusting for factors that influence health services utilization, compared with those without any vulnerabilities, statin use prevalence was 0.91, 0.83, 0.74 and 0.68 ( P <0.0001) in those with 1, 2, 3, and 4 or 5 vulnerabilities, respectively. Participants with more simultaneously occurring vulnerabilities experienced the greatest disparities in statin use. Black women and those without health insurance were at particularly high risk of underutilization. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

What if quality of damage data is poor: an Entity-Vulnerability approach for flood vulnerability assessment

NASA Astrophysics Data System (ADS)

Naso, Susanna; Chen, Albert S.; Djordjević, Slobodan; Aronica, Giuseppe T.

2015-04-01

The classical approach to flood defence, aimed at reducing the probability of flooding through hard defences, has been substituted by flood risk management approach which accepts the idea of coping with floods and aims at reducing not only the probability of flooding, but also the consequences. In this view, the concept of vulnerability becomes central, such as the (non-structural) measures for its increment. On 22 November 2011, an exceptional rainstorm hit the Longano catchment (North-East part of Sicily, Italy) producing local heavy rainfall, mud-debris flow and flash flooding. The flash flood involved property, buildings, roads and more than 100 commercial estates have suffered severe damages. Some days after the event, the municipality provided people forms to describe the damages that occurred on their properties. Unfortunately, the lack of common guidelines in compiling them, their coarseness and the impossibility to have monetary information on them (such us damage data from previous events), did not allow the implementation of a detailed damage analysis. What we're developing in this work is a method for a qualitative evaluation of the consequences of floods, based on vulnerability curves for structures and classes of entities at risk. The difficulty in deriving the vulnerability curves for different building typologies, as function of the water depth, was due to the lack of quantitative information both on damages caused by previous events and on buildings' value. To solve the problem we submitted a questionnaire to a team of experts asking for an estimation of building damages to different hypothetical inundation depths. What we wanted to obtain was deriving the vulnerability data from technicians' experience, believing in the fundamental importance of the collaboration among research and professional engineers. Through the elaboration and the synthesis of the experts' estimations we derived the vulnerability curves for different building typologies and for inundations of both short and long duration. At the same time we defined the classes of the variable Entity in function of both buildings' asset value and their importance for society. Once the buildings of different typologies are grouped, a GIS-based tool (using hazard information obtained from hydraulic modelling, building parcels, vulnerability curves and entity classes) is used to collocate each element at risk inside an Entity-Vulnerability matrix. The construction of a E-V matrix allow both to understand the actual situation of flood-prone area (and the possible consequences of a flood event) and to study the effectiveness of non-structural measures, just studying how their implementation modifies the distribution of elements at risk inside it. The proposed approach can be useful for authorities responsible for development and periodical review of adaptive flood risk management plans.

Selling sex in unsafe spaces: sex work risk environments in Phnom Penh, Cambodia

PubMed Central

2011-01-01

Background The risk environment framework provides a valuable but under-utilised heuristic for understanding environmental vulnerability to HIV and other sexually transmitted infections among female sex workers. Brothels have been shown to be safer than street-based sex work, with higher rates of consistent condom use and lower HIV prevalence. While entertainment venues are also assumed to be safer than street-based sex work, few studies have examined environmental influences on vulnerability to HIV in this context. Methods As part of the Young Women's Health Study, a prospective observational study of young women (15-29 years) engaged in sex work in Phnom Penh, we conducted in-depth interviews (n = 33) to explore vulnerability to HIV/STI and related harms. Interviews were conducted in Khmer by trained interviewers, transcribed and translated into English and analysed for thematic content. Results The intensification of anti-prostitution and anti-trafficking efforts in Cambodia has increased the number of women working in entertainment venues and on the street. Our results confirm that street-based sex work places women at risk of HIV/STI infection and identify significant environmental risks related to entertainment-based sex work, including limited access to condoms and alcohol-related intoxication. Our data also indicate that exposure to violence and interactions with the police are mediated by the settings in which sex is sold. In particular, transacting sex in environments such as guest houses where there is little or no oversight in the form of peer or managerial support or protection, may increase vulnerability to HIV/STI. Conclusions Entertainment venues may also provide a high risk environment for sex work. Our results indicate that strategies designed to address HIV prevention among brothel-based FSWs in Cambodia have not translated well to street and entertainment-based sex work venues in which increasing numbers of women are working. There is an urgent need for targeted interventions, supported by legal and policy reforms, designed to reduce the environmental risks of sex work in these settings. Future research should seek to investigate sex work venues as risk environments, explore the role of different business models in mediating these environments, and identify and quantify exposure to risk in different occupational settings. PMID:22099449

Mapping global vulnerability index in mining sectors: A case study Moulares-Redayef aquifer system, southwestern Tunisia

NASA Astrophysics Data System (ADS)

Khelif, Nadia; Jmal, Ikram; Bouri, Salem

2016-09-01

Contrary to the DRASTIC model grouping together the saturated and unsaturated zones to compute a global intrinsic vulnerability index, the global vulnerability index method incorporates both hydrogeological and hydrochemical data for a comprehensive index mapping for the saturated zones. This concept depends on the behavior and the uses of the groundwater. The main aim of this study is to propose a scientific basis for sustainable land use planning and groundwater management of the Moulares-Reayef aquifer, located in Southwestern Tunisia. The overexploitation of this aquifer causes the threat of groundwater quality by various sources of pollution. The global vulnerability index was applied in the Moulares-Reayef aquifer. The results show that the most favorable zones to pollutant percolation are situated along the wadis (Tabaddit, Zallaz, Berka, …) which are drained by continuous discharges. The global vulnerability values were correlated with nitrates values for validation. It revealed a significant correlation showing that high values of nitrates occurred in highly vulnerable zones with a value of 0.69 for the Pearson coefficient. The global vulnerability evaluation shows that the aquifer is characterized by high vertical vulnerability and high susceptibility.

A Climate Change Vulnerability Assessment of California's At-Risk Birds

PubMed Central

Gardali, Thomas; Seavy, Nathaniel E.; DiGaudio, Ryan T.; Comrack, Lyann A.

2012-01-01

Conservationists must develop new strategies and adapt existing tools to address the consequences of anthropogenic climate change. To support statewide climate change adaptation, we developed a framework for assessing climate change vulnerability of California's at-risk birds and integrating it into the existing California Bird Species of Special Concern list. We defined climate vulnerability as the amount of evidence that climate change will negatively impact a population. We quantified climate vulnerability by scoring sensitivity (intrinsic characteristics of an organism that make it vulnerable) and exposure (the magnitude of climate change expected) for each taxon. Using the combined sensitivity and exposure scores as an index, we ranked 358 avian taxa, and classified 128 as vulnerable to climate change. Birds associated with wetlands had the largest representation on the list relative to other habitat groups. Of the 29 state or federally listed taxa, 21 were also classified as climate vulnerable, further raising their conservation concern. Integrating climate vulnerability and California's Bird Species of Special Concern list resulted in the addition of five taxa and an increase in priority rank for ten. Our process illustrates a simple, immediate action that can be taken to inform climate change adaptation strategies for wildlife. PMID:22396726

Depressive vulnerabilities predict depression status and trajectories of depression over 1 year in persons with acute coronary syndrome.

PubMed

Doyle, Frank; McGee, Hannah; Delaney, Mary; Motterlini, Nicola; Conroy, Ronán

2011-01-01

Depression is prevalent in patients hospitalized with acute coronary syndrome (ACS). We determined whether theoretical vulnerabilities for depression (interpersonal life events, reinforcing events, cognitive distortions, Type D personality) predicted depression, or depression trajectories, post-hospitalization. We followed 375 ACS patients who completed depression scales during hospital admission and at least once during three follow-up intervals over 1 year (949 observations). Questionnaires assessing vulnerabilities were completed at baseline. Logistic regression for panel/longitudinal data predicted depression status during follow-up. Latent class analysis determined depression trajectories. Multinomial logistic regression modeled the relationship between vulnerabilities and trajectories. Vulnerabilities predicted depression status over time in univariate and multivariate analysis, even when controlling for baseline depression. Proportions in each depression trajectory category were as follows: persistent (15%), subthreshold (37%), never depressed (48%). Vulnerabilities independently predicted each of these trajectories, with effect sizes significantly highest for the persistent depression group. Self-reported vulnerabilities - stressful life events, reduced reinforcing events, cognitive distortions, personality - measured during hospitalization can identify those at risk for depression post-ACS and especially those with persistent depressive episodes. Interventions should focus on these vulnerabilities. Copyright © 2011 Elsevier Inc. All rights reserved.

A climate change vulnerability assessment of California's at-risk birds.

PubMed

Gardali, Thomas; Seavy, Nathaniel E; DiGaudio, Ryan T; Comrack, Lyann A

2012-01-01

Conservationists must develop new strategies and adapt existing tools to address the consequences of anthropogenic climate change. To support statewide climate change adaptation, we developed a framework for assessing climate change vulnerability of California's at-risk birds and integrating it into the existing California Bird Species of Special Concern list. We defined climate vulnerability as the amount of evidence that climate change will negatively impact a population. We quantified climate vulnerability by scoring sensitivity (intrinsic characteristics of an organism that make it vulnerable) and exposure (the magnitude of climate change expected) for each taxon. Using the combined sensitivity and exposure scores as an index, we ranked 358 avian taxa, and classified 128 as vulnerable to climate change. Birds associated with wetlands had the largest representation on the list relative to other habitat groups. Of the 29 state or federally listed taxa, 21 were also classified as climate vulnerable, further raising their conservation concern. Integrating climate vulnerability and California's Bird Species of Special Concern list resulted in the addition of five taxa and an increase in priority rank for ten. Our process illustrates a simple, immediate action that can be taken to inform climate change adaptation strategies for wildlife.

The impact of depression and diabetes mellitus on older workers' functioning.

PubMed

Stynen, D; Jansen, N W H; Kant, I J

2015-12-01

Using the International Classification of Functioning, Disability and Health as a framework, this study investigates the impact of depression and diabetes mellitus on older workers' functioning (problems with concentration, physical functioning, need for recovery and work and social participation restrictions). The study focuses on how these chronic conditions, in their interaction with the work context, affect older workers' functioning, which may be an important precursor of early retirement. Older workers (≥ 45years) with depression (n=127) or diabetes mellitus (n=107) enrolled in the prospective Maastricht Cohort Study (MCS) were followed between October 2008 and October 2012. Linear, logistic and Cox regression analyses were performed to investigate the effect of these health conditions on workers' functioning compared to a reference group of older workers without a chronic condition (n=1612). The interaction with participants' working conditions (psychological job demands, decision latitude and strenuous work) was also analysed. Compared to the reference group, depression and diabetes mellitus were (over time) positively related with need for recovery caseness and restrictions in social participation but not with restrictions in work participation. Depression was positively related with concentration problems and need for recovery, whereas diabetes mellitus was negatively related with physical functioning. Finally, the relationship between functioning and depression and diabetes mellitus depends on working conditions. Older workers with depression or diabetes mellitus are vulnerable to losses in specific domains of functioning. The impact on functioning varies across working conditions, providing insight for disease-tailored preventive measures. Copyright © 2015 Elsevier Inc. All rights reserved.

Racial/ethnic harassment and discrimination, its antecedents, and its effect on job-related outcomes.

PubMed

Bergman, Mindy E; Palmieri, Patrick A; Drasgow, Fritz; Ormerod, Alayne J

2012-01-01

A general model of workplace prejudice acts, their antecedents, and their consequences is proposed and examined in the context of racial/ethnic harassment and discrimination (REHD). Antecedents proposed and tested here include context and climate, whereas consequences proposed and tested here include work, supervisor, and opportunity satisfaction and turnover intentions. The theoretical model is first tested and cross-validated in two ethnically diverse subsamples (approximately 2,000 each). Then, hierarchical multigroup modeling was conducted to determine whether the relationships among REHD, its antecedents, and its outcomes are equivalent across five racial/ethnic groups (N = 1,000 per group) in the U.S. military. This addresses the issue of differential exposure (i.e., varying amounts of stressors across groups) versus differential vulnerability (i.e., discrepant impact of a stressor on outcomes across groups) across racial/ethnic groups. Consistent with expectations, results suggest that although racial/ethnic groups differ in their mean exposure to REHD, the relationships among REHD and its outcomes are the same across race/ethnicity, supporting the differential exposure view. In addition, the results show some differences between antecedents and REHD across race/ethnicity.

An Activist Approach to Sport Meets Youth from Socially Vulnerable Backgrounds: Possible Learning Aspirations

ERIC Educational Resources Information Center

Luguetti, Carla; Oliver, Kimberly L.; Dantas, Luiz Eduardo Pinto Basto Tourinho; Kirk, David

2017-01-01

Purpose: This study was a 2-phase activist research project aimed at co-creating a prototype pedagogical model for working with youth from socially vulnerable backgrounds in a sport context. This article addresses the learning aspirations (learning outcomes) that emerged when we created spaces for youth to develop strategies to manage the risks…

Social Work with Children when Parents Have Mental Health Difficulties: Acknowledging Vulnerability and Maintaining the "Rights of the Child"

ERIC Educational Resources Information Center

Monds-Watson, Aisling; Manktelow, Roger; McColgan, Mary

2010-01-01

The 40 substantive rights contained within the United Nations Convention on the Rights of the Child (UNCRC) 1989, have applied, without discrimination, to all children in the United Kingdom since 1992. However, recurrent tragedies starkly highlight the potential vulnerability of some children when their parents experience mental health…

It Feels Like Home: The Role of the Aesthetic Space in Participatory Work with Vulnerable Children

ERIC Educational Resources Information Center

Hunka, Emily

2015-01-01

The author's entry into the Applied Theatre field coincided with "Research in Drama Education" ("RiDE's") inaugural issue in 1996 and, for the ensuing two decades, her practice has been primarily with "vulnerable" children. The purpose of this article is to interrogate a growing concern: that applied theatre's…

Transformative Inquiry While Learning-Teaching: Entry Points Through Mentor-Mentee Vulnerability

ERIC Educational Resources Information Center

Tanaka, Michele T. D.; Farish, Maureen; Nicholson, Diana; Tse, Vanessa; Doll, Jenn; Archer, Elizabeth

2014-01-01

In Transformative Inquiry (TI), pre-service teachers explore issues about which they are personally passionate in order to enter into the delicate work of transformation. We examine how shared vulnerability within three mentor-mentee pairs leads to new pedagogical possibilities. Michele and Vanessa discuss poetry as a way of entering into TI and…

Some Contributions from Latin American Career Counselling for Dealing with Situations of Psychosocial Vulnerability

ERIC Educational Resources Information Center

Ribeiro, Marcelo Afonso; da Conceição Coropos Uvaldo, Maria; da Silva, Fabiano Fonseca

2015-01-01

Facing a working world more flexible, unstable and potentially generator of vulnerabilities, the career counselling has required contemporary approaches that meet these demands, which ones have been present in Latin America for a long time. Thus, the present paper aimed to analyse some Latin American proposals and highlight general principles to…

The Experience of Adolescents and Young Adults Treated for Cancer in an Adult Setting: A Review of the Literature.

PubMed

Marshall, Steve; Grinyer, Anne; Limmer, Mark

2018-02-13

The purpose of this review is to explore the literature on the experience of adolescents and young adults (AYAs) having cancer treatment in an adult setting, rather than on a specialist adolescent cancer unit. The integrative review method was used to explore the current literature. Primary research on the topic was located systematically and then synthesized into a thematic narrative. The experience of AYAs undergoing treatment in an adult setting was generally negative. This can be attributed to three themes: feeling isolated in the adult setting; the lack of empathy from staff working in the adult setting; and the inappropriateness of the adult environment for this age group. As many AYAs with cancer will continue to have treatment in adult settings, staff working in this environment should be aware of the negative experience of this cohort and the impact this can have on a vulnerable group of patients. Staff could consider simple ways of improving the AYA experience, such as connecting AYA patients with their peers to reduce isolation; adapting their approach to take account of the unique emotional needs of this age group; and considering ways of making the environment more welcoming and age-appropriate.

The Clinical Research Associate Retention Study: A Report From the Children's Oncology Group.

PubMed

Owens Pickle, Emily E; Borgerson, Dawn; Espirito-Santo, Anelise; Wigginton, Sabrina; Devine, Susan; Stork, Sue

Pediatric medicine often struggles to receive adequate research funding for its small, yet vulnerable population of patients. Remarkable discovery in pediatric oncology is credited in large part to the collaborative structure of its research community. The Children's Oncology Group conducts studies supported by the National Cancer Institute. The clinical research associate (CRA) discipline comprises professionals who support administrative duties, regulatory duties, subject management, and data collection at individual research sites. The purpose of this study was to identify factors associated with CRA retention, as the group continues to have high turnover and position vacancy. A cross-sectional survey design was used to characterize the most frequently cited reasons CRAs gave when considering leaving or staying within their position. Results suggest that low salary, unmanageable workload, lack of career advancement and professional development, and lack of research commitment from the medical team were associated with intent to leave CRA positions. The most frequently cited reasons for staying at their job were the meaningfulness and interest in the work, a supportive principal investigator, and enjoyment working with colleagues. CRAs reported serious but eminently solvable issues that can be addressed using practical and low-cost solutions to improve job satisfaction and retention.

Determinants of physician utilization, emergency room use, and hospitalizations among populations with multiple health vulnerabilities.

PubMed

Small, La Fleur F

2011-09-01

Understanding the factors that influence differing types of health care utilization within vulnerable groups can serve as a basis for projecting future health care needs, forecasting future health care expenditures, and influencing social policy. In this article the Behavioral Model for Vulnerable Populations is used to evaluate discretionary (physician visits) and non-discretionary (emergency room visits, and hospitalizations) health utilization patterns of a sample of 1466 respondents with one or more vulnerable health classification. Reported vulnerabilities include: (1) persons with substance disorders; (2) homeless persons; (3) persons with mental health problems; (4) victims of violent crime; (5) persons diagnosed with HIV/AIDS; (6) and persons in receipt of public benefits. Hierarchical logistic regression is used on three nested models to model factors that influence physician visits, emergency room visits, and hospitalizations. Additionally, bivariate logistic regression analyses are completed using a vulnerability index to evaluate the impact of increased numbers of vulnerability on all three forms of health care utilization. Findings from this study suggest the Behavioral Model of Vulnerable Populations be employed in future research regarding health care utilization patterns among vulnerable populations. This article encourages further research investigating the cumulative effect of health vulnerabilities on the use of non-discretionary services so that this behavior could be better understood and appropriate social policies and behavioral interventions implemented.

The concept of 'vulnerability' in research ethics: an in-depth analysis of policies and guidelines.

PubMed

Bracken-Roche, Dearbhail; Bell, Emily; Macdonald, Mary Ellen; Racine, Eric

2017-02-07

The concept of vulnerability has held a central place in research ethics guidance since its introduction in the United States Belmont Report in 1979. It signals mindfulness for researchers and research ethics boards to the possibility that some participants may be at higher risk of harm or wrong. Despite its important intended purpose and widespread use, there is considerable disagreement in the scholarly literature about the meaning and delineation of vulnerability, stemming from a perceived lack of guidance within research ethics standards. The aim of this study was to assess the concept of vulnerability as it is employed in major national and international research ethics policies and guidelines. We conducted an in-depth analysis of 11 (five national and six international) research ethics policies and guidelines, exploring their discussions of the definition, application, normative justification and implications of vulnerability. Few policies and guidelines explicitly defined vulnerability, instead relying on implicit assumptions and the delineation of vulnerable groups and sources of vulnerability. On the whole, we found considerable richness in the content on vulnerability across policies, but note that this relies heavily on the structure imposed on the data through our analysis. Our results underscore a need for policymakers to revisit the guidance on vulnerability in research ethics, and we propose that a process of stakeholder engagement would well-support this effort.

Assessing the geomorphological vulnerability of arid beach-dune systems.

PubMed

Peña-Alonso, Carolina; Gallego-Fernández, Juan B; Hernández-Calvento, Luis; Hernández-Cordero, Antonio I; Ariza, Eduard

2018-09-01

In this study, an arid dune vulnerability index (ADVI) is developed using a system of indicators to evaluate the geomorphological vulnerability of beach-dune systems of arid regions. The indicators are comprised of three analytical dimensions (susceptibility, exposure and resilience) and their corresponding sub-indices and variables and were assessed for eleven sites located in four aeolian sedimentary systems of the Canary archipelago (Spain). The selected sites have varying geomorphological characteristics, vegetation types, marine and wind conditions and human pressure degrees, and have seen different trends in their geomorphological evolution since 1960. The eleven sites were separated into three groups according to their different conservation status and different management needs, and the results of the ADVI dimensions and variables were compared and analyzed for these three groups. In general, the results obtained in the analyzed sites reveal that susceptibility and exposure dimensions are related to low-moderate values, while resilience was high. Only one site presented a state of critical vulnerability, due to the loss of its capacity to maintain its geomorphological function in recent decades. Given the lack of knowledge about geomorphological vulnerability processes in foredunes of arid regions, ADVI is the first approximation to geomorphological diagnostic in these environments and can be useful for managers. Copyright © 2018 Elsevier B.V. All rights reserved.

Inclusive and relevant language: the use of the concepts of autonomy, dignity and vulnerability in different contexts.

PubMed

Haugen, Hans Morten

2010-08-01

The article analyses the three terms autonomy, dignity and vulnerability. The relevance and practical application of the terms is tested in two spheres. First, as guiding principles in the area of ethics of medicines and science. Second, as human rights principles, serving to guide the conduct of public policies for an effective realization of human rights. The article argues that all human beings have the same dignity, but that the autonomy--and therefore vulnerability--differs considerably. Simply said, with reduced autonomy comes increased vulnerability, implying extra attention to the protective dimensions. The article finds that the three terms approach the protection of human beings in different ways and that all are relevant and applicable in both spheres, but that an isolated notion of autonomy and a 'group-based' notion of vulnerability are not adequate.

The perils of protection: vulnerability and women in clinical research.

PubMed

Schonfeld, Toby

2013-06-01

Subpart B of 45 Code of Federal Regulations Part 46 (CFR) identifies the criteria according to which research involving pregnant women, human fetuses, and neonates can be conducted ethically in the United States. As such, pregnant women and fetuses fall into a category requiring "additional protections," often referred to as "vulnerable populations." The CFR does not define vulnerability, but merely gives examples of vulnerable groups by pointing to different categories of potential research subjects needing additional protections. In this paper, I assess critically the role of this categorization of pregnant women involved in research as "vulnerable," both as separate entities and in combination with the fetuses they carry. In particular, I do three things: (1) demonstrate that pregnant women qua pregnancy are either not "vulnerable" according to any meaningful definition of that term or that such vulnerability is irrelevant to her status as a research participant; (2) argue that while a fetus may be vulnerable in terms of dependency, this categorization does not equate to the vulnerability of the pregnant woman; and (3) suggest that any vulnerability that appends to women is precisely the result of federal regulations and dubious public perceptions about pregnant women. I conclude by demonstrating how this erroneous characterization of pregnant women as "vulnerable" and its associated protections have not only impeded vital research for pregnant women and their fetuses, but have also negatively affected the inclusion of all women in clinical research.

Relations between species rarity, vulnerability, and range contraction for a beetle group in a densely populated region in the Mediterranean biodiversity hotspot.

PubMed

Fattorini, Simone

2014-02-01

Rarity is often considered an indication of species extinction risk, and it is frequently used to obtain measures of species vulnerability. However, there is no strong evidence of a correlation between species vulnerability and threat. Moreover, there is no consensus about how rarity should be measured. I used a multidimensional characterization of species rarity to calculate a vulnerability index for tenebrionid beetles inhabiting an Italian region in the Mediterranean biodiversity hotspot. I used different metrics to examine 3 dimensions of rarity: species range, ecology, and population. Species with rarity values below the median were scored as rare for each dimension. I combined rarity scores into a vulnerability index. I then correlated species vulnerability with range trends (expanded vs. contracted). Different measures of the same rarity dimension were strongly correlated and produced similar vulnerability scores. This result indicates rarity-based vulnerability estimates are slightly affected by the way a certain rarity dimension is measured. Vulnerability was correlated with range trends; species with the highest vulnerability had the strongest range contraction. However, a large number of common species also underwent range contraction in the last 50 years, and there was no clear relation between range contraction and their ecology. This indicates that in general human-induced environmental changes affected species irrespective of their assumed vulnerability and that focusing only on rare species may severely bias perceptions of the extent of species decline. © 2013 Society for Conservation Biology.

Hydrologic vulnerability of tribal reservation lands across the U.S.

NASA Astrophysics Data System (ADS)

Jones, C., Jr.; Leibowitz, S. G.; Sawicz, K. A.; Comeleo, R. L.; Stratton, L. E.

2017-12-01

We apply the hydrologic landscapes (HL) concept to assess the hydrologic vulnerability to climate of the United States (U.S.) with special emphasis on tribal lands. The basic assumption of the HL approach is that catchments that share similar physical and climatic characteristics are expected to have similar hydrologic characteristics. We map climate vulnerability by integrating a retrospective analysis of historical climate and hydrology into the HL approach, comparing this baseline of variability with future projections of temperature, precipitation, potential evapotranspiration, snow accumulation, climatic moisture, surplus water, and seasonality of the water surplus. Projections that are not within two standard deviations of the historical decadal average contribute to the vulnerability index for each metric. This allows stakeholders and/or water resource managers to understand the potential impacts of future conditions. The resulting vulnerability maps show that temperature and potential evapotranspiration are consistently projected to have high vulnerability indices across the U.S. including all tribal reservations. Precipitation vulnerability is not as spatially-uniform as temperature. Most areas with snow are projected to experience significant changes in future snow accumulation. The seasonality vulnerability map shows that mountainous areas in the West are most prone to changes in seasonality. This paper illustrates how the HL approach can help assess climatic and hydrologic vulnerability for disadvantaged groups across the U.S. By combining the HL concept and climate vulnerability analyses, we provide an approach that can assist tribal resource managers to perform vulnerability assessments and adaptation plans, which is a major priority for the tribes nationwide.

Employment effects of the Danish rehabilitation benefit.

PubMed

Pallesen, Palle B; Lynge, Elsebeth

2012-06-01

Social benefits aim to bring marginalised citizens back into the labour force. As benefits constitute a burden for tax payers, attention has been given to measure the effect. We used register data to assess the employment effect of rehabilitation benefit; the most liberal social benefit in Denmark. We used data on rehabilitation benefits paid during 1994-2004. In the study design, special care was given to overcome selection bias. We identified municipalities with most frequent (generous) and least frequent (stingy) use of rehabilitation benefit, controlling for confounders (step 1). From the generous municipalities, population subgroups where ≥10% received rehabilitation benefit (vulnerable group) were identified based on age, sex, education, cohabitation, children, and health (step 2). Outcome measure was employment rate in 2005 for vulnerable groups in generous municipalities compared with vulnerable groups in stingy municipalities, controlled for municipality employment rate, i.e. a ratio of ratios (step 3). Use of rehabilitation benefit varied 10-fold across the 271 Danish municipalities. The employment rate in 2005 for vulnerable groups was lower in generous than in stingy municipalities. The ratio of ratios was 0.915 (95% CI 0.888-0.945) for men and 0.919 (95% CI 0.896-0.942) for women. No positive employment effect of generous use of rehabilitation benefit was found. Although residual confounding cannot be excluded, it is nevertheless remarkable that the possibly positive effect of rehabilitation benefit was not sufficiently large to become visible, even in a study particularly designed to eliminate selection biases and to control for confounding.

The Relationships Among Sleep Quality and Chronotype, Emotional Disturbance, and Insomnia Vulnerability in Shift Nurses.

PubMed

Lee, Ching-Yi; Chen, Hsi-Chung; Meg Tseng, Mei-Chih; Lee, Hsin-Chien; Huang, Lian-Hua

2015-09-01

Shift work is a prominent feature of most nursing jobs. Although chronotype, emotional disturbance, and insomnia vulnerability are important factors for patients with insomnia in general, their effects on shift nurses are unknown. This study explores the relationships between the sleep quality of shift nurses and the variables of chronotype, emotional disturbance, and insomnia vulnerability. A survey was conducted with 398 shift nurses in a medical center. Chronotype, emotional disturbance, insomnia vulnerability, and sleep quality were evaluated using the Smith Morningness-Eveningness Questionnaire, the Brief Symptom Rating Scale, the Ford Insomnia Response to Stress Test, and the Pittsburgh Sleep Quality Index, respectively. On the Pittsburgh Sleep Quality Index, 70.1% of the participants scored higher than 5. Multiple regression analysis revealed that, together with night shift work (b [SE] = 1.05 [0.35], p = .003), higher levels of emotional disturbance (b [SE] = 0.30 [0.05], p < .001) and higher insomnia vulnerability (b [SE] = 0.18 [0.03], p < .001) were predictors of poor sleep quality and that chronotype was not a predictor of poor sleep quality. The multiple mediator model indicated that emotional disturbance significantly mediated an indirect effect of evening chronotype preference on poor subjective sleep quality (one subscale of the Pittsburgh Sleep Quality Index). In addition to shift patterns, emotional disturbance and high insomnia vulnerability are factors that may be used to identify shift nurses who face a higher risk of sleep disturbance. Because evening chronotype may indirectly influence subjective sleep quality through the pathway of emotional disturbance, further research into the mechanism that underlies this pathway is warranted.

The usefulness of optical analyses for detecting vulnerable plaques using rabbit models

NASA Astrophysics Data System (ADS)

Nakai, Kanji; Ishihara, Miya; Kawauchi, Satoko; Shiomi, Masashi; Kikuchi, Makoto; Kaji, Tatsumi

2011-03-01

Purpose: Carotid artery stenting (CAS) has become a widely used option for treatment of carotid stenosis. Although technical improvements have led to a decrease in complications related to CAS, distal embolism continues to be a problem. The purpose of this research was to investigate the usefulness of optical methods (Time-Resolved Laser- Induced Fluorescence Spectroscopy [TR-LIFS] and reflection spectroscopy [RS] as diagnostic tools for assessment of vulnerable atherosclerotic lesions, using rabbit models of vulnerable plaque. Materials & Methods: Male Japanese white rabbits were divided into a high cholesterol diet group and a normal diet group. In addition, we used a Watanabe heritable hyperlipidemic (WHHL) rabbit, because we confirmed the reliability of our animal model for this study. Experiment 1: TR-LIFS. Fluorescence was induced using the third harmonic wave of a Q switch Nd:YAG laser. The TR-LIFS was performed using a photonic multi-channel analyzer with ICCD (wavelength range, 200 - 860 nm). Experiment 2: RS. Refection spectra in the wavelength range of 900 to 1700 nm were acquired using a spectrometer. Results: In the TR-LIFS, the wavelength at the peak was longer by plaque formation. The TR-LIFS method revealed a difference in peak levels between a normal aorta and a lipid-rich aorta. The RS method showed increased absorption from 1450 to 1500 nm for lipid-rich plaques. We observed absorption around 1200 nm due to lipid only in the WHHL group. Conclusion: These methods using optical analysis might be useful for diagnosis of vulnerable plaques. Keywords: Carotid artery stenting, vulnerable plaque, Time-Resolved Laser-Induced Fluorescence

Poverty, vulnerability, and provision of healthcare in Afghanistan.

PubMed

Trani, Jean-Francois; Bakhshi, Parul; Noor, Ayan A; Lopez, Dominique; Mashkoor, Ashraf

2010-06-01

This paper presents findings on conditions of healthcare delivery in Afghanistan. There is an ongoing debate about barriers to healthcare in low-income as well as fragile states. In 2002, the Government of Afghanistan established a Basic Package of Health Services (BPHS), contracting primary healthcare delivery to non-state providers. The priority was to give access to the most vulnerable groups: women, children, disabled persons, and the poorest households. In 2005, we conducted a nationwide survey, and using a logistic regression model, investigated provider choice. We also measured associations between perceived availability and usefulness of healthcare providers. Our results indicate that the implementation of the package has partially reached its goal: to target the most vulnerable. The pattern of use of healthcare provider suggests that disabled people, female-headed households, and poorest households visited health centres more often (during the year preceding the survey interview). But these vulnerable groups faced more difficulties while using health centres, hospitals as well as private providers and their out-of-pocket expenditure was higher than other groups. In the model of provider choice, time to travel reduces the likelihood for all Afghans of choosing health centres and hospitals. We situate these findings in the larger context of current debates regarding healthcare delivery for vulnerable populations in fragile state environments. The 'scaling-up process' is faced with several issues that jeopardize the objective of equitable access: cost of care, coverage of remote areas, and competition from profit-orientated providers. To overcome these structural barriers, we suggest reinforcing processes of transparency, accountability and participation. Copyright 2010 Elsevier Ltd. All rights reserved.

Sexual hazards, life experiences and social circumstances among male sex workers in Nigeria.

PubMed

Okanlawon, Kehinde; Adebowale, Ayo Stephen; Titilayo, Ayotunde

2013-01-01

The sexual health and rights needs of male sex workers in Nigeria remain poorly understood and served. Men who sell sex are at high risk of discrimination and violation because of laws criminalising same-sex activity and sex work. This paper examines the experiences, social circumstances, vulnerabilities and sexual hazards experienced by male sex workers in Nigeria. In-depth interviews were used to explore the experiences of six male sex workers who were selected by means of convenience sampling from among those who came for counselling. Findings reveal that economic disadvantage drives some men to engage in sex work and risky sexual behaviour. Subsequently, sex work may put their lives and health at risk as a result of violation by the police and clients, including ritual murder. Men's extreme vulnerability points to the need for appropriate interventions to improve well-being. Sexual health and rights programmes must identify ways of making male sex workers less vulnerable to abuse, and devise strategies for protecting their health and human rights, while empowering them economically to reduce their dependency on often risky sexual behaviour for livelihoods.

Engaging Vulnerable Adolescents in a Pregnancy Prevention Program: Perspectives of Prime Time Staff

PubMed Central

Tanner, Amanda E.; Secor-Turner, Molly; Garwick, Ann; Sieving, Renee; Rush, Kayci

2011-01-01

Introduction Evaluating interventions for reducing unintended adolescent pregnancy is necessary to ensure quality and efficacy. The purpose of this study was to examine core case management practices and processes for engaging high-risk girls in Prime Time, an intensive multi-component intervention from the perspectives of intervention program staff. Method Structured individual interviews were conducted with the entire Prime Time program staff (N=7) to assess successes and challenges in engaging adolescent girls at high risk for early pregnancy recruited from school and community clinics. Results Program staff described different capacities of adolescents to engage with the program (easy, middle and difficult connecting adolescents) and provided specific recommendations for working with different connectors. Discussion Findings from this study support the notion that preventive interventions with vulnerable groups of adolescents must pay careful attention to strategies for establishing trusting youth-adult relationships. The ability of staff (e.g., case managers, nurses) to engage with adolescents is a crucial step in improving health outcomes. The identified strategies are useful in helping adolescents build skills, motivations and supports needed for healthy behavior change. PMID:22726710

Volcanic hazard assessment in western Europe

NASA Astrophysics Data System (ADS)

Chester, David K.; Dibben, Christopher J. L.; Duncan, Angus M.

2002-06-01

Volcanology has been in the past and in many respects remains a subject dominated by pure research grounded in the earth sciences. Over the past 30 years a paradigm shift has occurred in hazard assessment which has been aided by significant changes in the social theory of natural hazards and the first-hand experience gained in the 1990s by volcanologists working on projects conceived during the International Decade for Natural Disaster Reduction (IDNDR). Today much greater stress is placed on human vulnerability, the potential for marginalisation of disadvantaged individuals and social groups, and the requirement to make applied volcanology sensitive to the characteristics of local demography, economy, culture and politics. During the IDNDR a methodology, broadly similar to environmental impact analysis, has emerged as the preferred method for studying human vulnerability and risk assessment in volcanically active regions. The characteristics of this new methodology are discussed and the progress which has been made in innovating it on the European Union laboratory volcanoes located in western Europe is reviewed. Furnas (São Miguel, Azores) and Vesuvius in Italy are used as detailed case studies.

Understanding Risk Tolerance and Building an Effective Safety Culture

NASA Technical Reports Server (NTRS)

Loyd, David

2018-01-01

Estimates range from 65-90 percent of catastrophic mishaps are due to human error. NASA's human factors-related mishaps causes are estimated at approximately 75 percent. As much as we'd like to error-proof our work environment, even the most automated and complex technical endeavors require human interaction... and are vulnerable to human frailty. Industry and government are focusing not only on human factors integration into hazardous work environments, but also looking for practical approaches to cultivating a strong Safety Culture that diminishes risk. Industry and government organizations have recognized the value of monitoring leading indicators to identify potential risk vulnerabilities. NASA has adapted this approach to assess risk controls associated with hazardous, critical, and complex facilities. NASA's facility risk assessments integrate commercial loss control, OSHA (Occupational Safety and Health Administration) Process Safety, API (American Petroleum Institute) Performance Indicator Standard, and NASA Operational Readiness Inspection concepts to identify risk control vulnerabilities.

The Syrian Vulnerable Person Resettlement Programme: evaluation of Edinburgh's reception arrangements.

PubMed

Weir, Katherine E A; Wilson, Sheila J; Gorman, Dermot R

2017-11-07

During 2015 and 2016 a group of Syrian refugees were resettled in Edinburgh, Scotland under the United Kingdom Government Syrian Vulnerable Person Resettlement Programme. We evaluate the strengths and weaknesses of the settling in arrangements for these refugees. Semi-structured interviews were conducted with five Arabic interpreters who had worked extensively with these refugees. Interviews sought their impressions about what went well or was not successful. Interviews were transcribed and key themes extracted and analysed. Six themes emerged: 'first impressions', language skills, different healthcare systems, health of the refugees, relationships between the interpreters and refugees and support for the interpreters. The welcoming arrangements went well and exceeded refugees' and interpreters' expectations. There was perhaps too much information given immediately and reinforcing details about various public services and facilities after a first few months would be worthwhile. The Syrians were unfamiliar with NHS structures and found lack of direct specialist access surprising. Problems were amplified by low English levels. A need for Arabic literacy classes was also identified. Interpreters were often used informally out-of-hours and a better system with first contact in Arabic should be established. Interpreters find this work particularly stressful and the provision of psychological support for them should be prioritized. © The Author 2017. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Applying mixed reality to simulate vulnerable populations for practicing clinical communication skills.

PubMed

Chuah, Joon Hao; Lok, Benjamin; Black, Erik

2013-04-01

Health sciences students often practice and are evaluated on interview and exam skills by working with standardized patients (people that role play having a disease or condition). However, standardized patients do not exist for certain vulnerable populations such as children and the intellectually disabled. As a result, students receive little to no exposure to vulnerable populations before becoming working professionals. To address this problem and thereby increase exposure to vulnerable populations, we propose using virtual humans to simulate members of vulnerable populations. We created a mixed reality pediatric patient that allowed students to practice pediatric developmental exams. Practicing several exams is necessary for students to understand how to properly interact with and correctly assess a variety of children. Practice also increases a student's confidence in performing the exam. Effective practice requires students to treat the virtual child realistically. Treating the child realistically might be affected by how the student and virtual child physically interact, so we created two object interaction interfaces - a natural interface and a mouse-based interface. We tested the complete mixed reality exam and also compared the two object interaction interfaces in a within-subjects user study with 22 participants. Our results showed that the participants accepted the virtual child as a child and treated it realistically. Participants also preferred the natural interface, but the interface did not affect how realistically participants treated the virtual child.

Heat Wave Vulnerability Mapping for India.

PubMed

Azhar, Gulrez; Saha, Shubhayu; Ganguly, Partha; Mavalankar, Dileep; Madrigano, Jaime

2017-03-30

Assessing geographic variability in heat wave vulnerability forms the basis for planning appropriate targeted adaptation strategies. Given several recent deadly heatwaves in India, heat is increasingly being recognized as a public health problem. However, to date there has not been a country-wide assessment of heat vulnerability in India. We evaluated demographic, socioeconomic, and environmental vulnerability factors and combined district level data from several sources including the most recent census, health reports, and satellite remote sensing data. We then applied principal component analysis (PCA) on 17 normalized variables for each of the 640 districts to create a composite Heat Vulnerability Index (HVI) for India. Of the total 640 districts, our analysis identified 10 and 97 districts in the very high and high risk categories (> 2SD and 2-1SD HVI) respectively. Mapping showed that the districts with higher heat vulnerability are located in the central parts of the country. On examination, these are less urbanized and have low rates of literacy, access to water and sanitation, and presence of household amenities. Therefore, we concluded that creating and mapping a heat vulnerability index is a useful first step in protecting the public from the health burden of heat. Future work should incorporate heat exposure and health outcome data to validate the index, as well as examine sub-district levels of vulnerability.

Social vulnerability of rural households to flood hazards in western mountainous regions of Henan province, China

NASA Astrophysics Data System (ADS)

Liu, D. L.; Li, Y.

2015-11-01

Evaluating social vulnerability is a crucial issue in risk and disaster management. In this study, a household social vulnerability index (HSVI) to flood hazards was developed and used to assess the social vulnerability of rural households in western mountainous regions of Henan province, China. Eight key indicators were indentified through interactive discussions with multidisciplinary specialists and local farmers, and their weights were determined using principle component analysis (PCA). The results showed that (1) the ratio of perennial working in other places, hazard-related training and illiteracy ratio (15+) were the most dominant factors to social vulnerability. (2) The numbers of high, moderate and low vulnerable households were 14, 64 and 16, respectively, which accounted for 14.9, 68.1, and 17.0 % of the total interviewed rural households, respectively. (3) The correlation coefficient between household social vulnerability scores and casualties in a storm flood in July 2010 was significant at 0.05 significance level (r = 0.248), which indicated that the selected indicators and their weights were valid. (4) Some mitigation strategies to reduce the household social vulnerability to flood hazards were proposed based on the assessment results. The results provide useful information for rural households and local governments to prepare, mitigate and response to flood hazards.

Vulnerability assessment including tangible and intangible components in the index composition: An Amazon case study of flooding and flash flooding.

PubMed

Andrade, Milena Marília Nogueira de; Szlafsztein, Claudio Fabian

2018-07-15

The vulnerability of cities and communities in the Amazon to flooding and flash flooding is increasing. The effects of extreme events on populations vary across landscapes, causing vulnerability to differ spatially. Traditional vulnerability studies in Brazil and across the world have used the vulnerability index for the country and, more recently, municipality scales. The vulnerability dimensions are exposure, sensitivity, and adaptive capacity. For each of these dimensions, there is a group of indicators that constitutes a vulnerability index using quantitative data. Several vulnerability assessments have used sensitivity and exposure analyses and, recently, adaptive capacity has been considered. The Geographical Information Systems (GIS) analysis allows spatial regional modeling using quantitative vulnerability indicators. This paper presents a local-scale vulnerability assessment in an urban Amazonian area, Santarém City, using interdisciplinary methods. Data for exposure and sensitivity were gathered by remote sensing and census data, respectively. However, adaptive capacity refers to local capacities, whether infrastructural or not, and the latter were gathered by qualitative participatory methods. For the mixed data used to study adaptive capacity, we consider tangible components for countable infrastructure that can cope with hazards, and intangible components that reflect social activities based on risk perceptions and collective action. The results indicate that over 80% of the area is highly or moderately vulnerable to flooding and flash flooding. Exposure and adaptive capacity were determinants of the results. Lower values of adaptive capacity play a significant role in vulnerability enhancement. Copyright © 2018 Elsevier B.V. All rights reserved.

Neighborhood Effects on Heat Deaths: Social and Environmental Predictors of Vulnerability in Maricopa County, Arizona

PubMed Central

Declet-Barreto, Juan H.; Stefanov, William L.; Petitti, Diana B.

2012-01-01

Background: Most heat-related deaths occur in cities, and future trends in global climate change and urbanization may amplify this trend. Understanding how neighborhoods affect heat mortality fills an important gap between studies of individual susceptibility to heat and broadly comparative studies of temperature–mortality relationships in cities. Objectives: We estimated neighborhood effects of population characteristics and built and natural environments on deaths due to heat exposure in Maricopa County, Arizona (2000–2008). Methods: We used 2000 U.S. Census data and remotely sensed vegetation and land surface temperature to construct indicators of neighborhood vulnerability and a geographic information system to map vulnerability and residential addresses of persons who died from heat exposure in 2,081 census block groups. Binary logistic regression and spatial analysis were used to associate deaths with neighborhoods. Results: Neighborhood scores on three factors—socioeconomic vulnerability, elderly/isolation, and unvegetated area—varied widely throughout the study area. The preferred model (based on fit and parsimony) for predicting the odds of one or more deaths from heat exposure within a census block group included the first two factors and surface temperature in residential neighborhoods, holding population size constant. Spatial analysis identified clusters of neighborhoods with the highest heat vulnerability scores. A large proportion of deaths occurred among people, including homeless persons, who lived in the inner cores of the largest cities and along an industrial corridor. Conclusions: Place-based indicators of vulnerability complement analyses of person-level heat risk factors. Surface temperature might be used in Maricopa County to identify the most heat-vulnerable neighborhoods, but more attention to the socioecological complexities of climate adaptation is needed. PMID:23164621

Strategic use of communication to market cancer prevention and control to vulnerable populations.

PubMed

Kreps, Gary L

2008-01-01

There are significant challenges to communicating relevant cancer prevention and control information to health care consumers due both to the complexities of the health information to be communicated and the complexities of health communication, especially with vulnerable populations. The need for effective communication about cancer risks, early detection, prevention, care, and survivorship is particularly acute, yet also tremendously complex, for reaching vulnerable populations, those groups of people who are most likely to suffer significantly higher levels of morbidity and mortality from cancers than other segments of the population. These vulnerable populations, typically the poorest, lowest educated, and most disenfranchised members of modern society, are heir to serious cancer-related health disparities. Vulnerable populations often have health literacy difficulties, cultural barriers, and economic challenges to accessing and making sense of relevant health information. This paper examines these challenges to communicating relevant information to vulnerable populations and suggests strategies for effectively using different communication media for marketing cancer prevention and control to reduce health disparities and promote public health.

Understanding Vulnerability: From Categories to Experiences of Young Congolese People in Uganda

ERIC Educational Resources Information Center

Clark, Christina R.

2007-01-01

This article problematises the "vulnerables" category that the United Nations High Commissioner for Refugees applies to groups of refugees. Drawing on 9 months' qualitative research with young Congolese refugees in Uganda, it presents research subjects' self-identification and lived realities that do not correspond to the homogenous,…

Hearing Voices: Qualitative Research with Postsecondary Students Experiencing Mental Illness

ERIC Educational Resources Information Center

Venville, Annie; Street, Annette F.

2014-01-01

Vocational Education and Training (VET) students experiencing mental illness have been described as one of the most vulnerable student groups in the Australian post-secondary sector. This vulnerability can be attributed to the impacts of illness, the oft-reported experiences of stigma and discrimination, and low educational outcomes. There is…

The Transcription Factor Orthodenticle Homeobox 2 Influences Axonal Projections and Vulnerability of Midbrain Dopaminergic Neurons

ERIC Educational Resources Information Center

Chung, Chee Yeun; Licznerski, Pawel; Alavian, Kambiz N.; Simeone, Antonio; Lin, Zhicheng; Martin, Eden; Vance, Jeffery; Isacson, Ole

2010-01-01

Two adjacent groups of midbrain dopaminergic neurons, A9 (substantia nigra pars compacta) and A10 (ventral tegmental area), have distinct projections and exhibit differential vulnerability in Parkinson's disease. Little is known about transcription factors that influence midbrain dopaminergic subgroup phenotypes or their potential role in disease.…