Beyond the Frontstage: Trust, Access, and the Relational Context in Research with Refugee Communities

This paper examines the role of trust and the concept of access as they affect the relational context in which community research, and research with refugee communities in particular, is conducted. Sociologist Irving Goffman's metaphor of frontstage and backstage behavior is used to illustrate the complexity and importance of developing of relations of trust, and thereby gaining "backstage" access, in communities that are generally closed to outsiders. It is argued that gaining authentic ("backstage") access to refugee communities, as well as other communities that have developed a self-protective insularity, is essential if we are to gather data that accurately reflect the actual beliefs, feelings, and experiences of community members. The paper then examines the puzzling lack of discussion regarding issues of trust, access, and the relational context in the literature on refugee mental health. Explanations for this apparent inattention are sought in the influence of the prevailing scientific paradigm that guides most research with refugees, and that shapes the values of the field's "gatekeepers," the editors and reviewers of scholarly journals. Throughout the paper, key points are illustrated with examples drawn from the author's research with refugees from Guatemala, Bosnia, and Afghanistan.     

区域卫生规划与卫生资源配置

区域卫生规划与卫生资源配置的关系密不可分,同时也是解决医疗保健供需平衡的重大举措和主要手段。首先提出了区域卫生规划的现实意义和基本理论,并分析了建立区域卫生规划对解决以上问题怎样产生积极的影响。     

Factors influencing career maturity in the South African National Defence Force: A diagnostic approach

This study investigated factors influencing the career maturity of young members of the South African National Defence Force (SANDF). A sample of 310 young SANDF members (females=35%, blacks=90%) completed the following measures: career maturity inventory-revised, the career decision self-efficacy scale, the military hardiness scale, and the seven habits profile. They also completed a biographical information form. Data were analysed using multiple regression to predict career maturity from career decision self-efficacy, self-appraisal, occupational information, goal selection, planning, problem solving, hardiness, control, challenge, commitment, conscientiousness, life balance, pro-active behaviour, life goals, self-management, mutual-benefit thinking, listening, teamwork, continuous improvement and life skills. Findings suggest self-efficacy, occupational information, self-appraisal, commitment, challenge, emotional intelligence and continuous improvement have the strongest influence on career maturity. The results indicated that self-efficacy, life skills and personal drive empower young members to seek employment.     

The relationship between mental vitality and cardiovascular health

Past measurement of vitality has included both emotional and physical components. Since aspects of physical vitality such as fatigue can be indicative of physical illness, the usefulness of existing measures of vitality to predict health is limited. This research was designed to examine the psychometric properties of a new Mental Vitality Scale and to test its associations with measures of cardiovascular health over the course of 2 years. The measure of mental vitality was administered in a two-part study using three different samples. In part 1, the reliability and validity of the scale was assessed with a student and a clinic sample. In part 2, medical data on mental and physical health were abstracted over a two-year period from 1041 patient records from a multi-specialty medical practice, and mental vitality assessed through a mailed questionnaire. The findings indicate that the Mental Vitality Scale is a valid and reliable questionnaire for measuring this construct. Mental vitality was also associated with reduced odds of several cardiovascular outcomes and prospective analyses suggest that mental vitality may serve a protective function in the development of cardiovascular disease. The results lend support for the importance of mental vitality as a construct that may be relevant for considering resilience in relation to cardiovascular disease.     

Window view of nature after brief exercise improves choice reaction time and heart rate restoration

Research indicates that natural environments induce restorative effects on cognitive capacity and autonomic arousal. The present study investigates differences in choice reaction time (CRT) and heart rate responses in students (n = 9) resting with or without a window view of a modest natural environment after a physical exertion. Subjects performed a CRT-task before pedaling a spinning bike, followed by resting in a chair with either a window view of a natural environment, or no view. Heart rate was obtained during the rest-period, and the CRT task was performed again immediately after resting.Results indicated that subjects elicited significantly larger improvement in CRTs and more efficient heart rate restoration after resting with a window view, compared to resting without a view. Resting with a modest view of a natural environment after brief exercise demonstrated both a greater effect of cognitive enhancement and more efficient physiological restoration compared to resting without a view. These findings advance prior research by demonstrating both cognitive and physiological benefits from resting in a modest natural environment.     

Depression and cognitive sequelae registered within the first year among young Danish TBI survivors

The aim of the study was to determine the proportion of depression and cognitive sequelae among young (15-30 years) Danish TBI survivors referred to interdisciplinary evaluation through a nationwide government-initiated health initiative. The cross-sectional study is based on data from the “Danish register for young adults with acquired brain injury” on TBI survivors included from October 2013 to December 2016. The main measures were Major depression inventory, Trail making test A and B, Fluency, Word learning with selective reminding, Matrix reasoning, Coding and Glasgow outcome scale - extended (GOS-E). During the study period, 131 young TBI survivors were referred to one of five national outpatient clinics. Ninety-six had complete data and of these 14.6% fulfilled the ICD-10 diagnostic criteria for depression and 34.4% had cognitive sequelae. An association was found between depression and cognitive sequelae (p = 0.004). Patients with both depression and cognitive sequelae (n = 10) had a significantly lower mean score on GOS-E (p = 0.0001). Depression and cognitive sequelae were frequent and associated with a poorer global functional outcome among young TBI survivors referred within a year after trauma. This finding and the notion that only 20% of the expected TBI population was referred to this nationwide health initiative indicate an unacknowledged need for interdisciplinary follow-up.     

Travailler dans un réseau de santé : effets sur la santé psychique au travail

The new needs as regards care taking charge of patients have contributed to the creation of health networks. As they are growing fast, they are an integral part of the French sanitation system. The impact, on the health professionals, of networking is, today, the object of contrasted research and results, but has little been studied as far as Social Psychology, Work and Organizations are concerned. This article follows a research project which had the objective, on the one hand, to describe the effects of the participation to a health network mental health at work and, on the other hand, to examine the variables and process accounting for the variability of these effects. This research privileges an approach to the health network as a place of socialization and personalization (Malrieu, 1979). The research on the ground is carried out in collaboration with the health network town-hospital Prevention and Taking charge of Pediatric Obesity Network (RéPPOP) Midi-Pyrénées. We have carried out semi-guided interviews with 20 private professionals (8 doctors, 8 dieticians, 3 psychologists, 1 physiotherapist) members of the RePPOP Midi-Pyrénées network. The main results show that the perception of positive and/or negative effects of networking on mental health varies according to the age of membership of the network and the processes of transfer of experience (from professional practice within the network to professional practice off-network and vice versa). Proposals are deduced in terms of continuing education within the network.     

Secret médical en santé au travail

The occupational physicians are obliged, like any doctor, to respect the ethical obligations imposed on their profession, including in the exercise of the missions specific to occupational medicine and contained in the Labor Code. The occupational physician is not isolated and works in a multidisciplinary team of a health service at work. He must communicate with other health professionals, but also with employers, representative bodies of staff. Medical confidentiality holds a special place in the triangular relationship between the occupational physician, the employee and the employer. The medical practice in the field of occupational health requires that many provisions of the Labor Code be followed, including the respect of the secret of manufacture and the position of advising employers and employees. The occupational physician must communicate with the employer in order to best achieve his mission, but in practice, it may be difficult for the occupational doctor to make his recommendations heard to improve the working conditions of employees without power, when he cannot argue his opinions on medical information.