Subjective Quality of Life Among Individuals who are Homeless: A Review of Current Knowledge

The purpose of this article was to review the current literature on subjective quality of life (SQOL) in individuals who are homeless, with a focus on differences in SQOL (a) between homeless individuals and the general population, (b) based on housing situation, and (c) associated with demographic characteristics (such as age and gender), physical and mental health, and external variables such as service program type. A literature search was conducted of the online databases PubMed and PsycInfo for relevant studies published from January 1981 to August 2011. Although this review showed that individuals who are homeless tended to have lower levels of SQOL compared to the general population or housed individuals, it was also evident that our current understanding of the relationships between SQOL and various demographic, health, and other variables is based on very limited information. More information about the relationships between various characteristics and experiences of individuals who are homeless and SQOL is clearly needed to aid researchers, service providers, and policy-makers in addressing the needs of this population and examining the effectiveness of interventions to end homelessness and improve health among homeless individuals.     

A Conceptual Model of the Alcohol Environment of College Students

Lobola is in many Southern African countries a tradition, which is expected to be adhered by anyone who is part of the community. It is paying respect to the elders, and the community. In order to determine how much the actual fact of payment of lobola would influence the behavior of husbands and wives, we conducted several focus groups. Many participants see lobola as part of their African culture, although they wished that they would not actually have to pay lobola. There is no difference in the husband's behavior, whether they had paid lobola or not and having extramarital affairs.     

Creatively prototyping the future high street

Abstract

This paper gives a voice to a range of community and individual stakeholders who would not generally be heard in the conventional town planning process. We present a methodological technique, described as creative prototyping, that has at its heart, the capability to enable full stakeholder inclusivity into the future imagining of the smart city. Actively involving these individuals and community representatives in the research process enables deeper understanding of how technology and people can interact productively to create smart cities that are socially inclusive while still being commercially relevant. The research data for this paper are drawn from the findings of a workshop conducted by the authors that utilised Science Fiction Prototyping and Lego Serious Play. This research activity was driven by questions focusing upon the current complex interplay and tensions of technology and the UK’s physical high street. We first explore these issues theoretically in previous literature and then drawn upon this review to analyse the outcomes of the workshop. Three themes emerge from this analysis that have operational and strategic relevance to the development of future high streets; the importance of ever present but invisible technology, the forefronting of people in the smart city and the need for wide-ranging stakeholder input and participation into planning. The findings also illustrate that not all future imaginings of the retail high street are immediately practical or realistically applicable. However, in examining the many issues facing the current high street and in negotiating the multiplicity of voices with their competing demands and expectations, we offer the conclusion that the future smart city must become a place of truly shared sociality – rather than just mere proximity, customised convenience or a concentration point for multiple forms of entertainment.     

Local therapy facilitators working with children with developmental delay in rural and remote areas of western New South Wales,Australia: the ‘Outback’ service delivery model

Australia's dispersed population in rural areas contributes to poor access to therapy services and the inability of the existing rural therapy workforce to meet demand. As a result, rural children with a developmental delay wait a long time for therapy. This paper describes participant perceptions of a therapy facilitation service model that has worked to improve access to therapy for children in these circumstances. The model, given the pseudonym ‘Outback’, operates in rural and remote areas of western New South Wales. ‘Outback’ employs local people to work under the guidance of therapists based in larger centres to provide preschool children with developmental delays with access to therapy interventions they might not otherwise receive. A two‐stage case study design involving focus groups and interviews with the director, four therapy facilitators, nine therapists, and seven carers was used. Three themes were identified as central to the service model: 1) being part of the local community; 2) developing therapy facilitator knowledge and skills; 3) improving access to therapy intervention for children in rural and remote areas. The ‘Outback’ model demonstrates that appropriately supported, local therapy facilitators provide a flexible workforce adjunct that expands the reach of therapists into rural and remote communities and enhances service access for children and their families.     

Challenges of Dealing with Financial Concerns during Life-Threatening Illness: Perspectives of Health Care Practitioners

ABSTRACT

The costs of serious medical illness and end of life care are often a heavy burden for patients and families (Collins, Stepanczuk, Williams, & Rich, 2016 Collins, A., Stepanczuk, C., Williams, N., & Rich, E. (2016). Supporting better patient decisions at the point of care: What payers and delivery systems can do (Mathematica Policy Research Issue Brief). Retrieved from http://econpapers.repec.org/paper/mprmprres/6c6a86e28d7149c993713352eeceaa18.htm [Google Scholar]; Kim, 2007 Kim, P. (2007). Cost of cancer care: The patient perspective. Journal of Clinical Oncology, 25(2), 228–232. doi:10.1200/JCO.2006.07.9111[Crossref], [PubMed], [Web of Science ®] , [Google Scholar]; May et al., 2014 May, C. R., Eton, D. T., Boehmer, K., Gallacher, K., Hunt, K., MacDonald, S.,?… &?Rogers, A. E. (2014). Rethinking the patient: Using burden of treatment theory to understand the changing dynamics of illness. BMC health services research, 14(1), 1–11. doi:10.1186/1472-6963-14-281[Crossref], [PubMed] , [Google Scholar]; Zarit, 2004 Zarit, S. H. (2004). Family care and burden at the end of life. Canadian Medical Association Journal, 170(12), 1811–1812. doi:10.1503/cmaj.1040196[Crossref], [PubMed], [Web of Science ®] , [Google Scholar]). Twenty-six practitioners, including social workers, managers/administrators, supervisors, and case managers from five health care settings, participated in qualitative semistructured interviews about financial challenges patients encountered. Seven practitioners took part in a focus group. Practitioners were recruited from hospice (n?=?5), long-term care (n?=?5), intensive care (n?=?5), dialysis (n?=?6), and oncology (n?=?5). Interview and focus group questions focused on financial challenges patients encountered when facing life-threatening illness. Interview data were transcribed and thematically coded and trustworthiness of data was established with peer debriefing, member checking, and agreement on themes among the authors. Practitioners described interacting micro, meso, and macroinfluences on the financial well-being and challenges patients encountered. Microlevel influences involved patient characteristics, such as their demographic profile and/or health status that set them up for financial aptitude or challenges. Macrolevel influences involved the larger health care/safety net system, which provided valuable resources for some patients but not others. Practitioners also discussed the mesolevel of influence, the local setting where they worked to match available resources with patients’ individual needs given the constraints emerging from the micro and macrolevels. Practitioners described how they navigated the interplay of these three areas to meet patients’ needs and cope with financial challenges. Implications for practice point to directly addressing the kind of financial concerns that patients and families facing financial burden from serious medical illness have, and identifying ways to bridge knowledge and resource access gaps at the individual, organizational, and societal levels.     

The Riddle of Schizophrenia

This paper discusses the author's emotions and reactions, in her working experience with people diagnosed as schizophrenic.     

The influence of negative medical diagnoses and verbal and nonverbal support activation strategies on the interactive coping process

Sensitive Interaction Systems Theory suggests that complex problems, including adverse medical diagnoses, can create tension in the social support process. In this experiment one member of a romantic couple received medical feedback that either threatened gender roles or was irrelevant. The couple's interaction was covertly recorded for the support activation behaviors displayed by the support seeker and for the interactive coping behaviors offered by the help giver. Both type of support activation and type of problem affected the use of support behavior.Nonverbal support activation behaviors promoted helpers' use ofavoidance interactive coping behaviors, whereasverbal activation behaviors promotedapproach interactive coping behaviors, suggesting a tit-for-tat dynamic. The gender-role relevance of the medical diagnosis also influenced helpers' use of approach behaviors, although not the support seekers' need for support or efforts to elicit support.     

Constructing motherhood on the night shift: “Working mothers” as “stay-at-home moms”

Based on in-depth interviews with hospital nurses, this article examines the way in which employed women with children use the night shift to support a construction of motherhood which closely resembles that of mothers who are not in the labor force. Interview data reveal that a salient function of night shift work is the reconciliation of some of the structural and conceptual incompatibilities of being “working mothers.” Night-shift nurses construct themselves as “stay-at-home moms” by limiting the public visibility of their labor force participation, by involving their children and themselves in symbolically-invested activities, and by positioning themselves in the culturally-appropriate place and time: at home, during the day. All of these strategies work to highlight their visibility as mothers. An earlier version of this article was presented at the American Sociological Association Annual Meeting, August 13–17, 1993, Miami Beach, Florida. Funds for this research were provided in part by the University of California and by the National Institute of Child Health and Human Development.     

Speaking Personally

In this recent address to the Victorian Association of Family Therapists, the author discusses some of the changes in her personal and family life, since learning that she had an inoperable, malignant brain tumour. These changes have helped her clarify key aspects of her work with families and colleagues.