The objective of this study is to estimate associations between social capital and health when other factors are controlled for. Data from the standard-of-living survey by Statistics Norway are merged with data from several other sources. The merged files combine data at the individual level with data that describe indicators of community-level social capital related to each person's county of residence. Both cross-sectional and panel data are used. We find that one indicator of community-level social capital -- voting participation in local elections -- is positively associated with self-assessed health in the cross-sectional study and in the panel data study. While we find that religious activity at the community-level has a positive effect in the cross-sectional survey and no effect in the panel survey, we find that sports organizations have a negative effect on health in the cross-sectional survey and no effect in the panel survey. The question is raised whether the welfare state diminishes the effect of structural community social capital, as represented by voluntary organizations, on health.
This study examines the role of older people in Swedish society by exploring the prevalence of their informal caregiving and volunteering and by analyzing the profiles of these contributors of unpaid work. Data were collected by means of telephone interviews in a Swedish representative survey conducted in 2005. Our analysis reveals three distinct profiles of people involved in unpaid activities. One of these consists of those involved both in informal help giving and volunteering, a group that has been labeled "super helpers" or "doers" in earlier research. It is important for social policy planners to recognize these groups of older people and better understand the dynamics of their unpaid work in order to ascertain whether they might need support as providers and to enhance their well-being. There does not seem to be any simple contradiction between the parallel existence of a universal welfare model of the Swedish kind and an extensive civil society in which older people play important roles as active citizens.
Home care for cognitively impaired elderly puts tremendous stress and burden on their families. Therefore it is important to search for effective care models in order to provide support for this group. In this study, an intervention model--the Circle Model--was developed, tested and evaluated in six places in Sweden. The model is unique in that family caregivers and volunteers were trained together in study circles. After their training, the volunteers replaced the caregivers in the homes on a regular basis, which permitted the caregivers some relief from the demands of caregiving. Interviews were conducted with the participants to gather information about their training and relief care experiences. The caregivers reported that the study circle provided opportunity to exchange experiences with other people in similar situations. They felt a spirit of community with other relatives, and were able to increase their knowledge in care providing and coping strategies. The emphasis in temporary relief care by the volunteers was placed on providing the relatives with feelings of security and relaxation. The satisfaction among the Circle Model participants was reciprocal. The volunteers also reported high satisfaction and appreciation of the knowledge which they acquired from the caregivers. The Circle Model brings new dimensions to the home care situation and should be seen as a complement to social services support.
The trend within the Swedish healthcare system is to reduce the duration of hospital care. This means that a patient who is discharged to their home after critical illness is highly likely to be functionally impaired, and therefore, requires care-giving assistance from a family member. The aim of this study was to generate a theoretical model with regard to relatives' coping when faced with the situation of having an adult next-of-kin recovering at home after critical illness. The design incorporated grounded theory methodology. Four coping strategies exhibiting different characteristics were identified: volunteering, accepting, modulating and sacrificing. Factors determining the choice of coping strategy were the physical and psychological status of the relative, previous experience of ICU-care and the psychological status of the patient. The theoretical model described in this article can contribute to expanding healthcare professionals' understanding of the coping strategies of relatives during recovery, but also provide inspiration for social action to be taken.
Studies of long-term health consequences of disasters face unique methodologic challenges. The authors focused on studies of the health of cleanup and recovery workers, who are often poorly enumerated at the outset and difficult to follow over time. Comparison of the experience at the World Trade Center disaster with 4 past incidents of chemical and radiation releases at Seveso, Italy; Bhopal, India; Chernobyl, Ukraine; and Three Mile Island, USA, provided useful contrasts. Each event had methodologic advantages and disadvantages that depended on the nature of the disaster and the availability of records on area residents, and the emergency-response and cleanup protocol. The World Trade Center Worker Monitoring Program has well-defined eligibility criteria but lacks information on the universe of eligible workers to characterize response proportions or the potential for distortion of reported health effects. Nonparticipation may result from lack of interest, lack of awareness of the program, availability of another source of medical care, medical conditions precluding participation, inability to take time off from work, moving out of the area, death, or shift from initially ineligible to eligible status. Some of these considerations suggest selective participation by the sickest individuals, whereas others favor participation by the healthiest. The greatest concern with the validity of inferences regarding elevated health risks relative to external populations is the potential for selective enrollment among those who are affected. If there were a large pool of nonparticipating workers and those who suffered ill health were most motivated to enroll, the rates of disease among participants would be substantially higher than among all those eligible for the program. Future disaster follow-up studies would benefit substantially by having access to accurate estimates of the number of workers and information on the individuals who contributed to the cleanup and recovery effort.
To improve the outcome for out-of-hospital patients with ventricular fibrillation/pulseless ventricular tachycardia (VF/VT), the use of automated external defibrillators (AEDs) by first responders including non-medical personnel with a duty to respond to an emergency is recommended. A special CPR-AED course has been developed. We wanted to test the results (quality and speed of operating an AED and CPR) after completion of such a course and retention after approximately 1-year. At the same time we wanted to see if personnel could use an AED after receiving written information without having attended the course. Study subjects were divided randomly into groups, and tested pre-course (n=54), post-course (n=50), and unannounced 10+/-3 months after the course (retention group, n=61). For statistical analysis two sample tests for binomial proportions and Wilcoxon-Mann-Whitney test was used as appropriate. Fifteen of the 27 pairs (56%) in the pre-course group with no previous exposure to an AED decided to use it. There was no difference between the groups in electrode pad positioning, and all stayed clear of the manikin during the process of AED charging and shock delivery. The post-course group had a higher rate of checking for responsiveness (vs. pre-course), not to check for a pulse (vs. both other groups), the shortest time interval from arrival on scene to start of CPR and shock delivery, and in parallel the shortest hands-off interval (without chest compressions and ventilations) before shock delivery. The quality of chest compressions was improved by the course but decreased to a similar standard as in the pre-course when tested 10+/-3 months later, except for correct depth which was similar to post course. Most ventilation attempts in all groups were scored as incorrect due to the high incidence of excessively rapid inflations. The retention group had a lower frequency of correct inflations than the pre-course group, and the post-course group the highest number of correct ventilations per minute. These findings suggest that use of an AED by untrained laypersons may be feasible and that complex and time-consuming training programmes may not be necessary. The present study also supports the need for annual training and recertification.
The purpose of this article is to examine the current health promotion orientation of youth sports clubs in Finland in view of the standards created previously for the health promoting sports club (HPSC). Ninety-seven youth sports clubs participated, and 273 sports club officials and 240 coaches answered the questionnaires. To describe clubs health promotion orientations, an HPSC index was created. The HPSC index was formulated on sub-indices by factor analysis. The sub-indices were: policy, ideology, practice and environment indexes. The results indicate that youth sports clubs are fairly health promoting in general. On average, the clubs fulfilled 12 standards for HPSC out of 22. Every fourth club was categorized as higher health promoting (> or = 15 fulfilled standards), and every third as lower health promoting (
Change in social customs and institutions is usually a slow process. This seems particularly true in attitudes about child abuse. Two key elements for change are being utilized for child protection in a rural area of Alaska with a predominantly Caucasian population. First, application of an old church custom of "constructive gossip" by volunteers is changing this rural community attitude about children. Second, use of an innovative federal government health care delivery program has established this community's first obstetric and pediatric service. With the oil boom in Alaska, widespread family disruption with frequent child abuse and neglect has become commonplace. Despite the oil tax wealth, State of Alaska Child Protection Services are strained to keep up with family and community violence. Deliberate cooperation with local community, church and service organization leaders is helping keep up with child protection needs. The obstetric and pediatric specialists of the National Health Service Corps non-profit practice were co-leaders, along with community leaders, in starting a lay volunteer service called "Friends of Families." Working cooperatively with the state child protection office, 24 families have received assistance from parent aides of Friends of Families. The influence of these two key elements of change on rural community attitudes and institutions are described.