My diploma thesis focuses on finding out what health and social services are provided to the inhabitants of socially excluded localities in České Budějovice. Social exclusion is a process within which the access of individuals, groups of individuals or a community to sources, positions and opportunities enabling the involvement into social, economic and political activities society, is substantially impeded or completely prevented. The seriousness of the situation is illustrated by the fact that the year 2010 was declared the European European Year for Combating Poverty and Social Exclusion. One of the possibilities to deal with this situation is to provide health and social services, such as field programmes, social counselling, low-threshold services for young people and crisis assistance. My thesis aims at finding out whether health and social services provided to the inhabitants of socially excluded localities in České Budějovice are available, sufficient, oriented in the right direction, and whether they are used. At the beginning of the theoretical part, I made a brief definition of the terms social exclusion and poverty. Further, I described the main problem spheres of socially excluded citizens to which health and social services should react, and I also added a description of the current situation in individual socially excluded localities selected and of the specification of health and social services that the thesis deals with. The end of the theoretical part contains a summary of the theoretical part and subjects for my own research. The objective of my thesis was to survey the availability and sufficiency of services, especially in the health and social services offered to the inhabitants of socially excluded localities in České Budějovice. The defined objective of my thesis was achieved. To achieve it I used in the practical part the qualitative research, questioning method, the semi-controlled interview technique and analysis of the available data. Research was carried out in two selected sets, one of which consisted of inhabitants of chosen socially excluded localities, and of providers of health and social services in České Budějovice. The data obtained may be used by providers of services to consider an extension of these services. Further, it may serve as an output for an expert article or a basis for further research realised in this field.

O Agente Comunitário da Saúde (ACS) compõe a equipe mínima da Estratégia Saúde da Família e teve sua profissão reconhecida recentemente. Tem como especificidades o fato de atuar na mesma comunidade em que vive e não ter como exigência para o ingresso na profissão a conclusão prévia de curso técnico na área da saúde. O presente estudo teve como objetivo analisar as concepções de usuários e profissionais da equipe mínima da Estratégia Saúde da Família a respeito do trabalho do ACS. Trata-se de um estudo descritivo que utilizou o método qualitativo em pesquisa. Foram realizadas no contexto de duas Unidades de Saúde da Família: 1) entrevistas semiestruturadas com dezoito usuários e com sete profissionais (dois médicos, duas enfermeiras, duas auxiliares de enfermagem e uma dentista); 2) observações participantes, ao longo de seis meses, do trabalho do ACS especialmente das visitas domiciliares e das reuniões de equipe. O material da pesquisa, composto pelas transcrições das entrevistas e pelos registros das observações participantes, foi analisado através dos princípios da Análise de Conteúdo Temática, que possibilitou a descrição de dois temas: \"Processo de trabalho do Agente Comunitário de Saúde\" e \"Identidade do Agente Comunitário de Saúde: origem e formação de um trabalhador em suas especificidades\". A análise apontou que o \"processo de trabalho\" do ACS, segundo as concepções de profissionais e usuários, encontra-se centrado na realização das visitas domiciliares, que tem como finalidades: levar informações aos usuários, entregar produtos e/ou serviços a domicílio, escutar o usuário e fiscalizar o cumprimento de prescrições. Destacamos o predomínio, na perspectiva dos participantes, de uma concepção das visitas domiciliares centrada em uma prática individual, que focaliza os aspectos técnicos do trabalho em saúde e, portanto, reducionista. Além disso, a inserção do ACS em outras atividades laborais, como grupos com a comunidade e participações em reuniões de equipe, dá-se com o intuito de que o mesmo aprenda conteúdos e práticas do trabalho em saúde, ou seja, o \"saber/fazer\", apontando para uma desvalorização deste profissional em suas especificidades. Apesar dos participantes referirem à origem comunitária do ACS como forma de compartilhar vivências com os usuários da ESF, valoriza-se o conhecimento biomédico como viabilizador de práticas do ACS e como meio de diferenciá-lo de um \"leigo\". Deste modo, o estudo permitiu descrever e refletir acerca das contradições que perpassam o processo de trabalho do ACS e a construção de sua identidade profissional, bem como a captura do trabalho do ACS pela lógica reducionista/biomédica e a consequente desvalorização de tal profissional em suas especificidades. Apontamos a importância do resgate dos fundamentos filosóficos que possibilitaram a inserção do ACS enquanto um profissional da saúde no intuito de ressaltar suas especificidades e valorizá-las no seu fazer cotidiano, recuperando, assim, sua atuação comunitária/política e reconfigurando o lugar/papel do ACS na equipe e na comunidade em que atua. / The Community Health Agent (CHA) is a member of the minimal composition of the Family Health Team, whose profession has been recently acknowledged. The specificities of CHAs are that they must work in the same community in which they live, and that it is not necessary for them to complete any technical health course. The objective of the present study was to analyze the conceptions of workers and clients of the Family Health Team, in its minimal composition, regarding the work of the CHA. This descriptive study was performed using a qualitative research method. The following activities were performed within the environment of two Family Health Units: 1) semi-structured interviews with eighteen clients and seven workers (two physicians, two nurses, two nursing aides and one dentist); 2) participant observation of the CHA\'s work for six months, particularly of home visits and team meetings. The research material, comprised of the transcribed interviews and the records from the participant observations, was analyzed according to the principles of Thematic Content Analysis, which enabled the description of two themes: \"The Working Process of the Community Health Agent\" and \"The Identity of the Community Health Agent: the origin and development of a worker considering particular specificities\". The analysis revealed that the \"working process\" of the CHA, according to the conceptions of workers and clients, currently focuses on performing home visits, which aim at: bringing information to clients, delivering products and/or services at home, listening to the client, and supervising the clients\' compliance to drug treatments. We highlight the predominance, from the participants\' perspective, of a conception of home visits centered on an individual practice, focused on the technical aspects of health work; hence, reductionist. Furthermore, the inclusion of the CHA in other work activities, such as community groups and their participation in team meetings, occurs with the purpose of offering the CHA the chance to learn contents and practices of health work; i.e., the \"know/do\", which reveals an undervaluing of this profession and its particular specificities. Although the participants referred to the CHA being from the community originally as a way to share the experiences of the FHT clients, biomedical knowledge is valued as the foundation of the work of the CHA, and as the factor that differentiates a CHA from ordinary \"laymen\". Therefore, the present study permitted to describe and reflect upon the contradictions that permeate the working process of the CHA, and the construction of the professional identity of the CHA. Furthermore, this study allowed understanding the work of the CHA from the reductionist/biomedical rationale and the consequent undervaluation of this profession and its specificities. We highlight it is important to recover the philosophical foundations that allowed including the CHA as a health professional with the purpose to outline the specificities of this profession and value them in everyday practice, thus rescuing their community/political participation and reestablishing the position/role of the CHA in the team and community in which they work.

M.A. (Social Work) / Accountability and competence are two important attributes needed by medical social workers in the changing social, political, economic and organizational situation in South Africa, In order -to be accountable and competent, medical social workers must be in possession of scientific knowledge, skills and the correct attitude regarding assessment, intervention and evaluation. The change in emphasis from long-term to short-term hospitalization and the importance of primary health care, means that within the limitations of the present organization structure, assessment is often the most important and sometimes the only, aspect in the helping process. The knowledge and skills of the medical social workers need to be extended; this study therefore focuses on effective assessment that will equip the medical social worker to render an effective service through linking resources within the patient, hospital and within the community. The aim of this study is the development of a training programme for medical social workers to extend their knowledge and skills in assessment.

Abstract The aim of the study was to search for, analyse and describe the visions of the future of representatives of the baby boom generation in Northern Finland concerning their own ageing, the factors affecting their well-being and their social and health care services. Visions of the future are based on views charted in two phases in accordance with qualitative driven mixed method research methodology. The material consisting of narratives describing future visions (n = 39) was collected using the method of empathy-based stories. Analysis of themes revealed three main themes in the narratives: 1. ageing as a subjective and social experience, 2. factors contributing to well-being from the viewpoint of life control and the environment and 3. social and health care services from the viewpoint of operational environments and resources. The material for the second phase was collected with the aid of a questionnaire drawn up based on the results of phase 1 (n = 405). The material was analysed using multivariate methods: main component analysis, K-means Kluster analysis and correspondence analysis. According to the results, ageing consists of subjective and social experience associated with adaptation, resignation and opening up of new possibilities. An existential experience about life, active self-care and a sense of community based on different networks seemed to have increased. Three future scenarios of the role of senior citizens emerged: seniors as objects of actions, as active, participating actors and as actors in their immediate community. A sense of life control, which was associated with the social, physical and symbolical factors of the environment, was seen as a source of well-being in the future. The operational environments and resources of service and support providers made up three categories: public social services and support from the immediate community, varied service networks and support from the immediate community in a wider sense, as well as public health care services and self-help. It was considered both desirable and likely that future services would comprise pre-emptive, versatile and technology-aided service combinations as well as family- and community-based housing services. The information provided by the study contributes to and expands the social, health-policy and nursing science knowledge base. The information may be utilised as basis for planning, decision-making and operation among professionals, NGOs and political decision-makers working with the elderly. Gerontological nursing science research and practical nursing can obtain information about future clients of elderly care services and the operating environments and resources of nursing. / Tiivistelmä Tutkimuksen tarkoituksena oli etsiä, analysoida ja kuvata millaisia tulevaisuudenkuvia pohjoissuomalaisilla suurten ikäluokkien edustajilla on ikääntymisestään, hyvinvointiinsa vaikuttavista tekijöistä ja sosiaali- ja terveyspalveluistaan. Tulevaisuudenkuvat perustuvat näkemystietoon, jota on kartoitettu laadullisesti ohjautuvan monimenetelmällisen tutkimusperinteen mukaisesti kahdessa vaiheessa. Tulevaisuustarinoista (n = 39) koostuva aineisto kerättiin eläytymismenetelmän avulla. Teemoitteluanalyysi tuotti tarinoista kolme pääteemaa: 1. ikääntyminen subjektiivisena ja sosiaalisena kokemuksena, 2. hyvinvointia tuottavat tekijät elämänhallinnan ja ympäristön näkökulmasta ja 3. sosiaali- ja terveyspalvelut toimintaympäristöjen ja resurssien näkökulmasta. Toisen vaiheen aineisto kerättiin 1. vaiheen tuottamien tulosten pohjalta laaditulla kyselylomakkeella (n = 405). Aineisto analysoitiin monimuuttujamenetelmillä: pääkomponenttianalyysilla, K-means Kluster -analyysilla sekä korrespondenssianalyysilla. Tulosten mukaan ikääntyminen muodostuu subjektiivisesta ja sosiaalisesta kokemuksesta, johon liittyy sopeutumista, luopumista sekä uusien mahdollisuuksien avautumista. Eksistentiaalinen kokemus elämästä, aktiivinen itsestä huolenpito ja erilaisista verkostoista syntynyt yhteisöllisyys näyttivät lisääntyneen. Ikäihmisen roolista muodostui kolme tulevaisuudenkuvaa: ikäihminen toiminnan kohteena, aktiivisena osallistuvana toimijana ja lähiyhteisönsä toimijana. Hyvinvointia tulevaisuudessa tuottivat kokemus elämänhallinnasta, joka oli yhteydessä ympäristön sosiaalisten, fyysisten ja symbolisten tekijöiden kanssa. Palveluiden ja tuen tuottajien toimintaympäristöistä ja resursseista muodostui kolme tyyppiä: yhteiskuntavastuiset palvelut ja suppeiden lähiyhteisöjen tuki, monipuoliset palveluverkostot ja laaja-alaisten lähiyhteisöjen tuki sekä julkiset terveyspalvelut ja oma-apu. Toivottavana ja todennäköisenä pidettiin, että tulevaisuuden palvelut sisältävät ennakoivia, monipuolisia ja teknologia-avusteisia palvelukombinaatioita sekä perhekeskeisiä ja yhteisöllisiä asumispalveluita. Tutkimuksessa tuotetulla tiedolla laajennetaan yhteiskunnallista, terveyspoliittista sekä hoitotieteen gerontologista tietoperustaa. Tietoa voidaan hyödyntää ikääntyvien parissa työskentelevien ammattilaisten, kansalaisjärjestöjen sekä poliittisten päättäjien suunnittelun, päätöksenteon ja toiminnan perustana. Hoitotieteen gerontologiselle tutkimukselle ja hoitotyölle tutkimus tuottaa tietoa tulevaisuuden vanhusasiakkaista ja hoitotyön toimintaympäristöistä ja resursseista.

Objective Objective of this study was to investigate the impact of the recent economic crisis of 2007/2008 on the subjective well-being and health status in thirteen European countries. Methods The European Social Survey (ESS) database was searched for individual health and wellbeing indicators and the database of the European Commission Eurostat for economic indicators. Data representing social determinants like education, housing and employment status and others before, during and after the crisis were retrieved. Eurostat data were used to analyse economic indicators and health outcomes on country level. Descriptive statistics were used to describe the changes in the different parameters over time. Regression analysis was performed to demonstrate relations between subjective well-being and different social determinants. Results Between 2006 and 2012 all countries experienced changes in their populations' subjective well-being. From 2006 to 2010 (crisis) the number of people with good or very good subjective well-being increased in France, Ireland, Belgium and Portugal by 0.6%, 1.0%, 1.2% and 6.5%, respectively. In Denmark and Spain this number remained basically stable. In Sweden, the United Kingdom, Finland and Germany the percentage of the population with good or very good subjective well-being decreased by 1.1%, 2.7%, 1.7% and 2.8%, respectively. Regression analysis demonstrated a significant relation between good and very good subjective well-being and level of education, main activity during the last 7 days, satisfaction with life, satisfaction with household income, main source of household income, gender and age. This relation differed for various factors and countries. In none of the countries satisfaction with national health services and satisfaction with current state of economy within the country was found significantly related to subjective well-being. The main amendable determinant correlating with a higher degree of subjective well-being is good education. The correlation between education and subjective well-being got stronger after the crisis than before or during the crisis. Conclusion Economic development does not have a uniform impact on subjective well-being. Education is a major amendable determinant influencing individual well-being. We could not find evidence for any significant impact of the organization of the healthcare services or social system on the subjective well-being.

Kriterienkatalog zur Erfassung und Bewertung baulicher Anlagen in Hochschulen, u.a.: Gebäude, Zugänge, Flure, Treppen, Aufzüge, WCs, Ruheräume und Lehrräume (unkommentierte Fassung)

This thesis focuses on the findings of sex workers provided services in the Czech Republic and especially in the capital city Prague. It describes the different types of service, defines prostitution, its legislative basis, the historical development of approaches to the problems, and also theoretical approaches in social work focusing on the matching needs and service contracts. The practical part is then implemented survey among sex workers and district social workers. It aims to identify problem areas of sex workers, whether services adequately respond to them, or what service is in the list of missing. Finally, respondents' answers are evaluated from both groups and to create hypotheses about the "state service" and to draw the possible outcomes for practice. Keywords Prostitution, sex workers, social and health services, social work, matching.

No description available.

Earlier ecological studies on the relation between H. pylori infection and stomach cancer have considered that the relation between these two variables, as estimated by the exposure coefficient, is constant. However, there is evidence to suggest that this relation changes geographically due to differences in strains of H. pylori. Since the prevalence of H. pylori varies with socio-economic status, the association between the latter and stomach cancer mortality may also vary geographically. This thesis studies stomach cancer by taking into account the geographical variability of the exposure coefficients. The study proposes the use of regression mixtures, clustering models and spatially varying regressions for the study of varying exposure coefficients. The effect of transformations of variables in these models appears to have been little considered. We provide new necessary conditions for invariance under transformations of variables for mixed effect models in general, and for the proposed models in particular. In addition, we show that varying exposure coefficients may induce a varying baseline risk. The regression mixtures and the clustering model are applied to a data set on stomach cancer incidence and H. pylori prevalence in 57 countries worldwide. We extend the clustering model to reflect any distance measure between the geographical units, including the Euclidean distance, in the formation of clusters. We also show that the clustering model performs better than the regression mixture model when the aim is to identify connected clusters and the observations present large variance. The results obtained with the clustering model supported the existence of three clusters where the interaction between the human and H. pylori populations have similar characteristics. Spatially varying regressions are applied to a data set of areal death counts of stomach cancer and spending power in 275 counties in continental Portugal. We provide an original strategy for implementing multivectorial intrinsic autoregressions as the distribution for the random effects. The results obtained with the application of this methodology were consistent with a varying exposure coefficient of spending power.

This dissertation aims at analyzing mindfulness as a concept and a multidimensional phenomenon in its historic and primordial but also contemporary contexts. In the course of examining this more general question, this dissertation targets four specific objectives: 1) classifying existing definitions of mindfulness, 2) critically analyzing and interpreting the Buddhist and Western interpretations and practices of mindfulness, 3) elaborating on the social and existential dimensions of mindfulness, and 4) applying these dimensions in advancing the notion of mindful sustainable aging in the context of successful aging. Paper I examines and assesses the numerous definitions of mindfulness that have been presented over the years by a wide range of scholars from a variety of disciplines. Paper II traces the roots of modern mindfulness in Buddhism. It continues by exploring the utility and practices of mindfulness in the context of social work. The definitions provided in Paper I and the Buddhist underpinnings discussed in Paper II call attention to the fact that in addition to the more commonly considered physical and mental dimensions, mindfulness contains a social and an existential dimension as well – dimensions that remain under-researched and not well understood. To redress this imbalance, Paper III elaborates on these two latter dimensions, emphasizing their potential to enhance health, wellbeing and meaning in life. Paper III further argues that a more nuanced understanding of physical, mental, social and existential mindfulness can be obtained by examining the interconnectedness of all four fields. Paper IV continues the discussion of the social and the existential dimensions of mindfulness with specific emphasis on their utility for successful aging, and advances the notion of mindful sustainable aging. Paper IV highlights the potential of mindfulness for living a meaningful life and boosting the elderly’s capacity to find deeper meaning in their final stage of life.