Background: there is limited research to show that a social intervention such as increasing income improves health, especially as this relates to older people. It is known that poverty is a real problem for many older people in Northern Ireland. One reason for this is that older people often do not claim the financial benefits for which they are entitled. This is a randomised controlled study that sought to investigate the health effects of an increased uptake of social security benefits. Methods: The aims of this study were to find out if an increase in income through the take up of unclaimed financial benefits lead to a significant improvement in the health status of older people and discover if this was maintained over a reasonable period of time. This was a randomised control trial based in the community. Patients were recruited from 11 general practices in South Down, Craigavon, Fermanagh and Tyrone. The intervention consisted of a benefit assessment followed by assistance completing the benefit application. The control group received the assessment but were not give assistance with the application. Instead they were given a list of agencies where help with the application could be found. A range of health, psycho-social and financial outcome was measured. Results: Of the 2180 patients who were sent invitation letters 300 agreed to a benefits assessment. 189 enrolled in the study and 149 were followed up at six months. A total of 89 patients received additional weekly benefits amounting to approximately £3277.19 per annum (£63 per week). A further 13 patients received one off payments totaling £5,731.01. All but two patients received their benefits within three months of assessment. While analysis showed trends suggesting greater improvements in social support and depression scores for the intervention group when compared with the controls the difference were not statistically significant. This is probably due to the following factors. The sample size in this study was small because of problems with the recruitment and screening of patients. More patients in the control group claimed benefits than had been anticipated and as a result it was difficult to detect differences between the two groups. Discussion: Valuable lessons have been leant and modifications to the study methodology have been suggested that will be of use to other researchers attempting to undertake similar studies in the UK.

This is an inter-disciplinary argument for a moral entitlement to a capability to be healthy. Motivated by the goal to make a human right to health intelligible and justifiable, the thesis extends the capability approach, advocated by Amartya Sen and Martha Nussbaum, to the theory and practice of the human health sciences. Moral claims related to human health are considered at the level of ethical theory, or a level of abstraction where principles of social justice that determine the purpose, form, and scope of basic social institutions are proposed, evaluated, and justified. The argument includes 1) a conception of health as capability, 2) a theory of causation and distribution of health capability as well as 3) an argument for the moral entitlement to a sufficient and equitable capability to be healthy grounded in the respect for human dignity. Moreover, the entitlement to the capability to be healthy is defended against alternative ethical approaches that focus on welfare or resources in evaluating and satisfying health claims. In specific, it is argued that human health is best understood as a capability to be healthy - a meta-capability to achieve a cluster of basic and inter-related capabilities and functionings. Such a cluster of capabilities and functionings is in line with Martha Nussbaum's central human capabilities. A theory of causation and distribution of health capability is put forward that integrates the 'classic' biomedical factors of disease (genetic endowment, exposure to hazardous materials, behaviour), social determinants of disease, and Drèze and Sen's econometric analysis of the causation and distribution of acute and endemic malnutrition. Furthermore, the argument critiques Norman Daniels's revised Rawlsian theory of health justice, and advocates for the capability approach to recognize group capabilities in light of 'population health' phenomena. Lastly, the thesis also argues that a coherent, capability conception of health as a species-wide conception will tend to make any theory of justice recognizing health claims a cosmopolitan theory of justice.

x Klíčová slova: harm reduction - sociální služba - zdravotní péče - adiktolog Abstract Objective: The study is a institutional analysis of harm reduction services in the Czech Republic: possibilities and limits of providing health care in their context and the state of readiness on a combi- nation of health and social services to different target groups. Background: In the Czech Republic, there is currently a network of harm reduction services, especially for users of illegal drugs. These centres and programs are very diffrent in provided services, procedures, conditions for providing care and also in the status (registered social service x registered medical service x unregistred service). By analyzing the current status of harm reduction services, we can outline possible future development. Research file: The study was addressed to all contact centers and outreach programs for drug users in the Czech Republic (N = 96). Information will be provided by competent persons, mostly from senior staff. Methods: Data collection was conducted through a questionnaire survey. The questionnaire is structu- red, divided into 3 parts. If necessary, we will use the possibility of telephone interviews and analysis of documents. Contribution of the work: Achieved results may facilitace orientation in discussed posibility of...

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The diploma thesis is focused on the specifics of the work of a health and social worker in hospital facilities in a multidisciplinary team. The theoretical part focuses on the definition of basic concepts and the development of social work in health care. In one of the chapters I will introduce the reader to the code of ethics of a social worker and the legislative support of the profession. I also focus on competencies, job description or personal prerequisites for the performance of a health and social worker. In the same part I will introduce you to the methods of social work in health care. In conclusion, I will introduce the reader to the topic of typologies of clients of health and social workers working in the hospital environment. In the practical part, I chose a qualitative survey in the form of a semi-structured interview. The main idea of the whole research part is to find out on the basis of interviews with social workers in health care facilities, the position of the health and social worker in the multidisciplinary team and the related scope of work and prerequisites for the performance of this specific field of social work. To answer this question, three areas of research were created.

Aims: The aims of this thesis were to investigate the risk of severe maternal morbidity amongst women from different socioeconomic groups in the UK, explore why these differences exist and compare these findings to the setting in Australia. Methods: Three separate analyses were conducted. The first used UK Obstetric Surveillance System (UKOSS) data to assess the incidence and independent odds of severe maternal morbidity by socioeconomic group in the UK. The second analysis used quantitative and qualitative data from the 2010 UK National Maternity Survey (NMS) to explore the possible reasons for the difference in odds of morbidity between socioeconomic groups in the UK. The third analysis used data from the Victorian Perinatal Data Collection (VPDC) unit in Austra lia to assess the incidence and odds of severe maternal morbidity by socioeconomic group in Victoria. Results: The UKOSS analysis showed that compared with women from the highest socioeconomic group, women in the lowest 'unemployed' group had 1.22 (95%CI: 0.92 - 1.61) times greater odds associated with severe maternal morbidity. The NMS analysis demonstrated that independent of ethnicity, age and parity, women from the lowest socioeconomic quintiJe were 60% less likely to have had any antenatal care (aOR 0.40; 95%CI 0.18 - 0.87), 40% less likely to have been seen by a health professional prior to 12 weeks gestation (aOR 0.62; 95%CI 0.45 - 0.85) and 45% less likely to have had a postnatal check with their doctor (aOR 0.55; 95%CI 0.42 - 0.70) compared to women from the highest quintile. The Victorian analysis showed that women from the lowest socioeconomic group were 21% (aOR 1.21 ; 95% CI 1.00 - 1.47) more likely and that Aboriginal and Torres Strait Islander women were twice (aOR 2.02; 95%CI 1.32 - 3.09) as likely to experience severe morbidity. Discussion: The resu lts suggest that women from the lowest socioeconomic group in the UK and in Victoria have increased odds of severe maternal morbidity. Further research is needed into why these differences exist and efforts must be made to ensure that these women are appropriately prioritised in the future planning of maternity services provisio n in the UK and Australia.

<p> The purpose of this policy analysis is to critically review the Welfare and Institutions Code&sect; 369.5, which regulates the authorization of psychotropic medication to treat mental disorders among California's dependent children. While these medications have been proven effective forms of treatment, there is a growing concern about their life threatening side effects.</p><p> Research has concluded that children exposed to chronic child abuse and neglect often present with behaviors indicative of trauma. The <i>Diagnostic and Statistical Manual of Mental Disorders</i> 5th Edition has included criteria for Post-Traumatic Stress Disorder (P.T.S.D.) in children. However, the Welfare and Institutions Code&sect; 369.5 does not mandate psychiatrists and pediatricians to first rule out trauma prior to diagnosing foster children with one or more behavior, mood, or psychotic disorders.</p><p> Results support amending child welfare legislation and policies to reflect a shift toward trauma-focused services, thereby reducing the reliance on potentially dangerous pharmaceutical drugs.</p>

Extant literature has documented well that people seek health information via the internet as patients and consumers. Much less, however, is known about interaction and creation behaviors in the development of new online health information and knowledge. More specifically, generalizable sociodemographic data on who engages in this online health behavior via social media is lacking in the sociological literature. The term “social e-health” is introduced to emphasize the difference between seeking behaviors and interaction and creation behaviors. A 2010 dataset of a large nationally representative and randomly sampled telephone survey made freely available from the Pew Research Center is used to examine social e-health behavior according to respondents’ sociodemographics. The dependent variable of social e-health behavior is measured by 13 survey questions from the survey. Gender, race, ethnicity, age, education, and income are used as independent variables. Logistic regression analysis was used to determine the odds of engagement in social e-health behavior based on the sociodemographic predictors. The social determinants of health and digital divide frameworks are used to help explain why socioeconomic variances exist in social e-health behavior. The findings of the current study suggest that predictable sociodemographic patterns along the dimensions of gender, race, age, education, and income exist for those who report engaging in social e-health behavior. This study is important because it underscores the fact that engagement in social e-health behavior is differentially distributed in the general U.S. population according to patterned sociodemographics.

O desenvolvimento da redemocratização brasileira foi vigorosamente fomentado pelos movimentos populares de saúde, garantindo a participação da comunidade na Constituição Federal de 1988, por meio de conselhos de saúde paritários e deliberativos. O estudo propõe analisar a intensidade democrática de participação de um conselho municipal de saúde no que tange ao programa de melhoria do acesso e da qualidade na atenção básica à saúde (PMAQ) nos centros de saúde da família de um município sul mineiro. Como objetivos específicos pretende-se qualificar o perfil sócio econômico e participativo dos conselheiros municipais de saúde; caracterizar a organização e funcionamento do conselho municipal de saúde e identificar a percepção dos conselheiros em relação ao PMAQ. É uma pesquisa descritiva e explicativa com abordagem qualitativa a partir de um estudo de caso. O corpus da pesquisa se constituiu de entrevistas semiestruturadas com dezesseis conselheiros municipais de saúde. O percurso metodológico abarcou as premissas da análise temática de conteúdo de Laurence Bardin, mediante a sistematização dos dados qualitativos auferidos. A categorização e a análise alicerçaram-se nas teses sobre a democracia participativa discutidas nos pressupostos teóricos desenvolvidos pelo sociólogo Boaventura de Sousa Santos que advoga a emergência da renovação da teoria democrática hierarquizada de acordo com a intensidade dos processos de autoridade partilhada e da reciprocidade do reconhecimento. / The development of brazilian redemocratization was vigorously fostered by popular movements of health, ensuring the community participation in the federal constitution o 1.988, through parity and deliberative health advices. The study proposes to analyses the demographic intensity of participation of City council health regarding te improvement program access and quality in primary care to health (PMAQ) in health centers of the family of a miner southern municipality. The specific objectives intended to qualify the economic profile and participatory member of the municipal health directors; characterize the organization and functioning of municipal health council and identify the perception of the directors in relation to PMAQ. It is a descriptive and explanatory research with qualitative approach from a case study. The corpus of the research is composed of semi-structured interviews with sixteen municipal health aldermen. The methodological route encompassed the premises of thematic content analysis of Laurence Bardin, by systematizing accrued qualitative data. The categorization and analysis is underpinned in the theses on participatory democracy discussed the theoretical assumptions developed by the sociologist Boaventura de Sousa Santos which advocates emergence of renewal of democratic theory hierarchical according to the intensity of shared authority procedures and the recognition and of reciprocity.

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.