Volume 1, Issue 3, July 2008 Edition
Learning to Learn: towards a Relational and Transformational
Model of Learning for Improved Integrated Care Delivery
Peter Tsasis, Jenna M. Evans, Linda Rush, and John Diamond
Abstract
Health and social care systems are implementing fundamental changes to organizational structures and work practices in an effort to achieve integrated care. While some integration initiatives have produced positive outcomes, many have not. We reframe the concept of integration as a learning process fueled by knowledge exchange across diverse professional and organizational communities. We thus focus on the cognitive and social dynamics of learning in complex adaptive systems, and on learning behaviours and conditions that foster collective learning and improved collaboration. We suggest that the capacity to learn how to learn shapes the extent to which diverse professional groups effectively exchange knowledge and self-organize for integrated care delivery.
Key words: integrated care; health services integration; complex adaptive systems; learning to learn; self-organization
Improving the Psychosocial Work Environment at Multi-Ethnic Workplaces: A Multi-Component Intervention Strategy in the Cleaning Industry
Louise Hardman Smith, Kirsten Hviid, Karen Bo Frydendall, and Mari-Ann Flyvholm
Abstract
Global labour migration has increased in recent years and immigrant workers are often recruited into low status and low paid jobs such as cleaning. Research in a Danish context shows that immigrants working in the cleaning industry often form social networks based on shared languages and backgrounds, and that conflict between different ethnic groups may occur. This paper evaluates the impact of a multi-component intervention on the psychosocial work environment at a multi-ethnic Danish workplace in the cleaning sector. The intervention included Danish lessons, vocational training courses, and activities to improve collaboration across different groups of cleaners. Interviews about the outcome of the intervention were conducted with the cleaners and their supervisor. The Copenhagen Psychosocial Questionnaire was used as a supplement to the interviews. The results suggest that the psychosocial work environment had improved after the intervention. According to the interviews with the cleaners, the intervention had led to improved communication, trust, and collaboration. These findings are supported by the questionnaire where social support from supervisor and colleagues, social community, trust, and teamwork seem to have improved together with meaning of work, rewards, and emotional demands. The design of the intervention may provide inspiration for future psychosocial work environment interventions at multi-ethnic work places.
Key words: intervention; psychosocial work environment; multi-ethnic workplace; cleaning
Depressive Symptoms and Its Associated Factors in 13-Year-Old Urban Adolescents
Cláudia Bulhões, Elisabete Ramos, Jutta Lindert, Sónia Dias, and Henrique Barros
Abstract
The available estimates reveal that 20–50% of adolescents report depressive symptoms, being one of the most prevalent health problems in adolescence. The aim of this study was to assess the prevalence of depressive symptoms in a community sample of 13-year-old adolescents and identify associated features. Thirteen year-old adolescents attending private and public schools in Porto (n = 1,988, 52.2% females) were evaluated from October 2003 to June 2004 and completed a questionnaire including health behaviors and the Beck Depression Inventory II. A questionnaire on parents’ socio-demographics and clinical characteristics was sent home. Data were analyzed separately by sex. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using logistic regression. The prevalence of depressive symptoms was 18.8% in girls and 7.6% in boys (p < 0.001). Boys with a family history of depression and girls with smoking habits had a significantly increased risk of depressive symptoms (OR = 2.18, 95%CI 1.00–4.71; OR = 2.34, 95%CI 1.46–3.76). Menarche at an early age significantly increased the risk of depressive symptoms. The characteristics most strongly associated with depressive symptoms were family history of depression among boys, tobacco consumption and an early age at menarche among girls. The high prevalence of depressive symptoms early in adolescence calls for the awareness of public health professionals
Key words: adolescent; depression; epidemiology; health behavior
Psychological Distress, Related Work Attendance, and Productivity Loss in Small-to-Medium Enterprise Owner/Managers
Fiona Cocker, Angela Martin, Jenn Scott, Alison Venn, and Kristy Sanderson
Abstract
Owner/managers of small-to-medium enterprises (SMEs) are an under-researched population in terms of psychological distress and the associated health and economic consequences. Using baseline data from the evaluation of the Business in Mind program, a mental health promotion intervention amongst SME owner/managers, this study investigated: (i) prevalence of high/very high psychological distress, past-month sickness absenteeism and presenteeism days in SME owner/managers; (ii) associated, self-reported lost productivity; and (iii) associations between work, non-work and business-specific factors and work attendance behaviours. In our sample of 217 SME owner/managers 36.8% reported high/very high psychological distress. Of this group 38.7% reported past-month absenteeism, 82.5% reported past-month presenteeism, and those reporting presenteeism were 50% less productive as than usual. Negative binomial regression was used to demonstrate the independent effects of socio-demographic, work-related wellbeing and health-related factors, as well as various individual and business characteristics on continuous measures of absenteeism and presenteeism days. Health-related factors (self-rated health and treatment) were the strongest correlates of higher presenteeism days (p < 0.05). Work-related wellbeing factors (job tension and job satisfaction) were the strongest correlates of higher absenteeism days (p < 0.05). Higher educational attainment, treatment and neuroticism were also correlated with more absenteeism days. SME-specific information about the occurrence of psychological distress, work attendance behaviour, and the variables that influence these decisions, are needed for the development of guidelines for managing psychological distress within this sector.
Key words: depression; workplace; absenteeism; presenteeism; productivity; SMEs
Childhood Overweight/Obesity and Pediatric Asthma: The Role of Parental Perception of Child Weight Status
Salma M. A. Musaad, Katie N. Paige, Margarita Teran-Garcia, Sharon M. Donovan, Barbara H. Fiese, and the STRONG Kids Research Team
Abstract
Childhood obesity and asthma are on the rise in the U.S. Clinical and epidemiological data suggest a link between the two, in which overweight and obese children are at higher risk for asthma. Prevention of childhood obesity is preferred over treatment, however, in order to be receptive to messages, parents must perceive that their child is overweight. Many parents do not accurately assess their child’s weight status. Herein, the relation between parental perceptions of child weight status, observed body mass index (BMI) percentiles, and a measure of child feeding practices were explored in the context of asthma, food allergy, or both. Out of the children with asthma or food allergy that were classified as overweight/obese by BMI percentiles, 93% were not perceived as overweight/obese by the parent. Mean scores for concern about child weight were higher in children with both asthma and food allergy than either condition alone, yet there were no significant differences among the groups in terms of pressure to eat and restrictive feeding practices. In summary, parents of children with asthma or food allergy were less likely to recognize their child’s overweight/obese status and their feeding practices did not differ from those without asthma and food allergy.
Key words: childhood obesity; pediatric asthma; food allergy; parental perception
The Sustainability of Mediterranean Port Areas: Environmental Management for Local Regeneration in Valencia
Filomena Borriello
Abstract
Urban renovation projects, which have led to the conversion of port areas through a new vision of waterfronts as elements of the potential development of the urban system in its entirety, have spread since the early 1950s and now some port cities are able to trigger some mechanisms which, even if they are the result of some processes that have been activated for decades and which are still evolving, are able to amplify and to extend over time their generated positive impacts. These impacts also produce a system of relations in the context of the hinterland, attracted also by policies of economic, social, and cultural development. In the case of the city of Valencia, we have seen, in the last 50 years, a progressive spread of the urbanized area to the coasts, simultaneously with a process of renovation of the port area, which has been populated by important architectures, and which has been equipped by efficient infrastructures and subjected to numerous recovery and restoration operations of its historic buildings. However, the environmental conditions near the port area are not well suited to a good quality of life because ports are pollution producers, sites of urban decay, and of social degradation. A good plan can include some instruments to decrease those negative factors, leading to a close merging between the port area and the city hinterland, and generating new economies. The proposal of this research consists in a method of integrating the port planning with an environmental accounting system.
Key words: port city; emissions impact; strategic projects
Toward a Smart Sustainable Development of Port Cities/Areas: The Role of the “Historic Urban Landscape” Approach
Luigi Fusco Girard
Abstract
After the 2008 crisis, smart sustainable development of port areas/cities should be developed on the basis of specific principles: the synergy principle (between different actors/systems, in particular the socio-cultural and economic system), the creativity principle and the circularization principle. The Historic Urban landscape (HUL) approach becomes the guarantee that the transition toward the smart city development model is based on specific local cultural resources, and not only on technological innovations. In other words, the eco-town/eco-city strategy becomes culture-led. It stimulates places as spatial “loci” for implementing synergies and circularization processes. Without new evaluation tools and a widespread “evaluation culture” the risks in implementing HUL are very high.
Key words: circularization processes; synergistic approach; smart city development; evaluation tools; cultural city base
Measuring the Willingness to Pay for Tap Water Quality Improvements: Results of a Contingent Valuation Survey in Pusan
So-Yoon Kwak, Seung-Hoon Yoo, and Chang-Seob Kim
Abstract
With increasing concern regarding health, people have developed an interest in the safety of drinking water. In this study, we attempt to measure the economic benefits of tap water quality improvement through a case study on Pusan, the second largest city in Korea. To this end, we use a scenario that the government plans to implement a new project of improving water quality and apply the contingent valuation (CV) method. A one-and-one-half bounded dichotomous choice question (OOHBDC) format is employed to reduce the potential for response bias in multiple-bound formats such as the double-bound model, while maintaining much of the efficiency. Moreover, we employ the spike model to deal with zero willingness to pay (WTP) responses from the OOHBDC CV survey. The CV survey of 400 randomly selected households was rigorously designed to comply with the guidelines for best-practice CV studies using person-to-person interviews. From the spike OOHBDC CV model, the mean WTP for the improvement was estimated to be KRW 2,124 (USD 2.2), on average, per household, per month. The value amounts to 36.6% of monthly water bill and 20.2% of production costs of water. The conventional OOHBDC model produces statistically insignificant mean WTP estimate and even negative value, but the OOHBDC spike model gives us statistically significant mean WTP estimate and fitted our data well. The WTP value to Pusan residents can be computed to be KRW 31.2 billion (USD 32.1 million) per year.
Key words: tap water quality improvement; contingent valuation; willingness to pay; one-and-one-half bounded; spike model
Peter Tsasis, Jenna M. Evans, Linda Rush, and John Diamond
Abstract
Health and social care systems are implementing fundamental changes to organizational structures and work practices in an effort to achieve integrated care. While some integration initiatives have produced positive outcomes, many have not. We reframe the concept of integration as a learning process fueled by knowledge exchange across diverse professional and organizational communities. We thus focus on the cognitive and social dynamics of learning in complex adaptive systems, and on learning behaviours and conditions that foster collective learning and improved collaboration. We suggest that the capacity to learn how to learn shapes the extent to which diverse professional groups effectively exchange knowledge and self-organize for integrated care delivery.
Key words: integrated care; health services integration; complex adaptive systems; learning to learn; self-organization
 [Abstract-PDF]
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[References]
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1.3.7.2008.1
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Improving the Psychosocial Work Environment at Multi-Ethnic Workplaces: A Multi-Component Intervention Strategy in the Cleaning Industry
Louise Hardman Smith, Kirsten Hviid, Karen Bo Frydendall, and Mari-Ann Flyvholm
Abstract
Global labour migration has increased in recent years and immigrant workers are often recruited into low status and low paid jobs such as cleaning. Research in a Danish context shows that immigrants working in the cleaning industry often form social networks based on shared languages and backgrounds, and that conflict between different ethnic groups may occur. This paper evaluates the impact of a multi-component intervention on the psychosocial work environment at a multi-ethnic Danish workplace in the cleaning sector. The intervention included Danish lessons, vocational training courses, and activities to improve collaboration across different groups of cleaners. Interviews about the outcome of the intervention were conducted with the cleaners and their supervisor. The Copenhagen Psychosocial Questionnaire was used as a supplement to the interviews. The results suggest that the psychosocial work environment had improved after the intervention. According to the interviews with the cleaners, the intervention had led to improved communication, trust, and collaboration. These findings are supported by the questionnaire where social support from supervisor and colleagues, social community, trust, and teamwork seem to have improved together with meaning of work, rewards, and emotional demands. The design of the intervention may provide inspiration for future psychosocial work environment interventions at multi-ethnic work places.
Key words: intervention; psychosocial work environment; multi-ethnic workplace; cleaning
| [Abstract-PDF]
|
[References]
|
1.3.7.2008.2
|
Depressive Symptoms and Its Associated Factors in 13-Year-Old Urban Adolescents
Cláudia Bulhões, Elisabete Ramos, Jutta Lindert, Sónia Dias, and Henrique Barros
Abstract
The available estimates reveal that 20–50% of adolescents report depressive symptoms, being one of the most prevalent health problems in adolescence. The aim of this study was to assess the prevalence of depressive symptoms in a community sample of 13-year-old adolescents and identify associated features. Thirteen year-old adolescents attending private and public schools in Porto (n = 1,988, 52.2% females) were evaluated from October 2003 to June 2004 and completed a questionnaire including health behaviors and the Beck Depression Inventory II. A questionnaire on parents’ socio-demographics and clinical characteristics was sent home. Data were analyzed separately by sex. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using logistic regression. The prevalence of depressive symptoms was 18.8% in girls and 7.6% in boys (p < 0.001). Boys with a family history of depression and girls with smoking habits had a significantly increased risk of depressive symptoms (OR = 2.18, 95%CI 1.00–4.71; OR = 2.34, 95%CI 1.46–3.76). Menarche at an early age significantly increased the risk of depressive symptoms. The characteristics most strongly associated with depressive symptoms were family history of depression among boys, tobacco consumption and an early age at menarche among girls. The high prevalence of depressive symptoms early in adolescence calls for the awareness of public health professionals
Key words: adolescent; depression; epidemiology; health behavior
| [Abstract-PDF]
|
[References]
|
1.3.7.2008.3
|
Psychological Distress, Related Work Attendance, and Productivity Loss in Small-to-Medium Enterprise Owner/Managers
Fiona Cocker, Angela Martin, Jenn Scott, Alison Venn, and Kristy Sanderson
Abstract
Owner/managers of small-to-medium enterprises (SMEs) are an under-researched population in terms of psychological distress and the associated health and economic consequences. Using baseline data from the evaluation of the Business in Mind program, a mental health promotion intervention amongst SME owner/managers, this study investigated: (i) prevalence of high/very high psychological distress, past-month sickness absenteeism and presenteeism days in SME owner/managers; (ii) associated, self-reported lost productivity; and (iii) associations between work, non-work and business-specific factors and work attendance behaviours. In our sample of 217 SME owner/managers 36.8% reported high/very high psychological distress. Of this group 38.7% reported past-month absenteeism, 82.5% reported past-month presenteeism, and those reporting presenteeism were 50% less productive as than usual. Negative binomial regression was used to demonstrate the independent effects of socio-demographic, work-related wellbeing and health-related factors, as well as various individual and business characteristics on continuous measures of absenteeism and presenteeism days. Health-related factors (self-rated health and treatment) were the strongest correlates of higher presenteeism days (p < 0.05). Work-related wellbeing factors (job tension and job satisfaction) were the strongest correlates of higher absenteeism days (p < 0.05). Higher educational attainment, treatment and neuroticism were also correlated with more absenteeism days. SME-specific information about the occurrence of psychological distress, work attendance behaviour, and the variables that influence these decisions, are needed for the development of guidelines for managing psychological distress within this sector.
Key words: depression; workplace; absenteeism; presenteeism; productivity; SMEs
| [Abstract-PDF]
|
[References]
|
1.3.7.2008.4
|
Childhood Overweight/Obesity and Pediatric Asthma: The Role of Parental Perception of Child Weight Status
Salma M. A. Musaad, Katie N. Paige, Margarita Teran-Garcia, Sharon M. Donovan, Barbara H. Fiese, and the STRONG Kids Research Team
Abstract
Childhood obesity and asthma are on the rise in the U.S. Clinical and epidemiological data suggest a link between the two, in which overweight and obese children are at higher risk for asthma. Prevention of childhood obesity is preferred over treatment, however, in order to be receptive to messages, parents must perceive that their child is overweight. Many parents do not accurately assess their child’s weight status. Herein, the relation between parental perceptions of child weight status, observed body mass index (BMI) percentiles, and a measure of child feeding practices were explored in the context of asthma, food allergy, or both. Out of the children with asthma or food allergy that were classified as overweight/obese by BMI percentiles, 93% were not perceived as overweight/obese by the parent. Mean scores for concern about child weight were higher in children with both asthma and food allergy than either condition alone, yet there were no significant differences among the groups in terms of pressure to eat and restrictive feeding practices. In summary, parents of children with asthma or food allergy were less likely to recognize their child’s overweight/obese status and their feeding practices did not differ from those without asthma and food allergy.
Key words: childhood obesity; pediatric asthma; food allergy; parental perception
| [Abstract-PDF]
|
[References]
|
1.3.7.2008.5
|
The Sustainability of Mediterranean Port Areas: Environmental Management for Local Regeneration in Valencia
Filomena Borriello
Abstract
Urban renovation projects, which have led to the conversion of port areas through a new vision of waterfronts as elements of the potential development of the urban system in its entirety, have spread since the early 1950s and now some port cities are able to trigger some mechanisms which, even if they are the result of some processes that have been activated for decades and which are still evolving, are able to amplify and to extend over time their generated positive impacts. These impacts also produce a system of relations in the context of the hinterland, attracted also by policies of economic, social, and cultural development. In the case of the city of Valencia, we have seen, in the last 50 years, a progressive spread of the urbanized area to the coasts, simultaneously with a process of renovation of the port area, which has been populated by important architectures, and which has been equipped by efficient infrastructures and subjected to numerous recovery and restoration operations of its historic buildings. However, the environmental conditions near the port area are not well suited to a good quality of life because ports are pollution producers, sites of urban decay, and of social degradation. A good plan can include some instruments to decrease those negative factors, leading to a close merging between the port area and the city hinterland, and generating new economies. The proposal of this research consists in a method of integrating the port planning with an environmental accounting system.
Key words: port city; emissions impact; strategic projects
| [Abstract-PDF]
|
[References]
|
1.3.7.2008.6
|
Toward a Smart Sustainable Development of Port Cities/Areas: The Role of the “Historic Urban Landscape” Approach
Luigi Fusco Girard
Abstract
After the 2008 crisis, smart sustainable development of port areas/cities should be developed on the basis of specific principles: the synergy principle (between different actors/systems, in particular the socio-cultural and economic system), the creativity principle and the circularization principle. The Historic Urban landscape (HUL) approach becomes the guarantee that the transition toward the smart city development model is based on specific local cultural resources, and not only on technological innovations. In other words, the eco-town/eco-city strategy becomes culture-led. It stimulates places as spatial “loci” for implementing synergies and circularization processes. Without new evaluation tools and a widespread “evaluation culture” the risks in implementing HUL are very high.
Key words: circularization processes; synergistic approach; smart city development; evaluation tools; cultural city base
| [Abstract-PDF]
|
[References]
|
1.3.7.2008.7
|
Measuring the Willingness to Pay for Tap Water Quality Improvements: Results of a Contingent Valuation Survey in Pusan
So-Yoon Kwak, Seung-Hoon Yoo, and Chang-Seob Kim
Abstract
With increasing concern regarding health, people have developed an interest in the safety of drinking water. In this study, we attempt to measure the economic benefits of tap water quality improvement through a case study on Pusan, the second largest city in Korea. To this end, we use a scenario that the government plans to implement a new project of improving water quality and apply the contingent valuation (CV) method. A one-and-one-half bounded dichotomous choice question (OOHBDC) format is employed to reduce the potential for response bias in multiple-bound formats such as the double-bound model, while maintaining much of the efficiency. Moreover, we employ the spike model to deal with zero willingness to pay (WTP) responses from the OOHBDC CV survey. The CV survey of 400 randomly selected households was rigorously designed to comply with the guidelines for best-practice CV studies using person-to-person interviews. From the spike OOHBDC CV model, the mean WTP for the improvement was estimated to be KRW 2,124 (USD 2.2), on average, per household, per month. The value amounts to 36.6% of monthly water bill and 20.2% of production costs of water. The conventional OOHBDC model produces statistically insignificant mean WTP estimate and even negative value, but the OOHBDC spike model gives us statistically significant mean WTP estimate and fitted our data well. The WTP value to Pusan residents can be computed to be KRW 31.2 billion (USD 32.1 million) per year.
Key words: tap water quality improvement; contingent valuation; willingness to pay; one-and-one-half bounded; spike model
| [Abstract-PDF]
|
[References]
|
1.3.7.2008.8
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