二炮某部夏秋入伍新兵应对方式、社会支持及心理健康状况调查

目的:调查分析夏秋入伍新兵心理健康状况及其与应对方式、社会支持的关系,为针对性开展新兵心理卫生服务,提高新兵心理健康水平提供参考依据。方法:采用自编心理需求调查问卷、简易应对方式、社会支持以及症状自评量表(SCL-90)对二炮某部首次夏秋季入伍新兵进行心理测试,并进行相关回归分析。结果:新兵在应对方式上的得分与全国成人常模存在显著差异;在社会支持量表的得分与军人常模存在显著差异;在SCL-90中,与2010年新兵比较在躯体化、强迫症状、忧郁、焦虑、恐怖、精神病性6个因子之间存在显著差异,与军人常模比较在躯体化、强迫症状、人际关系敏感、忧郁、敌对、恐怖、偏执、精神病性8个因子之间均存在显著差异。简易应对方式、社会支持与心理健康的相关分析显示,消极应对与心理健康各因子间均存在显著相关关系;主观支持与强迫症状、人际关系敏感、忧郁和敌对4个因子间存在显著相关,客观支持与人际关系敏感、敌对2个因子间存在显著相关,对支持的利用度与人际关系敏感、焦虑、敌对、恐怖和精神病性5个因子间存在显著相关。以新兵心理健康作为因变量,社会支持与应对方式作为自变量,进行逐步回归分析,最终进入回归的因子为对支持的利用度和消极应对。结论:本年度新兵整体心理健康状况良好,他们多采用积极应对方式应对应激事件,所得到的社会支持以及对支持的利用度良好,愿意在新训期间通过心理素质训练,提高心理健康水平。     

Effects of Minority Stress,Group-Level Coping,and Social Support on Mental Health of German Gay Men

Objective

According to epidemiological studies, gay men are at a higher risk of mental disorders than heterosexual men. In the current study, the minority stress theory was investigated in German gay men: 1) it was hypothesized that minority stressors would positively predict mental health problems and that 2) group-level coping and social support variables would moderate these predictions negatively.

Methods

Data from 1,188 German self-identified gay men were collected online. The questionnaire included items about socio-demographics, minority stress (victimization, rejection sensitivity, and internalized homonegativity), group-level coping (disclosure of sexual orientation, homopositivity, gay affirmation, gay rights support, and gay rights activism), and social support (gay social support and non-gay social support). A moderated multiple regression was conducted.

Results

Minority stressors positively predicted mental health problems. Group-level coping did not interact with minority stressors, with the exception of disclosure and homopositivity interacting marginally with some minority stressors. Further, only two interactions were found for social support variables and minority stress, one of them marginal. Gay and non-gay social support inversely predicted mental health problems. In addition, disclosure and homopositivity marginally predicted mental health problems.

Conclusions

The findings imply that the minority stress theory should be modified. Disclosure does not have a relevant effect on mental health, while social support variables directly influence mental health of gay men. Group-level coping does not interact with minority stressors relevantly, and only one relevant interaction between social support and minority stress was found. Further longitudinal or experimental replication is needed before transferring the results to mental health interventions and prevention strategies for gay men.     

Social characteristics and fertility: A study of Two Religious Groups in Metropolitan New York

Abstract

Reproductive time lost through marital dissolution is a potential factor in decreased fertility. This study of survey data from six Latin America metropolitan areas shows that, among variables examined, type of marital union is the primary determinant of reproductive time lost. The study establishes that appreciably more reproductive time is lost from consensual unions than from legal ones. It also indicates that this difference cannot be explained by such social‐background characteristics as a woman's place of birth or educational attainment.     

A Demographic and Behavioral Profile of Homeless Youth in New York City: Implications for AIDS Outreach and Prevention

Rapid changes in the world market economy have served to destabilize many local institutions, widening the gap between the rich and the poor and undermining viability of key social and economic institutions such as family and household. Among those most deeply affected by this displacement are children and adolescents, many of whom are forced to leave family institutions before they have acquired the skills and maturity needed to become economically self-sufficient. Fending for themselves amid the vagaries of the underworld of virtually every major city in the world, these youths are at exceptional risk for a wide range of poor health outcomes and premature death. While perhaps a familiar sight in many non-Western countries, this phenomenon also has emerged in the industrialized world, a fact that accounts for the rise in exposure to violence and disease among street-involved youth and young adults in nations such as the United States. There are as yet few empirical data available about the nature of these youth populations or the constellation of behaviors that place them at increased risk for disease outcomes. In this report we construct a demographic and behavioral profile of the homeless youth population in New York City, particularly as behavioral patterns relate to risk associated with HIV infection.     

Beyond UHC: Monitoring Health and Social Protection Coverage in the Context of Tuberculosis Care and Prevention

Tuberculosis (TB) remains a major global public health problem. In all societies, the disease affects the poorest individuals the worst. A new post-2015 global TB strategy has been developed by WHO, which explicitly highlights the key role of universal health coverage (UHC) and social protection. One of the proposed targets is that “No TB affected families experience catastrophic costs due to TB.” High direct and indirect costs of care hamper access, increase the risk of poor TB treatment outcomes, exacerbate poverty, and contribute to sustaining TB transmission. UHC, conventionally defined as access to health care without risk of financial hardship due to out-of-pocket health care expenditures, is essential but not sufficient for effective and equitable TB care and prevention. Social protection interventions that prevent or mitigate other financial risks associated with TB, including income losses and non-medical expenditures such as on transport and food, are also important. We propose a framework for monitoring both health and social protection coverage, and their impact on TB epidemiology. We describe key indicators and review methodological considerations. We show that while monitoring of general health care access will be important to track the health system environment within which TB services are delivered, specific indicators on TB access, quality, and financial risk protection can also serve as equity-sensitive tracers for progress towards and achievement of overall access and social protection.

This paper is part of the PLOS Universal Health Coverage Collection.

Summary Points

1. The WHO has developed a post-2015 Global TB Strategy emphasizing that significant improvement to TB care and prevention will be impossible without the progressive realization of both universal health coverage and social protection. This paper discusses indicators and measurement approaches for both.
2. While access to high-quality TB diagnosis and treatment has improved dramatically in recent decades, there is still insufficient coverage, especially for correct diagnosis and treatment of multi-drug resistant TB.
3. Continued and expanded monitoring of effective coverage of TB diagnosis and treatment is needed, for which further improvements to existing surveillance systems are required.
4. Many households face severe financial hardship due to TB. Out-of-pocket costs for medical care, transport, and food are often high. However, income loss is the largest financial threat for TB-affected households.
5. Consequently, the financial risk protection target in the post-2015 Global TB Strategy—“No TB affected families experience catastrophic costs due to TB”—concerns all direct costs as well as income loss. This definition is more inclusive than the one conventionally used for “catastrophic health expenditure,” which concerns only direct medical costs.

     

A Systematic Review of the Health and Social Effects of Menstrual Hygiene Management

Background

Differing approaches to menstrual hygiene management (MHM) have been associated with a wide range of health and psycho-social outcomes in lower income settings. This paper systematically collates, summarizes and critically appraises the available evidence.

Methods

Following the PRISMA guidelines a structured search strategy was used to identify articles investigating the effects of MHM on health and psycho-social outcomes. The search was conducted in May 2012 and had no date limit. Data was extracted and quality of methodology was independently assessed by two researchers. Where no measure of effect was provided, but sufficient data were available to calculate one, this was undertaken. Meta-analysis was conducted where sufficient data were available.

Results

14 articles were identified which looked at health outcomes, primarily reproductive tract infections (RTI). 11 articles were identified investigating associations between MHM, social restrictions and school attendance. MHM was found to be associated with RTI in 7 papers. Methodologies however varied greatly and overall quality was low. Meta-analysis of a subset of studies found no association between confirmed bacterial vaginosis and MHM (OR: 1.07, 95% CI: 0.52–2.24). No other substantial associations with health outcomes were found. Although there was good evidence that educational interventions can improve MHM practices and reduce social restrictions there was no quantitative evidence that improvements in management methods reduce school absenteeism.

Conclusion

The management of menstruation presents significant challenges for women in lower income settings; the effect of poor MHM however remains unclear. It is plausible that MHM can affect the reproductive tract but the specific infections, the strength of effect, and the route of transmission, remain unclear. There is a gap in the evidence for high quality randomised intervention studies which combine hardware and software interventions, in particular for better understanding the nuanced effect improving MHM may have on girls’ attendance at school.     

Prevalence and Risk of Violence and the Physical,Mental, and Sexual Health Problems Associated with Human Trafficking: Systematic Review

Background

There is very limited evidence on the health consequences of human trafficking. This systematic review reports on studies investigating the prevalence and risk of violence while trafficked and the prevalence and risk of physical, mental, and sexual health problems, including HIV, among trafficked people.

Methods and Findings

We conducted a systematic review comprising a search of Medline, PubMed, PsycINFO, EMBASE, and Web of Science, hand searches of reference lists of included articles, citation tracking, and expert recommendations. We included peer-reviewed papers reporting on the prevalence or risk of violence while trafficked and/or on the prevalence or risk of any measure of physical, mental, or sexual health among trafficked people. Two reviewers independently screened papers for eligibility and appraised the quality of included studies. The search identified 19 eligible studies, all of which reported on trafficked women and girls only and focused primarily on trafficking for sexual exploitation. The review suggests a high prevalence of violence and of mental distress among women and girls trafficked for sexual exploitation. The random effects pooled prevalence of diagnosed HIV was 31.9% (95% CI 21.3%–42.4%) in studies of women accessing post-trafficking support in India and Nepal, but the estimate was associated with high heterogeneity (I ² = 83.7%). Infection prevalence may be related as much to prevalence rates in women''s areas of origin or exploitation as to the characteristics of their experience. Findings are limited by the methodological weaknesses of primary studies and their poor comparability and generalisability.

Conclusions

Although limited, existing evidence suggests that trafficking for sexual exploitation is associated with violence and a range of serious health problems. Further research is needed on the health of trafficked men, individuals trafficked for other forms of exploitation, and effective health intervention approaches. Please see later in the article for the Editors'' Summary     

Interrelation of Sport Participation,Physical Activity,Social Capital and Mental Health in Disadvantaged Communities: A SEM-Analysis

Background

The Health through Sport conceptual model links sport participation with physical, social and psychological outcomes and stresses the need for more understanding between these outcomes. The present study aims to uncover how sport participation, physical activity, social capital and mental health are interrelated by examining these outcomes in one model.

Methods

A cross-sectional survey was conducted in nine disadvantaged communities in Antwerp (Belgium). Two hundred adults (aged 18–56) per community were randomly selected and visited at home to fill out a questionnaire on socio-demographics, sport participation, physical activity, social capital and mental health. A sample of 414 adults participated in the study.

Results

Structural Equation Modeling analysis showed that sport participation (β = .095) and not total physical activity (β = .027) was associated with better mental health. No association was found between sport participation and community social capital (β = .009) or individual social capital (β = .045). Furthermore, only community social capital was linked with physical activity (β = .114), individual social capital was not (β = -.013). In contrast, only individual social capital was directly associated with mental health (β = .152), community social capital was not (β = .070).

Conclusion

This study emphasizes the importance of sport participation and individual social capital to improve mental health in disadvantaged communities. It further gives a unique insight into the functionalities of how sport participation, physical activity, social capital and mental health are interrelated. Implications for policy are that cross-sector initiatives between the sport, social and health sector need to be supported as their outcomes are directly linked to one another.     

Focus: Preventive Medicine: The Opportunity of Social Ecological Resilience in the Promotion of Youth Health and Wellbeing: A Narrative Review

Youth experience adversity that increases their risk for immediate and long-term health consequences. Resilience has traditionally been conceptualized as an internal disposition or trait that supports youth to overcome that risk and avoid the negative impact on their health and wellbeing. However, this model of resilience overemphasizes the role of the individual and their capacity to control their environment, while minimizing the integral role of relational, social, structural, and cultural contexts in which they live. Instead, social ecological resilience (SER) emphasizes the influence of social and environmental factors on individual processes and outcomes and offers different pathways for preventive interventions to promote youth health and wellbeing. Within preventive medicine, it is important for researchers and practitioners to understand the processes that support or impede SER, particularly in youth when adversity can impact health throughout the lifespan. The purpose of this review was to examine the contributions and scope of the SER model in research on youth, with the goal of advancing SER-informed research and interventions within preventive medicine. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) approach as a guiding framework, we conducted a narrative review of the literature. The review characterizes 37 existing studies across the fields of education, psychology, and social work in terms of topic, focal population, methods, use of SER, and implications. We conclude with recommendations for future applications of SER to promote the health and wellbeing of youth.