RESUMO
OBJECTIVE: This study sought to examine oral health beliefs and attitudes, and utilisation of oral health care services among individuals with diabetes and health professionals who serve them in Ghana. BASIC RESEARCH DESIGN: A qualitative study using grounded theory was conducted. CLINICAL SETTING: University of Ghana Dental School at Korle Bu, University of Ghana School of Public Health, National Diabetes Research and Management Centre at Korle Bu, and New York University College of Dentistry. PARTICIPANTS: A convenience sample of 59 patients comprised 7 focus groups conducted in either Twi or English. Seven key informant interviews with healthcare professionals and one spiritual leader were completed. RESULTS: Data from the focus groups and interviews reveal: 1, half of the participants with diabetes have oral manifestations (e.g., bleeding gums) and participants are generally unaware of interrelationship between diabetes and oral health; 2, dental treatment utilisation is minimal and associated almost exclusively with reparative and emergency care; and 3, medical health providers do not acknowledge the interrelationship between oral health and diabetes nor do they incorporate oral health issues into diabetes screening/treatment. CONCLUSION: Oral health knowledge and practices are limited among patients with diabetes in Accra, Ghana. Collaborative efforts for in-service education and training for oral health and medical professionals may be beneficial in serving the oral and general health care needs as well as improving the oral health-related quality of life of Ghanaians with diabetes.
Assuntos
Atitude Frente a Saúde , Diabetes Mellitus Tipo 2/complicações , Saúde Bucal , Adulto , Assistência Odontológica/psicologia , Assistência Odontológica/estatística & dados numéricos , Diabetes Mellitus Tipo 2/prevenção & controle , Diabetes Mellitus Tipo 2/psicologia , Feminino , Grupos Focais , Gana , Hemorragia Gengival/complicações , Gengivite/complicações , Comportamentos Relacionados com a Saúde , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Higiene Bucal , Educação de Pacientes como Assunto , Pesquisa Qualitativa , Qualidade de Vida , Terapias EspirituaisRESUMO
BACKGROUND: Later years of life are accompanied by many physical, emotional and environmental changes which may impact on the well-being of the individual. Many factors are known to influence the subjective well-being of older adults, but most, if not all of this information was the result of studies in the Western world. This study aimed at obtaining and documenting the predictors of subjective well-being (SWB) among older Ghanaians. METHODS: Data for the study was obtained from the WHO SAGE study. The single item measure of life satisfaction was used to determine subjective well-being. Descriptive statistics as well as logistic regression analysis were carried out to determine the predictors of SWB. RESULTS: A total of 4724 individuals aged 50 years and above responded to the questionnaires. Of these 50.4% were males. Following multivariate logistic regression analysis, age, sex, educational level, income and ethnic background were found to significantly affect the SWB of older Ghanaians. Being male was associated with higher level of SWB (OR=1.68; CI: 1.39 - 2.03). For those 50 years and above, being younger (50-59 years) was also associated with a high level of SWB (OR=17.72; CI: 10.13-30.98). Earning a low income and having low educational level were both associated with low levels of SWB (OR=0.304; CI: 0.22-0.42; and OR=0.47; CI: 0.37-0.60 respectively). Ewes (p=0.027), Grumas (p=0.002) and Mole-Dagbons (p=0.04) had significantly higher SWB compared to the other ethnic groups. CONCLUSION: Among older Ghanaians, factors that positively influence SWB are younger age, male sex, high educational level and high income.
Assuntos
Nível de Saúde , Satisfação Pessoal , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Escolaridade , Etnicidade/psicologia , Feminino , Gana , Humanos , Renda , Masculino , Pessoa de Meia-Idade , Fatores Sexuais , Inquéritos e QuestionáriosRESUMO
Using ellipsometry, we characterized the nanoconfinement effect on the glass transition temperature (T (g)of supported polystyrene (PS) films employing two methods: the intersection of fits to the temperature (Tdependences of rubbery- and glassy-state thicknesses, and the transition mid-point between rubbery- and glassy-state expansivities. The results demonstrate a strong effect of thickness: T(g) (bulk) - T(g)(23 nm) = 10 degrees C. The T -range needed for accurate measurement increases significantly with decreasing thickness, an effect that arises from the broadening of the transition with confinement and a region below T (g) where expansivity slowly decreases with decreasing T . As determined from expansivities, the T (g) breadth triples in going from bulk films to a 21-nm-thick film; this broadening of the transition may be a more dramatic effect of confinement than the T (g) reduction itself. In contrast, there is little effect of confinement on the rubbery- and glassy-state expansivities. Compared with ellipsometry, T (g) 's from fluorescence agree well in bulk films but yield lower values in nanoconfined films: T (g)(bulk) - T (g)(23 nm) = 15( degrees ) C via fluorescence. This small difference in the T (g) confinement effect reflects differences in how fluorescence and ellipsometry report "average T (g) " with confinement. With decreasing nanoscale thickness, fluorescence may slightly overweight the contribution of the free-surface layer while ellipsometry may evenly weight or underweight its contribution.
Assuntos
Fluorescência , Vidro/química , Hemorreologia , Poliestirenos/química , Temperatura de Transição , Elasticidade , Fluorometria , Membranas Artificiais , Modelos Químicos , Análise Espectral , Propriedades de Superfície , Resistência à TraçãoRESUMO
The World Leadership Survey, which began a worldwide dialogue on a set of important issues facing managers in the 1990s, continues with commentaries from four recognized experts, each of whom addresses the survey results from a different perspective. Kenichi Ohmae, chairman of McKinsey and Company in Tokyo, addresses "The Perils of Protectionism." Ohmae argues that the old definitions of national boundaries and corporate interests reflect obsolete economic theories. The real test of national well-being, Ohmae suggests, should be the economic welfare of a nation's citizens. Sylvia Ann Hewlett, economist and former director of the Economic Policy Council in New York, analyzes the survey in terms of "The Human Resource Deficit." According to Hewlett, four principles should guide corporate strategies in the 1990s: human resource development should move up the scale of corporate priorities; a family-friendly workplace will attract and keep talented workers; companies will take limited direct responsibility for training and education; the private sector will promote public investment in social issues. James E. Austin, the Richard P. Chapman Professor of Business at the Harvard Business School, writes about "The Developing-Country Difference." In developing countries, Austin observes, managers display attitudes and follow practices that diverge from those in developed nations. In particular, the role of government, investments in education and technology, and environmental concerns set these nations apart. Michel Crozier, president of the Centre de Sociologie des Organisations in Paris, writes about "The Changing Organization." In the 1990s, Crozier argues, managers need to break from old management theories and practice, questioning hierarchy, control, distance, access to information-the whole managerial system.
Assuntos
Pessoal Administrativo/tendências , Comércio/tendências , Competição Econômica , Gestão de Recursos Humanos/tendências , Coleta de Dados , Estudos de Avaliação como Assunto , Estados UnidosRESUMO
PIP: The annual net flow of illegal immigrants into the US is around 500,000/year which has increased tenfold over the last 15 years; these people, unprotected by US law, are targets of exploitation. Unless a restrictive policy is put into practice for illegal and legal immigrants the flow will accelerate, creating domestic pressures. A package proposed by a Presidential Task Force in 1982 proposed: 1) there be better border patrols and stricter laws regarding hiring of illegals, 2) issuing a counterfeit-resistant social security card, 3) conditional amnesty for some illegal immigrants already in the US, 4) a small increase in the number of legal immigrants allowed into the US from Mexico, and 5) a limited guest worker program. These ideas differed in some respects from those of an earlier Select Committee on Immigration. Guest worker programs in other countries are described. In July 1982 President Reagan faced 3 policy options: 1) he could ignore his Task Force's ideas and use a large guest worker program, legalizing and continuing the inflow of cheap labor; 2) he could adopt the recommendations and get a new, tougher policy initiated; or 3) he could allow the issue to abort itself. He adopted the 3rd option, a policy package with little internal force which he will not pursue vigorously. Any serious effort to achieve a more serious immigration policy must include 4 elements: 1) a tough set of employer sanctions, 2) a foolproof worker identification card system, 3) better border control, and 4) an amnesty program. These 4 measures are interrelated; if 1 fails, the policy ceases to achieve its goals. This 4-point program would have the advantage of maintaining a short-term "safety-valve" for those countries which are the sources of illegal migration.^ieng