The New Mental Health Programme of WHO

Abstract

Over 40 million persons are suffering from severe mental illness allover the world and their number will grow during the next decades. The reasons why their treatment is often neglected and of low priority are reviewed, and research in the subject is criticized as being insufficiently interdisciplinary. During the last three years WHO has developed a new approach to mental health, urging mental health professionals to reorient their philosophy of work. Suggestions for urgent interdisciplinary research projects conclude the review.     

Geography's difficult engagement with the psychological therapies

The consideration of psychoanalytic issues presents geography and geographers with a number of difficulties; this paper examines those difficulties from within a humanistic perspective. The most common geographical engagements with the psychological therapies have been with their psychodynamic and, to a lesser extent, humanist methodological forms. A humanist perspective on this engagement suggests that it has led to two associated problems. At a disciplinary level it has resulted in an approach that has tended to privilege intellectual knowledge at the expense of emotion, and at a personal level it has not encouraged an approach that is sensitive to difference. This essay proposes that a commitment to an engaged, 'congruent' listening might help temper these difficulties.     

EFFECT OF LIVING ARRANGEMENT ON THE HEALTH STATUS OF ELDERLY IN INDIA

Epidemiological studies show strong association between lack/inadequate family support with increased mortality and poor health among the elderly. This study examined the effect of living arrangement on elderly health status by analysing the data of 39,694 persons aged 60 and above included in India's second National Family Health Survey conducted in 1998–1999. Results indicate that elderly who are living alone are likely to suffer more from both chronic illnesses, such as asthma and tuberculosis, and acute illnesses, such as malaria and jaundice, than those elderly who are living with their family, even after controlling for the effects of a number of socio-economic, demographic, environmental and behavioural confounders. The findings have important programme and policy implications for countries such as India, which has the second largest elderly population in the world. There is a strong need for the implementation of specific public support systems and health care strategies focused on the elderly population in general and elderly living alone in particular.     

Survey,Settlement, and Population History at the Ancient Maya Site of Pacbitun,Belize

Abstract

Survey and excavations of mounds on the outskirts of the site of Pacbitun in western Belize provide insights into the ancient Maya settlement pattern at this medium-sized regional center. This research employed two methods: analysis of structural remains from four separate 1000 m transect surveys,and a subsequent complete (100%) survey of intervening and adjacent quadrant areas. The overlap of quadrant zones with portions of the transect units permits an examination of the accuracy of transect surveys. Excavation of a 22% sample of all identified mounds provides chronological and functional information. An estimate of 200 persons for the resident elite population of the Epicenter of Pacbit un is offered. Initial settlement occurred in the Epicenter of the site during the Middle Preclassic period (900–300 B.C.), with a population rise through time until the final phase of the Late Classic period (A.D. 700–900), when density reached 550 persons (periphery Zone) to 950 persons (Core Zone) per sq km. The impact on settlement size and distribution of topography, soils,water resources,and intensive agriculture (hillside terracing) is assessed and found to be significant. At the time of florescence,the population of the 9 sq km site is estimated to have been about 5000–6000 persons. This population estimate is compared with several coeval lowland Maya centers,and found to be reasonable for a medium-sized, Late Classic Maya center.     

Interdisciplinary Teaching in Health

Abstract

In this brief survey, the author sketches his hopes and the difficulties of introducing an interdisciplinary approach to the academic training of health personnel. The solution would appear to be an organizing framework in which the many medical and health disciplines, their values and end results, could be synthesized into a single interdisciplinary approach. Our quality of life depends on this.     

The Aakash tablet and technological imaginaries of mass education in contemporary India

Abstract

We explore here public and private initiatives in technological solutions for educating the poor and the disadvantaged in India since the second half of the twentieth century. Specifically, we document Ministry of Human Resource Development’s project to develop an affordable tablet computer, named ‘Aakash,’ as a personal access device for digital courses and online learning materials. We approach this case study in relation to several educational technologies that preceded it, and with a wider interest in mapping a contemporary transition from satellite-based mass education to Internet-based mass education. We argue that this process cannot be easily seen as a transition from unilateral broadcasting to more democratic multi-casting model of communication and learning. Specifically, we study the manufacturing process of Aakash and the public debates around it, to comment on the nature of state power in India, as revealed in its attempts to imagine and develop a digital personal device to deliver mass education.     

Radiographic Analysis of Temper in Ceramic Vessels: Goals and Initial Methods

Abstract

Information on several characteristics of temper particles can aid the archaeologist in interpreting details of ceramic vessel use and functional variation. The paper summarizes theoretical reasons and experimental procedures for using X-radiography to obtain rapid, low-cost quantitative measurements of the sizes, shape, density, and orientation of temper particles. The feasibility of this approach is assessed using Woodland period pottery from the central midwestern United States. The paper concludes with a discussion of technical limitations and areas for further investigation and procedural refinement.     

Self-rated Health of older persons in Indonesia

This study contributes to expanding the knowledge of the health of older persons living in Indonesia, a country with limited welfare benefits. The research employs a variable, ‘self-rated health’ (SRH), to investigate socio-cultural factors linked to the health of older Indonesians. The data presented in this study are based on fieldwork collected using a mixed-method approach. Sex-difference in SRH in older age is shown to be predominantly a result of enduring inequalities across the life course, manifested in cultural practices, education, employment and programs for health. An older person's status within the family is a significant determinant of SRH, but the direction of the relationship depends on the sex and ethnicity of the person. Other variables related to SRH are age, lifestyle, education, residential area and intergenerational transfers.     

Women Beneficiaries or Women Bearing the Cost? A Gendered Analysis of the Red de Protección Social in Nicaragua

Conditional Cash Transfer programmes aim to alleviate short‐term poverty through cash transfers to poor households, and to reduce longer‐term poverty through making these transfers conditional on household investment in the health and education of children. These programmes have become increasingly popular with institutions such as the World Bank. However, the need for conditionalities has been questioned on a number of levels, including its necessity: it has been suggested that the cash transfer in itself may be sufficient to secure most of the programme's wider aims. The example of Nicaragua supports this contention, demonstrating that only a small incentive is needed to bring the desired changes in the uptake of education, since this is something prized by the poor themselves. In health, the Nicaraguan case suggests that demand‐side initiatives might not be as important as supply‐side changes that improve the affordability and accessibility of services. The Nicaragua case also highlights the long‐term limitations of applying such programmes in countries with high levels of poverty and low economic growth. A gendered analysis of the programme highlights the fact that women ‘beneficiaries’ bear the economic and social cost of the programme without apparent benefit to themselves or even necessarily to the household in the short or longer term.     

Eric W. Pasold,O.B.E.

Abstract

This article examines the clothing of the rural poor in seventeenth-century Sussex, considering what men and women wore, what their clothing was made of and where they got it from, drawing on a broad range of documentary sources including legal depositions, probate material and overseers’ accounts. As would be expected, the clothing of this social group was primarily functional, reflecting limited budgets and arduous working lives. But we can see in the choice of fabric colour, trimmings and accessories that men and women were concerned about their appearance and could achieve a measure of social display, at least in their ‘holiday’ clothes. The ways in which the poor acquired their clothes were complex, involving them in overlapping spheres of production and distribution, which included home production and shop-bought ready-to-wear, all accommodated within a range of economic survival strategies.     

Estimation of the Original Number of Individuals from Paired Bone Counts Using Estimators of the Krantz Type

Abstract

In 1968, G. S. Krantz proposed a method for estimating the original number of animals deposited at an archaeological site when bone counts have been reduced, whether by attritional processes or by a failure to find all the bones. His formula involved using the number of unmatched left, unmatched right, and matched pairs of a class of paired bone. In this paper we investigate estimators derived using Krantz's assumptions from both theoretical and practical viewpoints and make a number of recommendations; for example, that Krantz's estimators are useful only in relatively large assemblages. The method is applied to fish bones obtained from three sites in New Zealand, and practical difficulties with the procedure are described.     

Examining social isolation by gender and geography: conceptual and operational challenges using population health data in Canada

In 2003, the Canadian Federal/Provincial/Territorial Task Force on Seniors identified social isolation as an important issue for further study and policy development given that socially isolated persons are considered to be more vulnerable to both inappropriate use of the health care system and poorer health outcomes. In order to provide adequate support to this vulnerable population, it is critical to untangle the complex web of relationships that influence the need for care, and the health status and service utilization patterns of socially isolated older adults. Using data from the 2000–01 Canadian Community Health Survey (CCHS), this article explores social isolation as a multidimensional social construct examining in particular the axes of gender and geography to try to tease out some of this complexity and its relationship to health status and service utilization. When individual characteristics like gender are considered together with broader contextual variables like place of residence, a more comprehensive and layered portrait of vulnerability among socially isolated persons begins to emerge with insights into their unique patterns of health and service use. For example, home care may be an extremely critical resource for keeping older women in their homes and out of hospital. On the other hand, among socially isolated older men, those living in rural communities may be particularly ‘invisible’, neither benefiting from home care nor having strong social supports. It seems plausible then that both men and women may be in need of special interventions or targeted programmes to help them to remain, or to become, more socially integrated in their communities as they age in place. In addition, this article addresses some of the limitations of using both a quantitative analytic approach and the CCHS dataset itself in grappling with such complexity.     

Family,community and the Victorian asylum: a case study of the Northampton General Lunatic Asylum and its pauper lunatics

Abstract

This article explores how the medicalization of poverty in 19th-century aetiologies of insanity provided the basis for which the Northampton General Lunatic Asylum became an option for the relief and treatment of the poor. It is argued that the poor, their communities and poor law officials, by being key to the process of committal, were partially responsible for the asylum population and the role that the asylum played in the local community. The article explores how important poverty was in asylum admissions and, from an analysis of the length of stay of those entering the asylum, the number of patients for whom the asylum provided short-term respite. Using case histories of patients, the article argues for the asylum to be seen as part of the poor law process that discriminated between the deserving and undeserving poor.     

Depth and diversity in parochial healthcare: Northamptonshire 1750–1830

Abstract

Notwithstanding interesting recent work, the nature of parochial healthcare under the Old Poor Law, particularly in its later years, remains very much under-researched. This article considers a sample of Northamptonshire parishes in order to investigate attitudes towards health care on the part of poor law officials between the mid-18th and early 19th centuries. It will be shown that long-term sickness could be matched by a long-term commitment to paying for diverse and innovative care for the sick poor. Parochial authorities drew on a range of formal and informal medical practitioners to improve the lot of the sick poor, as well as employing a considerable variety of nurses from amongst the wider pauper population. The article represents the first attempt to conduct a systematic study of parochial records for any county.     

Effects of U.S. States' Social Welfare Systems on Population Health

Social scientists have studied the welfare state extensively. Many studies seek to understand the determinants of the welfare state; however, a few have explored the social consequences of social welfare systems, especially on health outcomes of the population. Even though cross-national comparative studies support the thesis that the welfare state regime type, which represents different levels of commitment on social welfare, is closely linked to population health, there is little research to support this argument at a sub-national level. To fill the gap, this study explores the effects of the U.S. states' social welfare systems on health using age-adjusted mortality rates as a proxy for population health. By operationalizing social welfare systems as three dimensions—public expenditures, tax structures, and welfare program rules—we find that more generous education spending, progressive tax systems, and more lenient welfare program rules help to improve population health. The model corrects for first-order serial correlation using Prais-Winsten regression methods and is estimated with state and year-fixed effects.     

Analysis of ante mortem trauma in three modern skeletal populations

When archaeological skeletons are assessed, the prevalence (and patterns of bone involvement) of trauma is important. The number and pattern of fractures can be used to gain insight into the occurrence of interpersonal violence, workload and living conditions. However, the question remains as to how these results should be interpreted—such as what constitutes high or low levels of trauma? The aim of this study was to investigate the occurrence of trauma in a population of modern Greeks living in Crete, as well as South African (SA) whites and blacks in the Pretoria Bone and Raymond Dart collections. The sample comprised mostly of older individuals (n = 90–100 within a sex‐population group). Each skeleton was studied for healed trauma. For the vertebrae, only spondylolysis was assessed. In the Greek sample, it was found that 42% of the males and 46% of females had at least one fracture, with corresponding figures of 63 and 44% for SA whites and 83 and 69% for SA blacks. Radius, rib and femur fractures were most common in Greeks, with skull, radius and ribs most common in SA whites and skull, ulna and ribs in SA blacks. These prevalences of trauma are high, but the composition of the samples (mostly of lower socio‐economic origin) should be kept in mind. It may also be questioned whether these individuals reflect the society as a whole. It seems that the fractures in Greeks are mostly related to old age due to falls and accidents (radius and hip fractures), while the SA black sample reflects high prevalences of interpersonal violence (such as cranial vault and ulna fractures). The SA white sample follows a comparatively moderate pattern of trauma. These comparative figures may be useful when assessing trauma in other skeletal populations. Copyright © 2009 John Wiley & Sons, Ltd.     

Six decades of ethnic minority population change in China

ABSTRACT

China’s 55 non-Han ethnic minority groups were at least in part politically and institutionally ‘invented’ by China’s ethnic classification project, and also through the effects of the system of continuous population census. This paper investigates population change of the non-Han ethnic minorities (NHEMs) over the past six decades. The number of NHEMs as a whole tripled from 1953 to 2010. However, growth has differed among individual groups and in different time periods. The population of some groups has fluctuated while that of others has grown steadily, regardless of the size of the groups. As a whole, since 2000 the growth rate of NHEMs has been lower than that of the Han Chinese, and the population of 13 NHEM groups has begun to decline. A growing number of people belonging to ethnic minorities have switched their ethnic identities to Han. This has especially been the case for NHEM youth. The change in ethnic minority populations has been influenced by dynamic interactions among demographic factors, ethnic identification as well as political, economic and policy changes.     

Health hazards and socio-economic status: a neighbourhood cohort approach, Vancouver, 1976–2001

This paper lays the foundation for a research program concerned with the geographical patterning of environmental and population health at the urban neighbourhood scale. Based on the Vancouver metropolitan region, the aim is to better understand the role of neighbourhoods as epidemiological spaces where environmental and social characteristics combine as health processes and outcomes at the community and individual levels. With respect to procedure, this paper builds a cohort of commensurate neighbourhoods across all six census periods from 1976 to 2001, assembles neighbourhood air pollution (total particles) data, and provides an initial analysis to demonstrate how air pollution systematically and consistently maps onto neighbourhood socio-economic markers, specifically education and family status. We conclude with a discussion of how the neighbourhood cohort can be further developed to address emergent priorities in the population and environmental health literatures, namely the need for temporally matched data, a life-course approach and analyses that control for spatial scale effects.     

Curriculum development and society: West German geographers respond to the American high school geography project

Abstract

Industrial geography courses at the Historically Black Universities (HBUs) and the Historically White Universities (HWUs) in South Africa are a true reflection of apartheid education designed by the government in the 1950s. The education system offers whites good and quality education, while blacks receive poor education. The nature and history of the HBUs have affected the content and the teaching of industrial geography. Unlike the HWUs industrial geography courses at the HBUs do not contain much of the recent changes in the subject.     

Protecting a Cemetery in Saqqara: Site Works 1975–2009

Abstract

This article considers the varied threats to Ancient Egyptian architectural remains that have been exposed by modern excavation. A number of possible measures that counter such threats are outlined, together with the practical difficulties facing the architectural conservator working in this context. The approach taken at the New Kingdom Necropolis in Saqqara — a group of elite tombs constructed c. 1350–1250 BC — during the post-excavation phase is detailed, with an emphasis on the works carried out by the author from 2004 to 2009. This encompasses the conservation of surviving limestone relief decoration in situ, the reconstruction of missing masonry elements, and the final presentation of the site to visitors.