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Browsing by Subject "Social history"

Now showing 1 - 2 of 2
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    Towards A Model Representation Of Residence, Living Conditions, And Living Situation: An Evaluation Of Clinical Practice In Documentation, And Associated Standards And Informational Models
    (2017-03) Winden, Tamara
    Social determinants of health (SDOH) play an important role in diagnosis, prevention, health outcomes, and quality of life and have long been a consideration in the provision of care. SDOH can cause illness, exacerbate chronic illness, but can also improve health. The SDOH target domains of interest for this proposal are Residence, Living Situation, and Living Conditions. Historically, these three topic areas are either not well documented in the EHR or, if they are documented, they are in unstructured or semi-structured text making the information inaccessible to clinical decision support tools or secondary use in research. Building upon previous work, the overall goal of this three-part study is to enhance current information models of these three domains through the evaluation of content and completeness of existing standards and terminologies and examine how coherent our documentation is of these target domains is in the electronic health record through analysis of specific ancillary notes as well as other structured and unstructured sections of the EHR. Examination of 27 standards and terminology sources contributed to an enhanced model representation for Residence, Living Situation, and Living Conditions. However, our findings show there are no fully comprehensive standards for EHR documentation of these topic areas. An analysis of unstructured text from the EHR demonstrated that SDOH are being documented in notes and these data contributed to further enhanced model. Lastly, an examination of flowsheet data showed many inconsistencies in flowsheet build and documentation, many of which could be solved if we have a comprehensive standard for documentation of SDOH.
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    "We faced Mabvuto": a gendered socio-economic history of Malawian women's migration and survival in Harare, 1940-1980.
    (2011-10) Mudeka, Ireen
    The dissertation examines Malawian women's migration from their natal homes to the colonial capital of Zimbabwe, Harare between 1940 and 1980. It stresses that though colonial states in the two territories instituted policies designed to limit or deny women access into the migrant stream, women challenged such policies. Especially from the 1940s, the government instituted a male oriented migrant system which spurred the most massive rural exodus from Malawi, draining rural areas of the able bodied male laborers. It also caused serious family disintegration leading to the escalation of women's vulnerabilities, forcing many to flee the villages against state efforts to limit their mobility. They entered and settled in Zimbabwe's capital, although the colonial government sought to deny them access and primarily preferred male workers.Even so, women faced serious hardships en-route and also in Harare due to brutal police inspections, arrests and repatriations.The had very limited, if any formal employment opportunities, and had to establish economic ventures such as urban farming, beer brewing and usury to supplement their husbands' meager wages and survive as families. In varied ways they coped with, fought against and resisted the male biased system in both Malawi and Zimbabwe. In the process, the women who migrated from a wide diversity of ethnic groups renegotiated their identities in Harare, constituting national oriented welfare and burial associations to cope with urban life.By the 1970s, they had also drawn from events in Malawi where African nationalism triumphed with the rise of Kamuzu Banda. Adopting the concepts of umodzi/ unity and dziko/ nation which became central in national identity formation in Malawi, migrant women redefined themselves as Malawian , even as they remained migrants in Harare, where they illegally settled and transformed the social and economic landscape.