bluuebunny/crossref_metadata_2025_split huggingface dataset:
Characteristics and Course of Major Depression in Older Primary Care Patients
Authors: Schulberg Herbert C. , Mulsant Benoit , Schulz Richard , Rollman Bruce L. , Houck Patricia R. , Reynolds Charles F. 
Published: May 2005

Objective: Identify the morbidity patterns displayed by older primary care patients experiencing depressive symptomatology who do and do not meet criteria for a major depression. Method: Patients ages sixty and older presenting at two ambulatory internal medicine centers were administered the CES-D. Among those scoring ⩾ 11, 104 completed a comprehensive assessment of their psychiatric symptomatology, medical illness, and functional abilities. The assessment battery was again administered six months later. Results: The point prevalence of major depression in older primary care patients is estimated at 9 percent based on SCID interviews. Patients meeting criteria for this diagnosis compared to those who are symptomatic but not experiencing a major depression described more extensive psychopathology but also significantly more limitations in performing social and functional roles. At six-month follow-up, only 11.5 percent of those initially diagnosed with a major depression were considered fully recovered. Conclusions: Major depression is a prevalent disorder in older primary care patients which affects their ability to perform expected social and physical roles. Mechanisms for delivering efficacious treatments in routine medical practice are of a high priority.
An Explanatory Model for Munchausen by Proxy Abuse
Authors: Rand Deirdre C. , Feldman Marc D. 
Published: May 2005

Objective:In Munchausen by proxy (MBP) abuse, a caretaker fabricates or induces illness in another person to obtain emotional gratification. In representative cases, a mother is the perpetrator and her child is the victim. In view of the limits of current explanatory models, we use personal accounts of MBP perpetrators, physicians, and family members as a window into understanding this counterintuitive behavior.Method:As subspecialty clinicians and consultants, we supplemented our extensive direct experience with MBP with a review of published reports of MBP located via MEDLINE and PsycINFO (1980 onward). We also examined the books devoted to the subject and incorporated personal accounts of MBP perpetrators and of family members and professionals involved with them.Results:Factors contributing to the onset and continuation of MBP are the perpetrator's experiencing a particular drive (e.g., intense anger or frustration); lacking or overcoming internal inhibitions against abusive actions; and overcoming external inhibitions, such as the potential intercession of a spouse or pediatrician. As a result, the MBP parent experiences release from unpleasant emotions and a sense of renewed control. MBP behavior gains “habit strength” each time it occurs.Conclusions:Psychodynamic explanations of MBP, while favored by some authors, are inherently speculative and tend to be low in predictive value. We suggest broadening these traditional explanations by emphasizing observable behaviors and verifiable background factors. The behavioral perspective we outline helps explain how MBP behavior is learned, why it is more prevalent among mothers, and why it is so difficult for perpetrators to stop.
A Bridge between Traumatic Life Events and Losses by Death
Authors: Trolley Barbara C. 
Published: May 2005

The bereavement process associated with losses by death has been well documented. More recently, the existence of a grief reaction following certain traumatic life events has been recognized. A main purpose of this article is to provide support for such a connection. Reactions to a gamut of life traumas (alcoholism, abuse, disability, divorce, and infertility) are discussed within the context of a grief framework. Literature pertaining to the responses to suicide and murder is applied to traumatic life events. Proposed differences between death related bereavement and reactions to life traumas are discussed and dissolved. Through this discussion, an attempt is made to generalize grief work to a broader range of traumatic life situations. Another central goal of this review is to offer a unified conceptualization of loss among differential life and death traumas. Emphasis is on the common bond which exists among these survivors without disregard to the presence of individual differences. Clinical implications are briefly reviewed with respect to assessment, diagnostic choice and utilization of interventions.
Service Meetings in a Renal Transplant Unit: An Unused Adjunct to Total Patient Care
Authors: Eisendrath Robert M. , Topor Michele , Misfeldt Catherine , Jessiman Andrew G. 
Published: May 2005

This paper presents a commonly known event which is uncommonly practiced consisting of a meeting of all personnel involved in the care of renal transplant patients meeting together once a week. The purpose is to coordinate and facilitate the total care of these patients. The discussions involve the medical, social, psychological, and financial aspects of the lives of these patients as well as the functioning of the service. Information and suggestions can be exchanged and policy, additional care, and changes in management can be effected. Such meetings promote increased knowledge of the patient and improved functioning of the service team. The patient's care and staff morale are improved. It would seem that the institution of such service meetings provides a significant advance in total patient care.
A STudy of Psychiatric Emergencies: Part III. Findings on Followup
Authors: Miller Sheldon I. , Browning Charles H. , Tyson Robert L. 
Published: May 2005

Criteria to measure the effectiveness of a psychiatric emergency consultation service include (1) whether or not the recommendations made were followed, and (2) the rate of hospitalizations in the followup period. Negro females were identified as following outpatient recommendations least often of any group. With this finding, the suitability of the classical recommendations available is discussed. The hospitalization rate for the psychiatric emergency group in the followup period is significantly higher than the national rate. This finding is independent of (1) hospitalizations effected at the time of the emergency evaluations and (2) psychiatric hospitalizations in the followup period. This result suggests that a large fraction of the psychiatric emergency population presents with extensive pathology which is not or cannot be dealt with in the context of the emergency consultation.
An Examination of the Impact of Tuning Students' Attention to Information in a Mathematics Problem on Their Problem-Solving Performance
Authors: Arthurs Edna M. , Defranco Thomas C. , Young Michael F. 
Published: May 2005

This study asked the question: Does tuning students' attention to information in a mathematics problem impact their problem-solving performance? This was a traditional quasi-experimental research study, using some observation and interviewing techniques. The participants were sixth grade middle school students in Connecticut. The experimental group was provided a “tuning” activity prior to solving the Jasper problem, “Rescue at Boone's Meadow.” Statistical analyses were used to determine the difference on mathematical performance between the two groups and qualitative data were analyzed for emerging themes. Tuning students' attention to information in a mathematics problem affected their performance on the modified Cloze Procedure Problems. No significant difference was found between the two groups on Transfer Problems. Some differences between the two groups emerged from the qualitative data analysis.
Predictors of Depression in Geriatric Medically Ill Inpatients
Authors: Borin L. , Menon K. , Raskin A. , Ruskin P. 
Published: May 2005

Objective: Depression in medically ill inpatients has been associated with increased morbidity and mortality. The purpose of this study was to identify variables that would successfully predict depression in this population. Methods: The sample consisted of 314 male, medically ill veterans, age 60 and older, admitted to the acute medical service at Baltimore Veteran Administration Medical Center. Sixty of 314 patients met criteria for Major Depression and scored 11 or higher on the Geriatric Depression Scale. Variables assessing age, race, social support, severity of illness, degree of functional disability, life satisfaction, and hopelessness were included in a logistic regression analysis as predictors of depression. Results: The variables that significantly predicted depression were derived from the Beck Hopelessness Scale, Life Satisfaction Score, and the Cumulative Illness Rating Score. Conclusions: The results indicated that medically ill inpatients who feel hopeless about the future, feel the best years of their lives are behind them, and have serious medical problems are likely to be clinically depressed.
The Influence of Spirituality on Substance Use of College Students
Authors: Stewart Chris 
Published: May 2005

Objectives: The issue of substance use and the problems resulting from that use has become a major concern in the United States. The past decade has seen several new trends in substance use by college students and an increase in the effort to try and determine factors that may ameliorate the problem. Spirituality is one possible factor that may have some role in the phenomenon. Some research has been conducted on the relationship of spirituality to substance use but the results are mostly descriptive and concerned with religiosity rather than spirituality. The purpose of this study was to explore the relationship between a student's spiritual and religious beliefs and the impact of those beliefs on the decision to use substances. Method: A sample of 337 university students was surveyed using the CORE Alcohol and Drug Survey and several supplemental questions. Results: In general, spirituality had a moderate buffering effect upon the decision to use alcohol and marijuana. This general protective effect exists for both alcohol use and binge drinking but dissipated as the students reached upper-class levels. Conclusion: Spirituality may play a significant role in the decision of college students to use substances. Further research should focus on this important factor. Also, implementation of spiritual aspects into university prevention and treatment programs may help boost efficacy rates.
Professional Ideology and the Health Care System in Chile
Authors: Chanfreau Diana 
Published: May 2005

Doctors' ideology and the role the medical profession plays in the organization and development of health services of a particular country are subjects of scientific interest. This article examines the case of Chile, where doctors centralized administrative and professional power over the last 30 years, and illustrates how doctors' ideology had a major influence over the type of health services provided to the population. Changes in this ideology throughout the century have been reflected in changes in the system of medical care. A shift can be traced from a professional ideology emphasizing socialized medical services during the first half of the century toward the current position favoring the abolition of free medical care and a return of “fee per service” medicine. The possible explanation for these changes is that medical ideology has altered through the combined influence of the class position of physicians and the development of the profession itself. Increasing polarization of the political forces in Chile led doctors to act according to their class affiliation, regardless of their original professional positions. Some historical facts are provided at each stage of analysis as a way of clarifying the conflicting influences upon the doctors' position.
The Doctor-Patient Relationship in the Practice of Medicine
Authors: Schüffel Wolfram 
Published: May 2005

The patient-doctor relationship is based on the principles of interaction, collecting data and integration of both interaction and data into an overall diagnosis/therapy. Patients with functional abdominal disorders are seen as representatives of today's general patients and a study of their management in present medical practice is reported, as revealed through literature. The literature reveals an almost complete neglect of interactional and integrational principles. This holds true even for psychosomatically oriented literature, which offers some crude clinical guidelines at best. Thus the primary physician gets little support from psychosomatic medicine in understanding the full meaning of the doctor-patient relationship. The clinical implications of the relationship are demonstrated through a short case history and implications for future training are described which are based on the primary physician's actual working experiences.
A Descriptive Study of the Use of the Black Communication Style by African Americans within an Organization
Authors: Corsini Vonnie , Fogliasso Christine 
Published: May 2005

The purpose of this qualitative study was to describe the use of the Black communication style by African Americans in an organized environment. The research method which was used involved a multimethod approach of data collection in the field using direct observation, and obtrusive observations, as well as semi-structured interviews. This investigation has shown that although the Black employees in this organization felt, in general, as if they were changing their communication style to fit the organizational norms, they continued to rely on the cultural norms underlying the Black communication style. U.S. demographics are foretelling a future that will require innovative organizational communication strategies. According to Fine, two facts about the U.S. corporate environment which are uncovered by demographic trends are that the workforce will be comprised of a “greater diversity of gender, race, age, culture, and language” and that the demand for qualified workers will exceed the supply thereby “creating intense competition among organizations for workers” [1]. These changing demographics are not going unnoticed by the U.S. corporate leaders. Specifically, the issues of most concern to organizational executives, according to Workforce 2000, center around linguistic and cultural differences. Most organizations have no innovative strategies for meeting the demands of a diverse workforce. Traditional programs, such as day-care provisions, flexible work times, and hiring and recruiting more people of color are being implemented by corporate America in an effort to meet the demand for diversity. However, organizations are often lacking in creative programs which will provide for this emerging diverse workforce an environment that will accept and nurture their diversity. Certainly these corporate executives are receiving little in the way of guidance from organizational researchers.
The Development of Population Policy in Britain
Authors: Simons John 
Published: May 2005

Between 1960 and 1964, the projected population of the United Kingdom at the end of the century was revised from 64 to 75 million. Ecologists and others clamored for a policy aimed at controlling population growth before it placed intolerable burdens on resources and amenities. Skeptics retorted, however, that population policy was not a substitute for environmental policy, that average family size (about 2.5 children) was already relatively low, and that the problems were being exaggerated. Successive British governments showed little enthusiasm for the adoption of a positive policy on population growth. In the late 1960s public birth control services were extended, but these were regarded as a part of health care and not as an instrument of population policy. The only measures to limit numbers were those adopted in the 1960s to restrict immigration from the British West Indies and other parts of the Commonwealth. In 1971 the government set up a panel of experts to assess the available evidence on the significance of population trends. A much more purposeful attitude had been adopted toward the problems associated with uneven distribution of population. After the Second World War, plans for building construction and most other forms of development had to conform to physical planning policy. New towns were established to draw population from congested urban areas, and businessmen were given incentives to expand in those areas where unemployment tended to encourage migration to more prosperous parts of Great Britain.
Diagnosis and Management of Late Life Depression: A Guide for the Primary Care Physician
Authors: Conn David K. , Steingart Allan B. 
Published: May 2005

Objective: The purpose of this article is to provide a brief and practical approach for the primary care physician regarding the recognition, diagnosis, and management of depression in elderly patients. Method: Empirical evidence and current recommendations regarding the recognition, diagnosis, and treatment of depression are reviewed as the basis for this approach. Appropriate modifications for geriatric depression are added where indicated. Results: The recommendations are listed by category and briefly explained. Conclusions: It is important to be vigilant for the variety of depressive presentations that occur in older primary care patients. Neurological causes of depression (such as stroke), suicide, and a longer time to recovery are all more frequent concerns in older depressed patients.
The Expression of Bipolar Affective Disorders in Brain Injured Patients
Authors: Zwil Alexander S. , McAllister Thomas W. , Raimo Eric 
Published: May 2005

Objective: A prospective study was designed to investigate the varied presentations of major affective disorders in patients with organic brain disease. Method: Patients admitted to our neuropsychiatry service, with affective and behavioral disturbances, and known neurological disorders, were classified, on phenomenological grounds, into the following groups: 1) elated mania; 2) irritable mania; 3) affective lability with periods of irritability, but without other symptoms pathognomonic for mania; and 4) intermittent psychosis with absent or ambiguous mood changes. Results: A majority of patients in all four groups responded to pharmacotherapy with anti-cycling agents. Conclusions: It is proposed that these groups represent different expressions of mania in brain injured persons, and that these expressions range through a spectrum of phenomenology, included elated mania, irritable mania, episodic psychosis and explosive organic personality disorder. The DSM-III-R classification of these disorders, and approaches to their clinical management, are discussed.
A Not So Modest Proposal: Technology and Tomorrow's School
Authors: David Brother Austin 
Published: May 2005

This paper examines the use of the technology of the electric typewriter and the electronic calculator in the curriculum of the elementary school. Each technology will be looked at in context of the historical development of the skill which each technology implies, viz., communication and calculation respectively. A summary section will discuss the significance of each technology as it pertains to current and future curricula. As controversy waxes and wanes periodically over the training of future writers, this paper points out an interesting issue, instruction in elementary school.
Self-Reported Allergy-Related Symptoms and Psychological Morbidity in Primary Care
Authors: Euba R. , Chalder T. , Wallace P. , Wright D. J. M. , Wessely S. 
Published: May 2005

Objective: To examine the relationship between allergy-related symptoms, food intolerance and psychological distress in primary care. Methods: Two thousand three hundred and thirty two adults in five General Practices in the South of England completed questionnaires regarding allergy and psychological health. Results: There was a weak link between allergy-related symptoms and psychological symptoms, but no association was demonstrated between a history of diagnosed or treated asthma, eczema or hay fever and psychological morbidity. Cases of food intolerance had lower levels of psychological distress than expected compared to hospital samples. Current, but not past wheezing and eczema, was associated with an excess of life stresses in the previous six months. Conclusions: The association between psychological distress and the label of food allergy/intolerance found in specialist care does not extend to primary care.
The Lithium Toxic Patient in the Medical Hospital: Diagnostic and Management Dilemmas
Authors: Ramchandani Dilip , Schindler Barbara A. 
Published: May 2005

Objective: Patients with lithium toxicity can pose difficulties in diagnosis and management in the general hospital setting. The authors examined patients who were referred to the Psychiatric Consultation-Liaison Service with suspicion of lithium overdose to delineate and characterize medical and psychiatric risk factors for toxicity and to follow the course and resolution of their toxicity. Method: The authors reviewed the charts of patients with lithium levels >1.5 mEq/L who were admitted consecutively to a general hospital over an 18-month period. Results: Of twelve patients, eight were found to have developed lithium toxicity due to incidental and iatrogenic factors. These patients presented with a variety of confusing signs and symptoms. Hypothyroidism and coexisting organic illness contributed to the lack of clarity in their clinical picture. Conclusion: The widening scope of indication for lithium therapy leads to increased risk of toxic reactions which challenge the diagnostic skills of the consulting psychiatrist in a general hospital setting.
The ‘Research Magnificent’ in Late Life: Psychiatric Epidemiology and the Primary Health Care of Older Adults
Authors: Gallo Joseph J. , Rabins Peter V. , Iliffe Steve 
Published: May 2005

Objective: Primary care occupies a strategic position in the evaluation, treatment, and prevention of the mental disturbances of later life. This article highlights four themes that are crucial to understanding mental disturbances among older adults: 1) subsyndromal depression, 2) coexisting depression and anxiety, 3) comorbidity of depression and chronic medical conditions, and 4) risk factors for cognitive impairment. Method: The literature was selectively reviewed for each theme to ask the central question, “What can primary care physicians learn about mental disturbances of their older patients from epidemiologic and community studies?” Results: The primary care setting itself is an important venue for an examination of aging issues and mental health. Workers in the “middle ground of psychiatric epidemiology”—primary health care—have not yet reached a full appreciation for the value of research in the primary care setting for enhancing our understanding of the mental disturbances of late life, and how these intersect with other salient factors. Conclusions: Primary care physicians and others who work in primary care should advocate for further mental health integration and research in primary care. Research is needed that will lead to new ways of maximizing the health and quality of life of older adults and their families.
Instructional Product Review: Procedure and Instrumentation
Authors: Poole Richard L. 
Published: May 2005

An instructional product review process is conceived and analyzed from a generic and systemic viewpoint. As conceived, it is composed of the planning, implementation, and analysis stages, with each stage converging on a series of generic concerns. The review process is illustrated with materials which can be used to assess the quality of an instructional package or module. And includes a set of “Directions for Reviewers,” a list of module assessment or development criteria, and an instrument entitled “External Module Review Form.”