bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparative Nutrition and Health Services for Victims of Drought and Hostilities in the Ogaden: Somalia and Ethiopia, 1980–1981
Authors: Henderson Peggy L. , Biellik Robin J. 
Published: May 2005

The civil chaos created by a combination of drought and hostilities in the Ogaden region of southern Ethiopia during the past five years has caused the majority of the indigenous, principally nomadic population to flee the area and seek refuge either in Somali refugee camps or in Ethiopian shelters for displaced persons. This paper compares the provision of basic food rations, selective feeding programs, primary health care, and preventive health measures between the two groups. During 1980–1981 Somalia received more international assistance per capita than Ethiopia. Large numbers of Western personnel provided health and nutrition services in Somali refugee camps, whereas no foreigners were involved in Ethiopian shelters. These disparities were largely due to inadequate publicity concerning the problems Ethiopia faces, partly resulting from real and perceived political limitations related to the Soviet presence in that country. Refugee needs in Somalia have been publicized far more adequately, partly due to that country's alignment with the West. The Ethiopians nevertheless demonstrated greater efficiency in assisting their disaster victims; camp services comparable to those in Somalia were available despite greater logistic difficulties and fewer donated resources. The effectiveness of relief operations in Somalia was reduced by political constraints on governmental agencies.
On the Political Economy of Risk: Farmworkers, Pesticides, and Dollars
Authors: Strigini Paolo 
Published: May 2005

The rapid industrialization of world agriculture has been one of the most eventful social and economic transformations taking place in the second half of the 20th century. Today two agricultures coexist in most countries: capital-intensive agribusiness and labor-intensive subsistence farming. In the U.S., the former exploits largely nonwhite immigrant labor and the latter female unpaid labor, surviving as a “second job.”The striking increase of production in industrial agriculture has been accompanied by uneven and irrational development and by a tragic upsurge of mechanical accidents and chemical hazards. Current pesticide use poses a threat to workers and their families, the general public, the environment, and future generations. Acute risks begin to be known largely through farmworkers' exposure, while chronic risks are often inferred from experimental studies but generally are disregarded.Because of industry's historic neglect of health and environmental hazards, regulation has evolved under pressure from workers and citizens. Regulation is at present the best tool available to shape technological development according to society's needs and goals. Its basic requirements are information, reorientation of public resources, and democratic control. A major obstacle to its implementation is the inequitable social distribution of risks and benefits, within and among nations.
Professionally-Led Support Groups for Cancer Patients: An Intervention in Search of a Model
Authors: Krupnick Janice L. , Rowland Julia H. , Goldberg Richard L. , Daniel Ursula V. 
Published: May 2005

Objective: The objective of this review was to evaluate the clinical and research literature on professionally-led support groups for cancer patients and to propose an approach that would address patients' needs from diagnosis through survivorship. Method: Computerized and manual searches, including Medline and Psychlit searches, were completed for reviews of the literature. Twelve research studies were identified that met our criteria for in-depth review. A clinical model emerged from discussions of an oncology study group based on theoretical formulations and clinical experience with oncology patients. Results: We found that recent research suggests that professionally-led support groups are increasing in number and that participation in such groups seems to enhance patients' quality, and possibly even quantity, of survival. Despite this, little effort has been made to determine what type of group may be appropriate for which patients and when in their course of care. Conclusions: If psychosocial intervention, in the form of professionally-led support groups for cancer patients, is to be more effective, it should be guided by a model which takes into consideration the changing needs and concerns of patients over the course of illness and, in many cases, recovery. The authors present an outline delineating what such a model might entail.
Waste Not, Want Not—Differential Lithic Utilization and Efficiency of Use
Authors: Feder Kenneth L. 
Published: May 2005

Prehistoric people utilized different lithic raw materials differently. The differential “efficiency of use” as measured by average debitage flake weight and average percentage of flake edge retouched should differ as a function of raw materials' value. Value is a product of inherent qualities in the stone including ease of flake production and edge characteristics. Value is also a function of the labor input necessary for a material's procurement. The further a source, the greater the necessary labor input, the higher the value and, hypothetically, the greater the expected efficiency of use. The above construct was tested at the Loomis II site in central Connecticut. Here, raw materials used in stone toolmaking included locally available quartz and basalt and exotic flint and jasper. Efficiency of use as measured by an Efficiency Index indicates that indeed, the further a raw material's source, the higher the efficiency of use.
Integrating Clinical Nurse Specialists into the Treatment of Primary Care Patients with Depression
Authors: Swindle Ralph W. , Rao Jaya K. , Helmy Ahdy , Plue Laurie , Zhou X. H. , Eckert George J. , Weinberger Morris 
Published: May 2005

Objective: To examine the effectiveness of integrating generalist and specialist care for veterans with depression. Method: We conducted a randomized trial of patients screening positive for depression at two Veterans Affairs Medical Center general medicine clinic firms. Control firm physicians were notified prior to the encounter when eligible patients had PRIME-MD depression diagnoses. In the intervention firm, a mental health clinical nurse specialist (CNS) was to: design a treatment plan; implement that plan with the primary care physician; and monitor patients via telephone or visits at two weeks, one month and two months. Primary outcomes (depressive symptoms, patient satisfaction with health care) were collected at 3 and 12 months. Results: Of 268 randomized patients, 246 (92%) and 222 (83%) completed 3- and 12-month follow-up interviews. There were no between-group differences in depressive symptoms or satisfaction at 3 or 12 months. The intervention group had greater chart documentation of depression at baseline (63% versus 33%, p = 0.003) and a higher referral rate to mental health services at 3 months (27% versus 9%, p = 0.019). There was no difference in the rate of new prescriptions for, or adequate dosing of, anti-depressant medications. In 40% of patients, CNSs disagreed with the PRIME-MD depression diagnosis, and their rates of watchful waiting were correspondingly high. Conclusions: Implementing an integrated care model did not occur as intended. Experienced CNSs often did not see the need for treatment in many primary care patients identified by the PRIME-MD. Integrating integrated care models in actual practice may prove challenging.
Perinatal Care Services for Hispanic Women: A Study of Provider-Receiver Communication
Authors: Alcalay Rina 
Published: May 2005

The present case study 1) identified and evaluated perinatal care needs among Hispanics in Albuquerque, New Mexico, as perceived by a sample of perinatal care providers and receivers in the community, and 2) compared those needs with needs previously identified by a national team of Hispanic health experts and political and academic leaders. Results showed that while Hispanic experts emphasized technical needs, the community emphasized humanistic and communication needs in perinatal care services. Within the community, there were also differences between providers' and receivers' identification of barriers. Providers thought that cultural biases of receivers toward the medical profession prevented effective use of services. Receivers identified structural, mainly service related, limitations as barriers to effective perinatal care. This study shows the need to not base programs on “expert” opinion of public needs only.
The Role of Provider Attitudes in Prescribing Antidepressants to Older Adults: Leverage Points for Effective Provider Education
Authors: Arean Patricia A. , Alvidrez Jennifer , Feldman Mitchell , Tong Lowell , Shermer Rebecca 
Published: May 2005

Objectives: The purpose of this study was to determine if primary care provider knowledge of late-life depression, attitudes about treatment of depression in late life, and experience treating late-life depression affect the likelihood internists would prescribe antidepressants to older patients. Methods: This study was a primary care provider survey study. From a pool of 456 eligible mailed surveys, 253 providers completed (55% response rate) a survey assessing provider self-reported knowledge about treating late-life depression with antidepressants, their attitudes about older patients' acceptance and response to antidepressant medications, their professional and personal experience with antidepressant medication, and their comfort with prescribing antidepressants to older patients was created for this study. Results: Univariate analyses indicated that 75% of primary care providers were knowledgeable about the use of antidepressant treatment in older people, and 86% said they felt comfortable treating depression in older patients. Multivariate analyses indicated that the decision to treat older patients with antidepressants was largely influenced by time to treat patients, provider belief that antidepressants could treat late-life depression, their comfort with treating late-life depression, and having had older patients respond to anti-depressant treatment in the past ( R2 = .52, p < .001). Conclusions: This study shows that attitudinal and experiential factors play an important role in the likelihood that a provider will treat an older, depressed patient with an antidepressant, more so than knowledge about how to prescribe an anti-depressant to older patients. Residency programs for primary care practitioners should include education about the efficacy of antidepressant treatment in older people and should involve hands-on experience in treating late-life depression.
Attitudes of Cancer Specialists toward Their Patients in Greece
Authors: Manos Nikolas , Christakis John 
Published: May 2005

A three-part questionnaire was mailed to Greek cancer specialists practicing in the two largest cities of Greece. Part I addressed the question of telling the truth to the cancer patient, Part II the question of telling the truth to the terminal cancer patient, and Part III investigated the psychological difficulties of the above specialists in the care of their patients. Most of Greek cancer specialists (73%) choose not to tell the true diagnosis to the cancer patient and an even greater majority (95%) prefer not to inform the terminal cancer patient of his impending death. A considerable number of them, though (41%), favor a change towards telling the cancer patient his true diagnosis. Furthermore, two thirds of them admit to psychological problems in their contact with the cancer patient and subscribe to the need for specific psychiatric training to improve the care of their patients.
Prevalence of Somatic Indicators of Distress in Diabetes Patients: Comparison to Psychiatric Patients and Community Nonpatients
Authors: Aikens James E. 
Published: May 2005

Objective: Because psychiatric screening methods are usually developed using psychiatric samples but not medical samples, they often include distress indicators that overlap with medical illness. This potentially inflates psychopathology estimates for medically ill patient groups. The objective of this study was to determine whether somatic distress indicator base rates are elevated in diabetes patients. Method: The occurrence of Symptom Checklist 90-R (SLC-90-R) somatic symptoms was studied in fifty-six diabetes mellitus patients (27 insulin dependent, 29 non-insulin dependent) with non-elevated SLC-90-R profiles, as compared to both community nonpatient and psychiatric patient norms. Results: Of the fifteen SCL-90-R items rated by endocrinologists as most likely to be diabetes-related, nine were endorsed more frequently by diabetes patients than by nonpatients: faintness/dizziness (endorsed by 36% of diabetics), reduced libido (endorsed by 41%), anenergia (68%), memory problems (66%), trembling (18%), numbness (55%), weakness (39%), overeating (59%), and somatic concerns (41%). Anergia and faintness/dizziness were endorsed more frequently by psychiatric patients than diabetes patients, whereas numbness was endorsed more often by diabetes patients. Conclusions: Conservatism is warranted when applying these somatic indicators of distress to diabetes patients. Further studies are needed to determine whether such illness overlap biases case classification.
The Effects of the Balint Group on its Members and Leader
Authors: Knoepfel Hans-Konrad 
Published: May 2005

Balint's work promotes better psychological and medical treatment of many so-called “problem patients.” With understanding, these patients often lose the characteristic of being a heavy burden and even become interesting and gratifying. Time invested at the beginning phase of treatment often brings considerable saving of time over extended periods. The doctor's need for intensive involvement diminishes and psychological emergencies become less frequent. Balint helped to make these goals possible by teaching psychoanalytic principles in a simple way, talking in clear, comprehensible language and creating for physicians the possibility for emotional experience and growth through group work. Such experience is indispensable for the training of the family doctor. This paper summarizes essential elements of the group work, in which the leader profits as well as the family doctor. The leader has to learn to formulate clinical experience in clear, non-technical language which describes how patients are treated in the practice of hospital and office medicine. The group experience, furthermore, helps the physician to develop his capacity for empathy by better understanding himself.
The Impact of Coping Styles on the Control of Juvenile Diabetes
Authors: Tietz Walter , Vidmar J. Ted 
Published: May 2005

The relevance of psychosocial factors to the control of diabetes has been referred to in the literature, and previous studies have shown a particular relationship between family behavior and degree of control. This study of twenty-one children from the U.S.C. Pediatric Diabetes Clinic was undertaken to evaluate the extent to which specific variables correlate with control of diabetes. Statistically, no correlation was found between degree of control and: age of onset, duration of illness, number of siblings, intactness of family, degree of family psychopathology, intelligence of child and parents, knowledge about diabetes, birth rank or ethnic and social class. Positive correlation existed between family history of diabetes and good control. Children who appeared to be in the midst of an “adolescent growth spurt” clustered in the group with fair or poor control. Clinical observations of individual patients and their families suggest that the reactions to the onset of diabetes did influence the styles of coping with fears, anxieties and guilt. Case examples are given. The relation of psychologic and neurophysiologic mechanisms is discussed.
Assessing Psychiatric Impairment in Primary Care with the Sheehan Disability Scale
Authors: Leon Andrew C. , Olfson Mark , Portera Laura , Farber Leslie , Sheehan David V. 
Published: May 2005

Objective: Several recent studies have documented that substantial functional impairment is associated with many of the mental disorders seen in primary care. However, brief measures of mental health-related functional impairment are not commonly applied in primary care settings. The Sheehan Disability Scale (SDS), a three-item instrument for assessing such impairment, is evaluated in this study. Method: A psychometric analysis of the SDS was conducted with a sample of 1001 primary care patients at Kaiser Permanente in Oakland, California. The SDS and the Symptom Driven Diagnostic System for Primary Care assessments were completed. Results: The internal consistency reliability of the SDS is high, with coefficient alpha of 0.89. The construct validity was substantiated in two ways. A one-factor model fit the data quite well. Furthermore, patients with each of six psychiatric disorders had significantly higher impairment scores than those who did not. Finally, over 80 percent of the patients with mental disorder diagnoses had an elevated SDS score and nearly 50 percent of those with elevated SDS scores had at least one disorder. Conclusions: The psychometric properties of the SDS were evaluated in primary care. The internal consistency reliability was high. The analyses also lend empirical support for the construct validity. The scale is a sensitive tool for identifying primary care patients with mental health-related functional impairment, who would warrant a diagnostically-oriented mental health assessment.
Childhood Trauma and Adult Somatic Preoccupation by Body Area among Women in an Internal Medicine Setting: A Pilot Study
Authors: Sansone Randy A. , Gaither George A. , Sansone Lori A. 
Published: May 2005

Objective: This study was designed to explore the relationship between three types of abuse in childhood and their relationship to somatic preoccupation, in general and by body area, in adulthood. Method: Eighty-five women in an internal medicine clinic completed self-report measures of childhood sexual, physical, and emotional abuse as well as the Bradford Somatic Inventory. Results: Using simple correlations, all three types of abuse were positively related to current somatic preoccupation. Using multiple regression analysis that included demographic variables (education and age) and the three forms of childhood abuse, only the demographic variables and sexual abuse were uniquely predictive of somatic preoccupation. To determine the relationship between childhood abuse and somatic symptoms based on body area (head, chest, stomach, throat) and fatigue, a series of multiple regression analyses were performed. The chest and throat areas were significant, but no abuse variable was uniquely predictive. Conclusions: Among females in adulthood, all studied forms of abuse in childhood appear to contribute to general somatic preoccupation, as well as specific somatic symptoms in the chest and throat areas. Sexual abuse, specifically, is a unique predictor for general somatic preoccupation, but not necessarily specific body areas.
General Medical and Specialty Mental Health Service Use for Major Depression
Authors: Burns Barbara J. , Wagner H. Ryan , Gaynes Bradley N. , Wells Kenneth B. , Schulberg Herbert C. 
Published: May 2005

Objective: While major depression is common, many depressed persons receive, at best, inadequate treatment. A first step in remedying inadequate detection and treatment of major depression requires understanding the pathways into treatment—from situations of no care, to disease recognition, to referral and appropriate treatment—as well as identifying factors associated with movement between these several stages. Methods: Using the Epidemiologic Catchment Area sample, we identified factors associated with treatment in the general medical or mental health specialist section, or no treatment in a subsample of individuals with current major depression. Results: Strikingly, one-fourth of the sample received no services, over half received care in the general medical sector, and only one-fifth accessed a mental health specialist. Among those receiving any health services (general or mental), men and respondents reporting suicidal symptoms were at risk of receiving no care, while perceived poor health and a cluster of core depressive symptoms were associated with increased odds of service use (general or mental). Among respondents receiving general medical services, perceived poor health, core depressive symptoms, a history of depression, and comorbid mental conditions increased the odds of treatment in the specialty mental health sector. Conclusions: The findings emphasize the need for public health initiatives to 1) improve detection and movement into treatment among those at risk of receiving no care; and 2) insure that, once within the health care system, the processes of primary care treatment and specialty referrals conform to evidence-based treatment guidelines.
Adult Neuronal Ceroid Lipofuscinosis Presenting with Psychiatric Symptoms: A Case Report
Authors: Augustine Annamma , Fricchione Gregory , Woznicki Robert , Broberg Darla , Holt Jonathan 
Published: May 2005

Objective: Psychiatric symptoms can occur early in the course of neurodegenerative metabolic conditions like Kufs' disease. This report is an illustration of a case where the diagnosis was considered primarily psychiatric till MRI (magnetic resonance imaging) of the brain was found abnormal. Method: A case of adult neuronal ceroid lipofuscinosis (NCL) or Kufs' disease in a 24 year old white female who presented with phobic symptoms, behavioral changes, thought disorder and depressed mood prior to the onset of seizures is reported. She was referred to psychiatry for further treatment. We report the various features of the case including the peculiar finding in the MRI of the head. Results: The MRI finding was unique in that it revealed extensive cortical gray matter lesions. This finding led to further investigations. Kufs' disease was diagnosed following a brain biopsy. The MRI finding is noteworthy because it is not typical of previously published cases. The patient was treated with tegretol mainly to control seizures. The overall prognosis seemed poor since patient showed break through seizures in two months. Conclusions: Clinicians should consider neurological or medical conditions and pursue further investigations in psychiatric patients when they concurrently or later develop subtle neurologic symptoms, idiopathic seizures or cognitive deficits.