bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Effect of Psychiatric Symptoms on the Recognition of Alcohol Disorders in Primary Care Patients
Authors: Crum Rosa M. , Ford Daniel E. 
Published: May 2005

Objective: To determine factors related to physician recognition of alcohol abuse in a primary clinic, specifically factors associated with psychiatric illness. Method: Using a cross-sectional study design, we conducted a comprehensive chart review of an existing study sample. A total of 321 systematically sampled patients completed a patient interview. One-hundred-and-one patients scored one or more on the CAGE screening questionnaire for alcohol abuse and were eligible for the medical chart review, which assessed socio-demographic variables, psychiatric and medical diagnoses, alcohol and other substance use, laboratory tests results, and number of patient contacts. Results: 35 percent of the CAGE positive sample had a history of a psychiatric disorder documented in the chart, and an additional 17 percent had symptoms consistent with possible underlying psychopathology. Using multiple logistic regression analysis, the presence of documented psychiatric disorders was not found to be significantly associated with physician recognition (odds ratio = 1.7, 95% confidence interval, 0.5–5.8), relative to patients without these disorders. However, patients who reported psychiatric complaints were significantly more likely to have been recognized by their physicians as having a probable alcohol disorder (odds ratio = 4.4,95% confidence interval, 1.2–16.2), relative to those without such complaints. Other factors found to be associated with recognition are discussed. Conclusions: The evidence indicates that a large proportion of alcohol disorders go unrecognized by physicians, however it does not appear that this is due to the misclas-sification of alcoholism as other psychiatric disorders or symptoms. Additional studies with objective assessment of psychiatric status will be helpful in further investigating this question.
The Epidemic as a Social Event
Authors: Stark Evan 
Published: May 2005

The concept of disease causation has changed twice, first from natural to social determining factors, and, second, from determination by social conditions to determination by stressful social relations. These changes roughly parallel the emergence of industrial capital and its change from a highly individualistic and competitive process to a “social” process. In this article, “epidemics” are treated as social events that occur amidst these changes in disease and the economic organization of society. Nineteenth-century epidemics occurred when business attempted to solve its economic problems by creating dramatic gaps between the social needs of an expanding labor force and available goods and services. The coincidence of periodic crises in production and in health ensured that “epidemics” would be occasions for labor to struggle against injustice, not simply sickness. And workers demonstrated a capacity for self-organization during epidemics that forced municipal authorities to reform fundamentally their organization of work, the market, and social service. After 1900, “reform” was a permanent part of capital's developmental strategy. The new “social” capitalist sought to organize work politically, far beyond the factory, and to extract “value” not from blue-collar workers alone but from all social activity. These developments reduced mortality due to infectious and childhood disease. But they also created the new epidemics of chronic stress. Despite the mystification of social etiology by medicine, the identity of the disease process with more general means of social reproduction indicates that illness is now “endopolic,” the product not of nature but of historically specific political and economic decisions and processes.
Funerals, Family, and Forefathers: A View of Italian-American Funeral Practices
Authors: Coweii Daniel David 
Published: May 2005

Italian-American funeral practices have received little attention in the literature. This study deals with this gap by tracing the evolution of funeral practices from the Old World, preimmigrant culture of the southern Italian to the contemporary New World funeral practices of Italian-Americans reflective of the so-called American way of death. The article is structured around the thesis that the author's own family experience of the ritualistic observance of death had its roots in Old World customs and traditions, was subsequently modified by American social patterns, secularism, industrialization, and funeral customs, and was further shaped by particular psychosocial family dynamics. The concluding section compares the author's personal experience of Roman Catholic home funerals with the larger societal practices described.
Is Psychiatric Consultation in Abortion Obsolete?
Authors: Marmer Stephen S. , Pasnau Robert O. , Cushner Irvin M. 
Published: May 2005

The 1973 United States Supreme Court decision removing all impediments to abortion requested by adult women in the first trimester eliminated the necessity for psychiatrists to “approve” such abortions on psychiatric grounds. At the same time, the development of new thinking about post-abortion emotional problems occurred. It was shown that despite the formerly widely held view that abortion was usually followed by psychiatric illness, such complications are in fact rare. Therefore, the two principle reasons for routine psychiatric consultations in abortion cases are no longer viable. Nevertheless, there are important indications for psychiatric involvement in pre- and post-abortion counseling and consultation which cannot be overlooked. These can be summarized as cases in which: 1) the woman exhibits marked ambivalence, or in which motivation for continuing or terminating the pregnancy is suspect; 2) unhealthy, self-destructive or inappropriate use of sexuality results in pregnancy, with the use of abortion as birth-control; 3) the woman is incompetent to decide on continuation or termination of pregnancy; 4) a serious physical illness may have compromised the ability of the woman to cope emotionally with the issue of pregnancy or abortion; 5) there is a history of prior psychiatric illness, especially postpartum illness or suicidal behavior; or 6) the primary role of the psychiatrist is in liaison or education of the physician or staff. Six illustrative cases are briefly presented and discussed.
Adjustment to Loss of Spouse as a Multivariate Construct
Authors: Lowenstein Ariela , Landau Ruth , Rosen Aron 
Published: May 2005

Interview data collected in 1985–86 from a stratified random sample of widows under the age of fifty-four ( n = 150) in Israel were analyzed in an attempt to answer the following question: is adjustment to widowhood a univariate or a multivariate construct? Using four indicators for adjustment to widowhood—functioning in everyday living, depression level, health status, and life satisfaction—factors that may affect adjustment to widowhood are examined. Multiple regressional analysis of the data reveals that the four indicators are associated with different clusters of predictors, and that only two predictors are associated with all four of them: widow's locus of control and present standard of living as compared to prior one. The results, providing evidence that adjustment to widowhood may be perceived as a multivariate construct and their implications for further research, are discussed.
Simulation vs. Lecture Demonstration: Alternative Approaches to Teaching Television Lighting
Authors: Carroll James K. 
Published: May 2005

The increasing dependence upon the medium of television to inform, instruct, and entertain our citizens in the 1970's has created a need for Broadcast Communication personnel, trained in media production techniques. The effectiveness of television is dependent upon the mastery of these techniques which serve to clarify action, reduce distractions and add emphasis to messages. Appropriate illumination of the subject matter is the key element in television production. It provides the base for all camera coverage and subsequent electronic manipulation of images. With a shortage of time, facilities and faculty, today's Broadcast Communication student often operates at the level of an observer, thereby taking a passive role in the education process. Given a lecture-demonstration approach to such instruction as found in a majority of institutions of Higher Education, individual differences and needs in many relevant variables simply are not accounted for. One such variable in television production lies in the area of television lighting, a field demanding, but rarely receiving, an adequate amount of individualized instruction and “hands on” manipulation of equipment.
A Case of Factitious Aplastic Anemia
Authors: Bright Robert , Eisendrath Stuart , Damon Lloyd 
Published: May 2005

Objective: We report the case of factitiously induced aplastic anemia by the ingestion of busulfan, a bifunctional alkylating chemotherapeutic agent used in the treatment of chronic myelogenous leukemia. The medical consequences and financial costs of this illness are reported. The reader will gain an understanding of the relevant clues to the diagnosis of a factitious hematologic illness, the psychodynamic issues present in this case and the legal, ethical and countertransferential issues raised by the case. Method: A single case review including medical and billing records, patient and staff interviews and literature review. Results: The covert ingestion of busulfan by this patient resulted in life-threatening bone marrow suppression, bilateral aseptic hip necrosis, transfusion-dependent thrombocytopenia and a chronic pain syndrome. Her treatment was complicated by noncompliance with prescribed treatments and polymicrobial sepsis possibly secondary to the self-injection of feces into her central line. To date, the total cost of care for the treatment of this patient's medical complications secondary to her ingestion of busulfan exceeds $1,100,000.00. Conclusions: This case underscores the importance of the early recognition by the primary care physician of the possibility of a factitious etiology of hematologic abnormalities such as aplastic anemia due to the ingestion of bone marrow ablative medications. The index of suspicion is increased when the patient is a young health care provider, usually female, with atypical pancytopenia and an unusual disease course and response to treatment.
Lake Theo: Late Quaternary Paleoenvironmental Data and New Plainview (Paleoindian) Date
Authors: Johnson Eileen , Holliday Vance T. , Neck Raymond W. 
Published: May 2005

Lake Theo (Briscoe County, Texas) is a well stratified archaeological site with Paleoindian (Folsom, Plainview) and Archaic occupations. It is located immediately east of the Southern High Plains (Llano Estacado). Preliminary field and laboratory investigations of site stratigraphy, soils, and microbiology were initiated in order to reconstruct late Quaternary paleoenvironments and date the Paleoindian occupations. The site contains a series of ten late Quaternary fluvial, and possible aeolian, deposits; and five soils (ranging from weakly to moderately well developed) formed therein. Radiocarbon ages of 9950 ± 110 years B.P. (SMU-866) and 9420 ± 85 years B.P. (SMU-856) were determined on humates from the bottom and top (respectively) of a thick, slowly aggrading, buried A horizon. The lower date is associated with a Plainview occupation and immediately overlies a Folsom occupation. Comparison of dates and associated stratigraphic and pedologic data with other sediments and soils in the section indicates that during the past 12,000 years, most sedimentation was relatively rapid and sporadic with intervening periods of soil formation of varying lengths. Citrate soluble phosphorous analysis of the soils did not show notable evidence of intense human occupation at any time. Invertebrates recovered indicate a progressive, local extirpation of terrestrial gastropods since Folsom times. The progression is a result of decreased effective precipitation. The most marked stage of extirpation occurred during deposition of Unit 7 (9000 to 8000 B.P.).
Prevalence of Medical Illness in Patients with Anxiety Disorders
Authors: Rogers Malcolm P. , White Kerrin , Warshaw Meredith G. , Yonkers Kimberly A. , Rodriguez-Villa Fernando , Chang Grace , Keller Martin B. 
Published: May 2005

Objective: This investigation examines the prevalence and characteristics of medical illness in 711 patients enrolled in the Harvard/Brown Anxiety Disorders Research Program (HARP), a multi-center, longitudinal study of anxiety disorders. Method: Elligible subjects were those with present or past index anxiety disorders: panic disorder without agoraphobia, panic disorder with agoraphobia, agoraphobia without panic disorder, social phobia, or generalized anxiety disorder. They were assessed by trained raters using structured diagnostic interviews and the Medical History Form II. Results: Patients with panic disorder and co-morbid major depressive disorder had significantly higher rates of reported medical illness than anxiety disorder patients without depression. When the rates of medical illness for all subjects were compared with those from the Rand Health Insurance Experiment, we found the prevalence of several medical problems to be disproportionately increased. Conclusions: Although our results are preliminary, it appears that patients with panic disorder have more reported medical problems than the public at large, in particular, more ulcer disease, angina, and thyroid disease. Somatic complaints in patients with panic disorder, therefore, need to be carefully considered.
When Students and Media Center Work Together
Authors: Boylan Richard F. , Sanford Clarke 
Published: May 2005

Media centers have a continual need for self-instruction programs which assist patrons in the operation and use of a variety of equipment. Students involved in media production classes need projects that simulate “real life” situations as closely as possible. Having a client with specific needs — a client who can be demanding with regard to project evaluation, and who can also pay students who produce usable programs — is an ideal way to simulate that “real life” environment. California State University at Bakersfield merged these two needs. Beginning multimedia students' first assignment was to develop programs for instructing their classmates on how to use audiovisual equipment. The media center director agreed to buy projects that met his standards and fit the center's needs. This cooperative venture between communication classes and the media center served several instructional goals, and afforded many mutual benefits. Students learned valuable lessons in project design, audience analysis, media production, and marketing. The media center provided the faculty instructional support, a motivating context for students to work, and assistance in evaluation. And, by developing self-instruction programs, the students and faculty provided an expanded resource that directly benefited the Media Center's customers.
The HIV-Positive Psychiatric Patient and the Duty to Protect: Ethical and Legal Issues
Authors: Searight H. Russell , Pound Patricia 
Published: May 2005

A small, yet significant, percentage of HIV-positive patients have a concomitant psychiatric or neurological disorder associated with impaired judgment. Clinical problems such as psychoses, certain personality disorders, and dementias are associated with disinhibition of impulses and diminished capacity for self-monitoring. These deficits in reasoning and judgment may prevent the patient from comprehending the significance of their HIV status and the consequences of sexual behavior or needle sharing. There are indications that the Tarasoff duty-to-protect may apply to this situation. Method: Available data about the prevalence of HIV risk behavior and HIV infection among psychiatric patients are reviewed. The applicability to these situations is described. Results: When an HIV patient engages in high risk sexual behavior with identifiable partners and refuses to notify them of their HIV status, physicians and mental health professionals may have a legal and ethical duty to warn. Conclusion: A decision model for this clinical dilemma is presented. Clinical strategies for these patients may include ongoing supervision and monitoring as well as possible quarantine.
Validation of a Scale for Measuring Attitudes toward Psychiatry in Medicine
Authors: Klos D. M. , Dielman T. E. , Curtis G. C. , Krol R. A. 
Published: May 2005

An 80-item scale for measuring attitudes toward psychiatry in medicine was developed and tested. Item selection from the initial 160 items was based on factor analysis and internal consistency of the eight resulting subscales, six subscales exhibiting Cronbach Alpha coefficients ranging from .79 to .95, with two showing coefficients of .57 and .59. The subscales were sensitive to differences in medical specialty, with consultation-liaison psychiatrists exhibiting the most favorable attitudes and highly specialized physicians showing the least. The subscales correlated significantly with subscales of the Zimny Medical Specialties Preference Inventory related to preference for psychosocial and non-specialized medical activities.
The Electronic Blackboard: Potential for the Developing World's Education
Authors: David Brother Austin 
Published: May 2005

After briefly reviewing the history of computer technology used for instruction, the author introduces the concept of collectivized computer assisted instruction. Here the focus is on the use of the microcomputer as a tool for group instruction as opposed to the individualized instruction developed in early C.A.I. efforts. Several possible scenarios of execution are examined and the potential use of microcomputer technology together with satellite communications is explored. The author then questions traditional instructional strategies which treat students as “single channel processors” while with instructional technology they could be instructed as “multi-channel processors” which indeed humans really are.
Lithium Side Effects in the Medically Ill
Authors: Morton W. Alexander , Sonne Susan C. , Lydiard R. Bruce 
Published: May 2005

Objective: This review will include the general pharmacology of lithium and discuss its effects on various organ systems, with emphasis on the medically ill patient as well as the geriatric patient with multiple medical problems. Methods: A full literature review on the side effects of lithium was performed. Attention is focused on the medically ill and possible drug interactions. Results: This review points to the numerous problems which can result in toxicity in the medically ill or the geriatric patient. Conclusion: Serious side effects can be avoided with proper drug monitoring and knowledge of potential drug interactions.
Training the Trainers: Substance Abuse Screening and Intervention
Authors: Brown Richard L. , Fleming Michael F. 
Published: May 2005

Objective: Screening and brief intervention for substance abuse is effective yet underutilized by primary care physicians. This article reports on Project SAEFP (Substance Abuse Education for Family Physicians), which aimed to enhance the clinical and teaching skills and activities of U.S. family practice residency faculty. Method: Ten five-day workshops were designed and administered for 165 participants. Evaluation data included measures of participant satisfaction and pre-workshop and twelve-month post-workshop measures of the frequency of teaching, consulting, and clinical activities, and the attainment of self-identified teaching goals. Results: The participants were very satisfied with the workshops. They improved significantly in the key outcome measures. Conclusions: Several workshops may have contributed to the apparent success of Project SAEFP. Attributes of the workshops which might have facilitated their success were their duration, funding, frequency of offering, collegial learning environment, opportunities for active learning, emotionally moving exposure to recovering individuals, focus on how to modify curriculum at participant residency programs, availability of family physician role models as faculty, and readily usable instructional materials. Planners of interventions for physician educators might profit from similar attention to these attributes.
Hispanic Ethnicity, Language, and Depression: Physician-Patient Communication and Patient Use of Alternative Treatments
Authors: Sleath Betsy L. , Williams John W. 
Published: May 2005

Objective: To examine the relationship between Hispanic ethnicity and language spoken with physician communication about depression and patient use of alternative treatments for depression. Method: This is a secondary data analysis from a trial of depression screening conducted in four primary care clinics. Patients with Hispanic or non-Hispanic White ethnic backgrounds and those meeting DSM-III-R criteria for current major depression, minor depression, dysthymia as well as those that screened positive on a depression screening instrument ( n = 141) are included in this analysis. We labeled those who screened positive for depression but did not meet DSM-IIIR criteria for a current depressive disorder as “distressed.” Clinicians' use of counseling and patient use of alternative treatments were based on patient self-report. Results: Forty-two percent ( n = 59) of the sample stated that their physician had either told them that they had depression, treated them for depression, or recommended that they seek help for depression. Over 40% of patients spent time talking with their physicians at their current visit about what was making them depressed and 34% received counseling about depression. Hispanic ethnicity and language were not significantly related to physician communication with patients about how to overcome depression. Thirty-six percent of patients reported talking with a minister or other religious person about feelings of depression or sadness. Seventeen percent of patients had used herbal remedies or non-prescription medications and 5% had seen a curandero for feelings of depression or sadness. Hispanic ethnicity and language were not significantly related to patient use of alternative treatments for depression. Conclusions: Hispanic ethnicity and language were not significantly related to physician-patient communication about depression or patient use of alternative treatments for depression. Physicians should make sure to ask patients about all of the types of things they are doing to help overcome their depression.
Ten Survivors of Cardiac Arrest
Authors: White Robert L. , Liddon Sim C. 
Published: May 2005

Patients from two hospitals who had experienced a cardiac arrest with resuscitation, within a forty-three month period, were considered for the study. All surviving patients within a one-hundred mile radius were actually included; these ten were interviewed and evaluated. The two most marked psychological reactions of these patients were 1) the use of “major denial” and 2) the experiencing of a transcendental redirection in their lives. Three patients used “major denial” and made good adjustments. Five patients experienced either a religious conversion or a philosophical redirection in their lives. All of these used either minimal or partial denial, and two made good adjustments. The “life review” prior to arrest, as reported by other authors, was not experienced in this sample. All of the families interviewed assumed an overprotective role toward the patients, while the patients themselves were relieved to be able to discuss the incident. Case examples of various reactions are presented.