bluuebunny/crossref_metadata_2025_split huggingface dataset:
Psychiatric Disorders in Patients with Fabry's Disease
Authors: Grewal R. P. 
Published: May 2005

Objective: To determine the frequency and etiology of psychiatric complications in patients with Fabry's disease. Method-Retrospective analysis and review of the records of thirty-three patients with confirmed Fabry's disease. Results: Six patients (18%) developed psychiatric disorders. Five patients suffered depression and two of these patients committed suicide. One patient developed an acute confusional episode with subsequent development of behavioral changes as a complication of cerebrovascular disease. Conclusions: Psychiatric disorders, most commonly depression, complicate Fabry's disease and contribute to the morbidity and mortality of this disease.
Socio-Medical Indicators of Health in South Africa
Authors: Jinabhai Champak C. , Coovadia Hoosen M. , Abdool-Karim Salim S. 
Published: May 2005

Socio-medical indicators developed by WHO for monitoring progress towards Health-for-All have been adapted to reveal, clearly and objectively, the devastating impact of state planning based on an outmoded immoral and unscientific philosophy of race superiority in South Africa on the health of the disenfranchised majority within the context of social and economic discrimination; Health policy indicators confirm that the government is committed to three options (Bantustans, A New Constitution, and A Health Services Facilities Plan) all of which are inconsistent with the attainment of Health-for-All; Social and economic indicators reveal gross disparities between African, Coloured, Indian, and White living and working conditions; Provision of health care indicators show the overwhelming dominance of high technology curative medical care consuming about 97 percent of the health budget with only minor shifts towards community-based comprehensive care; and Health status indicators illustrate the close nexus between privilege, dispossession and disease with Whites falling prey to health problems related to affluence and lifestyle, while Africans, Coloureds, and Indians suffer from disease due to poverty. All four categories of the indicator system reveal discrepancies which exist between Black and White, rich and poor, urban and rural. To achieve the social goal of Health-for-All requires a greater measure of political commitment from the state. We conclude that it is debatable whether a system which maintains race discrimination and exploitation can in fact be adapted to provide Health-for-All.
Major Depressive Disorder and Health Care Costs in Multiple Sclerosis
Authors: Patten Scott B. , Jacobs Philip , Petcu Ruxandra , Reimer Marlene A. , Metz Luanne M. 
Published: May 2005

Objective: Multiple Sclerosis (MS) is associated with elevated levels of depressive symptoms and an elevated frequency of depressive disorders. Depressive disorders, in general, are associated with substantial direct and indirect economic costs, and have been shown to increase the costs associated with the management of medical conditions in a variety of clinical settings. However, the impact of depressive disorders on costs associated with MS have not been evaluated. The objective of this study was to evaluate this association. Methods: The Composite International Diagnostic Interview (CIDI) was used to identify subjects with major depressive disorder in a sample who had earlier been selected for a broader economic evaluation of the costs associated with MS. Costs were measured in two ways: retrospectively (by questionnaire covering a 2-year period) and prospectively (using a 6-month diary). The proportion of subjects reporting any costs and the proportion exceeding various cost thresholds were calculated in subjects with and without lifetime major depression. These proportions were compared using exact statistical tests and confidence intervals. Non-parametric (rank sum) tests were used to compare median costs. Results: Of 136 subjects, 31 had a lifetime history of major depression. MS-related expenses evaluated retrospectively (e.g., house and vehicle alterations and purchases) did not differ depending on major depression status. In the prospective analysis, subjects with lifetime major depression were more likely to purchase vitamins, herbs, and naturopathic remedies ( p < 0.01) and more likely to incur costs associated with utilization of services provided by alternative practitioners ( p = 0.04). Other differences (e.g., in mental health care, medical specialists, general practitioner visits) were not observed. Conclusions: Contrary to expectation, this study did not find increased direct medical costs in persons with comorbid major depressive disorder and multiple sclerosis. Persons with comorbid MS and (lifetime) major depression did not incur greater costs or utilize more services. The Canadian health care system is guided by principles of universality and is publicly funded and administered, however, the lack of an impact of major depression on utilization may reflect limited access to services. The lack of an association between costs and major depression may or may not be generalizable to health care systems in other countries.
Of Euphemisms and Euthanasia: The Language Games of the Nazi Doctors and Some Implications for the Modern Euthanasia Movement
Authors: Mitchell C. Ben 
Published: May 2005

Euphemisms are place-holders for important concepts. They may disguise a practice which one might abhor if it were given another name. In Nazi Germany during World War II, euphemisms were used to desensitize physicians and society to the horrors of a program of euthanasia. This article examines some of the euphemisms used by the Nazi physicians to redefine medicalized killing, compares the Nazi language games with those of contemporary proponents of medicalized killing, and concludes that the consistent application of euphemisms for medicalized killing significantly weakens arguments against assisted killing. We should watch the way we talk. Human society can be described as a long conversation about what matters. In this conversation, the language we use to describe our social practices not only reveals our attitudes and virtues, it shapes them (Winslow, 1994, p. 1).
Obituary Analysis and Describing a Life Lived: The Impact of Race, Gender, Age, and Economic Status
Authors: Marks Alan , Piggee Tommy 
Published: May 2005

A Comparison Of The Sampling Distribution Of The 2,262 obituaries from the Sunday edition of The Arkansas Democrat Gazette, for the year 1993, was made with the actual mortality patterns of Arkansans, as reported by the state health department. The two distributions were found to be nearly identical on gender and age. This is a significant methodological improvement over previous methods used in obituary analysis that relied on using the ratio of obituaries to death notices as an indicator of mortality experience and then using that as a basis for evaluating the likelihood of obituary discrimination. We tested three hypotheses derived from a status continuum model. This model was based primarily on race and gender. Economic status of racial background was also taken into account as was age. Detailed analysis was done on the 4 percent ( n = 90) of the 2,262 obituaries accompanied by a photograph. Racial and gender differences existed regarding length and complexity of the obits. Whites were more likely than blacks to have longer and more complex obituaries. Blacks were more likely than whites to have a picture accompany their obituaries. Economic background of racial membership explains the differences found in length of the obituary. Evidence suggested a set of conditional relationships based on the interaction of race and gender. Within each racial community, those hypothesized to be of higher status were more likely to have a photograph accompany their obituary. Differences were found by race and gender on themes mentioned in the obituary. There were no significant differences within each racial group by gender on length of the obituary. Age was not related to length or number of themes in the obituaries.
Variation in Patients' Compliance with Doctors' Orders: Medical Practice and Doctor-Patient Interaction
Authors: Davis Milton S. 
Published: May 2005

Doctor-patient interactions were tape-recorded and coded according to a modified system of Interaction Process Analysis. These data, combined with a series of patient interviews and a self-administered questionnaire completed by physicians, were analyzed to determine the extent of patient compliance with doctors' orders and how variations in patient compliance are influenced by some selected patient characteristics and by the structure and process of the doctor-patient relationship. None of the demographic characteristics of patients investigated here was associated with compliance. However, the ways in which doctors and patients initially fit their activity into the presumably institutionalized patterns of behavior appropriate for doctor-patient interaction and the way they deviate over time from the institutionalized role expectations was found to be related to variations in patient compliance.
Treatment of Panic Disorder in Older Adults: A Pilot Study Comparison of Alprazolam, Imipramine, and Placebo
Authors: Sheikh Javaid I. , Swales Pamela J. 
Published: May 2005

Objective: Several studies have documented that a variety of pharmacological compounds are quite effective in controlling acute symptomatology of panic disorder in the general population. However, there is a paucity of such studies in the management of panic disorder in older adults (ages 55 and above). The purpose of this study was to gather pilot data in older patients with panic disorder to begin to assess the efficacy of two commonly-used antipanic medications, imipramine and alprazolam. Method: Twenty-five ( n = 25 (23 females; 2 males); 18 completers, 7 dropouts) older panic disorder (DSM-III-R) patients (age range = 55–73; mean = 61.24) were studied in an eight-week randomized, parallel-groups, double-blind, placebo-controlled, flexible dose design. Outcome was assessed weekly by global change ratings (Hamilton Anxiety and Depression Scales; Physicians' Global Impression ratings) and panic diaries. Because of small sample size, we present data descriptively. Results: Subjects in active medication groups evidenced reductions in panic attacks and in levels of overall anxiety and depression. Therapeutic dosages were approximately half those commonly used in younger panic disorder patients. Conclusion: Our data suggest the comparable efficacy of alprazolam and imipramine in the short-term treatment of older adults with panic disorder. There is clearly the need for a larger scale placebo-controlled study, preferably comparing imipramine and/or alprazolam with one of the SSRIs, to substantiate our findings.
Health Policy in France: A Major Issue in the 1978 Legislative Elections
Authors: Canone François , Guyot Jean Claude 
Published: May 2005

For the 1978 legislative elections, all French political parties have, for the first time, a relatively detailed health policy. The right-wing parties of the present government concentrate on the reduction of medical expenditure and the maintenance of the free enterprise tradition of French medicine. The left-wing parties concentrate more on the development of public health institutions and suggest nationalization of the pharmaceutical industry. Within the Left, there is, however, a difference of emphasis: the Socialists propose the setting up of medicosocial centers and abolition of the fee-for-service system; the Communists concentrate rather on industrial health and believe that an improved health service can only come from changes in overall social economic policy. None of these policies is particularly adventurous but their mere existence shows that health is now a major political preoccupation in France. Some of these policies are mainly concerned with individual and public welfare and others with the necessity of maintaining a certain social order. The debate surrounding health policy usually turns around these two issues.
A Longitudinal Study of the Impact of Village Health Education on Environmental Sanitation
Authors: Tonon Marilyn A. 
Published: May 2005

Health educators working in developing nations commonly encounter administrative constraints and methodological problems which prevent rigorous program evaluation. Using a time-series design, this study followed approximately 600 families in two Guatemalan villages during a four-year period to measure the impact of community health education on seven indicators of change in environmental sanitation. Adoption of new behavior was accompanied by widespread change in village attitudes and perceptions of health benefits. At the level of the family, change in perception was not predictive of change in behavior. A strong relationship between participation in planned educational events and the adoption of sanitation changes suggests that the formative educational strategy was responsible for stimulating change for five of seven indicators. Suggestions are made about the usefulness of the methodology, ways that private behavioral changes may be measured are discussed, and the advantages of the time-series design for health education evaluation and monitoring are noted.
Evaluation of a Master's Program in Technical Communication—Results of a Questionnaire
Authors: Gould Jay R. 
Published: May 2005

This is an expanded version of an evaluation originally given at the International Technical Communication Conference, Washington, D.C., 1976. The questionnaire was an attempt to get in touch with as many graduates of Rensselaer's Master's Program in Technical Communication as possible and to find out their reactions to the curriculum. The questions covered such topics as present and past occupations, usefulness of the Rensselaer curriculum, recommended curriculum changes, making use of invited speakers, degree of emphasis on style and format, supplementary courses, contact with professional writers, and adoption of new techniques.
Confinement and Ego Regression: Some Consequences of Enforced Passivity
Authors: Sargent Douglas A. 
Published: May 2005

This paper suggests a relationship between the enforced passivity of confinement and certain peculiarities of behavior seen among both hospitalized patients and other incarcerated groups such as prisoners. It is proposed that confinement has deleterious effects on certain ego functions. Finally, it is recommended that steps may be taken, based upon a knowledge of the psychological issues involved, which may lessen regression during confinement and facilitate return to normal mental functioning upon release from confinement. Clinical material illustrating effects of confinement is drawn from the author's experiences as a psychiatrist in the federal prisons and juvenile courts and from observations of patients hospitalized for physical and mental disorders.
Case Problems Improve Tech Writing Courses and Seminars
Authors: Hays Robert 
Published: May 2005

Case problems based upon believable circumstances can improve instruction in technical writing in college courses and industrial seminars. Such case problems give students and trainees realistic tasks, carry them through the various stages of writing a report, and reflect the systems approach to technical writing. This article explains the usefulness of case problems, suggests ways and criteria for their preparation, and offers a brief example of a case problem.
A Brief Depression Scale for Use in the Medically Ill
Authors: Koenig HArold G. , Cohen Harvey J. , Blazer Dan G. , Meador Keith G. , Westlund Ron 
Published: May 2005

Objective: Using items from two existing depression scales, we have sought to develop a brief self-rated instrument for detecting major depressive disorder (M.D.D.) in medically ill, hospitalized patients. Method: Forty-two items from the Geriatric Depression Scale (G.D.S.) and Carroll Depression Scale were administered to 559 men under age 40 or over age 70 consecutively admitted to the hospital. Eighty-two M.D.D.'s were diagnosed in this group by structured psychiatric interview. After eliminating 12 items confounded by medical illness, 11 items were selected using regression analysis, correlation with the total score, and factor analysis. The 11-item scale includes an assessment of the five DSM-III-R criteria for M.D.D. which are least confounded by medical illness (mood, suicidal intent, guilt or worthlessness, concentration, and psychomotor agitation). The scale was then tested in 78 medical inpatients who were later assessed for M.D.D. using a structured psychiatric interview. Results: Ten out of twelve M.D.D.'s were identified (83% sensitivity) and depression excluded in 51 of 66 non-depressed subjects (77% specificity) (compared with 82% sensitivity and 76% specificity for the 30-item G.D.S.). Scores on the 11-item scale were also correlated with the G.D.S. (.92), the Zung Depression Scale (.58), and the C.E.S.-D (.67). Conclusion: The 11-item scale is a practical tool for clinicians who screen patients for depression and for investigators who need a brief measure of depression in studies involving medical inpatients.
Religious Coping in the Nursing Home: A Biopsychosocial Model
Authors: Koenig Harold G. , Weiner Debra K. , Peterson Bercedis L. , Meador Keith G. , Keefe Francis J. 
Published: May 2005

Objective: To examine psychosocial and physical health correlates of religious coping in medically ill chronically institutionalized older adults. Religious coping is defined as the extent to which persons use religious beliefs and practices to help them to cope. Method: This is a cross-sectional cohort study conducted in a 120 bed VA-affiliated and a 125 bed university-affiliated community-based nursing home in Durham, North Carolina. Participants were 115 chronic care nursing home residents; mean age of the sample was seventy-nine years, 44 percent were women, and 17 percent were African Americans. Subjects were enrolled for a one-month period during which comprehensive psychosocial and health assessments were performed, including evaluation of cognitive function (Mini-Mental State Exam), physical function (Barthel index), severity of medical comorbidity (Cumulative Illness Rating Scale), self-reported physical pain (vertical verbal descriptor scale), depressive symptoms (Geriatric Depression Scale), social support (social network), and religious coping (Religious Coping Index). Results: Over 43 percent of the sample scored in the depressed range of the Geriatric Depression Scale. Almost 60 percent reported they used religion at least to a large extent when coping with their problems; 34 percent said that it was the most important factor that enabled them to cope. Patients who used religion to cope had greater social support ( p = .01), more severe medical illness ( p = .04), and better cognitive functioning ( p = .02). Conclusions: Religious beliefs and practices are frequently used by chronically institutionalized older adults to help them to cope. Religious coping is associated with more severe medical illness, higher social support, and better cognitive functioning.
Dimensions of Thought as a Function of Age, Gender and Task Difficulty
Authors: Parks Carlton W. , Klinger Eric , Perlmutter Marion 
Published: May 2005

Forty-two younger adult college students (ages 17–28) and forty-two older adult college alumni and their spouses (ages 60–82) participated in a two-session study. During the questionnaire session, subjects completed background information, self-ratings of health and activity, and questionnaires related to daydreaming activity and current concerns in the natural environment. During the experimental session, subjects participated in four ten-minute thought-sampling periods consisting of two puzzle and two relaxation periods. The mean number of current concerns reported on questionnaires was higher among younger than older adults. Moreover, younger adults reported engaging in more daydreaming as well as having more visual imagery in those daydreams than older adults. The mean proportions of stimulus-dependent evaluative thoughts and attention-control utterances elicited during thought-sampling were higher among older than younger adults. The mean proportions of evaluative thoughts and attention-control utterances were higher during the two puzzle sessions than during the two relaxation sessions. There were no age differences in stimulus-independent thought or number of designs attempted, although younger adults completed more easy and difficult puzzles than older adults. There were few gender differences in problem-solving stream of consciousness. The results support the efficacy of a multidimensional approach to the definition and assessment of imagery.
Unmet Needs as Sociomedical Indicators
Authors: Carr Willine , Wolfe Samuel 
Published: May 2005

This paper discusses the Meharry Medical College Study of Unmet Needs designed to measure the effectiveness of alternative health care delivery systems: (a) comprehensive care with broad outreach, (b) comprehensive care with limited outreach, and (c) traditional care. Unmet needs are defined as the differences between services judged necessary to deal appropriately with health problems and services actually received. The central hypothesis is that comprehensive health programs will be more effective than traditional care in reducing unmet needs. Unmet needs are viewed as measures of program outcome and are one of several types of sociomedical indicators which use factors other than biomedical or biological states as measures of outcome. The distinction is made between unmet needs indicators and health status indicators. Various approaches to measuring unmet needs are discussed and the relatively limited focus of these is contrasted with the more comprehensive Meharry approach. Household interviews and clinical examinations provide the data base for deriving professional judgments of unmet needs in the medical, dental, nursing, and social services areas. The Meharry work suggests several areas in which further work on unmet needs would be useful.
Liaison Psychiatry: Factors Influencing the Consultation Process
Authors: Krakowski Adam J. 
Published: May 2005

In the last two decades psychiatrists in liaison work have asked nonpsychiatrists to accept a greater role in the management of mental illness, sponsoring educational programs and offering consultative services to provide assistance in diagnosis and management of patients. The triadic doctor-doctor-patient relationship and transference-countertransference phenomena often have more influence on the consultation process and the effectiveness of didactic methods than real problems like the degree of availability of consultants. Such factors as 1) the circumstances of the choice of medicine as a profession, 2) the special meaning of the choice of specialty, and 3) personality factors have great influence upon the relationship between the consultant and the consultee, the quality of the consultation, and the effectiveness of educational methods used in liaison psychiatry. The results of an attitudinal survey of fifty physicians, conducted to explore conscious motivations for choosing the medical profession, attitudes toward consultation process, and less conscious elements such as fears of illness or death are discussed as a basis for understanding the consultation process and designing effective continuing education programs on the psychosocial aspects of medical care. An important implication of the study is the need to question the ways in which nonpsychiatrists are encouraged and expected to assume more responsibility for the care of patients with emotional problems.