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Family caregivers of post-hospitalized older persons and persons receiving hospice: similarities and differences.

The study reported here explored similarities and differences between 103 family caregivers of older persons who had been discharged from the hospital and 70 caregivers of terminally ill older persons receiving hospice care. Caregiving variables were selected for examination based on role theory. Major findings include: hospice caregivers provided significantly more personal care and medically related tasks, significantly fewer transportation tasks, and worried less than the post-hospitalized sample. Otherwise, the two groups were strikingly similar. Similar patterns of correlations for the two groups were also found.

Aftercare↗

Low 25-hydroxyvitamin D and osteopenia are prevalent in persons > or =55 yr with fracture at any site: a prospective, observational study of persons fracturing in the community.

Ethnic diversity and lower socioeconomic populations are poorly captured in most studies of osteoporosis and fracture risk. This article describes a prospective, observational study designed to analyze risk factors for fracture in an ambulatory, ethnically diverse, urban population aged > or =55 yr. The goal of the study was to determine the number of fractures associated with hypovitaminosis D (< or =15 ng/mL serum 25-hydroxyvitamin D) and osteopenia (T-score <-1.5) by bone mineral density (BMD). From January 1 to July 31, 2001, we identified 262 persons who fractured in our community; 83 chose to enroll in the study. Enrolled patients had a BMD examination at two sites; their blood was drawn for 25-hydroxyvitamin D (25VitD), calcium, phosphorus, albumin, and alkaline phosphatase. At the completion of the study a letter was sent to the patients detailing the findings, and a copy sent to their physician. Of the 83 persons enrolled, 73 (88%) had evidence of osteopenia or osteoporosis (T-score <-1.5) and/or low 25VitD. All fractures in the community in person > or =55 yr, with or without a history of antecedent trauma, should be assessed with BMD and screening for 25VitD.

Age Factors↗

Leisure activities of retired persons in the United States: comparisons with retired persons in the People's Republic of China.

This study was undertaken in view of the large and growing numbers of retired persons in the People's Republic of China; the dearth of information about how they spend their time; and the importance of such knowledge in guiding city reform and accomplishing the Four Modernizations and the future cause. The discretionary-activity patterns and rates, the importance of these activities, and their perceived impact upon the health of 551 retired persons and 100 employed workers in Shanghai were compared in order to investigate the role of retirement in China. To assess similarities and differences between retired persons in China and in the West, the activity patterns and rates of retired Chinese adults were compared with retired adults in two samples from the United States (352 from San Antonio and 899 from San Francisco).

Aged↗

Transmission of Strongyloides steracolis person to person.

A case of presumed person-to-person transmission of Strongyloides steracolis is described. The index case was immunocompromised following high dose glucocorticosteroid therapy for myelodysplasia, which resulted in reactivation of latent strongyloides infection with the hyperinfestation syndrome. Physicians unfamiliar with this disease should realize that a history of foreign travel is unnecessary to acquire this parasite, and that transmission to persons in close proximity to the index case does occur and warrants treatment.

Aged↗

The effect of a test meal on serum group I pepsinogens (PG I) and serum gastrin in persons with normal gastric H+ secretion and in persons with achlorhydria.

Thirteen persons with normal pentagastrin-stimulated gastric H+ secretion and 17 with achlorhydria were studied with a liquid test meal after an overnight fast. Blood was drawn before and every 30 min for 180 min after start of the meal. Serum gastrin, serum PG I, and serum vitamin B12 were determined by radioassay methods. Serum PG I was significantly lower in the achlorhydric subjects than in the normal secretors. The meal induced a slight and late rise in serum PG I in the control group. In contrast, the meal caused a slight fall in the achlorhydric persons. Basal serum gastrin was significantly higher in the achlorhydric group, in whom the meal also caused a significant fall in serum gastrin, which contrasts sharply with the rise in the control group. Although serum gastrin fell significantly in the achlorhydric group, a meal-induced rise in serum gastrin was observed in some of the achlorhydric subjects with basal serum gastrin below 100 pmol/l. Serum vitamin B12 was reduced in 8 of the 17 persons with achlorhydria, and in these 8 subjects serum PG I was significantly lower than in those with achlorhydria and normal serum vitamin B12.

Achlorhydria↗

Legal issues in the care of mentally impaired elderly persons: competence, surrogate management, and protection of rights. Working Group on Legal Issues, Committee on Guidelines for Comprehensive Services to Elderly Persons with Psychiatric Disorders.

This article identifies a number of areas of concern in the care of mentally impaired elderly persons, focusing on the need for improved criteria, definitions and procedures in the following areas: the determination of competence or incompetence; the initiation, implementation and monitoring of measures for surrogate management (power of attorney, trusteeship, guardianship); standards of care; and advocacy in defence of the rights of elderly persons. The large and growing number of elderly persons in need of care--the very old, the frail, those without relatives and, in particular, the mentally impaired--has many legal implications. The critical issue is how effectively the law can protect and maintain the rights of people who are unable to do so themselves.

Aged↗

Intrafamilial person-to-person spread of bacillary dysentery due to Shigella dysenteriae in southwestern Saudi Arabia.

OBJECTIVE: To identify the factors that influence transmission of bacillary dysentry (BD) within families during a propagated outbreak of bacillary dysentery. DESIGN: A retrospective cohort study. SETTING: Eighteen neighbouring villages in rural Gizan, southwestern Saudi Arabia. SUBJECTS: Two hundred and thirty three cases of BD were identified among seventy nine families. RESULTS: Secondary cases of BD occurred in 57 of 79 families with a primary case of BD. The secondary attack rate per cent (AR%) within families ranged between 7.7% and 80%. Age of primary cases did not correlate with degree of secondary AR% in exposed families (p > 0.04; p > 0.05); however, within households, the age of the first secondary cases (median = two years) was usually less than the age of the primary case (median = six years). Children under five years of age constituted 43% of secondary cases. The median interval between successive cases within a house ranged from three and seven days. Two hundred and twenty cases (94.4%) gave history of close contact within another case of BD. Cases of BD were exposed to close relatives with BD (79.1%), neighbours (11.4%), and friends (9.5%). Risk factors influencing the spread of BD within families included two rooms or fewer per house (OR = 4.3, 9.5% CI 1.3-14.3), family size of five or more (p = 0.012, two-tailed Fisher's exact test), and presence of more than two persons per room (OR = 11.2, 95% CI 3.1-42.4). CONCLUSION: Person-to-person secondary transmission can amplify the spread of bacillary dysentery within households and neighbouring villages. Crowding was a risk factor that amplified transmission of BD within families.

Adolescent↗

Mass identification of persons missing from the break-up of the former Yugoslavia: structure, function, and role of the International Commission on Missing Persons.

The staff of the International Commission on Missing Persons (ICMP) is attempting to undertake the largest mass human identification effort in history. Through the generosity of numerous governmental and private corporations the ICMP has established or is currently establishing a strong network of political allies, family outreach centers, and DNA laboratories throughout the former Yugoslavia. Furthermore, the ICMP is currently working to streamline current technology as well as employ new technology in its efforts to assist in identifying missing individuals. ICMP will continue to act as a link between the family associations in the region and will synchronize the work of the DNA identification process in the countries affected by the war in the regions of the former Yugoslavia. In the longer term, ICMP seeks to contribute to the closure of the missing persons issue, to raise awareness of the human dimension of the missing persons tragedy, and to preserve a shared and common memory of the missing in the former Yugoslavia.

Bosnia and Herzegovina↗

Relationship of family and personal history to the occurrence of depression in persons with Alzheimer's disease.

The authors tested the associations of family history and personal history of depression with mood disorders among patients with Alzheimer's disease (AD; N=161). Considered individually, a positive family history and a positive personal history each conferred increased risk for depression in AD. Conjointly, neither family nor personal history accounted for a substantial amount of the variance in syndromal depression after the onset of AD. Most depressed AD patients in this sample did not have a positive family history or a previous episode of depression. Our understanding of the etiology and course of depression and dementia may be augmented with further neuropsychological and brain-imaging studies of the neuropathological substrates shared by these illnesses.

Aged↗

[The loss of close person and the cognitive functions of persons with Alzheimer type dementia].

AIM: The aim of the present investigations was qualification of influence of loss of near and dear persons on cognitive functions in persons with Alzheimer's disease. METHOD: The initial population consisted of all the people who in the period from 1/02 to 30/10/2000 were treated at one of the following psychiatric treatment institutions: psychiatric ward of the hospital, psychiatric regional outpatient clinic, psychiatric department. The qualifying criteria were:--patient's consent to the examinations;--possibility of obtaining an objective interview;--no psychic diseases in the interview;--recognition of dementia syndrome on the basis of DSM IV criteria. 59 persons have been qualified for the examinations. After qualifying the patient basic examination was being conducted and consisted of the following elements:--Mini Mental Scale Examination (MMSE);--Alzheimer's Disease Assessment Scale: AMDP scale--inventory 3--anamnesis was applied to obtain history data. RESULTS: The investigations showed a possible relationship between stress factors and degree of cognitive function.

Activities of Daily Living↗

[Young persons's personal experiences in student counseling and health care].

The aim of the study was to clarify the present student counseling and school health care of young people who have experienced difficulties at school. The aim was to enlighten the multidimensionality of their personal experiences and to understand the fundamentals of student counseling and school health care from this perspective. The theoretical basis of the study was in Rogers' and Parse's theories of nursing. In these theories man is viewed as a unitary being in continuous mutual interrelationship with the environment. The research method was phenomenological and the research material consists of theme interviews. Nine young people, aged 15-16 years, who had experienced difficulties at school and the student counselors and the health care personnel at their school were interviewed. Many difficulties were entangled together in the young peoples lives. The professionals had different viewpoints on the personal experiences of the young people based on their different beliefs about man. It was not possible to differentiate exactly the tasks of the different professions. The study gives evidence of the importance of observating the personal experiences of the young people in their entirety in school nursing and in student counseling. From this basis health promotion could be possible.

Adolescent↗

Personal computer word processing for veterinary article writing: personal computers and printers.

Word processing makes the writing and altering of scientific articles faster, easier, and more accurate. Personal computers that are ideally suited to this use are now available. Certain factors must be taken into consideration when a system is selected with word processing in mind. A small business computer or a suitable transportable computer, linked to a printer, provides all the hardware, or machinery, necessary. This, along with a sufficiently powerful word processing program, and all the essential accessories, can be purchased for between $2,300 and $6,000. The editors of all (with one uncertain) 29 clinical veterinary and medical journals surveyed will accept articles written by the dense dot matrix or near-correspondence quality printers that frequently accompany personal computers. The major problem affecting the veterinarian who wishes to purchase a personal computer word processing system is that of spending the time to acquire sufficient information in order to choose the computer and the programs that will be appropriate to his or her requirements. These will include the specialized word processing demands of scientific article writing and many other applications, as appropriate.

Computers↗

[Aspects of the life situation of spinal cord injured persons - a socio-medical study of 246 persons with spinal cord injuries (author's transl)].

The findings of the study are presented in extracts, and are compared to results of representative surveys (Federal Republic of Germany) in order to trace the differences that exist between the study sample and the rest of the population. It was found that spinal cord injured persons have more living space at their disposition than other people in the Federal Republic of Germany. Gainful employment, frequency of travelling, and mobility are considerably reduced in comparison to the pre-injury condition. The unemployment rate is above the national average. Severely disabled wheelchair drivers overestimate their independence. They are for example reluctant to admit that they depend on personal assistance and technical aids. The investigation clearly shows that further effort has to be made to gradually diminish unrealistic self-images in spinal cord injured person, and to improve markedly those of their living conditions that can be influenced from outside.

Activities of Daily Living↗

The person with schizophrenia as a person. II: Approaches to the subjective and complex.

In the mental health field, the attention given to the subjective side of a person's experience is grossly inadequate. The best way to reflect the subjectivity of a person may be by means of the subjectivity of another. To take account of both subjective experience and objective measures in the course of mental disorders, a new concept is needed. This may be the person's story.

Adaptation, Psychological↗

Integrating one-person and two-person psychologies: autochthony and alterity in counterpoint.

The classical psychoanalytic concept of the one-person treatment model and its assumptions concerning psychic reality are compared with the contemporary two-person model, subsumed under the concept of "alterity" (otherness). The classical model of unconscious mental life is explored in terms of the principles of "autochthony" (signifying the fantasy that self and object are created entirely from and by the self) and "cosmogony" (an aspect of primary and secondary processes that accounts for the creation of a personal and an objective world-view). Autochthony and cosmogony are subsumed under the category of "creationism." I discuss why I identify these three phenomena by these relatively unused terms.

Adult↗

Some psychosocial aspects of nonlethal chondrodysplasias: V. Assessment of personal social support using the Personal Resource Questionnaire.

Social support has been shown to be an important influence on how an individual copes with a number of stresses, including acute and chronic illness, psychiatric morbidity, and life events. It can be thought of as a dynamic process consisting of a network of persons who are available to provide support, and the level of support that is perceived to be available from those persons. Patients with disproportionate short stature due to a chondrodysplasia might be expected to face greater challenges in developing a social support network. This study assessed social support among a group of dwarfed patients using the Personal Resource Questionnaire (PRQ85). The overall extent and functioning of social support appears comparable to that in the general population, but there are some differences when unmarried patients are compared with married patients and when those who have affected spouses are compared with those whose spouses are of average stature.

Adult↗

The big five factors of personality and their relationship to personality disorders.

Articles examining the relationship between the Big Five factors of personality and personality disorders (PDs) are reviewed. A survey of these studies indicates that there is some agreement regarding the relationship between the Big Five and PDs. However, the level of agreement varies and may be a function of instrumentation, the method of report, or how data have been analyzed. Future research should consider the role of peer-ratings, examine the relationship between PDs and the first-order factors of the Big Five, consider dimensions over and above the Big Five as predictors of PDs.

Humans↗

Personality disorders in the community: results from the Australian National Survey of Mental Health and Well-being Part III. Relationships between specific type of personality disorder, Axis 1 mental disorders and physical conditions with disability and health consultations.

BACKGROUND: The aim of the present study was to examine in a national survey sample the risks of having a specific personality disorder (PD) and associations with gender, of having one or more physical conditions, of having one or more Axis 1 conditions, and of the severity (or degree) of disability. We also examined the association of specific PDs with having sought a consultation for health or mental health problems with a general practitioner (GP), a psychologist, or psychiatrist over the past 12 months. METHOD: Data were derived from the Australian National Mental Health and Well-Being Survey, conducted between May and August 1997. A stratified random sample of households was generated, from which all persons aged 18 or over were considered potential interviewees. There were 10,641 survey respondents, this representing a response rate of 78%. Each interviewee was asked 59 questions indexing specific ICD-10 PD criteria. RESULTS: Logistic regressions identified that some specific PDs, especially borderline PD, were more strongly associated with having one or more Axis I conditions, greater mental disability and lost days of total and partial role functioning than having No PD, and that others, notably anankastic PD, were less likely to be associated with the same variables. Some specific PDs, again most notably borderline PD, were more associated than others, again most notably anankastic PD, with having sought mental health consultations from GPs, psychiatrists, and psychologists. By contrast, PD associations with gender, physical conditions, physical disability and health consultations with the three professional groups were weaker as reflected in the comparatively smaller odds ratios and were also less consistent than the pattern with the previously mentioned variables. CONCLUSION: The study reports findings from a nationwide survey and, as such, the data are less influenced by the selection and setting bias found in most other studies investigating these variables. The findings of the study do point to some specific PDs, such as borderline PD, being associated with greater Axis 1 psychopathology, disability and mental health consultations than others, such as anankastic PD. It appears that although anankastic PD in itself is associated with more disability than having No PD, it becomes significantly more disabling when it is associated with other comorbid PDs.

Adult↗