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At least 433 records · Page 24Linked to original sources
PubMed1998

Characteristics of geriatric patients related to early and late readmissions to hospital.

The aim of the study was to evaluate which characteristics of geriatric patients account for readmission to hospital, 6 months after discharge. All patients (203 females, 176 males) consecutively admitted over a two-month period to four acute geriatric care units, located in the cities of Chieti, Perugia, Pescara and Prato, participated in the study. Data that could potentially explain early and late readmissions were collected for each patient. Prevalence of diseases and comorbidity were assessed with the Cumulative Illness Rating Scale (CIRS); physical function by self-report (ADL, IADL) and objective (Stand and Walking Speed) measures; cognitive level by MMSE; and depressive symptoms by the Geriatric Depression Scale (GDS). Information on family and social support were also obtained. After discharge, data on hospital readmissions were collected for six months. For each readmitted patient (cases), medical records were reviewed, and supplementary information was obtained from families and general practitioners. Readmissions were classified as "early" (within the first three months), "late" (within the third and sixth month), and "multiple" (2 or more readmissions irrespective of the period). Patients not readmitted (alive at home) were considered as controls. Systematic differences between centers and between periods of readmissions were evaluated using one-way analyses of variance, and Pearson's chi 2 test. Factors related to early, late, and multiple readmission were identified in multivariate logistic regression models. On univariate analysis, patients readmitted over the first three-month period were sicker than controls (CIRS classes 3-4: 52.1% vs 34.1%), had more social problems or behavioral symptoms, and were more functionally impaired (ADL dependencies 3.3 +/- 0.4 vs 2.1 +/- 0.2). Patients who were readmitted between the third and the sixth month after discharge had a significantly higher CIRS total score (p = 0.006). Patients with multiple readmissions had more severe diseases, and more social problems. On multivariate analysis, early readmission was associated with unsatisfactory social conditions, living alone, severity of diseases and cognitive impairment, while late readmission was associated with comorbidity only. Multiple readmissions were related only to social factors, and to hospital admission before the baseline evaluation. The findings of this study suggest that interventions aimed at improving unfavorable social conditions may reduce the rate of rehospitalization in geriatric patients.

Activities of Daily Living↗
PubMed1993

The Latin American trial of psychosocial support during pregnancy: a social intervention evaluated through an experimental design.

Perinatal health problems are a public health priority in Latin America. Among the identified risk factors, psychological and social conditions play a crucial role. However, care during pregnancy and delivery in the region is usually hospital-centered and does not address women's psychological and social conditions. The preeminence of research on perinatal health, along with the necessity for testing interventions that represent alternative models to improve women's health, gave the Latin American Network for Perinatal and Reproductive Research grounds to develop a multicenter randomized controlled trial to evaluate a program of social support and health education during pregnancy. The conceptual framework for this study was based on an ecological model of social support, i.e. a model in which social support and health education play a synergistic role and are meant to modify stressful situations and negative health-related behaviors. The target population consisted of women attending obstetric hospitals before the 22nd gestational week, at high psychological and social risk (n = 2236). The intervention consisted of four to six home visits, carried out by social workers, and had four main components: the reinforcement of pregnant women's social support network, emotional support, health education, and the improvement of health services utilization. The main foci of the intervention were determined after an ethnographic study was carried out to identify stress-producing situations and needs for support during pregnancy. Besides the home visits, the program also offered a hot-line, an office in the hospital, a specially designed poster and booklet, and a 'guided tour' of the health institution. Since this was a multicenter trial, the program's standardization was a crucial methodological aspect that was achieved through the training course for the home-visitors team. Biological and psychosocial outcomes were measured in both experimental and control groups at the 36th week of gestational age, post-partum and at the 40th day after delivery. The attributes of the multicenter population showed an important variability, reflecting differences in the countries or hospitals' population prevalent attributes. The results of the program's implementation were analyzed, demonstrating that home visitors adapted topics discussed during the interviews to the women's conditions and the stage of pregnancy during which the visit took place.(ABSTRACT TRUNCATED AT 400 WORDS)

Female↗
PubMed2003

The dynamics of spine density changes.

Numerous papers have been published describing the effects of learning and environmental changes on the wiring of brain areas in mammals and birds. The density of dendritic spines, which can be taken as a measure of the complexity of a given neuronal network, has been shown to increase or to decrease depending on the experiment and on the brain area involved. Almost no information is available concerning the speed with which a given network reacts to learning events or environmental changes. We therefore examined the time course of spine density changes in two areas of the zebra finch forebrain, which have been shown previously to be either involved in sexual imprinting (LNH, lateral part of the neo-hyperstriatum) or to react to environmental changes (ANC, archi-neostriatum caudale). The decrease of spine density in LNH of zebra finch males after sexual imprinting is very fast, the new level of spine density is reached after 2 days. In contrast, decrease of spine density within ANC as a consequence of transferring birds from a social condition into isolation is very slow, lasting about 3 weeks. The increase of spine density within ANC after transfer of the males from isolation to a social condition occurs within 3 days. The differences in adaptation times cannot be due to limitations in the growth speed of single spines, because this has been shown to be much faster (hours instead of days). Instead, the speed of adaptation may be dependent on the availability of information about the final wiring diagram and on functional aspects like the energy demands for maintenance or alteration of a given neuronal network, or the necessity of quick adaptation to enhance the fitness of the animal.

Animals↗
PubMed1975

The problem of generalization in the operant conditioning of social speech in the severely subnormal. Use of reversal to establish generalizability.

Many severely subnormal patients talk little to each other. In this experiment, three pairs of subjects were reinforced for talking to each other, and learned to do so quite quickly. Whether social speech would continue to occur without the benefit of external reinforcement was examined by observing the subjects through a one-way mirror in a bare interview room adjacent to the teaching room immediately after each training session. On some occasions untrained subjects were observed in the bare room with the trained subjects. The reinforcement of social speech was demonstrated to be effective by the use of a reversal design (baseline, reinforcement, no reinforcement, reinforcement), where the rate of speech increased considerably when reinforcement was available but decreased when it was discontinued. Generalization of the increased social speech, however, was very poor and only significantly above baseline levels with the pair who seemed responsive to social as well as material reinforcement. The implications of this for training programmes are discussed.

Adult↗
PubMed2004

Long-lasting effects of social stress on peritoneal inflammation in some strains of mice.

Adult male mice were kept for one week either one or four animals per cage. Some were maintained under the same social conditions for an additional 9 days (controls); their counterparts were either grouped (4 per cage) or isolated (1 per cage). Changes in housing conditions caused a significant increase of plasma corticosterone measured 30 minutes after separation or grouping of SWISS, C57C3H, and BALB/c but not of C57BL/6 mice. Peritoneal inflammation was induced by i.p. zymosan injection on day 9 after changes in housing conditions when corticosterone was again at its initial level in each group. Peritonitis-connected pain symptoms, exudatory PMN numbers, and cytokine (IL-1beta and MPC-1) and corticosterone levels were compared between animals living in stable social conditions with those shifted 9 days earlier from separation to the group or vice versa. These factors were unaffected by social stress in C57BL/6 mice and in SWISS animals transferred from the group to isolation. In all other instances at least two parameters were significantly different in the post-stressed and control animals, being either enhanced or inhibited. In conclusion, social stress had long-term consequences on the course of inflammation in three out of four investigated strains of mice.

Analysis of Variance↗
PubMed1994

Phase specific morphological changes induced by social experience in two forebrain areas of the zebra finch.

We examined the changes of spine density in Golgi preparations of two different areas of the forebrain of the zebra finch, the ANC (Archi-Neostriatum caudale) and MNH (medial Neo-Hyperstriatum) during development, after transferring male birds from isolation to a social condition (exposure to a female for 1 week), and after a second isolation period. MNH and ANC are two of four brain regions which are strongly activated if a male bird is exposed to a female after some time of isolation. The results of our study can be summarized as follows. 1: a peak-decline trend is observed in ANC, but not in MNH. 2: rearing conditions do not affect the development of both areas until day 70. 3: from 80 days of age, isolation leads to reduced spine density within ANC, but to enhanced spine density within MNH. 4: short social contact after isolation diminishes or eliminates the effects of isolation by an enhancement of spine density in ANC and a reduction of spine density within MNH. 5: the effects of short social rearing after isolation are reversible within ANC, but not within MNH. We presume that the alterations of spine density, which are induced by changes in social conditions, are restricted to ages older than 70 days by hormonal factors. We propose that the complexity of the ANC neuronal net follows the complexity of the social environment, and that the level of arousal is the most important factor influencing the complexity.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1996

Radicalizing recovery: addiction, spirituality, and politics.

Treatment centers and self-help recovery programs promote individual solutions to substance abuse through changing dysfunctional behavior and relying on spiritual beliefs and practices. The root problems are understood to be diseases within the person. However, the social conditions implicated in causing the addiction remain unaddressed. Although class, race, and gender do not predict substance abuse, many people entering clinics are from disempowered groups. Can social workers bring recovery and social justice methods together? What can radical social workers in the addiction-recovery industry do?

Humans↗
PubMed1998

Private and public in the lives of chronic schizophrenic patients.

This article argues that both the private and public spheres must be taken into account when analyzing the development and everyday reality of the mentally ill. Private and public are two poles whose reciprocal relationship constitutes the form taken by a person's life. The interplay of both areas expresses how a person uses his thinking, feeling, and acting to relate to a real or imaginary audience. The psychosocial reality of a person is based on cooperation of the public and private selves. According to a central thesis of this essay, a loss of public presence leads in equal measure to a loss, rather than an increase, of private reality. An empirical study based on a sample of patients with chronic schizophrenia confirms this assumption by showing that such patients, under today's social conditions, develop lives characterized by a high degree of private reclusiveness. This is linked with an external and internal loss of life reality. Many patients, however, look for indirect and socially noncommittal forms of participating in public life without having to deny their private reality.

Adaptation, Psychological↗
PubMedDate not supplied

Health as a socially mediated process: theoretical and practice imperatives emerging from research on health inequalities.

Population-based studies on health disparities provide compelling evidence that inequities in health status over the life course accrue from social conditions. Our knowledge of how such conditions exert their effect on health, however, is limited. An examination of explanations for health disparities shows that a theoretical perspective that enables the exploration of the links between broader social processes (macro) and experience (micro) would offer valuable insights for practice. This article introduces a theoretical perspective informed by Bourdieu and Smith that has been used to undertake such an analysis and that opens up possibilities for new practice forums and foci.

Anthropology, Cultural↗
PubMed1991

Sociophysiology of relationships in squirrel monkeys. I. Formation of female dyads.

Physiological and behavioral consequences of formation of female-female relationships were investigated in adult squirrel monkeys. Plasma cortisol, heart rate, and behavior were evaluated during confinement in a test cage while animals were housed alone, during the first hour of isosexual pair formation, and while animals were housed as isosexual dyads. In addition, basal cortisol levels were assessed both before and after pair formation, as were behavioral and cardiovascular responses to social and nonsocial stimulus presentations. Basal cortisol levels underwent a marked and sustained reduction following formation of pairs, independent of both dominance status and the quality of social interactions between pairmates. In contrast, adrenocortical responsiveness was not altered by social conditions, apart from a modest and transitory difference between dominant and subordinate females in their initial response to pair formation. Heart rate declined sharply during each test session, but did not reliably differentiate social conditions, stimulus conditions, or dominance status. These findings contrast with results of a parallel study of male squirrel monkeys and suggest that isosexual relationships in males and females are associated with different sociophysiological processes.

Animals↗
PubMed1999

Role of interleukin-1 beta in impairment of contextual fear conditioning caused by social isolation.

Isolating rats immediately after conditioning impairs contextual but not auditory-cue fear conditioning. The reported experiments examine the involvement of brain interleukin-1beta (IL-1beta) in the impairment in contextual fear conditioning caused by social isolation. As measured by the conditioned freezing response, 5 h of social isolation after conditioning, impaired contextual but not auditory-cue fear conditioning in adult male Sprague-Dawley rats. Social isolation for 1 or 3 h after conditioning also increased IL-1beta protein in the hippocampus and cerebral cortex. No differences in IL-1beta protein levels were found in the pituitary or the hypothalamus. Intracerebroventricular (ICV) IL-1 receptor antagonist (IL-1ra) given after conditioning prevented the impairment in contextual fear conditioning caused by isolation. ICV IL-1ra had no effect on auditory-cue fear conditioning in these same animals, nor did it affect the level of contextual fear conditioning displayed by home cage controls. Like isolation, ICV IL-1beta (10 or 20 ng) after conditioning also impaired contextual but not auditory-cue fear conditioning. These results suggest that increased levels of brain IL-1beta play a role in producing the impairment in contextual fear conditioning produced by social isolation. These findings also add to the generality of the idea that stressors induce IL-1beta activity in the brain and that IL-1beta may play physiological roles in the uninjured brain.

Acoustic Stimulation↗
PubMed2003

[A nationwide study in primary health care: One out of four patients suffers from anxiety and depression].

Anxiety and depression in Swedish primary care has rarely been studied. A national sample of 131 primary care physicians and their 1,348 patients during one day in September 2001 responded to questionnaires on somatic disease, social conditions, treatments, and symptoms of anxiety and depression. A total of 23% of the patients had generalized anxiety and/or depression with or without receiving treatment, i.e. the most common category following musculoskeletal conditions. The appointment was caused by anxiety in 7.1% of the patients, depression in 8.5%, and insomnia in 11%. This group of patients did not deviate much in terms of somatic and social conditions, except being younger. Doctors were confident in diagnosing and treating them. Five key questions can be used in primary care to screen for these common psychiatric conditions.

Adult↗
PubMed1990

Impaired hoarding and olfactory learning in DSP-4-treated rats and control cagemates.

The possibility that variables affecting rats' home-cage odor preferences also influence hoarding behavior was examined. Neonatal male rats were injected SC with the noradrenergic neurotoxin, N-(2-chloroethyl)-N-ethyl-2-bromobenzylamine (DSP-4), or with vehicle. At weaning, rats were assigned to control-only, DSP-4-only, or mixed groups of DSP-4 and control rats. For the next 10 days, half the rats in each social condition were housed in cedar shavings, and remaining rats were housed in pine. Exposure to cedar significantly increased preference for the odor in control-only groups, but not in DSP-4-only or mixed treatment groups. Control-only groups also hoarded significantly more pellets per animal than rats in the other two social conditions. The results suggest that both olfactory adaptation and hoarding can be impaired by either neonatal NE depletion or an abnormal social environment.

Animals↗
PubMed2004

Tyrosine hydroxylase expression is affected by sexual vigor and social environment in male Cnemidophorus inornatus.

Although the distribution of catecholamine-synthesizing cells has been described for a variety of taxa, less is known about the functional significance of particular populations in nonmammalian species, especially reptiles. To understand the role of these populations in the display of social behaviors in lizards, we studied the interactive effects of sexual vigor (sexually vigorous vs. sluggish) and social condition (housing in isolation vs. with females) on the number and somal areas of cells expressing tyrosine hydroxylase (TH), a rate-limiting enzyme in catecholamine synthesis, in male whiptail lizards, Cnemidophorus inornatus. We found that, regardless of social condition, sexually vigorous males had more TH-immunoreactive (TH-ir) cells in the dorsal hypothalamus (DH) relative to sluggish males. Sexually vigorous males also had more TH-ir cells in the substantia nigra pars compacta (SNpc), but this difference was significant only among males housed with females. Sexually vigorous males that had been housed with females had smaller TH-ir cells in the preoptic area (POA) than vigorous males housed in isolation. On the other hand, no significant differences were found in the anterior hypothalamus. These results highlight the regional heterogeneity in the plasticity of TH expression and suggest that, just as in other species, the DH, SNpc, and POA might be involved in the expression of social behaviors and in behavioral plasticity following social experiences in lizards.

Animals↗