[Social problems among tuberculosis patients in the Raseborg district].
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During the course of a malnutrition study, the efficiency of two diets has been followed by clinical observations and biochemical tests. The diets were adapted to the physiological state of 25 patients (16 children, 6 young mothers, 1 adolescent and 2 men) undergoing treatment in a rural hospital at Yasa-Bonga, Zaïre. One group of patients was examined after two weeks of treatment (6 children, 2 mothers), the other group after two months (8 children, 5 adults). In order to study the evolution of the illness, 9 children and 3 young mothers were examined regularly after the return to their villages every 6 months for 2-4 years. The patients responded positively to both diets. After two months of treatment they had clinically recovered, except for the most serious cases. After two weeks of treatment a deficiency in electrolytes, low levels of prealbumin and a net increase in transferrin were noted. After 2 months of treatment the children had regained their normal growth (hydroxyproline index), and most of the biochemical parameters had reached their normal value despite a few deficiencies in electrolytes, phosphorus and magnesium. However, the prealbumin level remained low, particularly amongst children suffering from relapses. In a few cases the activities of cholinesterase (CHE) and gamma-glutamyltranspeptidase (gamma-GT) remained low, which was taken as a sign of poor response to treatment. Generally, the adults responded more slowly to treatment than the children. Regular examinations carried out on certain patients on their return to the villages permitted 2 groups to be distinguished: the first one was composed of patients recuperating well due to good social conditions; the second group of patients suffered from relapses due to lack of hygiene and of rudimentary knowledge of nutrition, and above all severe social problems. The condition of the liver of all these patients was very important; it could be estimated by the determination of the serum levels of prealbumin and the activities of CHE, gamma-GT and isoenzymes of gamma-GT.
OBJECTIVE: To examine whether increasing cumulative deprivation has an incremental effect on total as well as cause specific mortality. DESIGN: Census data on housing conditions as indicators of deprivation from 1960, 1970, and 1980 were linked to 1990-98 death registrations. Relative indices of inequalities were computed for housing conditions to measure the cumulative impact of differences in social conditions. PARTICIPANTS: 97 381 (71.1%) 30-49 year old and 70701 (80.0%) 50-69 year old inhabitants of Oslo, Norway, in 1990 with census information on housing conditions and recorded length of education. MAIN RESULTS: Mortality risk was increased when all censuses' housing conditions were summed in both age groups and sex. The cause specific analysis indicated such an effect particularly for coronary heart disease, chronic obstructive lung disease, and smoking related cancers. Violent deaths were essentially associated with housing conditions closer to the time of death in men in both age groups and in young women. CONCLUSIONS: To fully account for socially mediated risk of death, a full life course approach should be adopted. The relative importance of each stage seems to vary by cause of death.
Social control and social support are important aspects of psychiatric care. Modern psychiatric care in an area close to the residential quarters of patients requires attentive and self-critical observation, especially of the subtle forms of social control. The concepts of social control and social support are explained; basing on own investigations by the authors, as well as on own experiences and literature, some aspects of social support of schizophrenics and alcoholics are described from the viewpoint of local care.
BACKGROUND: The authors hypothesised that medical schools need to support their students by identifying the challenges inherent in the demanding study of medicine, especially during the transitional phase at the beginning of study. Therefore, a study was conducted to evaluate Year 1 students' perceptions on how well 2 different programmes--a reformed and a traditional programme--helped students make a good start to their studies. DESIGN: Cross-sectional survey. METHOD AND PARTICIPANTS: A questionnaire was distributed to Year 1 medical students on reformed (RT) and traditional track (TT) curricula. Its 5 subscales measured perceived stress and support. RESULT: A total of 155 students (70% of the year group) responded. Significant differences between groups appeared in 4 of the 5 subscales. Students on the RT felt more supported than students on the TT in terms of study conditions, social support at university, perceptions of their own attitudes and competencies, and living conditions. No differences in perceptions of social support outside university were apparent. CONCLUSION: Key aspects that were perceived as supportive included good contact with fellow students and teachers, high quality of courses, and a curriculum that fulfilled students' expectations and made sense to them. In identifying particular features that led to the positive judgement of the RT, the authors hypothesised that the following aspects were crucial: the specific orientation unit in the first 2 weeks, the problem-based learning workshop, the coursebooks and extracurricular social activities.
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Eyelid conditional discrimination learning (ECDL) is a test of discriminative aversive conditioning. It places minimal demands on motivation and was shown to selectively test temporal lobe function. Twenty-five unmedicated social phobia (SP) patients (mean age 29.5 +/- 7.0 years), diagnosed according to DSM-IV criteria, and 25 age- and gender-matched healthy controls (HC, mean age 34.0 +/- 8.6 years) were examined with an ECDL paradigm. In the experiment two differently colored stimuli are randomly presented. Only one of the stimuli (reinforced trial) is followed by an aversive airpuff to the cornea, as opposed to unreinforced trials not followed by an airpuff. Conditioned responses (CRs) consist of reflex eyelid closures already upon light presentation. HC as well as SP patients showed a significant difference between reinforced and unreinforced trials. In SP patients, CR frequency did not increase during the ECDL task, while HCs showed appropriate conditional discrimination ability. Thus the results indicate an impairment of adequate behavior modification in an aversive conditioning task in SP.
'Social buffering'--the apparent capacity of group membership to reduce the adrenocortical response to stress, was investigated in squirrel monkeys by means of a between-within experimental design. Adult males were assigned to two groups. Group paired (n = 6) received pairings of a conditional stimulus (CS) with footshock. Group control (n = 6) received CS presentations without shock. All animals were then tested with 10 presentations of the CS without shock under three social-housing conditions, in four successive phases of the experiment: individual, dyad, group, and individual housing. Neither group showed a cortisol response to the CS prior to training. Following training, CS-evoked elevations of cortisol were found only in group paired, and only in the individual housing conditions. These results replicate and extend our previous finding that the presence of conspecifics can ameliorate a neuroendocrine response to psychological stressors in squirrel monkeys.