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PubMed2004

Nurses' and social workers' attitudes and beliefs about and involvement in life-sustaining treatment decisions.

Data were collected from 213 nurses and 61 social workers at major hospitals across Israel. Whereas nurses reported being more involved in the daily care of terminally ill patients, social workers reported being more involved in discussions with patients and family members. Nurses were more willing than social workers to use artificial feeding and less willing to use mechanical ventilation and CPR for all conditions. Social workers expressed stronger beliefs about their involvement in end-of-life issues. These findings, which reflect the differences in the professional values and experiences of both groups, encourage the use of interdisciplinary teams to improve end-of-life decision making.

Adult↗
PubMed1975

Purposive behavior as a basis for objective communication between chimpanzees.

The rate at which a chimpanzee approaches a hidden, distant goal varies according to social conditions and according to whether the goal is a novel object or food. This behavior furnishes a social group with sufficient information for simultaneous and successive disrciminations between leaders and between goals.

Animal Communication↗
PubMed2005

Social environment and frequent attendance in Danish general practice.

BACKGROUND: A lack of social support is associated with increased morbidity and mortality and a decreased effect of prevention. Frequent attenders to primary care are characterised by poorer social conditions than other patients in general practice, but we do not know whether this is due to social inequalities in health or whether social factors in themselves determine the use of general practice. AIM: To examine if social factors are associated with frequent attendance in general practice after adjusting for physical and psychological health variables. DESIGN OF STUDY: Population-based cross-sectional survey. SETTING: Two hundred and twenty GPs in 132 practices in the county of Aarhus, Denmark, and the listed adult population (aged 20-64 years). METHOD: A sample of frequent attenders and infrequent attenders was drawn. The study included only those resident in the county and who had consulted a GP during the period November 1997-October 1998. A questionnaire about physical, psychological and social factors was sent to the patients. The associations between social factors and frequent attendance were adjusted for physical and psychological health and tendency towards somatisation. RESULTS: A total of 1423 (73.7%) frequent attenders and 1103 (74.9%) infrequent attenders responded. Male frequent attendance was associated, with statistical significance, with living alone and being without work or on a disability pension. Among women, lack of professional education or being without work tended to increase the likelihood of frequent attendance. CONCLUSION: This study shows that for men, social factors may in themselves determine the use of general practice. None of the investigated social factors seemed to restrict the use of general practice.

Adult↗
PubMed1990

[Psychosocial conditions of psychotropic drug poisoning of patients treated in the Gdańsk Toxicology Center].

The purpose of the study was in analysis of both causes and social conditioning leading to attempts of self-intoxications by the use of psychotropic drugs. The study included 234 patients treated in the Gdańsk Toxicological Center during years 1982-1987. In a majority, the intoxications referred to young subjects up to 30 year of age, more frequently women than men. Only 10% of subjects studied have had university education. The alcohol or drug dependence and various psychiatric disturbances has been noted in a majority of cases studied. The lack of real suicidal determination was characteristic pattern of group observed.

Adolescent↗
PubMed1995

Emil Kraepelin and comparative sociocultural psychiatry.

Emil Kraepelin, well known as the principal designer of modern psychiatric nosology, is less well known for his pioneering work in comparative sociocultural psychiatry. This paper is trying to document Kraepelin's role as the inaugurator of systematic investigations into culture-dependent differences in psychopathology. Despite his many responsibilities as clinician, teacher, hospital administrator and scientific author, Kraepelin considered cross-cultural comparison of such importance that he spent considerable time on the preparation of then very cumbersome overseas expeditions. His first research journey in 1904 to Southeast Asia led to the programmatic formulation of comparative psychiatry as a scientific endeavour designed to contribute to the better understanding of psychopathological processes and to a comprehensive comparative ethnopsychology ("Voelkerpsychologie"). Kraepelin's main cross-cultural research project, planned to extend to seven non-European countries and to involve many foreign colleagues, was prevented by World War I and postwar complications. One year before his unexpected death, Kraepelin conducted comparative studies with American Indian, Afro-American and Latin American patients at psychiatric institutions in the United States, Mexico and Cuba in 1925. In his writings Kraepelin commented on certain differences in the incidence and presentation of psychopathological phenomena that he considered to be due to ethnic-cultural characteristics or social conditions. This paper discusses in detail Kraepelin's observations on the pathoplastic and pathogenic effects of cultural and social factors, and demonstrates the influence of his ideas on the development of modern social and transcultural psychiatry.

Cross-Cultural Comparison↗
PubMed2001

Social stress in laboratory rats: behavior, immune function, and tumor metastasis.

This report summarizes data from social confrontations studies in laboratory rats dealing with the effects of psychosocial stress on immune functioning and tumor metastasis. The paper focuses on the physiological alterations observed in subdominant males after 2 days of continuous social confrontation. A significant loss of body mass and elevated plasma concentrations of adrenal hormones in subdominant males indicate a stressful social environment. Subdominant males showed lower numbers of blood CD4 and CD8 T cells as well as reduced activity levels of T cells and natural killer (NK) cells relative to control subjects. In order to evaluate the possible health impact of suppressed NK functioning, we used the MADB 106 tumor model. A 10-fold lower tumor clearance in subdominant males demonstrates suppression of the animals' capacity to prevent metastatic development. The relationship between individual behavior and immunological outcome is briefly discussed. Together, the study of male rats in social confrontations appears to be a good model to investigate stress-induced immune modulation and tumor metastasis under relatively naturalistic social conditions.

Animals↗
PubMed1985

The assault and battery panorama at a county hospital in Sweden.

All patients who had been assaulted and battered and who consulted the surgical emergency service at the county hospital were included. Forty seven cases were registered during a 5-month period, representing 1.1% of the surgical emergency patients. There were 31 males and 16 females. No case of child assault was recorded. About 55% of the males were between the ages of 20 and 29, whereas the females were relatively evenly distributed between 20 and 50 years of age. The patient material was analysed regarding social conditions, in what way the injury had originated and also the degree of severity of the injury. The social background and the presence of alcohol use or abuse were, as expected, important factors. Males were, as a rule, assaulted outside the home, females mostly at home. A few of the assault cases were legally prosecuted. The need for follow-up welfare measures was judged as considerable.

Adolescent↗
PubMed1991

[Psychological and social aspects in women with syndrome X].

A sizeable proportion (20-30%) of patients undergoing coronary arteriography for a chest pain syndrome are found to have angiographically normal coronary arteries. Some of these subjects (10-15%) have ischemic-like electrocardiographic changes during stress and no evidence of spasm of the epicardial coronary arteries (syndrome X). The vast majority of these patients are middle aged females. In the present investigation we evaluated the psychological and social characteristics of a group of patients with syndrome X (PX, n = 30). The results obtained in the PX group were compared with those in a sex and age matched group of patients with angiographically proven coronary artery disease (PI, n = 32) and with those in a group of control subjects (C, n = 29). Two original questionnaires were employed to collect the demographic and family data. The psychological data were obtained through the following 4 questionnaires: Symptom Rating Test (SRT); Symptom Questionnaire (SQ); Illness Behaviour Questionnaire (IBQ); Maudsley Personality Inventory (MPI). The results of our study indicated that in most of the patients with syndrome X the psychological and social conditions are similar and they are not compatible with a satisfactory lifestyle. In most cases both family and social difficulties are present, which impose excessive workload and distress on the patients. Very often the beginning of the chest pain history tends to coincide with the periods of greatest stress and with the occurrence of dramatic events in the family. On the other hand, the onset of symptoms often has the effect of releasing some of the environmental pressure on the patient.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

[Libido-related changes in the elderly].

Sexual desire can be influenced in elderly men by a number of factors such as hormonal abnormalities, socio-cultural conditions, chronic diseases, drugs. Testosterone decrease per se is not sufficient to impair sexual function in the elderly; social and psychological factors are probably of relevance as it can be observed in people living in nursing homes. Diabetes may have a major impact on sexual desire. Drugs usually associated with impairment of libido (psychotropic drugs, anti-hypertensives) are frequently used by elderly people; alcohol is a leading cause of sexual dysfunction, particularly in unfavourable social conditions.

Aged↗
PubMed2003

Evaluating long-term effects of heroin-assisted treatment: the results of a 6-year follow-up.

Since January 1994, heroin-assisted treatment for opiate addicts has been available in Switzerland. This is the first report of the long-term effects of this form of treatment. The report examines subjects who entered a study involving medical prescription of opiates (Projekt zur ärztlichen Verschreibung von Betäubungsmitteln; PROVE) in Switzerland between January 1994 and March 1995 (n = 366). Opiates were dispensed in eight treatment centres. A follow-up was conducted 6 years after treatment entry. Two groups were assessed: clients who have continuously been on heroin-assisted treatment since entry into the PROVE study or who re-entered this treatment, and ex-clients who had discontinued heroin-assisted treatment at the time of follow-up. Two kinds of comparisons were conducted. Firstly, conditions at treatment entry were compared to 6-year follow-up outcomes, and secondly, outcomes were compared between clients still on heroin-assisted treatment and those who had been discharged. It was found that 46% of the clients still alive were on heroin-assisted treatment at the time of follow-up. A comparison of the present living conditions showed very little difference between those in treatment and those who had terminated treatment. Compared to the situation at entry, the results of the follow-up showed a significant decrease in the use of illegal substances, illegal income and most other variables concerning social conditions, but they also showed an increase in unemployment and reliance on social benefits. Heroin-assisted treatment is thus efficacious in the long-term course of treatment and is still effective after termination of treatment with respect to living conditions and use of illicit substances.

Activities of Daily Living↗
PubMed2000

Syphilis in Slovenia--on the threshold of the European Union.

The epidemiological situation of early syphilis (ES) in Slovenia is the subject matter of this report. After almost 25 years of decrease in Slovenia, ES is increasing again. The incidence of ES increased from 0.10 per 100,000 inhabitants in 1992 and 1993 to 1.82 in 1994 and 1.90 in 1995. In the years 1996-1998 there was a slight decrease at 1.25-1.45. The higher incidence of infections with ES is presumably the consequence of changed social conditions in the states of the former Eastern bloc and Yugoslavia, and of changing living conditions, and illegal prostitution in Slovenia. AIDS and HIV in Slovenia is still at an early stage and there is no apparent link into the same social groups as syphilis. The current epidemiological situation of sexually transmitted infections (STIs) in Slovenia and the conditions existing to the south and east of Slovenia warrant strict surveillance of STIs by the medical services.

Acute Disease↗
PubMed1978

Design, development and use of a standardized interview to assess social maladjustment and dysfunction in community studies.

A standardized social interview, designed to assess social maladjustment and dysfunction is described. The interview is composed of items grouped under the 3 headings of Material conditions, Social management and Satisfaction. Ratings are made on a 4-point scale by interviewers standardized in its use. The interview, which takes approximately 45 minutes to administer, covers housing, finance, occupation, social and leisure activities, and relationships with significant individuals in the subject's life. The inter-rater reliability is assessed and principal component analyses performed, and the results of these are provided and dicussed. Various methods of scoring are examined and the use of the schedule in a number of studies in the setting of general practice is described.

Adult↗
PubMed1998

Cultural safety: a new concept in nursing people of different ethnicities.

Cultural safety is a concept which has been developed by Maori nurses in New Zealand in order to reflect on nursing practice from their point of view as the indigenous minority in our country. The paper contrasts this new concept critically with Leininger's well-known model of transcultural nursing in order to suggest its potential significance. To date work on cultural safety in New Zealand has focused on the attitudes which individual nurses bring to their practice, attempting to change the effects of their social conditioning on their approach to nursing. The paper supports the view that all nursing care is provided in a social context which influences its efficacy, and specifies that the structural elements, such as the institutional context within which nursing care is provided and policies which influence how care is the provided, need to be explicitly recognized. The paper concludes that until the effects on the health care system of inequalities in power between groups in society are addressed we cannot ensure that the needs of persons from minority cultures will be met. Because it illuminates this dimension of nursing care, cultural safety is a concept of general significance for all nurses.

Humans↗
PubMed2003

'About a year before the breakdown I was having symptoms': sadness, pathology and the Australian newspaper media.

Portrayals of mental illness in the media reportedly highlight violence and crime by the 'mentally ill'. Using a discourse analytic approach we investigated representations of 'depression' in the print media in Australia during the year 2000. Unlike other 'mental illnesses', in the case of depression the media stress the need for the protection of the sufferer, rather than others. Three key discourses are identified - the biomedical, the psycho-social and the administrative/managerial - which work to normalise depression by presenting it as beyond the control of the afflicted individual: a consequence of faulty brain chemistry or the product of social conditions. These discourses work together to produce unhappiness as individualised pathology in need of management through biological, psychological or social structural controls.

Attitude to Health↗
PubMed1988

The longitudinal study of the northern Finland birth cohort of 1966.

The Northern Finland birth cohort comprises 12,058 live births in 1966-96.3% of all births in the region. The investigation was started during pregnancy and the last follow-up of the total series was at the age of 14 years, when the coverage was still large. Smaller samples of the children and data for the study population from national registers were also examined for the older age groups. The health and development of the children was studied, with special emphasis placed on obtaining reliable incidence figures for neurological handicaps and their correlation with perinatal events. In particular, the correlation between low birthweight and handicapping conditions was documented thoroughly. The indicators predictive of low birthweight among the biological characteristics of the mother and the social conditions of the mother and family, included maternal smoking during pregnancy. The latter was associated not only with adverse perinatal outcome but also with reduction in educational achievement and height among survivors.

Adolescent↗
PubMed1983

Alcohol-abusing teenage boys. Testing a hypothesis on alcohol abuse and personality factors, using a personality inventory.

This is the second part of an investigation of alcohol-abusing teenage boys, focusing on personality. One group of 50 High-consumers and one group of 50 0-consumers were selected from 862 18-year-old boys in the general population summoned to the Regional Recruiting and Replacement Office in Solna. These boys answered a personality inventory (KSP) to test a hypothesis on alcohol abuse and personality factors which might indicate psychopathy. The results support the hypothesis that alcohol-abusing teenage boys have psychopathic personality traits while the non-consuming boys have normal personalities. The study cannot reveal whether the differences in personality were the result of the high alcohol consumption or if the psychopathic personality traits preceded the high consumption. A reasonable hypothesis for further research is that vulnerable boys living under poor social conditions react to their situation with motoric restlessness, impulsiveness and aggressive acting-out behaviour. Due to this their social adjustment as grown ups is poor with consequent alcohol and drug abuse and criminality.

Adolescent↗
PubMed1996

Preventing violence in a structurally violent society: mission impossible.

The futility of violence prevention efforts by government, professional organizations, and social advocacy movements should not be surprising, since the aim of these efforts has been primarily to control, punish, and modify the behavior of individuals involved in violence, rather than to discern and eliminate its root causes in the fabric of societies. This paper argues that efforts to prevent violence will continue to fail, as long as its sources in oppressive and unjust social conditions and values are not understood, confronted, and eradicated.

Humans↗