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PubMedDate not supplied

Picky eating: a toddler's continuing approach to mealtime.

Research indicates that three primary components play a role in the picky eating phenomenon: development, personal preferences, and the family. Picky eating is an aspect of child development. Children will develop their own preferences when given the appropriate tools to do so. Parents are their children's greatest role models. An understanding of these concepts can help guide the primary care provider in making appropriate recommendations to parents to improve their toddlers' eating behaviors.

Adaptation, Psychological↗
PubMed1979

[Radiological changes of the lungs induced by inhalation of irritating gases (author's transl)].

The radiological changes and clinical symptoms induced by in 109 persons by inhalation of irritant gases are described. Seven persons developed pulmonary oedema, abnormal radiological manifestations were observed in 19 while 81 persons there were no detectable radiological changes. Toxic pulmonary oedema is frequently detected earlier by roentgenologic means than clinically. The length of the radiological latent period depends not only on the concentration of the irritant but also on the type of the gaseous substance. The first roentgenologic signs of toxic pulmonary oedema are broadening and blurring of the outline of the hilar vessels. The pulmonary changes are characterized initially by disseminated small to medium sized shadows in the central portion and base of the lungs; later they tend to spread and merge.

Adult↗
PubMed1993

[Preventive measures against HIV infection].

It is reported that approximately 900 persons with human immunodeficiency virus (HIV) are present in Japan. Among them, almost 300 persons developed acquired immunodeficiency syndrome (AIDS). However, we have to assure that more persons infected with HIV or patients with AIDS, which are not registered, appear to exist even in Japan like in other countries. Accordingly, it is just a matter of time for us to treat them in any hospital. At the present time when the curable treatment for AIDS has not been established, it is important to prevent further infection of HIV by spreading the proper knowledge on HIV and AIDS to many medical doctors, nurses, and other medical staffs as well as peoples. Medical staffs are needed to possess a better understanding of the disease status and the treatment. There is no need to have a overreaction to HIV infection and AIDS, since the route of infection and the source of infection are really restricted as in the case of hepatitis B or C virus.

HIV Infections↗
PubMed1989

[Infection by non-A, non-B acute viral hepatitis in hospital employees].

The aim of this study is to evaluate the risk of infection of non-A, non-B acute hepatitis (NANB-AH) in hospital employees. Among 593 patients with acute viral hepatitis (AVH), hospital employees were 3/147 (2%) in type A, 19/174 (11%) in type B and 21/272 (8%) in non-A, non-B (NANB). All 43 patients were medical staffs such as doctors, nurses and laboratory technicians. Out of 21 patients with NANB hepatitis of hospital employees, 7 were doctors, 14 nurses and 6 laboratory technicians. Eight of them had preceding accidental needlestick exposures. Out of 17,290 employees of our hospital during 18 years, 27 medical persons developed AVH. They were 2 hepatitis A, 10 hepatitis B and 15 hepatitis NANB. No non-medical staff developed AVH. Out of 15 NANB hepatitis patients, 7 had needlestick accidents 4 to 6 weeks before development of the illness, and all donor patients showed liver diseases. During 3 years (1985 to 1987), there were 116 needlestick accidents in our hospital which happened in medical staffs alone, and 50 of them were NANB hepatitis-related accidents. Three ml of human immune serum globulin (ISG) was administered intramuscurally just after accidents to 23 persons but not to 27 persons. NANB hepatitis were developed in 2 doctors who were not treated with ISG. In conclusion, NANB hepatitis occurred in hospital employees especially in medical staffs.

Accidents, Occupational↗
PubMed2006

Role of CYP2E1 immunoglobulin G4 subclass antibodies and complement in pathogenesis of idiosyncratic drug-induced hepatitis.

Idiosyncratic drug-induced hepatitis (IDDIH) is the third most common cause for acute liver failure in the United States. Previous studies have attempted to identify susceptible patients or early stages of disease with various degrees of success. To determine if total serum immunoglobulin subclasses, CYP2E1-specific subclass autoantibodies, complement components, or immune complexes could distinguish persons with IDDIH from others exposed to drugs, we studied persons exposed to halogenated volatile anesthetics, which have been associated with IDDIH and CYP2E1 autoantibodies. We found that patients with anesthetic-induced IDDIH had significantly elevated levels of CYP2E1-specific immunoglobulin G4 (IgG4) autoantibodies, while anesthetic-exposed healthy persons had significantly elevated levels of CYP2E1-specific IgG1 autoantibodies. Anesthetic IDDIH patients had significantly lower levels of C4a, C3a, and C5a compared to anesthetic-exposed healthy persons. C1q- and C3d-containing immune complexes were significantly elevated in anesthetic-exposed persons. In conclusion, our data suggest that anesthetic-exposed persons develop CYP2E1-specific IgG1 autoantibodies which may form detectable circulating immune complexes subsequently cleared by classical pathway activation of the complement system. Persons susceptible to anesthetic-induced IDDIH develop CYP2E1-specific IgG4 autoantibodies which form small, nonprecipitating immune complexes that escape clearance because of their size or by direct inhibition of complement activation.

Adult↗
PubMed2005

Causes of incident visual field loss in a general elderly population: the Rotterdam study.

OBJECTIVE: To determine the incidence and causes of visual field loss (VFL) in a general elderly population. METHODS: Central visual fields of both eyes were examined with suprathreshold perimetry in 3761 persons aged 55 years or older and free of VFL at baseline from the population-based Rotterdam Study. Goldmann perimetry was performed to confirm suprathreshold VFL. Causes of incident VFL (iVFL) were assessed based on all available ophthalmologic and neurological examination data and medical records. RESULTS: After a mean follow-up time of 6.3 years, 175 persons developed VFL. The overall incidence rate of iVFL was 7.4 per 1000 person-years, increasing to 21.1 per 1000 person-years in those aged 80 years and older. Glaucoma was the leading cause of iVFL in all age categories. The overall incidence of glaucomatous VFL was 2.0 per 1000 person-years. CONCLUSIONS: The incidence of all VFL increased 5-fold between 55 years and 80 years of age or older. After glaucoma, stroke was the second most common cause of iVFL in persons younger than 75 years, followed by age-related macular degeneration and retinal vascular occlusive disease.

Aged↗
PubMed1999

Toward creating physician-healers: fostering medical students' self-awareness, personal growth, and well-being.

To restore the "humanism" in medical care, medical education needs to espouse the goal of creating physician-healers. Critical, and often neglected, factors in healing are the personal development and well-being of the healer. Unexamined attitudes and biases and personal stress can interfere with patient care. Personal awareness and well-being can contribute to physicians' using their emotional reactions to patients for their patients' benefit. The authors suggest goals and objectives for medical education that can promote trainees' self-awareness, personal growth, and well-being, and comment on how medical educators might achieve and evaluate these goals and objectives.

Awareness↗
PubMed1998

[Tuberculosis in HIV-positive and HIV-negative drug users in Amsterdam].

OBJECTIVE: To determine and to compare the incidences of active tuberculosis in HIV positive and HIV negative drug users and to describe the main characteristics of the tuberculosis cases. DESIGN: Prospective. SETTING: Municipal Health Service, Amsterdam, the Netherlands. METHOD: Data of the ongoing cohort study of HIV infection in Amsterdam drug users, including HIV serostatus and CD4 cell counts, from 1986 until 1996 were completed with data from the tuberculosis registration of the tuberculosis department of the Amsterdam Municipal Health Service and analysed statistically. RESULTS: Of 872 participants 24 persons developed culture confirmed tuberculosis during a total follow-up period of 4000 person years (py) (0.6 per 100 py). Nineteen persons were HIV positive (1.54 per 100 py) and 5 HIV negative (0.18 per 100 py). Multivariately, HIV infection and higher age increased the risk of tuberculosis substantially (relative risks 12.9; 95% confidence interval (CI): 3.4-48.8 and 6.8: 95% CI: 1.3-35.0 respectively). Thirteen of 22 pulmonary tuberculosis cases (59%) were detected by half-yearly X-ray screening of the chest. Tuberculosis occurred relatively early in the course of HIV infection at a mean CD4 cell number of 390/microliter. All but one patient completed the tuberculosis treatment. CONCLUSION: HIV infection increases the risk of active tuberculosis in Amsterdam drug users 13-fold. The incidence of tuberculosis in HIV negative drug users in 6 times higher than that in the overall Amsterdam population. Periodic chest X-ray screening contributes substantially to case-finding of active tuberculosis in Amsterdam drug users.

AIDS-Related Opportunistic Infections↗
PubMed1984

Managing the pharmacy manager.

Methods of self-assessment, self-development, and coping with stress in the role of hospital pharmacy manager are described. Personal development and career growth should be systematically appraised; goals and priorities should be continually re-evaluated; and time management, response to change, and impact on others should be examined. Questions for assessment in each of these areas are provided. Advice for reducing stress and avoiding burnout is given. Managers' attitudes affect employee productivity; positive attitudes and related actions that are applicable to hospital pharmacy management are described. Managers' personal and professional goals and priorities and their methods of using time and coping with stress affect management of their departments.

Administrative Personnel↗
PubMed1998

A longitudinal study of body mass index and lens opacities. The Framingham Studies.

OBJECTIVE: The purpose of the study was to determine whether body mass index (BMI) is an independent risk factor for the development of nuclear, cortical, or posterior subcapsular lens opacities. DESIGN: A cohort study. PARTICIPANTS AND METHODS: Eye examinations were conducted on surviving members of the Framingham Heart Study Cohort from 1973 to 1975 (Framingham Eye Study I) and again from 1986 to 1989 (Framingham Eye Study II). Data from the Framingham Heart Study, including weight measurements collected biennially from 1948, were used to examine associations between BMI (mean BMI across examinations, slope of BMI over time, and fluctuations in BMI) and the development of lens opacities. This analysis included 714 individuals, aged 52-80 years, who were free of lens opacities at the first eye examination. MAIN OUTCOME MEASURES: Development of nuclear, cortical, and posterior subcapsular lens opacities. RESULTS: A total of 444 persons developed lens opacities during the approximately 13 years between eye examinations. In logistic regression analyses that controlled for age, sex, education, diabetes, and smoking, the risk of developing cortical opacity increased with higher BMI at the time of the first eye examination (P = 0.002). Risk of cortical opacities also increased, at a borderline level of significance, with higher average BMI (P = 0.09) across examinations and increasing BMI levels over time (P = 0.10). There was a strong association between increasing BMI over time and the development of posterior subcapsular lens opacities (P = 0.002). No associations were found for nuclear lens opacities. CONCLUSIONS: Although the mechanism explaining the association is unclear, these findings suggest that BMI, a potentially modifiable characteristic, is associated with the development of cortical and posterior subcapsular lens opacities.

Aged↗
PubMed1977

[Psychodynamic aspects of paraphrenia].

Proceeding from Kraeplin's original a brief summary is given of the literature about the extensive interpretations of the term paraphrenia. Our study is based on a catamnestic examination of schizophrenic diseases first acute in 1930-1940 after 30 respectively 40 years (H. Hinterhuber) and a second group of paraphrenics who at the time being have been under our control for five years. By a simplifying scheme our own conception of paraphrenia is then defined and differentiated from the paranoid schizophrenia and the development of paranoia with special reference to the characteristic juxaposition of schizophrenic symptomatic in otherwise intact personality without a noteworthy derangement of the evironmental relations. The intact personality stands in clear contrast to the only "intact outside personality' with schizophrenic derangement of the ego. Thus the paraphrenic has the possibility to withdraw to the core of his sound personality and erect a mostly stable barrier against the partly massive hallucinations on the periphery of his personality. This corresponds to a passive attitude of avoidance in the sense of behaviour psychology. As THEREFORE the paraphrenic, similar to the phobic, tends to confine the borders of his existence by an increasingly passive avoidance attitude, he tries by a systematic desensibilisation to keep the borders of existence just in the area between psychosis and sound personality and thus render the best possible extent of personality development avoiding secondary restrictions.

Behavior Therapy↗
PubMed2003

The development and application of a public health skills assessment tool for use in primary care organisations.

The public health skills assessment instrument described in this paper was developed to provide a key group of UK primary care practitioners (health visitors) with a personal development planning tool and researchers with a robust assessment tool for use in evaluations of innovative local public health programmes. Pilot testing with over 120 practitioners has provided evidence of its reliability and validity as a research instrument as well as yielding useful insights for public health educators, practitioners and policy-makers. Factor analysis confirms 10 core competency domains for health visitors which are remarkably consistent with those recently identified for UK public health specialists, interpreted here as grounds for optimism in the greater co-ordination between strategic and front-line approaches to public health work in primary care. However, results also confirm earlier findings indicating low levels of skill amongst health visitors in tackling health inequalities through interventions such as community development, raising questions about their capability to work effectively in new roles proposed by the Department of Health.

Community Health Nursing↗
PubMed2002

The mystery of human context and coping: an unraveling of clues.

Community and clinical psychology share a fundamental focus: to understand the interplay between human contexts, coping, and adaptation. To highlight recent progress in this area, I offer a guiding conceptual framework and discuss 8 propositions about environment and coping. The propositions consider such issues as patterns of social climate and coping and their links to personal development and dysfunction, the connections between ongoing life circumstances and intervention programs, the role of personal characteristics in matching individuals and environments, and the value of placing specific settings in an ecological context. I then focus on 8 enigmas, such as how to identify conceptually unifying dimensions of diverse social contexts, how to model the processes involved in person-environment transactions, how to understand the link between adversity and personal growth, how to examine the generality of models across ethnic and cultural groups, and how to enhance positive carryover from intervention programs to ongoing life contexts. I close by addressing some implications of these issues for a vision of a dynamic community psychology.

Adaptation, Psychological↗
PubMed1986

Bringing the visiting diary up to date.

A method is described for the systematic assessment and review of long term dependent patients in a small practice using a personally developed computer program and assessment scale.

Aged↗
PubMedDate not supplied

[Depression in older persons].

INTRODUCTION: Depression is a common problem in old age, especially among those with various medical illnesses. Aging brings about numerous losses that might lead to depression: loss of health, loved ones and social roles. Some of older persons develop depression. Depression in old age is a serious illness. The suicide rate among older persons is very high. Approximately 90% of elderly people who commit suicide suffer from depression. Adequate treatment of depression in late life includes reducing and resolving depressive symptoms, preventing its relapse and reoccurrence, improving quality of life, and reducing mortality and healthcare costs. MATERIAL AND METHODS: 32 female inpatients were examined. All patients suffered from depressive disorder (middle, according to International Classification of Diseases (ICD-X). Only patients without cognitive impairment were included in the study, according to Mini-Mental State Examination. Hamilton Rating Scale for Depression was used as primary measure of efficacy. Patients were evaluated for efficacy weekly. For statistical analysis t test was used. RESULTS: Depressive disorders are more severe among older patients, with greater suicidal risk, anxiety and psychomotor agitation. Patients treated with moclobemide show quicker remission of depressive symptoms compared to patients who were treated with mianserin. CONCLUSION: Depressive disorders among older patient are very serious illnesses, but with adequate therapy, symptoms can disappear, and there is no difference between remission in depression among older and younger patients.

Adult↗
PubMedDate not supplied

[Evaluation of temperament and personality in bulimia nervosa].

UNLABELLED: Previous studies revealed the possibility of abnormal personality development role in the etiology of eating disorders. It was found that a diagnosis of personality disorders, mostly borderline personality and/or histrionic personality can be made in about 44-46% of bulimic patients. The inconsistencies in identifying personality types using categorical assessment approaches have encouraged a conceptualization of the personality from a dimensional perspective. It was revealed that the Tridimensional Personality Questionnaire (TPQ) and Temperament and Character Inventory (TCI) are useful in studying patients with eating disorders. AIM: The aim of the study was personality dimensions and depression symptoms assessment in bulimic patients. METHOD: We studied 36 women with purging type bulimia according to DSM-IV and ICD 10 criteria. The mean age of the studied women was 19.7 years. The control group were 44 healthy women: university and last year high school students (mean age 20.4). We assessed body height, body mass and Body Mass Index (BMI). Severity of depression symptoms was assessed with the use of Beck Depression Index (BDI), and personality dimensions with the use of (TCI). CONCLUSIONS: Women from the study group had higher harm avoidance (HA) scores, which shows that bulimic patients are shy, fearful, doubtful, tend to be inhibited in most social situations. Mood disorders present in the studied women influenced HA scores. The results of the study revealed lower possibilities of self-directness in bulimic patients in comparison with the control group. Negative correlation between BDI and SD scores, shows that a decrease of depression severity may lead to an increase of self-esteem, independence and effectiveness of bulimic patients.

Adolescent↗
PubMed2005

As the wheel turns: a centennial reflection on Freud's Three Essays on the Theory of Sexuality.

Freud's theories of psychosexual development, while highly original, were anchored in the explosion of scientific studies of sex in the nineteenth century. Most of these studies were based on masturbation, homosexuality, and deviance, with little attention given to normal sexuality. Around the turn of the century, the narrow interest in pathological sexuality and sexual physiology gradually gave way to a broader interest in normal sexuality. It was in the context of these expanding studies of sexuality that Freud proposed the first psychological view of sexuality, a theory that defined sex as being at the interface between soma and psyche. Libido theory, which Freud developed, is a theory of drives and conflicts. For Freud, libido was the major force in personality development, and he posited sexual conflicts as the heart of neuroses, sexual fixations as the essence of perversions. This article traces the way Freud's libido theory has served as one of the mainsprings in the development of psychoanalytic theory. It also addresses the major revisions that have taken place in libido theory, with a focus primarily on object relations theory, and the impact of culture on the way sex and sexual mores are parsed.

Freudian Theory↗
PubMed2002

Depressive symptoms, cognitive decline, and risk of AD in older persons.

BACKGROUND: Cross-sectional and retrospective case-control studies suggest an association of depression symptoms with cognitive impairment and AD, but there have been few prospective studies and their results have been inconsistent. METHODS: Participants are Catholic clergy members who were aged > or =65 years and who did not have clinical evidence of AD. During a 7-year period, they underwent annual clinical evaluations that included clinical classification of AD and detailed cognitive function testing from which global and specific measures of cognition were derived. Number of depressive symptoms was assessed at baseline with a modified, 10-item Center for Epidemiologic Studies Depression Scale (CES-D). The association of CES-D score with incident AD, using proportional hazards models, and cognitive decline, using random effects models, was examined. RESULTS: At baseline, participants reported an average of about one depressive symptom on the CES-D scale (range, 0 to 8). During the 7 years of follow-up, 108 persons developed AD. In analyses that controlled for selected demographic and clinical variables including baseline level of cognitive function, CES-D score was associated with both risk of AD and rate of cognitive decline. For each depressive symptom, risk of developing AD increased by an average of 19%, and annual decline on a global cognitive measure increased by an average of 24%. CONCLUSIONS: The results raise the possibility that depressive symptoms in older persons may be associated with risk of developing AD.

Aged↗