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PubMedDate not supplied

Premorbid functioning in schizophrenia: a controlled study of Nigerian patients.

We compared the premorbid social adjustment of 38 schizophrenic patients with that of 20 manic patients. Even though the small sample size affected the number of significant differences obtained, schizophrenic patients consistently showed evidence of poorer premorbid functioning than manics at various stages of social development. Schizophrenic men also tended to have functioned more poorly than women. Poor premorbid functioning was associated with negative syndrome, but not with positive or disorganization syndromes. Our findings suggest that poor premorbid adjustment is an early sign of schizophrenic illness even among patient populations who may be characterized by good short-term outcome.

Adolescent↗
PubMed2004

Auto Action Learning: a tool for policy change. Building capacity across the developing regional system to improve health in the North East of England.

Health policy traditionally has tended to focus on health care policy. The World Health Organisation Investment for Health approach aims to influence policy development by locating health as both the outcome of, and an asset for, sustainable economic and social development. The policy context in England offers a range of drivers and opportunities to operationalise the Investment for Health approach through action to improve health and reduce inequalities, nationally and as importantly at a regional and local level. This paper traces developments in the North East of England April 2002-November 2002, from the perspective of an advocate for developing a systemic and systematic approach using an Investment for Health approach. The tool used to track change is based in action learning [M. Pedler, Action Learning for Managers, Lemos and Crane, London, 1996]. The Action Learning Problem Brief identifies why the goal is important, who to, how progress might be identified, difficulties and benefits. Generally, this acts as a starting point for problem solving within an Action Learning Set. This piece of work uses the framework for reflection and tracking, with input from a mentor, at four to eight weekly intervals, 'Auto Action Learning'. The authors pull out key learning points from the process, using a framework 'Towards a model for systematic learning from doing in the North East of England'.

Delivery of Health Care↗
PubMed2006

[Bio-psycho-social history--is it still up to date in the time of media communication?].

Specialization in medicine changes the kind of communication between doctor and patient. The direct personal communication is quite often complemented by the indirect communication via interactive media. A clinical investigation still demands a broad bio-psycho-social anamnesis which should encompass the history of the illness, the patient, and his/her ailment. The bio-psycho-social anamnesis is subdivided into nine steps: Joining, "map", actual disease, former illnesses, family history, personal development, social anamnesis, overview of the functioning of the systems, finalization of the anamnesis. The different steps are explained, and adequate techniques of exploration are described. How to conduct a professional doctor-patient conversation and exploration can similarly be learnt as the techniques of a physical investigation. These communication skills should be continuously taught during the education of medical students as well as during the further training of physicians.

Clinical Competence↗
PubMed1979

Mental health in the middle-aged population.

In the general health screening carried out 9 September 1973--11 January 1974 in the municipality of Säkylä in Southwest Finland as part of the Säkylä-Köyliö project, the current self-perceived psychological symptomatology of the population between the ages of 40 and 64 years (a total of 2,431 persons) was measured by the questionnaire developed by Goldberg. With a participation rate of 93.3%, the study revealed that 21% of those who took part suffered from psychological symptoms. In the subjects 50 years old or over these symptoms were nearly twice as common as in those under 50 years. Mental symptoms occurred most frequently in widowed and divorced persons as well as in pensioners and the unemployed. An increase in income and/or education appeared to be related to a decline in psychosymptomatology. In the municipality of Köyliö, with a less developed social organization, the frequency of psychological symptoms was 1.5 times that obtained for the more highly developed Säkylä.

Adult↗
PubMed2004

The current state of public health in China.

In the past 50 years, China has made great achievements in controlling infectious diseases and improving the public's health and hygiene. However, in the twenty-first century, owing to the negative effects brought on by aging of the population and the burdens of diseases, urbanization, industrialization, and globalization, Chinese public health officials are encountering greater difficulties than ever. Old operating models of public health cannot meet present requirements. The main problems are poor capacity to respond to public health emergencies, severe inequality of health care services, and lagging development of public health information systems. Public health in China can gradually meet the requirements of social development and the increasing public demand for health care services only when the public health is directed by informatization, globalization, technification, and humanization.

China↗
PubMed2001

Signing and lexical development in children with Down syndrome.

Language development in children with Down syndrome is delayed, on average, relative to general cognitive, motor and social development, and there is also evidence for specific delays in morphology and syntax, with many adults showing persistent problems in these areas. It appears that the combined use of signed and spoken input can boost early language development significantly, this evidence coming initially from single case-studies, and more recently from larger scale controlled studies. Research with typically developing hearing and deaf children, as well as children with Down syndrome, has demonstrated the importance of establishing joint attention for vocabulary development. Furthermore, studies carried out with children with Down syndrome indicate that reducing attentional demands may be especially important in scaffolding language development in this group. The use of signing strategies which have been found to facilitate language development in deaf children when signing to children with Down syndrome is discussed, as is the need for further research on this topic and on the importance of joint attention for the use of other augmentative and alternative communication systems, such as graphic symbol and picture systems.

Child Language↗
PubMed2001

Social networks as support interventions following traumatic brain injury.

The social network and social support needs of people following traumatic brain injury (TBI) are considerable and related to both health outcomes and community integration. We review what is known of the structure of social networks following TBI and explore the relationship of these networks to social support and health. Social network interventions in TBI are described and discussed. Empirically based suggestions are given for the development of interventions based on culturally sensitive programmes which develop social networks and support in a naturalistic manner.

Adaptation, Psychological↗
PubMed1990

[Management of elderly citizens in a residential setting].

On the basis of demographical and social developments as well as of the "demand" for nursing resources in the GDR, the medical and social care situation for the elderly is discussed with special emphasis on the responsibilities of the family practitioner. Concluding from our own investigations we propose to use the Classification of Disabilities for deducing indications of care activities and standards. Examples are given, in particular, in respect of differing forms of protected lodging of care-needing elderly citizens.

Aged↗
PubMed2001

Excreted metabolites of gonadal steroid hormones and corticosterone in greylag geese (Anser anser) from hatching to fledging.

Steroid hormones play major roles in the organization of the phenotype and in the activation of behavior. From hatching to fledging, they are involved in growth, development, and learning. We investigated the relationship between the ontogenetic patterns of steroid hormones and the sexual and social development of greylag goslings (Anser anser). Two groups of individually marked goslings (n = 10/5) were hand-raised under near-field conditions. 17beta-OH-androgen (AM), estrogen (EM), and corticosterone (BM) immunoreactive metabolites were measured noninvasively by enzyme immunoassay of individual fecal samples. Feces were regularly sampled from hatching to fledging. All excreted steroids were found to peak at hatching and to decrease thereafter. Gonadal steroids fluctuated more than BM, which remained at low levels throughout ontogeny after a slow decrease during the first 20 days. The pattern of BM is discussed in relation to learning processes (i.e., filial imprinting) and social stress. It is suggested that high initial BM may constrain energy allocation to growth. AM increased around the age of 20 days, when the feathers start growing, and later, together with EM, at the age of 40 days. These elevated values of gonadal steroids are discussed in relation to the sensitive phase of sexual imprinting. Females show higher EM levels than males throughout ontogeny. Furthermore, the ratio of excreted estrogen to androgen (EM/AM) of females before fledging correlates with the number of hatched and fledged goslings in their first years of reproduction. In conclusion, our data suggest a role for steroid hormones in the modulation of behavioral and morphological development in the precocial greylag geese, in agreement with the organizational-activational hypothesis.

Age Factors↗
PubMed2005

Safe motherhood in Jamaica: from slavery to self-determination.

The development of maternal health care in Jamaica is reviewed by examining government documents and publications to identify social and political factors associated with maternal mortality decline. Modern maternity services began with the 1887 establishment of the Victoria Jubilee Hospital and Midwifery School. Community midwives were deployed widely by the 1930s and community antenatal care expanded in the 1950s. Social policies in the 1970s increased women's access to primary health care, education and social support; improved transportation in the 1990s facilitated hospital delivery. Maternal mortality declined rapidly from approximately 600/100 000 in the 1930s to 200/100 000 in 1960, led by a 69% decline in sepsis by 1950, and a 72% decline from all causes thereafter, settling at approximately 100/100 000 in the 1980s. Skilled birth attendant deliveries moved from 39% in 1950 to 95% in 2001 and hospital births from 31% in 1960 to 91% in 2001. Maternal mortality plateaued at 70-80% prevalence of skilled delivery care. Deployment of midwives into rural communities and social development focused on women and children were associated with the observed improvements. Further reductions will require greater attention to the quality of emergency obstetric care.

Educational Status↗
PubMed2004

Constructing an understanding of mind: the development of children's social understanding within social interaction.

Theories of children's developing understanding of mind tend to emphasize either individualistic processes of theory formation, maturation, or introspection, or the process of enculturation. However, such theories must be able to account for the accumulating evidence of the role of social interaction in the development of social understanding. We propose an alternative account, according to which the development of children's social understanding occurs within triadic interaction involving the child's experience of the world as well as communicative interaction with others about their experience and beliefs (Chapman 1991; 1999). It is through such triadic interaction that children gradually construct knowledge of the world as well as knowledge of other people. We contend that the extent and nature of the social interaction children experience will influence the development of children's social understanding. Increased opportunity to engage in cooperative social interaction and exposure to talk about mental states should facilitate the development of social understanding. We review evidence suggesting that children's understanding of mind develops gradually in the context of social interaction. Therefore, we need a theory of development in this area that accords a fundamental role to social interaction, yet does not assume that children simply adopt socially available knowledge but rather that children construct an understanding of mind within social interaction.

Child↗
PubMed1990

The concept of distinct but voluminous groups of bipolar and unipolar diseases. I. Bipolar diseases.

One hundred and six affective (76 unipolar and 30 bipolar) and 101 schizoaffective patients (45 unipolar and 56 bipolar) were investigated after a long-term course of illness, evaluating sociodemographic and general data, the long-term course of illness, disability and psychosocial alterations according to WHO/DAS, WHO/PIRS and GAS, as well as several social consequences of the illness (living situation at the end of the observation time, downward occupational drift, downward social drift, premature retirement, achievement of the expected social development). Comparing the 30 bipolar affective and 56 bipolar schizoaffective disorders, no differences were found regarding (a) sociodemographic and general data (i.e. sex distribution, age at onset, education and occupation at onset, stable heterosexual relationship, premorbid personality and social interactions, mental illness in the family, broken home, life events, season of birth and social classes) and (b) relevant patterns of the long-term course. Regarding long-term outcome, the only difference found concerned the more favourable outcome of the bipolar affective disorders according to WHO/DAS, while using GAS the difference was not statistically significant. No difference was found either between the two bipolar groups in the social consequences of the illness. The combining of both bipolar groups as "bipolar diseases" is discussed, as well as the use of the terms "bipolar disease, affective subtype" and "bipolar disease, schizoaffective subtype".

Adult↗
PubMed1982

Primary health care in developing countries: the case of Nigeria, Sri Lanka and Tanzania.

The country health programmes reviewed in this paper are aimed at meeting the World Health Organization's (WHO) target of providing basic health services for all by the year 2000. In accordance with the objective of the programme, each of the country health programme is expected to focus on the mechanisms for expanding health facilities and strengthening the health planning machinery in order to achieve an equitable distribution of health facilities in the foreseeable future as part of social development and in the spirit of social justice. Although there are marked differences in the approach to the realization of the objectives of the various country programmes reviewed in this paper, the primary aim is to bridge the widening gap between the health 'haves' and the health 'have-nots' in the respective countries. A substantial part of the resources of these countries are now being set aside for the implementation of the health care programmes so as to meet the health aspirations of their people. It is our belief that the health programmes of these countries are laudable and if properly implemented they will meet the health needs of the people of the various countries. A continuous evaluation of the programmes will enable each country to assess the successes and failures of the schemes and the organizational bottlenecks that may make the realization of stated objectives a well nigh impossible task.

Developing Countries↗
PubMedDate not supplied

Promoting positive affect and diminishing loneliness of widowed seniors through a support intervention.

Seniors are most vulnerable to conjugal bereavement. Although social support buffers the effects of bereavement, widows and widowers have lower levels of social support than married individuals. Self-help/support groups can supplement support from their depleted natural networks. Accordingly, the aim of this demonstration project was to examine the impact of support groups on widowed seniors' loneliness, affect, and perceived support. Four face-to-face support groups for widowed seniors were conducted weekly for a maximum of 20 weeks. Participants completed pretest, posttest, and delayed posttest measures of support need and support satisfaction, positive and negative affect, and loneliness/isolation. The statistically significant impacts of the intervention were enhanced support satisfaction, diminished support needs, and increased positive affect. There was a trend toward decreased social isolation and emotional loneliness. In postintervention semistructured interviews, bereaved seniors reported increased hope, improved skills in developing social relationships, enhanced coping, new role identities, and less loneliness. Community health nurse researchers could conduct randomized controlled trials of face-to-face and telephone support groups for bereaved people of all ages. Community health nurse practitioners could benefit from lessons learned about timing, duration, and selection of sensitive outcomes.

Aged↗
PubMed1998

Psychological aspects of cleft lip and palate.

In addition to the influences of family dynamics, educational and vocational factors on the social development and rehabilitation of CLP patients, psychological problems, such as lowered self-esteem and difficulties during social interaction, are also experienced by CLP individuals. As only 20 per cent of cleft teams world-wide carry out a psychological assessment for their patients, it is likely that the prevalence of psychological problems is higher than the literature suggests. To maximize the chances of a positive outcome in the care of cleft affected individuals, CLP patients who are concerned about their appearance or who experience psychosocial problems need to be identified by cleft teams. Interventions, such as counselling or social interaction skills training, should be offered in order that the patient's self-esteem and social self-confidence can be increased. Current research surrounding patient and parent satisfaction with cleft care suffers from several areas of methodological weakness.

Adaptation, Psychological↗
PubMed1977

Some remarks on the economic and political development of health care in the Federal Republic of Germany.

The economic and political development of health care in the Federal Republic of Germany is analyzed within the framework of overall social development. This will be shown describing the main components of the health care system: outpatient care, inpatient care, the dispensing of medicines, and statutory health insurance. The functions of the state and the influence of the pressure groups, i.e. the medical professional associations, are examined. Finally, an assessment of the present situation is made.

Delivery of Health Care↗
PubMed1994

[The effects of international migration on the receiving countries, the countries of origin, and immigrants].

"This article points out that the societies who lack labour force and those who have a surplus, share common interests which may lead to organised or spontaneous migratory flows. Today, emigration is incapable of correcting the weaknesses of the socioeconomic structures of the host societies or of being a means of developing the societies of origin. The latter have in reality only benefited from 'passive' gains. In the future, countries providing labour force must endeavour to improve their understanding of the advantages of emigration for their development and take initiatives in order to improve the integration of population transfers in their economic and social development." (SUMMARY IN ENG)

Demography↗