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PubMedDate not supplied

Assessing the effect of psychiatric disorders on work function.

In summary, an effort to increase the specificity and replicability of assessments of disability has been made by a subcommittee on permanent psychiatric disability, consisting of four forensic psychiatrists, three clinical and forensic psychologists, a medical sociologist, a workers' compensation judge and a vocational rehabilitation expert. The subcommittee reviewed legislation, regulations and case law pertaining to workers' compensation, especially that related to compensation for work-related psychiatric injury in California. The subcommittee also reviewed published and unpublished papers that discuss problems related to the evaluation of claims arising from alleged work-related psychiatric injury in the California Workers' Compensation System. A limited review of existing systems for evaluating psychiatric disorder and psychiatric disability was carried out. A number of consultants, psychiatrists and psychologists reviewed the work independently or attended meetings at which the work was presented. Out of this work, a report was generated that has been described in detail in this chapter. An outline for assembling all of the data necessary for arriving at conclusions about impairment of work functions was generated. Eight work functions were chosen, derived from Social Security disability guidelines but somewhat modified to fit the issue of partial disability. Specific component factors for each of these work functions were identified. It is hoped that this method will provide a more quantitative, replicable and equitable system for assessing permanent psychiatric disability. If these are applied in good conscience by the medical-legal community, data will be generated that will make it possible to further modify specifications of these work functions.(ABSTRACT TRUNCATED AT 250 WORDS)

Humans↗
PubMedDate not supplied

How the UN is defending human rights.

Today some nurses are themselves victims of human rights violations (ranging from the extreme practice of torture to economic and social discrimination just because they are women), while others are witness to violations of the rights of their people or patients (minorities, indigenous population, AIDS sufferers, the mentally ill or children). But these injustices are not being ignored and nurses can help stop them. Since 40 years ago when the conscience of the world was awakened with the Universal Declaration of Human Rights, international instruments providing the legal clout and pressure to stop the oppressors have been set in motion and are working in some places. Unfortunately violations continue in a number of countries. There are numerous effective channels (see also Inside View), many through the UN. To mark the Declaration's 40th anniversary on December 10 and to give readers a better understanding of what the UN is doing to promote and protect the peoples of the world, INR below answers some questions that nurses may be asking, defines the treaties and shows what international machinery is available to realize those rights.* In a subsequent issue, INR will focus on nurses' involvement in torture and other inhuman treatment and their moral dilemma, giving the views of nurses who have cared for such victims.

Human Rights↗
PubMed1988

[Substance abuse with inhalants].

In this article, Charles Vaille maintains that for the past two decades there has been a renewed outbreak of substance abuse with inhalants among youth throughout the world. He asserts that this phenomenon can no longer be considered as limited to a few isolated incidents. The volatile substances are common place, inexpensive, and unlike other drugs, legal; they are subject to neither international nor national controls. The specificity of addicts to inhalants renders prevention very difficult. Vaille discusses this point after describing the following two types of inhalant addiction: 1. Inhalation of gas fumes: two examples of youths inhaling fumes are cited followed by a description of ways in which inhaling or "sniffing" is performed. Vaille then presents the short-term effects of the "high", both psychological and physical. He then proceeds to disclose the harmful long-term effects concluding that addiction due to inhaling fumes seems to be developed throughout Europe. 2. Forced hyperventilation: a detailed description of how the "game" of forced hyperventilation is played is followed by a discussion of its effects on health. In discussing regulatory measures, Vaille maintains that a country's first effort at preventing substance abuse is to limit and modify the existence of such substances. After describing the various means attempted, he concludes that these effects will always result in an elusive prevention, due to the extraordinary number of inhalant substances as well as the enticing aspect of the "forbidden fruit". Regulatory measures offer an answer to those seeking a clear conscience rather than attempting to get at the root of the problem.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1988

[Further comment on the distinction between humans and animals].

The problem of mind is considered in the aspect of natural scientific and philosophical problem of distinction between human and animal. The widespread confusion of the terms "rudiments", "elements" of specifically human properties in animals and "biological prerequisites" of these properties are critically analysed. The idea is formulated according to which only in the process of anthropogenesis the rudiments of new social property--mind, conscience--could appear in the developing human beings.

Animals↗
PubMed1986

The ethics of animal experimentation in the field of shock and trauma research.

This is a personal review of the concepts used in deciding ethical questions as to the use of animals in research in the field of shock and trauma. There are for me ethical considerations since I feel animals can and should be used experimentally to advance the cause of the alleviation of pain and suffering amongst severely injured patients. The framework within which such decisions are to be made has been provided for us in Sweden by laws enacted some years ago. Even with ethical review by specially appointed, regional Ethical Committees there still remain problems for the individual research scientist to resolve after the dictates of his own conscience. I operate under the dictum that human life is more valuable than animal life and that I can offer up animal lives to improve the health and welfare of humans. Research in the area of shock and trauma is important, since lives are lost due to our ignorance of many aspects of the pathophysiology of the problem. The injured are often relatively young who can be restored completely to health and gainful employment. The problem is also of interest for the emerging nations of the third world, since it is often their elite who are carried from the scene prematurely. New impetus to research has been provided by the realization that the trauma itself sets in motion events which can add to the final result. Better understanding here should lead to better treatment modalities.

Animal Welfare↗
PubMed1987

[Myxedema coma with hypervasopressinism. 2 cases].

Hyponatremia is usual during myxedema coma. Hereafter we report two cases with increased plasma arginine vasopressin (AVP). Patients were admitted because of hypothyroid coma. In each case, there was an hyponatremia with normal urine sodium and low serum osmolality. Renal function was normal. On hormonal results, primary hypothyroidism was evident. Plasma AVP was increased. The plasma cortisol of one patient was high. Immediate therapy associated: water restriction, hypertonic saline infusion, furosemide, oral thyroid hormones with low doses. On the fourth day, conscience improved obviously. Natremia and plasma AVP went back to normal state before returning to euthyroid state. Patients went on improving along with normalizing thyroid status. Hyponatremia can be a serious sign of hypothyroidism. In case of myxedema coma with hyponatremia, clinical improvement seems to be related to fast correction of water and electrolyte disturbances and we prefer to give low doses of thyroid hormones at first. The hyponatremia and increased plasma AVP mechanisms are complex. However, in each of these cases, plasma AVP come back to normal before returning to euthyroid state. In one case, high plasma cortisol level rules out adrenal insufficiency as causal mechanism of electrolyte disorders.

Aged↗
PubMed1986

Illness-behaviour, attitude, and knowledge in newly diagnosed diabetics.

Sixty-five consecutive patients with newly diagnosed type I diabetes, aged 15-52, were exposed to a systematic educational programme and followed up by three-monthly controls for two to four years. In order to identify psychic, social and behavioural factors associated with good metabolic control and appropriate adaptation to illness, they were clinically tested and filled in a questionnaire. The study shows that the illness and the therapeutic regime created few problems regarding practical circumstances of daily living, but there were a vast number of psychological problems: perceived disability, fatigue, fear, anger, strain, bad conscience, and perceived discrimination. The patients assessed the treatment regimen they had been taught as fair, but still the majority reported inadequate compliance and problems in relation to compliance, especially regarding dietary restrictions. The educational programme was evaluated by the patients as useful and satisfying. Actual illness-related knowledge, skills and compliance were not closely associated, suggesting that knowledge itself is an insufficient precondition to appropriate management of the illness. Social class and other social environment factors were not associated with illness-related behaviour and attitudes and neither was metabolic control. There were no psychological or social differences between the patients with good and those with poor control. A possible interpretation of these findings is that an increase of quality of life in diabetic patients requires separate efforts to increase metabolic control and to create appropriate psycho-social adjustment to the change in life situation.

Adolescent↗
PubMed1986

Two complementary cases of identification involving 'Third Reich' fathers.

The paper describes two complementary personality structures resulting from the identification processes of two patients whose fathers had believed in the 'Third Reich'. When the Nazi regime collapsed, both fathers failed to admit to their beliefs, developing a personality split characterized by 'double conscience', but each in a different way. The most conspicuous difference between the respective sons lay in their approach to reality. However, the two personality structures are virtually complementary and, taken together, make up a single structure deriving from Nazi ideology. This structure manifests itself in an extreme anal need to exercise power and control (the role of a perpetrator) and, conversely, the oral need to be dependent (the role of a victim) in a submissive relationship which has been idealized into a fateful promise. The polar extremes of submission and exertion of power exist in both patients. It is only a matter of time before the defence of experiencing oneself as a victim meets up with the repressed experience of harbouring the intentions of the perpetrator.

Fathers↗
PubMed1986

Forensic aspects of community dentistry.

Community Dentistry has developed as the dental profession's response to a social conscience, recognising the individual social and health needs and personal rights of each member of the community. In this context, forensic odontology is seen as providing that body of dental expertise necessary for the fulfillment of a number of social functions required by law, in both the civil and criminal arenas, with particular reference to the scientific identification of the dead, the investigation of bitemarks, the estimation of age and dental traumatology. The important role of dental records in these matters emphasises the social responsibility of each dentist to exercise great care in the documentation of his treatment procedures. This obligation also extends to the identification marking of dentures. The need for legislation in this area is discussed and the social responsibility of dental educators to include forensic odontology in the curricula of all dental schools, particularly in developing countries, is stressed. Research in forensic odontology should take into account the particular needs of each community in the light of their geographical, social and cultural backgrounds.

Community Dentistry↗
PubMedDate not supplied

Legal abortion in Italy: 1980-1981.

In 1980 and 1981, there were 446,430 legal abortions performed in Italy. There were about 345 legal abortions per 1,000 live births in 1980 and 363 in 1981. About 1.6 percent of women aged 15-49 obtained abortions in both years. An analysis of the characteristics of Italian women who obtained abortions indicates that most were married (about 70 percent), aged 18-36 (74 percent), had had less than a high school education (74 percent) and had had at least one previous live birth (70-75 percent). In 1981, 88 percent of abortions were obtained in public hospitals; 58 percent were carried out at eight or fewer weeks of gestation; and 78 percent were performed under general anesthesia. Only 20 percent were performed without an overnight stay in the hospital; and over 40 percent of women were hospitalized for two days or longer. Infection after the abortion was reported in only 0.03 percent of cases in 1981, and hemorrhage was reported in only 0.27 percent. In 1981, between 43 percent and 84 percent of gynecologists (depending on the region of the country) declined to perform abortions on grounds of conscience.

Abortion, Legal↗
PubMed1985

The chiropractic doctor.

Chiropractors as autonomous consulting professionals, acting as a portal of entry into the health care system, have a scope of practice which is diagnostically unlimited but therapeutically restricted. Chiropractic therapy is confined to natural means of intervention. Included in the health care responsibilities of primary contact practitioners is the requirement that they serve as a health relevant information source for their patients and clients. Chiropractors are achieving disease intervention by participating in the health education of their patients. Modern chiropractic doctors are teaching clinicians. In line with chiropractic philosophy, their perspective is holistic. In order to minimise intrusion upon the practice of their clinical expertise, health education tools are recommended and used by busy practitioners with a health promotion conscience.

Chiropractic↗
PubMedDate not supplied

[The Spanish woman and birth control].

The author presents in this article just a small part of the results obtained in national survey of 1.902 married women, carried out in 1972, on "fertility and family planning in Spain". More specifically, attitudes of this sample of Spanish married women towards family planning are explained. It is pointed out, in the first place, that eight out of every ten interviewed women say that all married couples who can have children ought to have them. Younger women and those with a higher socio-econimic status, however, are less in favor of that statement. Trough several questions it is also evident that the number of interviewees who think that other women control their fertility is higher the more distant from the respondent is the social circle about which the question is formulated. In other words, interviewees resist to admit that persons with whom they are more intimately related control their fertility. Approximately half the women in the sample say that married couples should have as many children as may come, but the other half say that couples should decide the number of children they want to have and when they want to have them. This last opinion is relatively more important among younger and higher status women. Along with the previous finding, almost half of the interviewees are very much in favor or rather in favor of family planning, that proportion being even higher among younger and higher status women. Finally, seven ou of every ten respondents say that there should be wide and complete information about all family planning methods, leaving it up to each individual to use or not to use them according to its own conscience. This opinion, of course, is also more common among younger and higher status women.

Adult↗
PubMed1979

[The place of institutions for the mentally deficient].

The institutions, more and more adjusted to the age and the specific handicap of the mentally deficients, attempt to provide an harmonious education. In order to do so, they have to resolve many problems: problems of the handicapped children, who are confronted to a new and very different life-style as well as to a large number of adults who will be taking care of them; problems of the parents, who are badly informed about the institutional methods; problems of the public to whom the existence of the medicoeducational centers gives good conscience; problems of the staff, called to work in a pluridisciplinary team and whose effeciency depends on its cohesion. Such teams should also include the parents.

Adolescent↗
PubMed1979

Self-mutilation of the eye.

While the act of self-enucleation is rare, other self-inflicted eye injuries may be more common. Six patients are reported who have documented histories of ocular self-mutilation. Several common factors are observed in these patients and in other cases reported in the literature: (1) the patient was judged to be psychotic; (2) the patient had a tyrannical conscience; (3) a source of guilt was present; (4) this guilt was displaced to the eye; and (5) an attempt at self-inflicted eye injury was followed by relief from anxiety when completed or by frustration when injury was prevented.

Adult↗
PubMed1979

[The frieze of the "Mystery villa" in Pompeii. Contribution to the development of female psychology].

The large frieze of the "Villa of the Mysteries" at Pompeji is interpreted on the base of the psychology of C. G. Jung, especially of his student Erich Neumann. According to his psychological theories the frieze is depicting the development of the female principle to individuation, arranged with extraordinary artistic inspiration. Through the myth of Ariadne-Theseus-Dionysus the change of the woman, disappointed from the personal man and hero is shown. Through the experience of the transpersonal male principle in herself she is entering in a new level of conscience, the patriarchism, and so coming to the highest development, to the "Selbst". The experience of the male principle is made through Dionysus, a symbol of change in the theory of the "Archetypen" found by C. G. Jung.

Art↗
PubMed1977

[Status epilepticus. Study of 105 cases 1972-73].

We have analyzed 105 cases of Status Epilepticus of variable etiology, cared for over a period of 3 years at the "Instituto de Neurología y Neurocirugía". Age, sex, origin, duration of illness before attending the Institute, Conscience variations, clinical crisis types, condition of Status Epilepticus appearance and unleashing factors were considered. Various complementary investigations were performed, although dissimilar in each case. Follow up EEG's were realized in 60% of the patients and pretherapeutic EEG's were done in less than 50%. The necessary time to control the Status was explained, depending on its duration before commencing treatment. Of 93 surviving patients, it was possible to learn the cause of epilepsy only in 43. The necroscopy study of 12 cases demonstrated that death in 9 patients was inevitable for various causes (tumorous, infectious, vascular, etc.) almost always intricate. In other 3 autopsied patients, only signs of cerebral hypoxia and non-neurologic infectious complications were found. In the discussion, the hypoxia-edema-hypoxia mechanism is insisted upon, as well as the need of breaking this circle as an important part of the treatment of these patients.

Adolescent↗
PubMedDate not supplied

[Psychological profile with Cushing disease (author's transl)].

Fifty-six patients with clinically and biologically unequivocal Cushing disease underwent psychological evaluation including at least one interview, a graphological test, a tree test, and a Szondi test. Patients were found to be hyperadapted, with a rigid repressive system, concealing major anxiety. These patients are closely dependent on their familial and professional affective relationships. This probably establishes the intensity of their repressive system. They need approval, appreciation, and recognition. Obsessional features are found (scrupulous conscience, compulsive activity) as well as manic-depressive features (fluctuations between depression and euphoric activity acting as a defense against depression). During the interviews it was established that onset of Cushing disease occurred a few months after prolonged stress; this stress dealt electively with the patients affective relationships.

Adult↗
PubMed1983

[Psychotherapy of schizophrenia].

Schizophrenic existence is the experience of an awful negativism, which comes from the depth of the Unconscious and appears at the surface of the conscience as the destruction of all positive symbols of life. Interpretations of psychodynamic mechanisms, of transference and countertransference, of dreams and fantasies must be rooted in the dominant therapeutic endeavour of creating with the remaining potentialities of the patient new positive symbols of the schizophrenic existence. The author's experience in the 30 years of his dealing with schizophrenic patients is here summarized.

Fantasy↗