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PubMed1994

[Chronic fatigue syndrome. Clinical, social psychological problems and management].

Fatigue chronic syndrome (SFC) is the heir-at-law of neurasthenia. Both are seen like physical diseases and share certain therapeutic measures, such as sleep; they have the same symbolic function and enable patients as well as doctors reluctant to psychological dimensions of pathology, to get and express sympathy and attention. A strong controversy developed these last years concerning the SFC physiopathology particularly concerning the responsibility of viral infectious agents or psychiatric troubles. The SFC fatigue is unlikely hysterical or neuromuscular but it probably depends on several associated factors; cerebral neurobiochemistry anomalies (possibly induced by an infection or immune reactions), effort perception trouble, affective trouble, lack of physical activity. The handicap seems to be worse on account of unsuitable care and inefficacious treatment. Especially sleep, which is often beneficial in a short term, is source of ulterior chronicisation. Antidepressants are the only justified pharmacological treatment for SFC at the moment. Referring to the existence and the nature of cognitive distortions, the author suggests a cognitivo-behavioural therapy, whose aim is a progressive activity resumption.

Adaptation, Psychological↗
PubMed1994

[Temporary aspects of aging: a new approach to the problem].

Medical, psychologic and social problems are typical of the old age. Usually growing old means organic impair, loneliness and a lower social role; moreover, spatial behavior is completely reduced. The period could be lived and be considered in a different way, although aging is unavoidable. This work suggests that we should consider the passing of time a most comprehensive way. The cyclic, biological time can be replaced by a time which considers and gives expression to everybody's needs and activities. The first aim is to give the elderly a new social role, necessary to avoid a "ecosystemic destabilization". Therefore social workers should supply the aged with a new education at "lived time", as a new therapy form.

Aged↗
PubMed2002

Problem behavior in boys with fragile X syndrome.

This study examines problem behavior over time in 59 boys with fragile X syndrome (FXS), aged 4-12 years, using the Child Behavior Checklist (CBCL). Approximately 49% of the boys scored within the borderline or clinical range on total problem behavior, while 56-57% scored in the borderline or clinical range on the attention and thought problems subscales, and 26% scored in this range on the social problems subscale. With a mean of 2.5 assessments per child, behavior problems were stable during the 3-year period of study. Total problem behavior was higher for children who displayed autistic behavior, were rated as low in adaptability, had mothers with higher maternal education levels, and were on medication. Mothers with more education also rated their children as having more attention, thought, and total problems. Children taking medication differed from boys who were not taking medication on social problems, but not on attention and thought problems. Low adaptability and more autistic characteristics predicted thought problems.

Adaptation, Psychological↗
PubMed1999

[Problem orientation in social medicine--participation in social medicine].

Problem-oriented learning is gaining increasing importance in medical education. The current discussion on reforming medical education in the medical schools in Austria reflects this importance. At the medical school in Graz for many years teaching the core module "social medicine" has been problem-oriented. Small groups of students work on selected topics of public health. The topics are related to every day practice and their particular psychosocial ramifications and consequences are illucidated. This subject is required in the last year of medical school. The students are not familiar with problem-based learning and have difficulties in adapting. To be better prepared for the coming changes in the discipline of medicine, the social dimension should be integrated earlier into medical education. The most efficient way of doing so should be clarified in the discussion of the reform in medical education.

Austria↗
PubMed1977

Physicians' knowledge of and response to patients' problems.

The purposes of the study were: 1) to describe the extent of the physician's knowledge and his response; 2) to measure the degree of correlation among four indicators of knowledge and among four indicators of response; and 3) to measure the association between physician's knowledge and his response. There were five physicians and 299 patients in the study. All the patients had at least one chronic condition and one current complaint. The four indicators referred to the four kinds of problems considered: discomfort, worry, disturbance of daily living, and social problems. The physicians had high percentages of perfect scores on knowledge of discomfort, worry, and disturbance of daily living, but a low percentage on knowledge of social problems. Scores on response to discomfort were high but were low on response to other aspects. The correlations between knowledge and response, although statistically significant, were low for all four types of problems. It is possible that these correlations were underestimated because the physician's responses were recorded only for the three-month period of the study.

Adult↗
PubMed1975

The flower children of Sudbury. The story of a street clinic for hippies.

In the summer of 1973 an effort was made to provide medical and social services to the hippie or counter culture population of Sudbury. Sudbury is a city of 50,000 people located in Northern Ontario, Canada. Beginning in early 1973 a sizeable hippie group had developed. Because of the numerous medical and social problems exhibited by these people and their expressed unwillingness to seek help from the normal hospital and social agencies a free or street clinic was developed. The clinic was unusual in that it was free, there was no paid staff, it was informal, it was an evening clinic, and medical records were not kept. This article is a detailed description of the clinic, why and how it was organized, the medical and social problems we encountered, the work we were involved in and what we experienced and learned.

Attitude↗
PubMed1978

Training psychiatrists in social research: problems and prospects.

An integrated program of psychiatric residency training and doctoral studies in social welfare has been conducted by Brandeis University and two Worcester (Mass) clinical institutions over the last five years. Its goal has been to train psychiatrists to conduct psychiatric research using social science concepts and techniques. This article reviews the advantages of such a program, as well as its problems, in the context of current trends in psychiatric education and research. This program is also compared to others with similar goals that use different models of training.

Hospitals, State↗
PubMed1989

Prevalence of psychiatric disorders among subjects exposed to a natural disaster.

A general practice study was carried out in 3 areas of the province of Naples, in southern Italy: Pozzuoli (PZ), a town exposed to significant seismic events in 1983, Monte Ruscello (MR), a village built to accommodate the victims of the earthquake, and Monte di Procida (MP), a town selected as a control since it is situated near PZ and was not significantly affected by the earthquake. The sociodemographic characteristics of the subjects examined were comparable in the 3 areas. The estimate of the real prevalence of psychiatric disorders according to Diamond & Lilienfeld was found to be higher in PZ and MR than in MP. Neurotic depression was the most frequent psychiatric diagnosis. The relative risk of mental disorders in subjects who reported none one or more social problems compared with those who reported none was more than 4 times greater in PZ and MR than in MP. Social problems also differed qualitatively, being more frequently related to living conditions in PZ and MR and to the primary social network in MP.

Adjustment Disorders↗
PubMedDate not supplied

Premarital childbearing in northwest Kenya: challenging the concept of illegitimacy.

A number of African countries, including Kenya, have experienced a marked rise in births among unmarried women. In Western countries, reproduction outside of marriage is assumed to be illegitimate and a social problem. One hypothesis used to explain the increasing incidence of premarital fertility in Africa is a breakdown of traditional social controls by the extended family over the sexual behavior of adolescents. A competing hypothesis suggests that unmarried women use sexual relations to achieve goals such as marriage. Among Turkana pastoralists of northwest Kenya, we find a pattern of premarital birth that fits either hypothesis only loosely. Premarital fertility among the Turkana is both widespread and culturally acceptable, with over 30 per cent of women having at least one child prior to marriage. Although women with premarital births initiate childbearing on average one year earlier than women with only marital births, women's marital status does not influence the length of the interval between first and second births. Marriage among the Turkana is not a social trigger for the onset and continuation of reproduction or a means to legitimate reproduction. Marital status of the parents simply determines the custody of a child. In a premarital birth, the father pays a set fee to the mother's family, and the custody of the child remains permanently with the mother's family. If the parents later marry, the father must purchase custody of the child by another fee at that time. Since the Turkana have experienced few effects of modernization, the existence of such a practice suggests that cultural factors must be taken into account before assessing premarital fertility in Africa as a social problem.

Adolescent↗
PubMed1991

Science and social policy problems: resolution of some, creation of others.

The scientist has two jobs: to do good science, and to be a spokesperson for science in the creation of rational social policy. Three categories of interaction between science and policy are described and examples given. The first is where science has provided data that were decisive in causing policy to be enacted. The second is where science is capable of resolving equity issues that have arisen from problems that science itself created. The third is where the issues are ultimately resolved by extra-scientific considerations. Two major issues where it is hoped that science can make a significant contribution include outcomes analysis, a new approach to dealing with health care costs and variations in clinical practice; and the disease concept of alcoholism, with questions it raises of volition, personal responsibility, and punishment. However, science alone is never the dominant force in the shaping of policy, which is determined by the interaction of many social forces, such as morals, values, politics, and economics.

Adult↗
PubMed1990

[Patients' evaluation of their own discharge].

This article illustrates how a group of patients assess their own discharge from a neuromedical department. The length of notice about discharge is connected with the patient's experience of orientation and planning. The longer the notice, the greater the satisfaction with the orientation given by the doctor about the disease, the therapeutic possibilities and the prognosis and with the nursing staff as regards intake of medicine. Although the patient clientele has serious social problems, only one fourth had had contact with a social worker in connection with hospitalization. Over one third of the patients found that the first weeks after discharge constituted the most difficult period during the entire course of the disease and this may be connected with the fact that many of them experienced discharge as being badly planned. This shows that discharge is a stressing event in the course of an illness and that it requires more attention than it has hitherto received.

Denmark↗
PubMed1980

A twin study of specific behavioral problems of socialization as viewed by parents.

Our study focused on the etilogy of specific behavioral problems rather than on a global syndrome such as hyerpactivity. As a first step in studying specific behavioral problems, we revised the Conners (1970) Parent Symptom Rating questionnaire to improve its factor structure. Our revised instrument and the test-retest reliabilities of its 12 scales are described. A classical twin analysis comparing intraclass correlations for 54 pairs of identical twins and 33 pairs of same-sex fraternal twins indicated substantial genetic influence on behavioral problems in school-aged children.

Child↗
PubMedDate not supplied

[Social scenarios in Latin America and the Caribbean].

A wide range of sources have pointed out the magnitude and depth of the social problems that trouble Latin America and the Caribbean and the risks that these problems pose for democracy. Although there are other issues that merit consideration, this article briefly outlines nine key social problems: 1) the increase in poverty, 2) the impact of poverty, 3) unemployment and informal employment, 4) deficiencies in public health, 5) problems in education, 6) the newly poor, 7) the erosion of the family, 8) increasing crime, and 9) the perverse cycle of socioeconomic exclusion. Solving these problems must not be delayed. It is urgent to move to a comprehensive view of development that achieves a different balance between economic and social policies, and that recognizes the indispensable role of these policies in achieving truly sustainable development. At stake are problems that not only concern resources, but also priorities, levels of equity, and the organization of society. Facing up to this poverty and inequity requires an in-depth assessment of these economic policies' social consequences, of the crucial subject of Latin American inequity--the greatest in the world--and of the role of social and public policies.

Caribbean Region↗
PubMed1999

[An evaluation of the feasibility and validity of a scale of social assessment of the elderly].

OBJECTIVES: To analyse the reliability and validity of a scale of social evaluation of the elderly. DESIGN: Descriptive, cross-sectional study. SETTING: Primary care. PATIENTS: Sample of 1062 people from the over-65 population. INTERVENTIONS: The scale evaluated has five items (family situation, economic situation, housing, relationships and social support), and an overall score is obtained. Its reliability was evaluated by an interview with two observers, and validity by contrasting the score obtained on the scale with a reference criterion of an independent, blind assessment by a social work expert. MEASUREMENTS AND MAIN RESULTS: The intraclass correlation coefficient (inter-observer reliability) was 0.957. The Cronbach alpha coefficient was 0.4467, which denoted moderate to low internal consistency. Sensitivity and specificity were calculated for the validity of the criterion. Nevertheless, to detect social problems in care practice, probability proportions for different levels on the scale were more useful. These ranged from 1 to 23, while in the detection of social risk they ranged from 1 to infinity. CONCLUSIONS: The scale studied by us as a measuring instrument enables risk situations and social problems to be detected with good reliability and acceptable validity. It should be introduced into the care practice of professionals working in the social or health care of the elderly.

Aged↗
PubMed1992

A triaxial classification of health problems presenting in primary health care. A World Health Organization multi-centre study.

Over the past two decades, research in a variety of countries and settings has revealed the extent to which psychological morbidity and social problems constitute an important proportion of primary health care contacts, either in their own right or in association with physical ill-health. The development of appropriate responses, medical and non-medical, to such problems is, in part, hindered by the relatively low level of awareness concerning the significance of such problems and by currently inappropriate methods of describing and classifying health care problems in the primary care setting. There is a pressing need for an appropriate, relatively simple and flexible classification or list of problems presenting in primary care. This study describes the development, under WHO auspices and in an international setting, of a triaxial classification of health problems and the testing and modification of the classification by means of an international case vignette rating exercise. A psychological problem list and a social problem list, together with detailed glossaries, suitably modified in the light of experience derived from the study, are described, and proposals enumerated of possible ways in which these lists might be further developed and used in research and clinical undertakings in primary care.

Cross-Cultural Comparison↗
PubMed2001

[Information servicing for the complex problems of social and occupational research].

Research directions set in 1976 on opening the Institute for Complex Problems of Hygiene and Occupational diseases with SD USSR AMSc in Novokuznetsk were based on new methodologic approaches. Fundamentals of the approaches are concept of life support, complex systemic attitude to social and hygienic research and to health care management--these are topical ones nowadays.

Humans↗
PubMed2001

Preschool developmental pathways to preadolescent internalizing and externalizing problems.

The present study investigated longitudinal pathways from specific early preschool behavioral problems (ages 2-3 years) to internalizing and externalizing problems in preadolescence (ages 10-11 years), and the role of social problems at school entry (ages 4-5 years) in such pathways. Path analyses were performed using both parent and teacher reports in a sample of 251 to 346 children from the general population, depending on the availability of parent and teacher data at each time of assessment. Structural equation modeling revealed homotypic internalizing and externalizing pathways, predictions from early preschool externalizing problems to later internalizing problems, and negative predictive paths from early internalizing problems to externalizing problems in preadolescence. Cross-informant predictions spanning 8 years were found between parent-reported aggression and overactivity at ages 2-3 years and teacher-reported externalizing problems at ages 10-11 years. Further, results showed that boys' pathways were more complex and showed greater predictive validity than pathways for girls, and that social problems at school entry played a significant role in pathways to internalizing problems, but only for boys. The results are discussed from a developmental psychopathology perspective.

Child↗
PubMed2005

Ethics and the comprehensive application of epistemology in medical practice.

Our simple definition of ethics is good thought, speak and action. Epistemology means the hypothesis of facts about thought, speech and action. Medical practice is all means of medicine. Medicine classifies people into normal and abnormal. The abnormal are the sick. They loose some organs or those normal looking organs are dysfunctional. They are social problems, some can be treated, and some do not get the appropriate care. The problems of society of normal people are overeating and obesity, abortion, drug abuse, promiscuity, torture, terrorism, disobeying rules and order, corruption, brain-washing and unethical advertisements, etc. On the other hand, the social problems of the abnormal are down, deafness, blindness, dumb, hypertension, hypercholesterolemia, diabetes mellitus and cancer, etc. An example of the social-doctor problem is the mal distribution of doctors in rural areas. It was reported by the ministry of public health that the ratio of doctor to population to be 1:800 in Bangkok and 1:5, 700 in some rural areas in the north eastern part of Thailand. The doctors, themselves, are at a high grade of worker and intelligent quotient. They know all the problem and, at the same time, create problems, both, faster than the general population can do. It affects good and bad in the society. In the past, present and the foreseeable future the medical students get their studies in the western style. Their medical schools are situated in big cities. These schools are old and famous. They learn their medical procedure in a big hospital of more than 400 beds in the inpatient department wards. Their instructors and professors are highly qualified, are middle class people and well accepted in the society. Their families are lovely and warm. Their children study in the first class schools in town. The medical students feel very happy and appreciate seeing their professors in television routinely at prime time. In conclusion, their professors are an example of role model for them to follow. Everyone looks for security in her/his profession. Facts need no proof and reference. People with justice in mind should believe and understand the above mentioned. This leads to the problem of mal distribution of doctors in rural areas, why do doctors live in big cities or wish to be in the private sector? In fact, not many a number of doctors serve in the rural area. About 4-5 of them, their name will be announced yearly as the best rural doctor award. After the big ceremony, lasted not longer than a month, it is hard to remember their name. They are proud to be praised, it pushes them into stress intentionally with all the best of their intelligence and the total of their body strength to work harder in rural. Unfortunately their earning, the security of their profession, the increased chance of being sued, to get caught in the medical litigation, the expenses of their family social status and the study of their children cannot be compared to of those doctors in big city and/or in the private sector. Mal distribution of doctors in remote rural areas has been a persisting unresolved problem in many parts of the world, why not apply the principles of ethics and epistemology? They have been left, untouched forever.

Career Choice↗