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Sample records for psychosomatic care primarily

  1. Psychosomatic consultation in the workplace” – a new model of care at the interface of company-supported mental health care and consultation-liaison psychosomatics: design of a mixed methods implementation study

    Directory of Open Access Journals (Sweden)

    Rothermund Eva

    2012-09-01

    Full Text Available Abstract Background Mental health issues are gaining in importance in society and the economic system. At the same time, the accessibility and stigmatisation of the mental health care system in Germany can obstruct help-seeking behavior and delay early psychotherapeutic interventions. Therefore, new models of care are being established at the interface of company-supported health promotion and conventional health insurance sponsored outpatient care for people developing mental illnesses. Two large industrial companies, in cooperation with two psychosomatic clinics, have recently established a model of “psychosomatic consultation in the workplace“. This new model of care offers the opportunity for a first psychotherapeutic door to door consultation with occupational medicine within the industrial workplace. The main empirical goals of this study are: 1 Describing the differences between patients who use this new diagnostic and therapeutic offer within the industrial workplace vs. patients who visit a conventional regional outpatient clinic, especially in regard to symptom duration and severity, work ability, and demographic characteristics, and 2 A first evaluation of how patients may benefit more from this new model of care compared to those first seen by standard outpatient care. In the qualitative part of the study, occupational physicians, psychosomatic therapists, involved personnel and select employees of the involved companies will be asked to comment on their experiences with this new approach. Methods/Design The implementation study will take place in Ulm and in Stuttgart, with each site looking at one regional conventional psychosomatic outpatient clinic and one psychosomatic consultation offer within the workplace. 70 consecutive patients in each setting will be recruited (overall n = 280. For the cross-sectional study and pre-post comparison we will use established and validated survey instruments (PHQ, SF-12, WAI, MBI, IS as

  2. Characteristics and trends in peer-reviewed publications in the field of psychosomatic medicine.

    Science.gov (United States)

    Heffernan, Sean P; Stern, Theodore A

    2014-01-01

    The field of psychosomatic medicine/consultation-liaison psychiatry, now a subspecialty in psychiatry, has focused its efforts on clinical care, education, and research at the interface of psychiatry, medicine, and neurology. We sought to categorize characteristics and trends (over the past decade) in several journals intended primarily for practitioners of psychosomatic medicine. We reviewed all articles published in 3 peer-reviewed journals (i.e., Psychosomatics, General Hospital Psychiatry, and the Journal of Psychosomatic Research) in 2002 and 2012. Each of the 3 journals has a different approach to publication of original research, clinical reviews, and case reports. The 3 journals demonstrate differing levels of international involvement, publish a different number of articles of different types (e.g., case reports, reviews, and original research), and focus on different types of medical-psychiatric problems. Copyright © 2014 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.

  3. Anxiety and psychosomatic symptoms in palliative care: from neuro-psychobiological response to stress, to symptoms' management with clinical hypnosis and meditative states.

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    Satsangi, Anirudh Kumar; Brugnoli, Maria Paola

    2017-08-09

    Psychosomatic disorder is a condition in which psychological stresses adversely affect physiological (somatic) functioning to the point of distress. It is a condition of dysfunction or structural damage in physical organs through inappropriate activation of the involuntary nervous system and the biochemical response. In this framework, this review will consider anxiety disorders, from the perspective of the psychobiological mechanisms of vulnerability to extreme stress in severe chronic illnesses. Psychosomatic medicine is a field of behavioral medicine and a part of the practice of consultation-liaison psychiatry. Psychosomatic medicine in palliative care, integrates interdisciplinary evaluation and management involving diverse clinical specialties including psychiatry, psychology, neurology, internal medicine, allergy, dermatology, psychoneuroimmunology, psychosocial oncology and spiritual care. Clinical conditions where psychological processes act as a major factor affecting medical outcomes are areas where psychosomatic medicine has competence. Thus, the psychosomatic symptom develops as a physiological connected of an emotional state. In a state of rage or fear, for example, the stressed person's blood pressure is likely to be elevated and his pulse and respiratory rate to be increased. When the fear passes, the heightened physiologic processes usually subside. If the person has a persistent fear (chronic anxiety), however, which he is unable to express overtly, the emotional state remains unchanged, though unexpressed in the overt behavior, and the physiological symptoms associated with the anxiety state persist. This paper wants highlight how clinical hypnosis and meditative states can be important psychosocial and spiritual care, for the symptom management on neuro-psychobiological response to stress.

  4. [Palliative psychosomatic medicine].

    Science.gov (United States)

    Rosin, U

    2001-07-01

    Psychotherapeutic medicine, the area of medicinal specialisation dealing with the foundations of psychosomatic medicine, so far dealt mostly with diagnosis and therapy of acute diseases. The course of illness in patients with bio-psycho-social disorders however ist most often chronic. Sigmund Freud the founder of scientific psychotherapy himself was a patient in palliative care for 26 years and underwent over 30 surgical procedures to treat his carcinoma of the palate and jaw. Some goals and psychotherapeutic strategies of intervention that can be used in palliative psychosomatic medicine are laid out. This important field has in itself so far not reached a wide spread recognition and there are hardly any theoretical concepts or empirical validation to be found.

  5. The use of presleep instructions and dreams in psychosomatic disorders.

    Science.gov (United States)

    Flowers, L K

    1995-01-01

    Economic restrictions in health care delivery encourage the development and use of efficacious, inexpensive, and brief psychiatric interventions in the treatment of psychosomatic illness that can be employed by generalists as well as psychiatrists. This article reports on the successful new application of recently developed techniques in dream interpretation in three cases of varying psychosomatic symptomatology. The improvements noted suggest that this approach may provide a rapid, low-cost diagnostic and treatment method appropriate for a range of psychosomatic patients.

  6. Institutionalism and "psychosomatic" diseases.

    Science.gov (United States)

    Liberakis, E A

    In a review of 324 long stay psychiatric patients, 37 per cent of them were found to suffer also from physical disorders. A little over half of them (18% of the total) suffered from "psychosomatic" disorder. While in the total populations 38.5 per cent of the patients were free from institutionalism, in the "psychosomatic" patients the percentage was only 25.8 per cent (p less than 0.05). It is possible that "psychosomatic" diseases are a biological inferiority predisposing to institutionalism.

  7. [Psychosomatic aspects in orthopedics].

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    Köllner, V; Rupp, S

    2012-02-01

    Psychosomatic disease patterns are a common differential diagnosis for orthopedic symptoms. Furthermore, mental factors, such as the method of disease processing or mental comorbidities, such as depression or somatization disorders have a great influence on the chronification of orthopedic complaints and the outcome following orthopedic interventions. The aim of this article is to present the psychosomatic pathomechanisms and disease patterns relevant for orthopedics and to derive recommendations for physician-patient communication, diagnostics, therapy and assessment.

  8. How to do a good job in elderly patients of psychosomatic care%如何做好老年病人的心身护理

    Institute of Scientific and Technical Information of China (English)

    毕玉霞

    2015-01-01

    psychosomatic care of elderly patients is an important task for nursing care, because the physical quality and the psychological characteristic of elderly patients compared with other patients have obvious differences, so in the nursing work should be according to the characteristics of elderly patients with professional and meticulous care. This article from the environment, psychological, illness, medication, the life of elderly patients, diet and other aspects of care to do the research, hope to be able to serve as a reference for clinical nursing of elderly patients.%老年病人的心身护理是护理工作中一项重要任务,因为老年病人的身体素质、心理特点与其他病人相较有明显的差异,所以在护理工作中更应该针对老年病人的特点进行专业细致的护理。本文从环境、心理、病情、用药、生活、饮食等方面对老年病人的护理做了研究,希望能给老年病人的临床护理提供借鉴。

  9. Psychosomatics: a current overview.

    Science.gov (United States)

    Fischbein, José Eduardo

    2011-02-01

    The term 'psychosomatic' has typically defined a series of illnesses in which somatic injury breaks out from psychic conflict not recognized as such. Currently, health is considered the only psychosomatic state of integration of mind and soma: an ideal state of integration. Somatic pathology is an effect of mind/body splitting. In the heterogeneous 'field of psychosomatics' interaction between psyche and soma ranges from classical psychosomatic illness to sporadic episodes in which the body has responded to an inability to process mental conflict. The author briefly reviews the development of psychoanalytic thought on psychosomatics in Argentina. He suggests the need to find appropriate conceptual tools to approach the mental structure underlying this pathology. He presents his ideas about the mental functioning of patients with somatization disorders. He introduces the concept of somatic event as a restitution phenomenon through which the subject attempts to re-establish self-integration and links with reality. He also offers some reflections on temporality and on changes in psychoanalytic technique with these patients. A clinical case illustrates his ideas.

  10. [Psychosomatic aspects of stress].

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    Okuse, S; Anzai, T

    1992-03-01

    We established the Bromocriptine test for the dopaminergic function of the hypothalamopituitary gland. The secretion patterns of plasma GH and PRL to 2.5 mg Bromocriptine, a dopamine receptor agonist, were classified into two types; a response type and a non-response type. The former showed an increase in plasma GH levels and suppression of PRL secretion; the latter showed no change in GH after Bromocriptine administration. The response type cases corresponded to psychosocial stress by neurotic and maladaptive behavior. The non-response type cases corresponded to psychosocial stress by alexithymic and over adaptive behaviors. Case Presentation 1. Essential Hypertension: a. 56-year old male, response type, blood pressure elevated by stress in daily life. Psychosomatic treatment: advice about blood pressure measurement at his home, brief psychotherapy and drug therapy. b. 53-year-old male, non-response type, type A behavior. Psychosomatic treatment: advice to increase awareness of body-mind relationships of his disorder, self-control training and drug therapy. 2. Gastric ulcers: a. 40-year-old male, response type, CMI IV region (Neurotic tendencies). Psychosomatic treatment: autogenic training and drug therapy. b. 28-year-old male, non-response type, high JAS scores(Over adaptative behavior). Psychosomatic treatment: advice to increase awareness of body-mind relationships of occurrence of his ulcers, to induce change in his perceptions of way of life, to encourage taking rest. 3. Technostress syndrome: a. 23-year-old female, response type, technoanxiety. Psychosomatic treatment: advice to make her take rest, and change in arrangements at her working place. b. 27-year-old male, non-response type, technodependent. Psychosomatic treatment: Fasting therapy. This therapy changed the non-response pattern to normal.

  11. [Psychosomatic diseases in dermatology].

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    Olvedyová, J

    1994-08-01

    The presented work provides a review of literature dealing with dermatoses (dermatitis atopica, eczemas, allergies, urticaria, pruritus, etc.) from the psychosomatic point of view. The presented work attracts attention to the association of psychical state with the skin; it indicates the necessity to comprehend each patient from the bio-psycho-social aspect and to take into account the multifactorial etiopathogenesis of each disease. The author recommends cooperation between dermatologists, clinical psychologists and psychiatrists. The aim of the cooperation is to supplement local therapy by psychotherapy in psychosomatic disorders, and the field of psychodermatology by psychopharmacology.

  12. [Palliative care workshop primarily aimed for physicians and nurses in order to improve the care of the end-of- life homecare patient].

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    Sato, Kyoko; Metoki, Yoko; Mori, Mitsuko; Arino, Kaoru; Ikemizu, Ayumi; Nito, Noriko; Yoshikawa, Sachiko; Tsutazawa, Tomomi; Oi, Fumiko; Ando, Takashi; Tokuno, Kenji; Ishimaru, Haruo; Ishiguro, Hiroshi; Tsutsui, Shoko; Miyamori, Tadashi

    2011-12-01

    Since 2008, we held a palliative care workshop primarily aimed for physicians, who engaged in clinical practice for cancer treatment. In order to improve the end-of-life stage patient care at home, we made all sorts of efforts not only for physicians, but we also made a workshop available for healthcare professionals to participate. There were more than 60 people participated the workshop: our 20% of physicians and 24% of nurses, 13% of nearby hospital and clinic physicians, 12% of pharmacists and 17% of nurses. According to our questionnaire survey, more than 90% of the participants were satisfied with the workshop. Only 8% of the participants expressed that the workshop was rather difficult. From our analysis of the results, it was clear that we attained a high level of participants' satisfaction.

  13. [Follow-up Care in the Field of Medical Rehabilitation Concerning Psychosomatic Indications Based on the New Conceptual Framework of the German Pension Insurance].

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    Boes, N

    2016-12-01

    Mental disorders rank first amongst all causes for disability pensions and second in the field of medical rehabilitation. Especially alarming is the significantly lower age of entry of the mentally ill disability pensioners, compared to those with other indications. Mentally ill people often look back at a long history of diseases before getting in contact with the German pension insurance. In this regard the German pension insurance, which is obligated to effectively support people in order to keep them in working life until reaching the regular retirement age, is facing a big challenge, which stands right next to further demands, due to the demographic change, the increase of chronic diseases, multimorbidity, retirement age of 67 and changes in the working environment.With their activities in the field of medical rehabilitation the German pension insurance is aiming at the reintegration of people whose working capacity is endangered or reduced into the labor force or to prevent them from leaving it early. One of the main challenges notably in the field of mental diseases is to keep the success of the medical rehabilitation long-lasting. In this regard the post-rehabilitation provisions of the German pension insurances offer support according to § 31 I 1 Nr. 1 Social Insurance Code VI, if so required.On January 1st, 2016 the German pension insurance has adopted a new conceptual framework in the field of post rehabilitation which is presented in the following article, covering the range of psychosomatic indications. The aim of the new conceptual framework, which has to be implemented within the next three years, is to establish a nationwide, uniformed and preferably comprehensive follow-up care concept, which can be referred to by everyone, regardless which agency of the German pension insurance is in charge.

  14. Psychosomatic syndromes and anorexia nervosa

    Directory of Open Access Journals (Sweden)

    Abbate-Daga Giovanni

    2013-01-01

    Full Text Available Abstract Background In spite of the role of some psychosomatic factors as alexithymia, mood intolerance, and somatization in both pathogenesis and maintenance of anorexia nervosa (AN, few studies have investigated the prevalence of psychosomatic syndromes in AN. The aim of this study was to use the Diagnostic Criteria for Psychosomatic Research (DCPR to assess psychosomatic syndromes in AN and to evaluate if psychosomatic syndromes could identify subgroups of AN patients. Methods 108 AN inpatients (76 AN restricting subtype, AN-R, and 32 AN binge-purging subtype, AN-BP were consecutively recruited and psychosomatic syndromes were diagnosed with the Structured Interview for DCPR. Participants were asked to complete psychometric tests: Body Shape Questionnaire, Beck Depression Inventory, Eating Disorder Inventory–2, and Temperament and Character Inventory. Data were submitted to cluster analysis. Results Illness denial (63% and alexithymia (54.6% resulted to be the most common syndromes in our sample. Cluster analysis identified three groups: moderate psychosomatic group (49%, somatization group (26%, and severe psychosomatic group (25%. The first group was mainly represented by AN-R patients reporting often only illness denial and alexithymia as DCPR syndromes. The second group showed more severe eating and depressive symptomatology and frequently DCPR syndromes of the somatization cluster. Thanatophobia DCPR syndrome was also represented in this group. The third group reported longer duration of illness and DCPR syndromes were highly represented; in particular, all patients were found to show the alexithymia DCPR syndrome. Conclusions These results highlight the need of a deep assessment of psychosomatic syndromes in AN. Psychosomatic syndromes correlated differently with both severity of eating symptomatology and duration of illness: therefore, DCPR could be effective to achieve tailored treatments.

  15. The message of psychosomatic diseases.

    Science.gov (United States)

    Rechardt, E

    1997-01-01

    Kant, Schopenhauer and Helmholtz brought to Europe a tradition of critical psychology, which, as its starting point, questions the idea of faultless perception and focuses on how the image of the world is formed through illusion and misunderstanding. These men were accompanied by Sigmund Freud, whose interest centered primarily on psychopathology. This era was followed by a long period shaken by political, historical, and cultural crises that brought new, fashionable ideas that indefinitely stopped many developmental trends with fruitful beginnings. Central European cultural heritage was replaced by Anglo-Saxon cultural influences. The heritage of Kant and Helmholtz was forgotten, and Freud's thinking was pulled from its roots and given a strongly technological and practical emphasis. Simplified orthodoxy with stringent positivism ruled the scientific thinking of the 1950s and 1960s. Meanings, qualities, experiences, psychosomatics, and psychoanalysis were temporarily cast into the trashbin of science. Today cognitive theory holds a strong position in psychology, and the research interests of those who practice it vary a great deal. They extend in many directions and have brought research in the history of psychological ideas back to life. This research is rapidly altering many distorted and ossified views.

  16. THESES OF PSYCHOSOMATIC MEDICINE

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    F. I. Belyalov

    2017-01-01

    Full Text Available The main results of psychosomatic studies are summarized. A high incidence of mental health disorders is shown in patients with somatic diseases. They worsen the prognosis, increase the severity of the condition, make diagnosis and treatment more difficult, reduce the quality of life and work capacity, increase healthcare costs. Antidepressants decrease severity of anxiety and depression, as well as diminish frequency of somatic events and hospitalizations in patients with depression. It is important to take into account the influence of psychotropic drugs on somatic diseases and their treatment. It is important to improve the training of doctors and develop national guidelines for improving the diagnosis and treatment of patients with comorbid somatic and mental diseases.

  17. [Informed consent in psychosomatic medicine].

    Science.gov (United States)

    Satohisa, E

    1998-01-01

    Obtaining informed consent perfectly is very difficult from the view of psychosomatic medicine. Medical education regarding informed consent is generally of a low level. However as it is important to defend patients' human rights, we must educate them as to the precise meaning of both "informed" and "consent". In this report I have tried to demonstrate that both the education of medical students and their social consciousness are very important. I examined students' opinions regarding the care of a sudden case of hysterectomy (Porro's emergent operation). The following students were involved: 1st year medical students (N = 73), 4th year (N = 85) and 6th year (N = 119), and 3rd year nursing students (N = 42) and midwife students (N = 27). I examined their answers by transactional analysis. The answers of the 1st year medical students reflecting the view of the child ego state were significantly greater than those of the other students (P students altered to reflect the view of the adult ego more (P Japan" in our clinic two years ago. Since then we have talked every month to people in general about various women's diseases, and also discussed various problems of the doctor-patient relationships during these talks. I feel that public awareness concerning informed consent has increased gradually recently in Japan.

  18. Psychosomatic breast and alexithymic breast: A Bionian psychosomatic perspective.

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    Magnenat, Luc

    2016-02-01

    The author develops the concept of 'psychosomatic breast' in both clinical and theoretical terms, a concept developed by Bion (1962b) to account for a breast in charge of primary symbolization and of the psychosomatic integration of the infant's raw physiological, emotional and sensory experiences. As such, the psychosomatic breast is a prototype, a core in the mother endowed with the capacity for reverie insofar as the transformative function of the latter not only pertains to the primary symbolization of emotional life, but also to its secondary symbolization. The author contends that a primal failure in the transformation of such raw emotional and sensory experiences through the reverie of primary objects results in the incorporation of an 'alexithymic breast' - a kind of obstructive object that has become impervious to communication via projective identification and has been internalized as a source of psychic and physical breakdown. This early deficiency in parental reverie is experienced by the infant as a primitive disaster that establishes a point of fixation, a fault line in psychosomatic organization which the individual is likely to regress to, at a later stage, by developing physical illness. The author illustrates the dynamics and the economy of the conflict between psychosomatic and alexithymic breasts thanks to fragments from the analysis of a woman who developed cancer in the course of her psychoanalysis and was eventually cured.

  19. Psychosomatics today: a review of contemporary theory and practice.

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    Gubb, Karen

    2013-02-01

    In the past few years there has been a dramatic increase in the number of psychoanalytic publications on the topic of psychosomatic illness, including edited collections and special editions of psychoanalytic journals. This paper is a critical conceptual review of the topic of psychosomatic illness using the material contained in a number of these recent publications as a basis, but also drawing on other works by the key authors of the publications discussed herein. This paper proposes that currently there appear to be two schools of thought around the origin, development, and treatment of psychosomatic symptoms. The first of these is the well-established "Paris School of Psychosomatics." The second approach does not formally exist, but is referred to in this paper as the "Attachment approach" since there are a number of authors who theorize about the treatment of psychosomatic symptoms in a similar and important way. The paper will compare and contrast the two approaches with respect to their underlying theories, treatment approaches, and conceptualization of the mind-body problem, with particular attention paid to how this is related to mentalization. The understanding of how problems in mentalization may be linked to psychosomatic illness can be conceptualized as the "speechless mind" from the perspective of the Paris School and as the "speaking body" by the Attachment approach. The paper concludes by engaging with these two conceptualizations and suggests that in order for an individual to achieve both psychological and physical health, the work of sensation must be located primarily in the logic and function of the body, while the work of making sense of these sensations and interpreting them must be located in the mind.

  20. Multiaxial diagnosis and the psychosomatic model of disease.

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    Oken, D

    2000-01-01

    Current medical diagnosis reflects the prevailing biomedical model of disease. A need exists for a new system of diagnosis that, instead, is based on the psychosomatic model. This article presents an analysis of the underlying framework of the multiaxial system developed in recent years for diagnosis in Psychiatry that indicates its relevance to the psychosomatic model. It goes on to describe a new multiaxial system of diagnosis derived from that analysis that allows diagnosis to be stated as a process of adaptation in the environment, which includes biological, psychological, and social factors. The practical application of this system to the broad range of medical illnesses is explained and illustrated. This multiaxial approach represents a first step toward, and a stimulus for, the development of a better diagnostic system that can provide one basis for the crucial transformation of medical care to reflect the psychosomatic model of disease.

  1. Psychosomatic health impacts of power plants and computer aided risk management

    Energy Technology Data Exchange (ETDEWEB)

    Pop-Jordanova, N.; Pop-Jordanov, J.; Boskovska, V.

    1998-07-01

    The concept ``psychosomatic'', initially introduced in the first half of this century, has recently being reconfirmed by the theory and practice of modern medicine. The psychosomatic disorders are generally defined as physical (somatic) diseases produced, in part, by psychological factors, primarily stress. The organs of cardiovascular, gastrointestinal, respiratory and endocrine system are being affected, as a result of innervation by the autonomic nervous system. In some of these diseases the psychological factors can play relatively essential role; these are named ``primary psychosomatic diseases'': essential hypertension, peptic ulcer, bronchial asthma, ulcerative colitis, neurodermatitis, rheumatoid arthritis and hyperthyroidism (the last two diseases were later replaced by eating disorders as bulimia and anorexia nervosa). In many other cases the psychological element is only one among several parallel factors; these are sometimes called ``secondary psychosomatic diseases''. As known from the psychosomatic medicine, the stressors are being refracted through the individual history of a person as through a prism, leading to a spectrum of possible reactions. The personality prism comprises heredity, early child experiences and actual conflict, while the resulting disorders, as a response of the human being, have the form of neuroses, disturbed behavior and psychoses from one side, and psychophysiological disorders and other psychosomatic diseases, including synergetic amplification, from the other side. The probability of each outcome depends primarily on the individual personality prism, as well as on the characteristics of the stressors.

  2. [Patients in (post)modern society--does psychosomatic medicine still have concrete foundations?].

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    Jordan, J; Franke, A

    1995-05-01

    The paper describes the scientific development psychosomatic medicine has undergone in the last decades, as well as the politically induced changes in the German Health Care system. In three future scenarios the dangers of a) biological and b) voluntaristic schools of thought are presented along with the c) consequences of ecological destruction and economic power. The increasing trend for psychosomatic medicine to use salutogenetic models is discussed as a feasible approach for the prevention of fear-provoking perspectives.

  3. Work-related stress and psychosomatic medicine

    Directory of Open Access Journals (Sweden)

    Nakao Mutsuhiro

    2010-05-01

    /body health care for stress management in the workplace: focusing on individuals, utilizing supervisory lines, enlisting company health care staff, and referring to medical resources outside the company. Good communications between occupational health practitioners and physicians in charge in hospitals/clinics help employees with psychosomatic distress to return to work, and it is critical for psychosomatic practitioners and researchers to understand the basic ideas of work-related stress from the viewpoint of occupational health.

  4. Work-related stress and psychosomatic medicine.

    Science.gov (United States)

    Nakao, Mutsuhiro

    2010-05-26

    This article introduces key concepts of work-related stress relevant to the clinical and research fields of psychosomatic medicine. Stress is a term used to describe the body's physiological and/or psychological reaction to circumstances that require behavioral adjustment. According to the Japanese National Survey of Health, the most frequent stressors are work-related problems, followed by health-related and then financial problems. Conceptually, work-related stress includes a variety of conditions, such as overwork, unemployment or job insecurity, and lack of work-family balance. Job stress has been linked to a range of adverse physical and mental health outcomes, such as cardiovascular disease, insomnia, depression, and anxiety. Stressful working conditions can also impact employee well-being indirectly by directly contributing to negative health behaviors or by limiting an individual's ability to make positive changes to lifestyle behaviors, such as smoking and sedentary behavior. Over the past two decades, two major job stress models have dominated the occupational health literature: the job demand-control-support model and the effort-reward imbalance model. In both models, standardized questionnaires have been developed and frequently used to assess job stress. Unemployment has also been reported to be associated with increased mortality and morbidity, such as by cardiovascular disease, stroke, and suicide. During the past two decades, a trend toward more flexible labor markets has emerged in the private and public sectors of developed countries, and temporary employment arrangements have increased. Temporary workers often complain that they are more productive but receive less compensation than permanent workers. A significant body of research reveals that temporary workers have reported chronic work-related stress for years. The Japanese government has urged all employers to implement four approaches to comprehensive mind/body health care for stress

  5. Psychosomatic Diabetic Children and Their Families.

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    Segal, Julius

    Examined was the nature of "psychosomatic" diabetes in children-a condition resistant to treatment and thought to be triggered by emotional upheaval. Continuous blood samples taken during the child's viewing parental conflict indicated that the psychosomatic diabetics were different in their stress reactions than control groups. Results of family…

  6. To the theory and practice of psychosomatics

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    Alexander V. Khaikin

    2012-06-01

    Full Text Available The author formulates the main topical theoretical issues of psychosomatics. It provides an overview of psychosomatogenesis models. It gives the hypothesis of the author about psycho-biological nature of cancer and mechanism of the placebo effect. It formulates a general model of psychosomatic work. It provides a brief overview of psychotherapeutic techniques used in the work with the somatic diseases, where the main attention is paid to the procedure and hypnotherapeutic techniques. Description of the author's techniques. It discusses the question of the integration of psychosomatics and somatic medicine.

  7. Temperament and Character in Psychosomatic Disorders

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    Medine Yazici Gulec

    2009-09-01

    Full Text Available Personality takes an important role in etiology of psychosomatic disorders. The studies conducted with Temperament and Character Inventory which investigates the personality according to psychobiological model is considered to have a major role in understanding the relationship between personality and psychosomatic disorders. In order to emphasize the previous studies on this subject, we have done database search in Pubmed and Turk Psikiyatri Dizini (Turkish Psychiatry Directory for the time period between 1991 and 2009 to determine and evaluate the articles conducted among somatization, dermatologic illness, headache, physical medicine, angina, irritable bowel syndrome and asthma patients using Temperament and Character Inventory. The most significant consistent result of these studies was elevated harm avoid-ance scores. Harm avoidance scores still remain high even after controlling for the effect of depression and anxiety. Thus this temperament dimension is possibly an important state and trait feature for development of psychosomatic illnesses. These findings also confirmed that serotonergic systems get involved in the process of psychosomatic organization. In many studies, the mean scores of self direction sub-dimension of Temperament and Character Inventory which has been considered as the fundamental dimension to achieve mature personality, was found to be lower in psychosomatic patient groups than normal healthy control. This result hence supports the notion that process of illness affects the personality among these patients. Detailed evaluation of temparement and character profiles of psychosomatic patients would contribute much into understanding the etiology of these disorders.

  8. Genetics in psychosomatic medicine : research designs and statistical approaches

    NARCIS (Netherlands)

    McCaffery, Jeanne M.; Snieder, Harold; Dong, Yanbin; de Geus, Eco

    2007-01-01

    It has become increasingly clear that genetic factors influence many of the behaviors and disease endpoints of interest to psychosomatic medicine researchers. There has been increasing interest in incorporating genetic variation markers into psychosomatic research. In this Statistical Corner article

  9. [Psychosomatic urology. A practice-oriented presentation].

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    Schwinges-Lymberopoulos, M

    2010-06-01

    Psychosomatics is a branch of medical science dealing with biopsychosocial interactions in the origin, course and treatment of human illnesses. In the biopsychosocial model the patient is considered in its entirety. In the practice of urologists the proportion of patients with psychosomatic clinical symptoms varies between 15 and 50%. The main focus is on somatoform autonomous dysfunctions. The main symptom involves the fact that often persisting complaints cannot be explained by suitable physical findings. The anatomical characteristics of the urogenital tract and the resultant three functional levels, production, reproduction and desire, explain the susceptibility to psychological participation. Besides the exclusion of inflammatory, obstructive or malignant illnesses, the diagnostics relies on an anamnesis interview in terms of the basic psychosomatic therapy. The treatment is individual and multimodal in cooperation with physiotherapists and psychotherapists.

  10. Psychosomatic Aspects of Cancer: An Overview.

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    Murray, John B.

    1980-01-01

    It is suggested in this literature review on the psychosomatic aspects of cancer that psychoanalytic interpretations which focused on intrapsychic elements have given way to considerations of rehabilitation and assistance with the complex emotional reactions of patients and their families to terminal illness and death. (Author/DB)

  11. The "Psychosomatic Family" Reconsidered: Diabetes in Context.

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    Coyne, James C.; Anderson, Barbara J.

    1988-01-01

    Disputes that original data of Minuchin, Rosman and Baker (1978) support their assertions that some diabetic patients' physiological disturbance serves a function in their families. Concludes that their psychosomatic family model decontextualizes families, assigning to them characteristics more appropriately seen as reflections of the disease…

  12. Stress causing psychosomatic illness among nurses

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    Kane Pratibha

    2009-01-01

    Full Text Available Stress in nurses is an endemic problem. It contributes to health problems in nurses and decreases their efficiency. Documenting the causes and extent of stress in any healthcare unit is essential for successful interventions . Aim : Establishing the existence and extent of work stress in nurses in a hospital setting, identifying the major sources of stress, and finding the incidence of psychosomatic illness related to stress. Materials and Methods: This study used a questionnaire relating to stressors and a list of psychosomatic ailments. One hundred and six nurses responded and they were all included in the study. Stressors were based on four main factors: work related, work interactions, job satisfaction, and home stress. The factors relating to stress were given weights according to the severity. The total score of 50 was divided into mild, moderate, severe, and burnout. Results: Most important causes of stress were jobs not finishing in time because of shortage of staff, conflict with patient relatives, overtime, and insufficient pay. Psychosomatic disorders like acidity, back pain, stiffness in neck and shoulders, forgetfulness, anger, and worry significantly increased in nurses having higher stress scores. Increase in age or seniority did not significantly decrease stress. Conclusion: Moderate levels of stress are seen in a majority of the nurses. Incidence of psychosomatic illness increases with the level of stress. Healthcare organizations need to urgently take preemptive steps to counter this problem.

  13. Effects of health education for migrant females with psychosomatic complaints treated by general practitioners. A randomised controlled evaluation study

    NARCIS (Netherlands)

    Kocken, P.L.; Zwanenburg, E.J.-v.; Hoop, T.de

    2008-01-01

    Objective: : The effectiveness of use of migrant health educators in the general practitioners' care for female migrants with psychosomatic problems was evaluated to contribute to the improvement of the care for these patients. Methods: : A randomised controlled trial (RCT) design was used. A total

  14. Therapeutic methods for psychosomatic disorders in oto-rhino-laryngology

    Directory of Open Access Journals (Sweden)

    Decot, Elke

    2005-09-01

    Full Text Available Psychosomatic disorders such as tinnitus, acute hearing loss, attacks of dizziness, globus syndrome, dysphagias, voice disorders and many more are quite common in ear, nose and throat medicine. They are mostly caused by a number of factors, although the bio-psycho-social model does play an important role. Initial contact with a psychosomatically ill patient and compiling a first case history are important steps to psychosomatic oriented therapy. This contribution will sum up the most important otorhinolaryngological diseases with psychosomatic comorbidity and scientifically evaluated methods of treatment. The contribution will also introduce the reader to important psychosomatic treatment methods from psychotherapeutic relaxation techniques to talk therapy. To conclude, the contribution will discuss the criteria for outpatient as well as inpatient treatment and look at the advantages of psychosomatically oriented therapy, both for the patient and for the doctor.

  15. Work-related stress and psychosomatic medicine

    OpenAIRE

    Nakao Mutsuhiro

    2010-01-01

    Abstract This article introduces key concepts of work-related stress relevant to the clinical and research fields of psychosomatic medicine. Stress is a term used to describe the body's physiological and/or psychological reaction to circumstances that require behavioral adjustment. According to the Japanese National Survey of Health, the most frequent stressors are work-related problems, followed by health-related and then financial problems. Conceptually, work-related stress includes a varie...

  16. PSYCHOSOMATIC "ARC" IN THE PSYCHOTHERAPEUTIC PRACTICE

    OpenAIRE

    Ivanka Boncheva

    2012-01-01

    The psychoneuroimmunology, the new brain science and the endocrinology today show a lot of results, with which symptoms are better to understand. The psychotherapeutic practice shows the ways to influence them by encoding the levels of bounding between the physical symptom and the psychological condition. The aim of the study was to show the encoding of the psychosomatic arc within a real psychotherapeutic contact. 59 psychotherapeutic cases are followed. 33 of them were with somatoform disor...

  17. Metapsychological and clinical issues in psychosomatics research.

    Science.gov (United States)

    Press, Jacques

    2016-02-01

    The author starts by treating the general epistemological problems inherent to research and emphasizes that all investigation takes place between two poles: a creative pole and one that is defensive in relation to the unknown and formlessness. In the psychosomatic field, an additional difficulty resides in the western dualistic vision of the relationship between psyche and soma which influences our way of thinking about the body as well as about otherness. The author continues by exploring Pierre Marty's psychosomatic model. Its psychosomatic monism is revolutionary but incomplete and creates a distance with the other, the somatizing patient, resulting in a medically oriented nosology symptomatic of the impossibility to think about some of the most important aspects of counter-transference. With the help of clinical material, the author considers these unthought aspects and some of their theoretical implications, particularly the way of understanding the negative often so prevalent with these patients. Based on these reflections as well as Freud's on beyond the pleasure principle and Winnicott's theorization on the fear of breakdown, the author suggests some directions for research. Somatic illness might occur when the attempts at filling the cracks created by a breakdown are unsuccessful.

  18. PSYCHOSOMATIC "ARC" IN THE PSYCHOTHERAPEUTIC PRACTICE

    Directory of Open Access Journals (Sweden)

    Ivanka Boncheva

    2012-11-01

    Full Text Available The psychoneuroimmunology, the new brain science and the endocrinology today show a lot of results, with which symptoms are better to understand. The psychotherapeutic practice shows the ways to influence them by encoding the levels of bounding between the physical symptom and the psychological condition. The aim of the study was to show the encoding of the psychosomatic arc within a real psychotherapeutic contact. 59 psychotherapeutic cases are followed. 33 of them were with somatoform disorders and 26 with chronic psychosomatic diseases. Every patient has minimum 12 psychotherapeutic sessions. The treatment is provided on the base of the 5 levels model of the positive psychotherapy.We ascertain the following:1. The most significant moment in the arise of such symptomatic is the gained past experience - "vital concepts"; "coping strategies";2. Unlocking moment for the arise of the affection is the fixed emotion - fear, aggression or depression, specific for the particular morbid pictures;3. Showing the connection between symptom and fixed emotion by the technique "positive interpretation", which unlocks the process of changingThis shows that the psychotherapeutic help is possible only if the patient rethink the psychosomatic arc. Showing the connections between the content of the unconscious, the fixed emotion in behavioral models and the symptom gives the impetus to change.

  19. То the theory and practice of psychosomatics

    Directory of Open Access Journals (Sweden)

    Khaykin A.V.

    2012-06-01

    Full Text Available The article considers the main theoretical issues of psychosomatics. It provides an overview of psychosomatic genesis models. The hypotheses of psychobiological nature of cancer and the mechanism of the placebo effect have been under the study. The general model of psychosomatic work has been worked out. The article provides a brief overview of psychotherapeutic techniques used in the work with somatic diseases, where the main attention has been paid to the procedural and hypnotherapeutic techniques. It discusses the integration of psychosomatics and somatic medicine

  20. [Research activity in the psychosomatic medicine/psychotherapy specialty at West German universities--a 1978-1988 status report].

    Science.gov (United States)

    Ahrens, S; Richter, R

    1990-01-01

    The documentation of research activities in the discipline of psychosomatics/psychotherapy at the Federal German universities during the past 10 years includes scientific papers and monographs as well as research projects. In addition, a list of theses submitted by candidates wishing to qualify for lecturing at a German university ("Habi,-litationsschrift") has been set up for the same period. The emphasis is on psychosomatic/psychotherapeutic care, specific psychosomatic diseases and the management of chronic diseases, whereas less research activity was seen in the areas of psychophysiology and epidemiology. The data represent considerable research activity in this discipline, but it would be advisable to see to it that in the future such data are better documented and coordinated.

  1. Psychosomatic Medicine: The Scientific Foundation of the Biopsychosocial Model

    Science.gov (United States)

    Novack, Dennis H.; Cameron, Oliver; Epel, Elissa; Ader, Robert; Waldstein, Shari R.; Levenstein, Susan; Antoni, Michael H.; Wainer, Alicia Rojas

    2007-01-01

    Objective: This article presents major concepts and research findings from the field of psychosomatic medicine that the authors believe should be taught to all medical students. Method: The authors asked senior scholars involved in psychosomatic medicine to summarize key findings in their respective fields. Results: The authors provide an overview…

  2. Clinical application of somatosensory amplification in psychosomatic medicine

    Directory of Open Access Journals (Sweden)

    Nakao Mutsuhiro

    2007-10-01

    Full Text Available Abstract Many patients with somatoform disorders are frequently encountered in psychosomatic clinics as well as in primary care clinics. To assess such patients objectively, the concept of somatosensory amplification may be useful. Somatosensory amplification refers to the tendency to experience a somatic sensation as intense, noxious, and disturbing. It may have a role in a variety of medical conditions characterized by somatic symptoms that are disproportionate to demonstrable organ pathology. It may also explain some of the variability in somatic symptomatology found among different patients with the same serious medical disorder. It has been assessed with a self-report questionnaire, the Somatosensory Amplification Scale. This instrument was developed in a clinical setting in the U.S., and the reliability and validity of the Japanese and Turkish versions have been confirmed as well. Many studies have attempted to clarify the specific role of somatosensory amplification as a pathogenic mechanism in somatization. It has been reported that somatosensory amplification does not correlate with heightened sensitivity to bodily sensations and that emotional reactivity exerts its influence on somatization via a negatively biased reporting style. According to our recent electroencephalographic study, somatosensory amplification appears to reflect some aspects of long-latency cognitive processing rather than short-latency interoceptive sensitivity. The concept of somatosensory amplification can be useful as an indicator of somatization in the therapy of a broad range of disorders, from impaired self-awareness to various psychiatric disorders. It also provides useful information for choosing appropriate pharmacological or psychological therapy. While somatosensory amplification has a role in the presentation of somatic symptoms, it is closely associated with other factors, namely, anxiety, depression, and alexithymia that may also influence the same

  3. The "psychosomatic family" reconsidered ii: recalling a defective model and looking ahead.

    Science.gov (United States)

    Coyne, J C; Anderson, B J

    1989-04-01

    The notion of the "psychosomatic" family continues to enjoy uncritical acceptance in the absence of promised data and despite its dependence on an outmoded view of how psychosocial factors are involved in illness. We review the decline of psychosomatic models of illness that assume that arousal is the only or primary means by which psychosocial factors influence illness. Focusing on brittle diabetes, we note the potential for family theorists to develop more adequate models of poor self-care and medical crises as interactional tactics, as dynamic efforts to solve problems, define relationships, and influence others, even if they are costly and self-defeating. In an appendix, we note the inadequacy of Rosman and Baker's (1988) reanalyses of the Minuchin, Rosman and Baker (1978) data.

  4. [The contribution of social work to psychosomatic rehabilitation in social insurance].

    Science.gov (United States)

    Mans, E J

    1994-01-01

    Psychosomatic rehabilitation conducted by the social insurance system aims at improvement or restitution of the patient's impaired competence of leading a regular social life and in particular of taking part in the working process. Psychoanalytically based in-patient psychotherapy is focussed on the patient's psychosocial conflict constellations and tries to enable him to cope with his daily social tasks in a satisfying and self-reliant way. In the process of psychosomatic treatment the social worker has an important function in the comprehensive treatment plan due to his expert knowledge and counselling competence. In coordination with the treatment team the social worker makes a genuine contribution in examining and diagnosing the patient, motivating him/her, working out a treatment scheme, realising the treatment process, completing the treatment and arranging for further social and psychotherapeutic care.

  5. Psychosomatic disorders: the canalization of mind into matter.

    Science.gov (United States)

    Kradin, Richard L

    2011-02-01

    Psychosomatic disorders represent a therapeutic conundrum. Despite compelling evidence to suggest the integrity of mind and body, humans are famously prone to experiencing them as separate. This paper explores the scientific challenges posed by psychosomatic disorders and how changing cultural notions contribute to their perplexing presentations. Excerpts of cases from patients with chronic pelvic pain, chronic fatigue, and a factitious disorder are presented as examples of the challenges that these patients pose in analysis. An explanatory model of mind/body interaction based on early maternal-infant interactions and the placebo response complex is proposed as the basis for how psychosomatic pathologies may develop. Finally, therapeutic approaches to the psychological treatment of patients with psychosomatic issues are considered.

  6. "Psychosomatic": a systematic review of its meaning in newspaper articles.

    Science.gov (United States)

    Stone, Jon; Colyer, Matthew; Feltbower, Steve; Carson, Alan; Sharpe, Michael

    2004-01-01

    In this study, the authors describe the meaning of the word "psychosomatic" in U.S. and U.K. newspaper articles using a systematic text word search and a consensus rating of the contextual meaning of all articles published in 14 U.S. and U.K. newspapers between 1996 and 2002. The survey was limited to broadsheet newspapers. "Psychosomatic" had a pejorative meaning, such as "imaginary" or "made up," in 74 of 215 (34%) of the articles in which the meaning could be judged. Most commonly, "psychosomatic" was used to describe a problem that was psychological or in which the mind affects the body (56%) rather than as a reciprocal interaction (5%). "Psychosomatic medicine" is the new name for the seventh subspecialty of psychiatry. More needs to be done to educate the media about its actual meaning to make it attractive to patients.

  7. Current state and future prospects for psychosomatic medicine in Japan.

    Science.gov (United States)

    Murakami, Masato; Nakai, Yoshihide

    2017-01-01

    In this article, we describe the history and current state of psychosomatic medicine (PSM) in Japan and propose measures that could be considered based on our view of the future prospects of PSM in Japan. The Japanese Society of PSM (JSPM) was established in 1959, and the first Department of Psychosomatic Internal Medicine in Japan was established at Kyushu University In 1963. PSM in Japan has shown a prominent, unique development, with 3,300 members (as of March 2016), comprised of 71.6% of medical doctors including psychosomatic internal medicine (PIM) specialists, general internists, psychiatrists, pediatricians, obstetricians and gynecologists, dentists, dermatologists, and others. Most of the non-physician members include psychology and nursing staff specialists. The Japanese Society of Psychosomatic Internal Medicine (JSPIM), founded in 1996, is another major society with more than 1,200 physicians that is mainly composed of internists. The first joint congress of the five major PSM societies from each field was held in 2009. They included the Japanese Society of Psychosomatic Medicine, Psychosomatic Obstetrics and Gynecology, Psychosomatic Pediatric Medicine, Psychosomatic Dental Medicine, and Psychosomatic Internal Medicine. Several subdivided societies in related medical fields have also been established for cardiovascular, digestive, dermatological, and oriental medicine and for eating disorders, pain, fibromyalgia, stress science, behavioral medicine, and psycho-oncology. JSPM and JSPIM participate in international activities including publishing BioPsychoSocial Medicine (BPSM) and the establishment of a sister society relationship with the Germany College of PSM. PSM in Japan has adopted a variety of professional psychotherapies, including transactional analysis, autogenic therapy, and cognitive behavioral therapy. Mutual interrelationship has been promoted by the Japanese Union of Associations for Psycho-medical Therapy (UPM). Although PSM in Japan is

  8. Personality traits, coping styles and psychosomatic tendencies in students

    OpenAIRE

    2013-01-01

    This paper examines differences in personality traits and coping styles between the students who are prone to psychosomatic conditions and those who are not, and it also examines if there is a connection between certain personality traits and coping styles among the two groups of students. The research was conducted in Niš on a sample of students of the Faculty of Law, Faculty of Economics, and Faculty of Philosophy (60 students were prone to psychosomatic conditions, and 60 comprised the con...

  9. [Influence of psychiatric and psychosomatic disorders on quality of life].

    Science.gov (United States)

    Pikó, Bettina; Rudisch, Tibor

    2007-09-02

    The term 'quality of life' has received a growing highlight in relation to the care of chronically ill people during the past decades. The main goal of the present study has been to analyze patients' quality of life regarding the following diagnoses: headache (tension headache); mood disorders (depression); anxiety, and comorbid states, involving some psychological variables, such as hostility or social support. There were 157 patients participating in the study who came from a registered patients' pool in the Neuropsychiatric Rehabilitation Ward, Department of Psychiatry, University of Szeged, during the spring semester of 2005. The final sample size contained 151 patients who might be sorted into five main disease groups: mood disorders (depression); anxiety disorders; mixed psychiatric diagnosis; headache; and comorbid diagnosis (headache and psychiatric disorder together). The mean scores of the scales of patients' quality of life were investigated according to gender and disease groups; in addition, we also analyzed the psychological background of the quality of life. Based on factor analysis, two factors of the quality of life scale were detected: one factor labelled 'everyday activities' factor (including items such as work, financial situation, nutrition, sexual life or self-actualization), and another one labelled 'social activities' factor (e.g., activities with spouse, family, other persons, religious and community activities). According to the disease groups, differences could be detected particularly in the field of everyday activities; especially patients suffering from mood disorders reported higher levels of deterioration of their quality of life, whereas in comparison with them, patients of headache showed less changes. When there was comorbid psychiatric illness besides headache, a more determinant deterioration of the quality of life could be detected. Hostility and psychosomatic/anxiety symptoms contributed mostly to deterioration of the quality

  10. [Psychosomatics and psychotraumatology of refugees and migrants : A Challenge for the Internist].

    Science.gov (United States)

    Schellong, J; Epple, F; Weidner, K

    2016-05-01

    Many refugees experience severely stressful events in their home countries, during migration and occasionally even after arrival in the country of destination. The individual reactions not only influence the mental health but also somatic well being. Traumatic events may have an essential impact on psychosocial functioning; moreover, the social circumstances during the integration process influence mental stability. Physicians play an important role in identifying possible traumatization and subsequently guiding towards adequate treatment; hence, the healthcare of refugees should regularly include psychosomatic and psychotraumatological aspects. Knowledge of screening instruments, trauma-informed care and interpreter-assisted communication are necessary to meet required standards.

  11. Family dynamics and family psychotherapy of psychosomatic.

    Science.gov (United States)

    Wirsching, M; Stierlin, H

    1979-01-01

    Family therapy of psychosomatic disorders is oftern difficult and comparable to the therapy of psychotic patients. Nonetheless, the results published today by authors such as Minuchin and Selvini and our own experiences are promising indeed. We have found that what seemed to be a deep-rooted psychic structure changed rapidly and enduringly if the relationship field changed. Amelioration of symptoms is in many cases easily attained if they are understood in their function within a relational system. Also, we regard the system or family approach as a chance for medical practice. The general practioner who usually deals with family systems has, in our view, an ideal position to bring about change if he uses his authority and trust properly. He has to obtain a positive, not pathology-oriented view and should use family and social resources in spite of engaging in an often fruitless and endless contact with the designated patient, which only serves to maintain and even to increase the homeostatic lock of the family system.

  12. [Choice of symptoms in neuroses. Psychosomatic syndromes].

    Science.gov (United States)

    Tissot, R; Zutter, A M; Andreoli, A

    1984-05-01

    We think that we have collected a certain amount of arguments in support of the following hypothesis: Without assuming if it is in itself the cause of neuroses, the way of being and of thinking in this world, characteristic of our times' positivistic technico-industrial culture seems to promote a more or less artificial and unconscious anti-anxiety behaviour leading to the psychosomatic syndromes. This way of being in the world and of thinking it is symptomatic of a discrepancy between the exogen (primacy of assimilation) and the endogen (primacy of accommodation) assimilation/accommodation balance. The non-decoupling of the exogen and endogen accommodation leads to a rigid content of concepts and limits the mind process to consider only the materially possible, leading to a regressive causality. Its' ultimate term is the object in which the essence includes the existence, the "causa sui" that is none other than the patient's body. Inability to take into account what is structurally possible makes it difficult to approach the notions of chance and of great numbers, proceeding on to apprehend the time in a way akin to Aristoteles', where the future is reduced to chance. This type of thinking limits the world's understanding to what is materially possible. Outside this, just everything is possible, including the possible the occult sciences account for.

  13. Clinical problems and levels of psychosomatic dysfunction

    Directory of Open Access Journals (Sweden)

    Clovis Martins

    1977-03-01

    Full Text Available As an introduction, some doctrinary and technical problems dealing with the complexity of the human mind and the possible approaches to investigate and treat the personality are discussed and, among them, the "medical model" is emphasized. A brief description of some cases in the author's experience are presented; they, at first, had been very difficult to diagnose. However, after some time, they were found to be of indisputable neuro-psychogenetic pathogenesis. The psychosomatic aspects of each case are analyzed, with emphasis on the different levels of pathogenic action and the means of elaboration to defend and readapt the affected personality, resulting in its final clinical expression. There are four possible levels where the primary dysfunction may act; (a physiopathologic neuronal level; (b cerebral subsystemic level; (c psychodynamic level; (d psychosocial level. The primary dysfunction, acting as a new stimulus on each of these levels, may determine in the personality pathologic responses that may assume very complex clinical situations. Many of these responses are quite different from the precipitating primary dysfunction, although there are still many evident links among them.

  14. Tinnitus: clinical experience of the psychosomatic connection

    Directory of Open Access Journals (Sweden)

    Salviati M

    2014-02-01

    the lack of coping capabilities can play a critical role in the clinical history of patients affected by severe tinnitus.Keywords: tinnitus, psychosomatics, stress, psychopathological dimensions, personality

  15. Stress, social support and psychosomatic symptoms in a deprived neighbourhood

    DEFF Research Database (Denmark)

    Bancila, Delia; Andersen, Pernille Tanggaard; Kronborg Bak, Carsten

    2012-01-01

    neighbourhood (851) and wealthier communities (2055), in Esbjerg, Denmark. A model that included psychosomatic symptoms as outcome, and daily worries, economic deprivation, perceived stress and social support as predictors was tested with structural equation modelling in two-group analyses. The findings showed......From a transactional perspective on stress, the study aimed to examine if the relationships of social support with perceived stress and psychosomatic symptoms are equivalent in deprived and wealthier neighbourhoods. Cross-sectional data were randomly collected from 2906 inhabitants in a deprived...... significant differences (D2 (6)¼16.66, p.¼0.011) between neighbourhoods, and the fit statistics (CFI¼0.930, RMSEA¼0.034, R2¼0.48) showed good fit. Under an increased perceived stress’ effect, the social support’s impact on psychosomatic symptoms decreased in the deprived neighbourhood compared with the other...

  16. [Theory and model in psychosomatic medicine--a historical sketch].

    Science.gov (United States)

    Bergmann, G

    1991-02-01

    Starting with "personal medicine" as it was formed by Ludolf von Krehl in the frame of a medical clinic at a university, psychosomatic medicine, in its narrow sense, is described in its historical development. Differences to the conception of behavioral medicine are noted. Some theoretical models following the conversion model of Freud like stress concept, life-event or coping are historically explained. Actual research such as change of paradigm towards a systemic approach describes the actual situation, the conception of the "Gestaltkreis" completes this. Practice of today's psychosomatic medicine can be outlined by the concepts of simultaneous diagnostic and simultaneous therapy.

  17. Psychosomatic medicine and the philosophy of life.

    Science.gov (United States)

    Schwartz, Michael A; Wiggins, Osborne P

    2010-01-21

    Basing ourselves on the writings of Hans Jonas, we offer to psychosomatic medicine a philosophy of life that surmounts the mind-body dualism which has plagued Western thought since the origins of modern science in seventeenth century Europe. Any present-day account of reality must draw upon everything we know about the living and the non-living. Since we are living beings ourselves, we know what it means to be alive from our own first-hand experience. Therefore, our philosophy of life, in addition to starting with what empirical science tells us about inorganic and organic reality, must also begin from our own direct experience of life in ourselves and in others; it can then show how the two meet in the living being. Since life is ultimately one reality, our theory must reintegrate psyche with soma such that no component of the whole is short-changed, neither the objective nor the subjective. In this essay, we lay out the foundational components of such a theory by clarifying the defining features of living beings as polarities. We describe three such polarities: 1) Being vs. non-being: Always threatened by non-being, the organism must constantly re-assert its being through its own activity. 2) World-relatedness vs. self-enclosure: Living beings are both enclosed with themselves, defined by the boundaries that separate them from their environment, while they are also ceaselessly reaching out to their environment and engaging in transactions with it. 3) Dependence vs. independence: Living beings are both dependent on the material components that constitute them at any given moment and independent of any particular groupings of these components over time.We then discuss important features of the polarities of life: Metabolism; organic structure; enclosure by a semi-permeable membrane; distinction between "self" and "other"; autonomy; neediness; teleology; sensitivity; values. Moral needs and values already arise at the most basic levels of life, even if only human

  18. Psychosomatic medicine and the philosophy of life

    Directory of Open Access Journals (Sweden)

    Wiggins Osborne P

    2010-01-01

    Full Text Available Abstract Basing ourselves on the writings of Hans Jonas, we offer to psychosomatic medicine a philosophy of life that surmounts the mind-body dualism which has plagued Western thought since the origins of modern science in seventeenth century Europe. Any present-day account of reality must draw upon everything we know about the living and the non-living. Since we are living beings ourselves, we know what it means to be alive from our own first-hand experience. Therefore, our philosophy of life, in addition to starting with what empirical science tells us about inorganic and organic reality, must also begin from our own direct experience of life in ourselves and in others; it can then show how the two meet in the living being. Since life is ultimately one reality, our theory must reintegrate psyche with soma such that no component of the whole is short-changed, neither the objective nor the subjective. In this essay, we lay out the foundational components of such a theory by clarifying the defining features of living beings as polarities. We describe three such polarities: 1 Being vs. non-being: Always threatened by non-being, the organism must constantly re-assert its being through its own activity. 2 World-relatedness vs. self-enclosure: Living beings are both enclosed with themselves, defined by the boundaries that separate them from their environment, while they are also ceaselessly reaching out to their environment and engaging in transactions with it. 3 Dependence vs. independence: Living beings are both dependent on the material components that constitute them at any given moment and independent of any particular groupings of these components over time. We then discuss important features of the polarities of life: Metabolism; organic structure; enclosure by a semi-permeable membrane; distinction between "self" and "other"; autonomy; neediness; teleology; sensitivity; values. Moral needs and values already arise at the most basic levels of

  19. Attachment, Acculturation, and Psychosomatic Complaints among Hispanic American University Students

    Science.gov (United States)

    Wang, Chiachih D. C.; Scalise, Dominick A.; Barajas-Munoz, I. Alejandro; Julio, Kathy; Gomez, Ayleen

    2016-01-01

    This study investigated adult attachment and acculturation frameworks of reported psychosomatic complaints related to perceived discrimination among a sample of Latino/Hispanic university students (N = 160). The model supported by the data suggests that attachment anxiety, acculturation toward the dominant cultural norms, and adherence to…

  20. The "Psychosomatic Family" Reconsidered: Diabetes in Context--A Reply.

    Science.gov (United States)

    Rosman, Bernice L.; Baker, Lester

    1988-01-01

    Responds to the critical evaluation of Coyne and Anderson in the previous article, of "Psychosomatic Families: Anorexia Nervosa in Context" (Minuchin, Rosman, and Baker). Asserts that indeed certain very specifically defined diabetic patients' physiological disturbance serves a function in their families, an assertion strongly supported by…

  1. Evaluation of a Salutogenetic Concept for Inpatient Psychosomatic Treatment

    Directory of Open Access Journals (Sweden)

    Thilo Hinterberger

    2013-01-01

    Full Text Available The increase of psychosomatic disorders due to cultural changes requires enhanced therapeutic models. This study investigated a salutogenetic treatment concept for inpatient psychosomatic treatment, based on data from more than 11000 patients of a psychosomatic clinic in Germany. The clinic aims at supporting patients’ health improvement by fostering values such as humanity, community, and mindfulness. Most of patients found these values realized in the clinical environment. Self-assessment questionnaires addressing physical and mental health as well as symptom ratings were available for analysis of pre-post-treatment effects and long-term stability using one-year follow-up data, as well as for a comparison with other clinics. With respect to different diagnoses, symptoms improved in self-ratings with average effect sizes between 0.60 and 0.98. About 80% of positive changes could be sustained as determined in a 1-year follow-up survey. Patients with a lower concordance with the values of the clinic showed less health improvement. Compared to 14 other German psychosomatic clinics, the investigated treatment concept resulted in slightly higher decrease in symptoms (e.g., depression scale and a higher self-rated mental and physical improvement in health. The data suggest that a successfully implemented salutogenetic clinical treatment concept not only has positive influence on treatment effects but also provides long-term stability.

  2. Attachment, Acculturation, and Psychosomatic Complaints among Hispanic American University Students

    Science.gov (United States)

    Wang, Chiachih D. C.; Scalise, Dominick A.; Barajas-Munoz, I. Alejandro; Julio, Kathy; Gomez, Ayleen

    2016-01-01

    This study investigated adult attachment and acculturation frameworks of reported psychosomatic complaints related to perceived discrimination among a sample of Latino/Hispanic university students (N = 160). The model supported by the data suggests that attachment anxiety, acculturation toward the dominant cultural norms, and adherence to…

  3. Results of a psychosomatic training program in China, Vietnam and Laos: successful cross-cultural transfer of a postgraduate training program for medical doctors

    Directory of Open Access Journals (Sweden)

    Fritzsche Kurt

    2012-08-01

    Full Text Available Abstract Background With the “ASIA-LINK” program, the European Community has supported the development and implementation of a curriculum of postgraduate psychosomatic training for medical doctors in China, Vietnam and Laos. Currently, these three countries are undergoing great social, economic and cultural changes. The associated psychosocial stress has led to increases in psychological and psychosomatic problems, as well as disorders for which no adequate medical or psychological care is available, even in cities. Health care in these three countries is characterized by the coexistence of Western medicine and traditional medicine. Psychological and psychosomatic disorders and problems are insufficiently recognized and treated, and there is a need for biopsychosocially orientated medical care. Little is known about the transferability of Western-oriented psychosomatic training programs in the Southeast Asian cultural context. Methods The curriculum was developed and implemented in three steps: 1 an experimental phase to build a future teacher group; 2 a joint training program for future teachers and German teachers; and 3 training by Asian trainers that was supervised by German teachers. The didactic elements included live patient interviews, lectures, communication skills training and Balint groups. The training was evaluated using questionnaires for the participants and interviews of the German teachers and the future teachers. Results Regional training centers were formed in China (Shanghai, Vietnam (Ho Chi Minh City and Hue and Laos (Vientiane. A total of 200 physicians completed the training, and 30 physicians acquired the status of future teacher. The acceptance of the training was high, and feelings of competence increased during the courses. The interactive training methods were greatly appreciated, with the skills training and self-experience ranked as the most important topics. Adaptations to the cultural background of the

  4. 心身疾病的心理护理方法%Psychological nursing methods of patients with psychosomatic disease

    Institute of Scientific and Technical Information of China (English)

    张蓉; 宋富强; 汤霄; 田丽娟; 郭文琼

    2015-01-01

    It summarize the psychological nursing methods of patients with psychosomatic disease from establis-hing good nurse patient relationship,applying the supportive psychological nursing technology,alleviating the psychological stressor,improving the social support and guiding the patients to implement self care.It empha-sized we should grasp the characteristics of psychosomatic disease,convert the medical concept,take psychologi-cal nursing method targetedly,so as to improve the holistic nursing quality and the cure rate of psychosomatic disease.%从建立良好的护患关系、运用支持性心理护理技术、缓解心理应激源、提高社会支持、指导病人实施自我护理方面综述心身疾病的心理护理方法,强调应把握心身疾病的特点,转换医学观念,有针对性地采取心理护理方法,以提高整体护理质量和心身疾病的治愈率。

  5. [Current aspects of attachment theory and development psychology as well as neurobiological aspects in psychiatric and psychosomatic disorders].

    Science.gov (United States)

    Pedrosa Gil, F; Rupprecht, R

    2003-11-01

    This review covers basic principles of attachment research and its relationship to and implications for psychiatric and psychosomatic disorders. A great number of studies deal with the importance of attachment theory in the development of these disorders associated with distinct attachment styles. The most well-known concept is the attachment theory created by John Bowlby (1907-1990), which has strengthened our knowledge on early mother-infant relationships and influenced guidelines for child care. Within this concept, family structure is of great importance for the psychological development of the child and later the adult. Attachment research indicates that disturbances of patients with psychosomatic, e.g., somatoform disorders, in establishing relations must be seen in a developmental genetic context. A model of vulnerability is introduced which describes the development of psychopathology concerning the formation of representations taking advantage of attachment theory. Additionally, recent progress in cognitive neurosciences addresses attachment theory. During the last decade, neurobiological studies in rodents, primates, and humans indicate that early influences of psychosocial factors could have permanent consequences for brain structure and function. Besides the psychoanalytical and behavioral view concerning psychiatric and especially psychosomatic disorders, the integration of neurobiological findings will be a major challenge for the generation of further concepts.

  6. [Basis disturbances in depressive neuroses and psychosomatic disorders].

    Science.gov (United States)

    Ermann, M

    1980-01-01

    Applying the concept of the "basic fault" (Balint) to depressive neuroses and psychosomatic disorders the author reports some analogies in the dynamic processes of both diseases. Both are based on a pre-verbel deficiency in communication which has an influence on further conflict-organisation. In the case of psychosomatic diseases this leads to a fixation on the pre-verbel, vegetative object-relation. At the stage of the re-activated psychovegetative basic fault only somatic reactions and satisfactions may be accepted by the patients. This impedes the working alliance, consolidates somatisation as a resistance mechanism, and may require discontinuation of psychoanalytic treatment. In the case of depressive neuroses the stage of the basic fault is characterised by a paradox form of sell-object-relationship which is both object-relation and narcistic isolation as well. Though at this stage verbal communication is less important the analist may advance dissolving of this paradox relationship by means of empathetic interventions.

  7. Absolute and relative family affluence and psychosomatic symptoms in adolescents.

    Science.gov (United States)

    Elgar, Frank J; De Clercq, Bart; Schnohr, Christina W; Bird, Phillippa; Pickett, Kate E; Torsheim, Torbjørn; Hofmann, Felix; Currie, Candace

    2013-08-01

    Previous research on the links between income inequality and health and socioeconomic differences in health suggests that relative differences in affluence impact health and well-being more than absolute affluence. This study explored whether self-reported psychosomatic symptoms in adolescents relate more closely to relative affluence (i.e., relative deprivation or rank affluence within regions or schools) than to absolute affluence. Data on family material assets and psychosomatic symptoms were collected from 48,523 adolescents in eight countries (Austria, Belgium, Canada, Norway, Scotland, Poland, Turkey, and Ukraine) as part of the 2009/10 Health Behaviour in School-aged Children study. Multilevel regression analyses of the data showed that relative deprivation (Yitzhaki Index, calculated in regions and in schools) and rank affluence (in regions) (1) related more closely to symptoms than absolute affluence, and (2) related to symptoms after differences in absolute affluence were held constant. However, differences in family material assets, whether they are measured in absolute or relative terms, account for a significant variation in adolescent psychosomatic symptoms. Conceptual and empirical issues relating to the use of material affluence indices to estimate socioeconomic position are discussed. Copyright © 2013 Elsevier Ltd. All rights reserved.

  8. A conceptual model of psychosomatic illness in children. Family organization and family therapy.

    Science.gov (United States)

    Minuchin, S; Baker, L; Rosman, B L; Liebman, R; Milman, L; Todd, T C

    1975-08-01

    Linear and open systems (multiple feedback) models of psychosomatic illness in children are contrasted in terms of their implications for cause and treatment. An open systems family model is presented that describes three necessary (but not independently sufficient) conditions for the development and maintenance of severe psychosomatic problems in children: (1) a certain type of family organization that encourages somatization; (2) involvement of the child in parental conflict; and (3) physiological vulnerability. Predisposition for psychosomatic illness, symptom choice, and maintenance are discussed within this conceptual framework. We report on family therapy strategies based on this model and the results of family treatment with 48 cases of "brittle" diabetes, psychosomatic asthma, and anorexia nervosa.

  9. Psychosomatic Factors and Psychologic Status in Psoriatic Patients and Approach to the Psoriatic Patients

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    Ertuğrul H. Aydemir

    2008-12-01

    Full Text Available Even if it has not been completely proven, psychosomatic factors are generally agreed and most of the patients talk about stress and the other emotional traumas at the beginning of disease and at the attacks. Furthermore since it is a difficult to treat disease easily seen on the skin, cause to hopeless, loneliness and isolation senses and they feel theirselves dirty and guilty. Then it leads to an unbreakable vicious circle. It is very important to make an approach with much care and affection. It is very important that to listen, to examine and to touch the dermatologist to the patient with patience and affection. Besides that to take a psychiatric support may also help too much to the treatment of the diseases.

  10. Cognitive behaviour therapy for psychosomatic disorders

    African Journals Online (AJOL)

    Repro

    ... behavioural model. (Modified from 5-Factor Model of Padesky & Mooney.7 .... sound therapeutic relationship .6 ... by the term collaborativ e .... short-term benefit is, however, like- ... child is ill, have a major impact in .... been cared for by his mother before dying, when Mr Q was 8 years old. ... the memories which are uncov-.

  11. The Effect of Interpersonal Relationships on Psychosomatic Symptoms: Moderating Role of Gender

    Science.gov (United States)

    Wang, Su-hsing; Luh, Wei-ming

    2009-01-01

    The purposes of this study were twofold: (1) to verify whether or not gender and interpersonal relationships influence the variance of psychosomatic symptoms in Taiwanese adolescents; and (2) to examine the moderating role of gender between interpersonal relationships and psychosomatic symptoms in Taiwanese adolescents. The present study adopted…

  12. [Questionnaire methods used in the psychosomatic evaluation of tinnitus].

    Science.gov (United States)

    Eğilmez, Oğuz Kadir; Kalcıoğlu, M Tayyar; Kökten, Numan

    2014-01-01

    Tinnitus is a common disorder in ear, nose and throat practice. Not only muscular, vascular, neuronal, odiologic and ear pathologies, also psychological parameters contribute to the formation of tinnitus. Scales which evaluate patients' perception of tinnitus and how they are affected from tinnitus psychosomatically have gained increasing importance. Questionnaire studies are very assisting in terms of showing the degree of anxiety and depression experienced by the patients, diagnosis of the disease, evaluation of treatment efficacy, and patient follow-up. In this study, we reviewed the visual analog scale which measures the level of subjective perception in tinnitus, tinnitus evaluation questionnaires, and questionnaires measuring the level of quality of life and depression.

  13. [Psychological comorbidities in patients with psychosomatic disorders of micturition].

    Science.gov (United States)

    Hohenfellner, U

    2016-08-01

    Many patients with chronic urological diseases report a long-term suffering. Because of previous failure to recognize the psychosomatic diagnosis they are inefficiently treated or even suffer from complications of unsuccessful therapy attempts, which in retrospect were not indicated. The patients are desperate and put all their hopes and expectations in every new doctor, which is why they put us urologists under tremendous pressure to perform and are a challenge for our diagnostic and therapeutic expertise. Knowledge of psychological comorbidities and their effect on the urogenital tract are essential for the differential diagnostics of the urological complaints and for a purposeful therapy.

  14. Private school activities and psychosomatic problems in Japanese children.

    Science.gov (United States)

    Matsumoto, K; Kaku, R; Nakagawa, K; Kaneko, Z

    1975-01-01

    This paper investigates the relation between private school activities and psychosomatic problems in Japanese elementary school children. Of 1,073 children studied, 67.3 percent attended private schools to study such subjects as calligraphy, abacus, and music. Of these children, 25.3 percent attended three to four times per week, and 18.1 percent five times and more. Statistical analysis showed that frequently attending children exhibited symptoms of dizziness, sleep disturbance, and other psycholphsiological problems. The results may warn educators as well as parents of some of the unfavorable effects of these extracurricular activities.

  15. [Psychosomatic medicine as a scientific approach for the 21st century].

    Science.gov (United States)

    Frommer, Jörg

    2004-01-01

    Subject of the article is the future of psychosomatic medicine as a science in the 21st century. The state of the art is reviewed from the perspective of philosophy of science and sociology. The subjects of psychosomatic research are dealt with as well as theory and research methodology. Psychosomatic medicine will be influenced by a decrease in concrete interpersonal interaction and an increase in interaction directed by electronic media of communication. Holistic theories will be replaced by a variety of consistent and interdisciplinary informed middle range theories. And, last but not least, naive research concepts of the subjects of psychosomatic research will be supplemented by more complex concepts due to the multiplicity of qualitative and quantitative aspects of psychosomatic phenomena. The theoretical approach developed in this article will be illustrated by concrete examples from some research projects, in particular a project on the psychology of donors in living donor liver transplantation.

  16. Bion's 'protomental system' and psychosomatic illness in general practice.

    Science.gov (United States)

    Sanders, K

    1984-06-01

    The work of Wilfred Bion, developing the psychoanalytic theories of Freud and Klein on the origins of anxiety in childhood, includes the hypothesis of a protomental system. This he defined as a matrix in the human organism in which physical and mental are at first undifferentiated. His postulate is that this system which equips human beings for life in a group is in conflict with their needs as individuals. The view of the world mediated by basic assumptions, relatively mindless, functioning by unconscious common consent, has a close association with psychosomatic illness. But individuals feel the need for a working relationship with others, where thought can be applied to problems before taking action. Within the family--a special case of a work group--the continuing experience by the infant of parental containment of its anxieties, through a process of projection and introjection, develops its capacity for thinking about frustration rather than evading it. The hypothesis is, that without this experience, frustration may lead to basic assumption mentality and psychosomatic illness rather than emotionality and thought. These ideas have been found useful in general practice as in the five cases described.

  17. PSYCHOSOMATIC ASPECTS IN THE TREATMENT OF GASTROESOPHAGEAL REFLUX DISEASE

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    V. I. Trofimov

    2015-01-01

    Full Text Available Gastroesophageal reflux disease is the most common disease of the esophagus, through the development of which is impaired motor function of the upper gastrointestinal system, allowing the disease to be quite be classified as psychosomatic, especially in the early stages of development, when no apparent organic complications that affect the structure of tissues. A significant percentage of mental disorders is observed in patients even before the development of somatic complaints. Patients in number of 105 people are examined. The first group — experienced (71 patient received complex treatment, which includes the basic pathogenetic, symptomatic, and psychotropic treatment in the form of anxiolytics and antidepressants. The choice of drug was based on the results of psychological testing. The second group — the comparison group (34 patients received only conventional treatment, without psychiatric support. Analysis was conducted of the astheno-vegetative syndrome, psychological characteristics of patients in relation to their disease, indicators of anxiety level and severity of depression. Patients with not erosive reflux disease have a frequency of detection of a depression and uneasiness was more than twice higher, than at patients with erosive reflux disease. After carrying out psychotropic treatment these indicators were practically made even. Prescription of psychotropic therapy in the form of antidepressants and anxiolytics has allowed to minimize the timing regression of clinical and psychosomatic manifestations of disease.

  18. The psychophysiology of confession: linking inhibitory and psychosomatic processes.

    Science.gov (United States)

    Pennebaker, J W; Hughes, C F; O'Heeron, R C

    1987-04-01

    A theory of inhibition and psychosomatic disease suggests that the failure to confide traumatic events is stressful and associated with long-term health problems. We investigated the short-term autonomic correlates of disclosing personal and traumatic experiences among two samples of healthy undergraduates. In Experiment 1, subjects talked into a tape recorder about extremely stressful events that had occurred in their lives, as well as what they planned to do following the experiment. Skin conductance, blood pressure, and heart rate were continuously measured. Based on judges' ratings of subjects' depth of disclosure, subjects were classified as high or low disclosers. Talking about traumatic events was associated with decreased behavioral inhibition, as measured by lower skin conductance levels among high disclosers. Disclosing traumatic material was also associated with increased cardiovascular activity. In Experiment 2, subjects both talked aloud and thought about a traumatic event and about plans for the day. Half of the subjects were alone in an experimental cubicle and talked into a tape recorder; the remaining subjects talked to a silent "confessor" who sat behind a curtain. Among high disclosers, both talking and thinking about traumatic events produced lower skin conductance levels than did thinking or talking about plans for the day. The presence of a confessor inhibited subjects' talking. Implications for understanding the nature of confession and the development of an inhibitory model for psychosomatic processes are discussed.

  19. Relationship between psychosomatic health and both maladjustment and job burnout in military personnel

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    Ling-ming KONG

    2012-07-01

    Full Text Available Objective To explore the influence of mental maladjustment and job burnout on the psychosomatic health of military personnel and their relationship and build a path mode. Methods A total of 358 military personnel were selected by random cluster sampling. Military Mental Maladjustment Scale (MMMS, Military Job Burnout Scale (MJBS, and Chinese Psychosomatic Health Scale (CPSHS were applied to collect data. SPSS (version 17.0 and Amos (version 7.0 were used for data analysis by correlative analysis, multiple-regression analysis, and path analysis. Results All single factors of job burnout were significantly positively related to interpersonal relationship and emotional disorder due to mental maladjustment (P < 0.05 or P < 0.01. All single factors of mental maladjustment and job burnout were significantly positively related to the psychosomatic health of military personnel (P < 0.01. Multiple regression analysis showed that somatization, negative cacanny, emotional disorder, and interpersonal relationship entered into the regression equation of total psychosomatic health score as dependent variable, and could serve as predictors for military personnel's psychosomatic health (P < 0.01, the four independent variables accounted for 45% of the total variance of psychosomatic health. The influence of mental maladjustment on psychosomatic health was enhanced by intervention of job burnout into the path model, the fit indexes of which were as follows: χ2/df=35.248 (P=0.000, GFI=0.963, AGFI=0.875, CFI=0.902, RMSEA=0.003. Conclusions Emotional disorder, poor interpersonal relationship, somatization, and negative cacanny exert significant effects on military personnel's psychosomatic health. Job burnout mediates the relationship between mental maladjustment and psychosomatic health.

  20. A proposal of basic guidelines for training in psychosomatic and liaison psychiatry in Spanish psychiatry training programs

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    Ignacio Gómez-Reino

    2014-09-01

    Full Text Available Background and Objectives: The Psychosomatic and Liaison Psychiatry is an emerging psychiatric subspecialty. This article is intended to summarize the philosophy supporting training programmes in Spain, and the recommended training guidelines. Methods: Review of the literature and teaching experience. Results: The increasing complexity of diagnosis and treatment, and the demand by patients and providers of resources for higher and more efficient quality of care, make skills training a key tool for achieving these goals. The human being is biology, feelings, thoughts, experiences and thus individuality when sick. Understanding all this is the core on which to base our competencies in this exciting crossroads between psychiatry and other medical specialties. We propose a set of competencies to achieve, and point learning spaces and evaluation mechanisms. Conclusions: Based on accumulated experiences in Spain, and the review of European and international literature, it is possible to summarize a realistic set of norms and directions for training in Psychosomatic and Liaison Psychiatry in residency programmes.

  1. [Significance of basic concepts in depth psychology for psychosomatics].

    Science.gov (United States)

    Barz, H

    1984-12-08

    The concept of "the unconscious" is considered the central concept of depth psychology. While the unconscious in Freud's conception consists essentially of repressed material and through conversion can result in psychosomatic illnesses, C. G. Jung saw in the "collective unconscious", which he discovered, the source of all psychic and spiritual development. Mediation between the collective unconscious and the conscious is effected by means of the "archetypes", whose function can be compared with the instincts. Archetypes are manifested through symbols, whose assimilation by consciousness is a prerequisite for psychic and physical health. Consideration of the archetype of the physician suggests that the grounding of medical science in depth psychology would modify not only our understanding of illnesses, but also the physician's understanding of himself.

  2. Sleep habits and psychosomatic health complaints of bank workers in a megacity in Japan.

    Science.gov (United States)

    Motohashi, Y; Takano, T

    1995-10-01

    The relationship between sleep habits and psychosomatic health complaints was investigated by a questionnaire study in 148 bank workers in Tokyo. Daily bedtime was more flexible than daily rising time, and both mean bedtime and rising time tended to be earlier with increasing age. Multiple logistic regression analysis showed that psychosomatic health complaints of sleep disturbances, fatigue, digestive troubles, and depressive mood were significantly associated with sleep habits and perceived mental stress.

  3. Are adolescents with high self-esteem protected from psychosomatic symptomatology?

    Science.gov (United States)

    Piko, Bettina F; Varga, Szabolcs; Mellor, David

    2016-06-01

    This study investigated the role of self-esteem, social (need to belong, loneliness, competitiveness, and shyness), and health (smoking, drinking) behaviors in Hungarian adolescents' psychosomatic symptoms. Our sample of 490 students (ages 14-19 years) from Debrecen (Hungary) completed the questionnaires. Besides descriptive statistics, correlation and multiple regression analyses were applied to test interrelationships. Frequency analysis revealed that fatigue was the most commonly experienced psychosomatic symptom in this sample, followed by sleeping problems and (lower) back pain. Girls reported experiencing more symptoms. Multiple regression analyses suggested that (1) need to belong, shyness, and competitiveness may serve as social behavioral risk factors for adolescents' psychosomatic symptomatology, whereas (2) self-esteem may play a protective role. The role of social and health behaviors was modified when analyzed by gender: the psychosomatic index score was positively related to smoking and shyness among girls, and need to belong among boys. Self-esteem provided protection for both sexes. We conclude that problems with social relationships (namely, unmet need to belong, competitiveness, and shyness) may lead to psychosomatic health complaints, whereas self-esteem may serve as a protection. Findings suggest that social skills training and strengthening self-esteem should be an important part of children's health promotion programs in schools to improve their psychosomatic health and well-being. • Despite being free of serious physical illness, many adolescents often report subjective health complaints, such as psychosomatic symptoms • As children in this life stage develop independence and autonomy, new types of social relationships, and identity, their social needs and skills also change What is new: • Need to belong, shyness, and competitiveness may serve as social behavioral risk factors for adolescents' psychosomatic symptomatology, whereas self

  4. Association between psychosomatic symptoms and work stress among Taiwan police officers.

    Science.gov (United States)

    Chueh, Ke-Hsin; Yen, Cheng-Fang; Lu, Luo; Yang, Mei-Sang

    2011-04-01

    The aim of the study was to explore the association between the severity of psychosomatic symptoms and perceived work stress among male police officers in southern Taiwan. By stratified random sampling, a total of 698 male police officers were recruited into this study (the response rate was 73.4%; 512 of 698). A structured self-administered questionnaire on demographic and working characteristics, the severity of psychosomatic symptoms, perceived work stress, and social support was used to collect data anonymously. The results of multiple regression analysis revealed that (1) the police officers who perceived high-work stress reported more severe psychosomatic symptoms than those who perceived low-work stress; and (2) perceived social support had a moderating effect on the association between severity of psychosomatic symptoms and perceived work stress. Perceived work stress is an indicator of psychosomatic symptoms in police officers. Strategies for reducing psychosomatic symptoms of police officers include police administrators taking into account the level of work stress as well as more attention being paid to the resources of social support. Copyright © 2011 Elsevier Taiwan LLC. All rights reserved.

  5. Framing the Cancer Patients’ Life Experiences and Attitudes: a Psychosomatic Approach

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    George MACARIE

    2013-03-01

    Full Text Available Our study addresses the relationship between life experiences, interpretations and the presumed somatic effects in terminal diseases, especially in cancer. The causes and the evolution of cancer were subject in the beginning to experiments and presuppositions, and only later the knowledge began to rely on experimental data and countless case studies. Beside the imperative need to find a treatment, there are numerous questions regarding diagnosis, early intervention or our capacity to do something to prevent the onset of this illness. These questions also include aspects as vulnerabilities, risks and psychological factors. One of the schools of thought that emerged was the psychosomatic medicine, who focused on the relationship between body impact of life experiences and attitudes. Considering this perspective, we searched for individual and social features, and the individual attitudes or beliefs that can be related with the onset or evolution of cancer in a number of cases. Our subjects were 7 patients, diagnosed with cancer, treated in the Palliative Care Unit in Municipal Hospital Pa?cani, Romania. They agreed to participate to the evaluation and to discuss openly their life experiences’ histories. Using a case-study design with qualitative and quantitative measures, our analysis suggest a relationship between characteristics of the lived experiences, personal responses (reaction and the localization and the type of cancer involved.

  6. Psychosomatic medicine: A new psychiatric subspecialty in the U.S. focused on the interface between psychiatry and medicine

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    Constantine G. Lyketsos

    2006-09-01

    Full Text Available Background and Objectives: In the past, Psychosomatic Medicine (PM has had ambiguous connotations, and there have been many other names for this specialized fields, including Consultation-Liaison Psychiatry. The objective of this report is to briefly review the background, the history and current status of PM, which recently was recognized in the U.S. a psychiatric subspecialty. Methods: Historical review and review of the literature. Results: PM has a rich history. Psychoanalysts and psychophysiologists pioneered the study of mind-body interactions, and crucial events in the development include the funding of PM units in several U.S. teaching hospitals by the Rockefeller Foundation, and the training grants and a research development program funded by the National Institute of Mental Health. By the 1980s, all psychiatry residency programs were requiered to provide substancial clinical experience in the field, and as of 2005 there were 32 fellowship programs in the Academy of Psychosomatic Medicine's (APM directory. In 2001, The Academy of Psychosomatic Medicine (APM applied for the recognition of PM as a subspecialty of psychiatry, and formal approval was granted by the American Board of Medical Specialties (ABMS in March 2003. The foundation of PM is a specialized body of scientific knowledge regarding psychiatric aspects of medical illness. This has been articulated in contemporary textbooks, journals and regular scientificic meetings of national and international societies A cadre of scholars and researchers has emerged, and important contributions have occurred. A major goal of the PM field is to improve the psychiatric care of patients with complex medical conditions. There are a number of obstacles and challenges ahead in pursuing optimal integration of PM services into existing service delivery systems of care, but anticipated expansion of accredited fellowship programs in PM will hopefully help address this shortfall. In the past 20

  7. Correlation of psychosomatic health and situation idiosyncratic coping of army men garrisoned at islands

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    Wei NIU

    2013-11-01

    Full Text Available Objective To explore the correlation between psychosomatic health and situation idiosyncratic coping of army men garrisoned at islands. Methods By randomized cluster sampling, a total of 499 service men garrisoned at islands were designated as experimental group, and 615 service men garrisoned out of islands were as control group. The both groups were assessed by Chinese Military Psychosomatic Health Scale and Chinese Military Situational Characteristics Scale in the Chinese Soldiers Mental Health Evaluation Instrument (TR-09, and the influencing factors were analyzed. Results The scores of each psychosomatic health factor of service men in experimental group were higher than those in control group (t=7.513-24.028, P<0.01. In the service men of experimental group, the scores of psychotic, anxiety and depression were higher than other factors, and the scores of cardiovascular and skin were lower. With exception of the factors of eye-ear and nervous system, the score of psychosomatic health was lower in the service men with college and above educational background than in those with junior and senior school educational background (F=0.526-3.245, P<0.05. The psychosomatic health were better in married service men than in unmarried ones (t=0.663-2.869, P<0.05. With exception of the cardiovascular system, the psychosomatic health score was higher in officers than in soldiers and non-commissioned officers (t=–1.434 - –4.381, P<0.05. With exception of psychotic factor, the psychosomatic health score in service men garrisoned at islands was negatively related to the active coping style (r=–0.065 - –0.121, P<0.05, and positively related to the inactive coping style (r=0.062-0.067, P<0.05. Conclusions The psychosomatic health of service men garrisoned at islands is worse. The psychosomatic health of service men with higher educational level, married and low ranked is better. Active coping style is beneficial to psychosomatic health of

  8. [Expanded anamnesis and psychodiagnostic classification in psychosomatic rheumatic patients. II: A recommendation for diagnostic classification of psychosomatic disorders of the locomotor system].

    Science.gov (United States)

    Eich, W

    1993-01-01

    This paper tries to associate psychosomatic manifestations of the locomotion-system to one of the following four diagnosis: 1) conversion disorder, 2) anxiety disorder, 3) depressive mood disorder, 4) somatization disorder. For each of these diagnosis definition, clinical manifestation, diagnostic and differential-diagnostic criteria are mentioned. The diagnostic criteria can easily be associated to the new ICD-10 (V)F diagnosis.

  9. [Psychosomatic medicine for non-cardiac chest pain].

    Science.gov (United States)

    Funakoshi, Seiko; Hosoi, Masako; Tsuchida, Osamu

    2009-09-01

    Recently, it has become problematic that the number of noncardiac chest pain (NCCP) patients are increasing among those who come to the emergency room with chest pain as a chief complaint. They tend to come to hospitals often and over many years, even after cardiac-chest pain has been excluded from their diagnosis. Moreover, studies have shown that NCCP patients have a high prevalence of anxiety, depression and disability. However, most NCCP patients are usually treated by cardiologists or primary physicians. Ordinary biomedical approaches often fail to treat NCCP. NCCP is one of the most important functional somatic syndromes from the view of medical economics. The cause of NCCP includes gastroesophageal reflux disease, panic disorder and esophageal dysmotility. In this review article, we summarize the definition, epidemiology, pathology, and process of diagnosis of NCCP. Finally, we propose a pathological hypothesis from a psychosomatic view. We discuss the effects of anxiety, fear and hyperactive behavior induced by affective stressors on the dysmotility and the lowering of the pain threshold.

  10. Metabolic syndrome - A truly psychosomatic disorder? A global hypothesis.

    Science.gov (United States)

    Ghike, Shrikant Madhukar

    2016-12-01

    Exact cause of the metabolic syndrome [MS], a global epidemic, is still unclear. Man has same fundamental needs to live as animals but modern man's life-style compels him to acquire certainty of resources for all his needs in a complex social network. Today money has become the sole life essential need. Contrarily none of the animals needs to earn money. Brain is also an organ of the human body with a unique thought process to define logical actions to achieve a person's goals. This way life is a flow of desires followed by logical actions. The person struggles to attain desired goals via the allostatic load but a perceived insurmountable threat can make his flow of life stalled to freeze him. Published data from varied branches of medical science indicates role of hormones in overall homeostasis. Particularly multifaceted role of serotonin is well documented. Adrenalin being the primary mediator of Cori cycle is also well known. From the integration of observations from published data with reference to common human's modern lifestyle, it is hypothesized that a perceived trapped situation in life creates acute chaos of thoughts in brain, which results in acute excess of stress hormones and concurrent depletion of resting hormones, which in turn triggers MS. In global terms, MS indicates an acute imbalance of a few hormones and implies psychosomatic roots of the disorder. This may pave a better way in deciding a personalized holistic protocol with combination of counter regulatory psychoactive medications. Copyright © 2016 Elsevier Ltd. All rights reserved.

  11. [Oswald Schwarz: a pioneer in psychosomatic urology and sexual medicine].

    Science.gov (United States)

    Berberich, H J; Schultheiss, D; Kieser, B

    2015-01-01

    Oswald Schwarz, a urologist from Vienna, was a scholar of Anton Ritter von Frisch and Hans Rubritius. As a physician during World War I, he was confronted with numerous bullet wounds to the spinal cord. In 1919, he completed his professorial thesis"Bladder dysfunction as a result of bullet wounds to the spinal cord". Oswald Schwarz was known as a committed surgeon. As an urologist he also treated patients with sexual dysfunction. Besides his practical and scientific urology-related work, he was also interested in psychology and philosophy. He held lectures on both subjects earning himself the nickname, the Urosoph. In the 1920s, Oswald Schwarz belonged to the inner circle of Alfred Adler, the founder of Individual Psychology, and was editor of the first psychosomatic textbook published in German, "Psychological origin and psychotherapy of physical symptoms" (1925). In addition, Schwarz wrote numerous articles and several books on sexual medicine. He also made many valuable contributions to the development of medical anthropology. Altogether, his work includes over 130 publications. Faced with the rise of fascism and National Socialism in Europe, Oswald Schwarz, who was of Jewish origin, emigrated to England in 1934. There he died in 1949. Unfortunately his scientific work has largely been forgotten. The aim of the following article is to remind us of his important contributions to the field.

  12. Changing concepts in psychosomatic theory. I. Historical analysis.

    Science.gov (United States)

    Kimball, C P

    1979-01-01

    Psychosomatic medicine has utilized static, linear, two-dimensional models in attempting to identify a causative relationship between psychosocially conceptualized events and biologically conceptualized ones. This has led to inherent difficulties that are logistically unresolvable. For example, the different language systems lend themselves to overlap with the possibility of addressing themselves to describing manifestations of the same phenomenon from dissimilar conceptual orientations. The problem is further complicated by attempting to link these together in a temporal sequence suggesting a causal relationship. We have ignored both feedback processes in terms of a sequential process modifying a preceding one and the possibility that a reverse order of relationships might explain some processes. In our quest for specificity, we have ignored that disease states are not static ones any more than is life but change over time, suggesting that alterations will occur in the original relationships proposed among our different systems of conceptualization. Among the remedies suggested for a reordering of our thinking are: (a) a revision of linear unidirectional causative models to cyclical bidirectional models; (b) a reformulation of two-dimensional temporal linear relationships toward three-dimensional spherical ones which overlap in time; (c) the relating of these aspects not to each other but to a third factor, common to the three which remains to be identified; (d) the development of a language that bridges the psychological, social and biological.

  13. Predictive factors of psychosomatic reactions during air raids

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    Samardžić Radomir

    2005-01-01

    Full Text Available Background. Civilian population of Yugoslavia was exposed to massive stressors of air raids by NATO in 1999. The aim of this study was to investigate somatic complaints and their predictive factors during stresses of air raids. Methods. Random sample of 434 subjects, consisting of 139 inhabitants of several Belgrade municipalities and 295 employees of Military Medical Academy, were assessed in the cross-sectional study. The basic factors of interest were stress severity, variables of personality and habits and behavior relevant for somatic complaints. Self-report of stress severity and the most common somatic complaints were performed by Questionnaire specially designed for this purpose and personality evaluation by EPQ-38. Multiple regression analysis was used to determine the influence of predictors on dependent variable (psychosomatic symptoms. Results. Personality was the most important predictor that explained 29% of variance in somatic symptoms (with the strongest impact of neuroticism; 11% was explained by habits and behavior and only 1% of variance by stress. Conclusion. The finding that personality had higher impact on stress reaction outcome could be important for preventive and therapeutic aspects of stress reactions.

  14. [Ergometric assessment of functional performance deficit in psychosomatic patients].

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    Ruppli, M; Radvila, A

    1990-03-10

    Patients with marked loss of physical and psychological fitness and cardiovascular symptoms without objective findings often pose diagnostic problems. Fifteen patients hospitalized for general incapacity with normal cardiovascular findings were tested in the ECG laboratory on a conventional bicycle ergometer and in a more natural environment climbing stairs in a windowed staircase. Work capacity in the two tests was compared. Eight out of fifteen patients achieved only 40% of their age and weight adjusted nominal value on the bicycle ergometer, while they were fully efficient on the staircase (= discordant result). Four patients reached their expected nominal values in both tests. The performance of three patients was much lower than expected, more markedly so in the laboratory situation on the bicycle. All patients' performance was limited by central nervous incapacitating cardiovascular symptoms. Diagnosis of psychosomatic situational cardiovascular insufficiency in the absence of pathological findings can be substantiated by comparing exercise tests in a physiological and non-physiological environment. This is helpful to both patient and physician by facilitating a more precise diagnostic process and documentation of therapeutic improvement.

  15. Abusive supervision, psychosomatic symptoms, and deviance: Can job autonomy make a difference?

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    Velez, Maria João; Neves, Pedro

    2016-07-01

    Recently, interest in abusive supervision has grown (Tepper, 2000). However, little is still known about organizational factors that can reduce its adverse effects on employee behavior. Based on the Job Demands-Resources Model (Demerouti, Bakker, Nachreiner, & Schaufeli, 2001), we predict that job autonomy acts as a buffer of the positive relationship between abusive supervision, psychosomatic symptoms and deviance. Therefore, when job autonomy is low, a higher level of abusive supervision should be accompanied by increased psychosomatic symptoms and thus lead to higher production deviance. When job autonomy is high, abusive supervision should fail to produce increased psychosomatic symptoms and thus should not lead to higher production deviance. Our model was explored among a sample of 170 supervisor-subordinate dyads from 4 organizations. The results of the moderated mediation analysis supported our hypotheses. That is, abusive supervision was significantly related to production deviance via psychosomatic symptoms when job autonomy was low, but not when job autonomy was high. These findings suggest that job autonomy buffers the impact of abusive supervision perceptions on psychosomatic symptoms, with consequences for production deviance. (PsycINFO Database Record

  16. Time feature of Chinese military personnel’s suicide ideation and its relationship with psychosomatic health

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    Li-yi ZHANG

    2012-07-01

    Full Text Available Objective To investigate the time feature of Chinese military personnel's suicide ideation and its relationship with psychosomatic health to provide scientific basis for formulation of mental health policy and intervention of related psychological crisis. Methods By random cluster sampling, a total of 11 362 military personnel including army, navy and air-force (1100 in 1980s, 8000 in 1990s, 2262 in year 2000 were tested by Chinese Psychosomatic Health Scale (CPSHS. SPSS statistic 17.0 program was used for data analysis, i.e., χ2-test, T-test and stepwise regression analysis. Results The incidence rate of military personnel's suicide ideation in the three decades from 1980 to 2000 was 10.27%, 7.09% and 2.83% respectively, which revealed a decreasing trend (P 0.05. Suicide ideation was selected into the regression equation of mental health, physical health, and total psychosomatic health scores, which could positively predict the level of military personnel's psychosomatic health (P=0.05 or 0.01. Conclusions Military personnel's suicide ideation presents a decreasing trend; the psychosomatic health of military personnel who have suicide ideation is worse than that of personnel without suicide ideation.

  17. Psychosomatic health status of children exposed to the Chernobyl accident

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    Korol, N. [Scientific Center for Radiation Medicine, Kiev (Ukraine); Shibata, Yoshisada; Nakane, Yoshibumi

    1998-12-01

    Childhood victims were investigated focussing on the psychosomatic disorders. The subjects were some of the 3834 children who evacuated from the Chernobyl zone to Kiev (evacuees) and 200 children who have been living in Kiev since prior to the accident (comparison group). A psychological test administered to 504 evacuees aged 12-14 years at the time of the accident and the comparison group indicated that the frequencies of neutroticism, high level of anxiety and conflicts were significantly higher in the evacuees than in the comparison group (p<0.001). Another psychological test administered at puberty to the 504 evacuees and 200 other evacuees exposed to the accident at 4-6 years of age indicated that the psycho-emotional portrait of evacuated teenagers significantly changed with time since the accident. The effects of the Chernobyl accident on the health of the vegetative dystonia observed in 1987-1990 and 1990-1995 were higher in the evacuees than in the comparison group, although they were not statistically significant. Furthermore, a significant (p<0.001) association of the vegetative dystonia with peptic and cardiovascular disorders was observed. The present study indicates that the vegetative dystonia is still highly prevalent among childhood victims and deems to support that the vegetative dystonia may be a precursor of several diseases such as cardiovascular and peptic disorders. It should be emphasized that a health promotion program to produce a change in psychological and social problems after the Chernobyl accident is necessary to decrease the health impact among Ukrainian people. (author)

  18. Subjective sleep complaints indicate objective sleep problems in psychosomatic patients: a prospective polysomnographic study.

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    Linden, Michael; Dietz, Marie; Veauthier, Christian; Fietze, Ingo

    2016-01-01

    To elucidate the relationship between subjective complaints and polysomnographical parameters in psychosomatic patients. A convenience sample of patients from a psychosomatic inpatient unit were classified according to the Pittsburgh Sleep Quality Index (PSQI) as very poor sleepers (PSQI >10, n=80) and good sleepers (PSQI subjective feeling of current well-being in the morning and subjective TST and negatively with subjective restfulness, subjective sleep onset latency, subjective evaluation of sleep onset latency, and evaluation of time awake after sleep onset. The data suggest that, in general, patients selected from the extremes of reported very poor sleepers and good sleepers have different amounts of sleep when measured in the laboratory, and that in general, the amount and timing of sleep in the laboratory are quite well perceived and reported by these groups. The data came from psychosomatic patients and suggest that even in this patient group, respective sleep complaints are more than just the expression of general somatization or lamenting.

  19. Role of anxiety and depressive disorders in the genesis of psychosomatic disorders

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    Aleksandr Anatolyevich Shatenshtein

    2013-01-01

    Full Text Available Patients and methods. The results of clinical and psychodiagnostic examination using the Minnesota Multiphasic Personality Inventory (MMPI were analyzed in 210 therapeutic inpatients from 4 groups of psychosomatic diseases (coronary heart disease, hypertensive disease, duodenal ulcer disease, asthma, and bronchitis with an asthmatic component and 3 groups of diseases in whose genesis the psychosomatic mechanisms (pneumonia, gastritis, renal diseases played a lesser role. Healthy individuals (n=38 served as a control group. The correlation coefficients between the first scale reflecting the number of somatic complaints and the magnitude of their hypochondriacal fixation and the second one characterizing the degree of anxiety and depressive disorders were calculated within each disease group. Results. In psychosomatic diseases, the correlation coefficients between the first and second MMPI scales proved to be insignificant and substantially lower than those in the healthy individuals. This suggests that in such patients, a larger number of somatic complaints and their enhanced hypochondriacal fixation alleviate anxiety and depressive disorders, which may be regarded as an indication that there is psychosomatic defense that lessens anxiety due to a somatic disease. In somatic diseases that are not referring to as psychosomatic ones, the correlation coefficient between the first and second scales is highly significant and considerably higher than that in the healthy individuals and particularly higher than in the group of psychosomatic diseases. In the patients of these groups, an increase in anxiety and depression aggravates autonomic dysregulation reflecting in the larger number of hypochondriacal complaints. This direct relationship between autonomic functions and the level of anxiety and depression may be a risk factor for developing these disorders.

  20. Problematic Internet use in Chinese adolescents and its relation to psychosomatic symptoms and life satisfaction

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    Sun Ying

    2011-10-01

    Full Text Available Abstract Background Problematic Internet use (PIU is a growing problem in Chinese adolescents. Little is known about associations of PIU with physical and psychological health. This study was designed to investigate the prevalence of PIU and to test the relationships between PIU and psychosomatic symptoms and life satisfaction among adolescents in mainland China. Methods A cross-sectional survey was conducted comprising a large representative sample of 17 599 students in eight cities of China. PIU was assessed by the 20-item Young Internet Addiction Test (YIAT. The Multidimensional Sub-health Questionnaire of Adolescents and the Multidimensional Students' Life Satisfaction Scale were administered to obtain information on psychosomatic symptoms and life satisfaction. Demographics and Internet usage patterns were also collected. Logistic regression was used to assess the effects of PIU on psychosomatic symptoms and life satisfaction. Results Approximately 8.1% of subjects showed PIU. Adolescents with PIU were associated with males, high school students, urban, eastern and western areas, upper self-report family economy, service type mostly used for entertainment and relieving loneliness and more frequency of Internet use. Compared with normal Internet users, adolescents with PIU were more likely to suffer from psychosomatic symptoms (P P P P P P P P Conclusions PIU is common among Chinese students, and PIU was significantly associated with psychosomatic symptoms and life satisfaction. Effective measures are needed to prevent the spread of this problem and interventions to prevent the effects of PIU on psychosomatic symptoms and life satisfaction should be conducted as early as possible.

  1. Helen Flanders Dunbar, John Dewey, and clinical pragmatism: reflections on method in psychosomatic medicine and bioethics.

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    Hart, Curtis W

    2002-01-01

    This article outlines the method utilized by physicians and major figures in the founding of Clinical Pastoral Education, Helen Flanders Dunbar, in her work of 1943, Psychosomatic Diagnosis, and relates it to the currently evolving approach in bioethics known as clinical pragmatism. It assesses Dewey's influence on both Dunbar in psychosomatic medicine and clinical pragmatism in bioethics, and illustrates the breadth of influence of the school of philosophical thought known as pragmatism with which Dewey's name and those of William James and Charles Sanders Pierce are most often identified.

  2. Psychosomatic group treatment helps women with chronic pelvic pain.

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    Albert, H

    1999-12-01

    This study evaluates group treatment for women suffering from chronic pelvic pain. The concept of group treatment was based on psychosomatic and physio-therapeutical principles and on cognitive and operant behavioral therapy. Each group was composed of up to six women suffering from chronic pelvic pain, and two physiotherapists. Each group treatment session lasted 2.5 h per week for a period of 10 weeks. The women completed questionnaires and pain drawings four times during the treatment period from the beginning of the period till 15 months later. During 13 group treatment periods 53 women accomplished the treatment. Before the treatment the women had experienced pain for an average period of 5 years and 9 months (ranging from 6 months to 22 years). The women's descriptions of the changes derived from group treatment were analyzed according to the Grounded Theory Method. A methodical triangulation of quantitative and qualitative data as well as analyzes of the drawings were applied. One year after the end of the treatment, 39% of the women were pain-free. The average level of pain measured according to the Visual Analog Scale was reduced from 2.8 to 0.9 (p Theory Analysis a model of the development process was elaborated. The process begins with the development of self-knowledge, followed by the woman assuming self responsibility for her own life and performing self-activeness. During the process the woman increases her feeling of self-control and personal mastery of her emotions. The women's pain drawings improved, resulting in more detailed drawings, the color intensity abating, the extent of pains declining, and the outlines blurring. In conclusion this kind of group treatment brings the women relief from their pain thus reducing the use of the National Health Service by women suffering from chronic pelvic pain. The women also experience a positive psychological development. This method of treatment, in which a synergetic combination of physical and

  3. Contemporary perspectives on psychosomatics in Germany: A commentary on Karen Gubb's paper, "Psychosomatics today: a review of contemporary theory and practice".

    Science.gov (United States)

    Frommer, Jörg

    2013-02-01

    Karen Gubb's (2013) review focuses on contemporary developments in psychoanalytic theory and practice in relation to psychosomatics, starting with some historical remarks, and Paris School with the Attachment approach. This paper examines the question of how the German scene fits into the issues raised in Gubb's discussion. From a historical point of view, psychosomatic thinking had already come into existence at the beginning of the twentieth century in internal medicine, influenced not only by Freud's ideas, but also by holistic philosophical approaches, anthropology, and semiotic systems theory as well. Psychosomatics is still under the influence of psychodynamic thinking, but as a required subject for all medical students, it is currently more involved in inpatient treatment settings than in psychoanalyses in the classical couch setting. Research projects using standardized questionnaires, neuroimaging, and other empirical methods have also proved that these treatments are as effective as therapy based on psychoanalytic concepts like alexithymia or the Attachment approach. In addition, qualitative methods have been implemented to grasp the fine-grained conscious and unconscious processes in the inner life of patients and in the verbal and nonverbal interaction phenomena of therapies. To sum up: Recent developments in psychoanalytic theory, which begin to overcome the differences among psychoanalytic schools in favor of re-erecting a common psychoanalytic understanding like that demonstrated in Gubb's article, fit together in bridging the gap between insights from classical psychoanalyses and results from empirical research.

  4. In defense of psychosomatic theory: A critical analysis of Allison and Heshkas critical analysis

    NARCIS (Netherlands)

    Strien, T. van

    1995-01-01

    This article analyses Allison and Heshka's (International Journal of Eating Disorders, 13, 289–295, 1993.) critical analysis of studies supporting psychosomatic theory. Questionned first is, Allison and Heshka's contention that the obese overreport emotional eating as a result of effects of demand c

  5. Bullying in Context: An Analysis of Psychosomatic Complaints among Adolescents in Stockholm

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    Modin, Bitte; Låftman, Sara Brolin; Östberg, Viveca

    2015-01-01

    Using multilevel modeling, this study examined how different types of bullying, involving both peers and teachers, relate to psychosomatic health complaints. Data were obtained via the Stockholm School Survey from 41,032 ninth- and eleventh-grade students in the years 2004, 2006, 2008, and 2010. Results showed that students involved in bullying as…

  6. Social relations in school and psychosomatic health among Swedish adolescents--the role of academic orientation.

    Science.gov (United States)

    Bergh, Daniel; Hagquist, Curt; Starrin, Bengt

    2011-12-01

    The purpose of this study was to analyse the connection between two types of social relations in school (to peers and to teachers) and psychosomatic health complaints among adolescents in school Year 9 in the Swedish compulsory school. In particular, the focus is on the importance of students' academic orientation as a possible modifier of the association between social relations and psychosomatic health complaints. The data were collected during the 1995-2005 time period from approximately 10,000 Swedish adolescents in the age of 15-16 years by using a questionnaire that was handed out in the class room. There are strong associations between adolescents' social relations in school (both to peers and to teachers) and psychosomatic health complaints. Worse relationships are connected to worse psychosomatic health. The health effects of teacher contacts were significantly modified by academic orientation; they were stronger for theoretically (i.e. those with better health) than for non-theoretically oriented students. Interpreted from a social class perspective, the results may reflect that the theoretically oriented students to a higher degree strive to conform to the culture present in school making this group of students more sensitive for teacher relations manifested as recognitions, rewards or penalties. In order to promote social equity in health, efforts to improve social relations in school should not solely focus on the teacher-student relationships but also on the relationships between peers.

  7. Bullying behavior and associations with psychosomatic complaints and depression in victims

    NARCIS (Netherlands)

    Fekkes, M.; Pijpers, F.I.M.; Verloove-Vanhorick, S.P.

    2004-01-01

    Objectives: To assess the association between bullying behavior and a wide variety of psychosomatic health complaints and depression. Study design: In a cross-sectional study, 2766 elementary school children age 9 to 12 years filled out a questionnaire on bullying behavior and health complaints.

  8. Bullying in Context: An Analysis of Psychosomatic Complaints among Adolescents in Stockholm

    Science.gov (United States)

    Modin, Bitte; Låftman, Sara Brolin; Östberg, Viveca

    2015-01-01

    Using multilevel modeling, this study examined how different types of bullying, involving both peers and teachers, relate to psychosomatic health complaints. Data were obtained via the Stockholm School Survey from 41,032 ninth- and eleventh-grade students in the years 2004, 2006, 2008, and 2010. Results showed that students involved in bullying as…

  9. Bullying behavior and associations with psychosomatic complaints and depression in victims

    NARCIS (Netherlands)

    Fekkes, M.; Pijpers, F.I.M.; Verloove-Vanhorick, S.P.

    2004-01-01

    Objectives: To assess the association between bullying behavior and a wide variety of psychosomatic health complaints and depression. Study design: In a cross-sectional study, 2766 elementary school children age 9 to 12 years filled out a questionnaire on bullying behavior and health complaints. Thr

  10. Psychosomatic approach is the new medicine tailored for patient personality with a focus on ethics, economy, and quality.

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    Fassino, S

    2010-09-01

    influence the results of treatment projects. Because all these aspects impact upon illness duration and quality of life, affecting both the individual concerned and his or her family, the economic consequences of this psychosomatic approach are important in both general and specialist medicine. Medicine is becoming, and will become even more in the future, an integrated science; human illness and the maintenance of good health may be better understood if all medical disciplines are considered as a whole. The domain of psychosomatic medicine has now extended to coincide with that of medical practice. There is increasing evidence, not only in psychiatry, but in all medical fields, that care of the mental well-being of a person is essential for effective care of the body. Not only mens sana in corpore sano, but also corpus sanus in mente sana.

  11. The History, present state, and future prospects of the Asian College of Psychosomatic Medicine (ACPM

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    Ishizu Hiroshi

    2012-01-01

    Full Text Available Abstract The Asian College of Psychosomatic Medicine (ACPM was founded as the Asian Chapter of the International College of Psychosomatic Medicine (ICPM-AC in Tokyo on April 12, 1982. The first president was Hitoshi ISHIKAWA (Japan, the vice-presidents were Mahalingam MAHADEVAN (Malaysia and Burton G.BURTON-BRADLEY (Papua- New Guinea, and the general secretary was Sueharu TSUTSUI (Japan. Five years previously, preparation for creation of the ICPM-AC was started at the 4th World Congress of the International College of Psychosomatic Medicine (ICPM held in Kyoto, Japan, September 5-9, 1977. The First Congress of the ICPM-AC was held by the President Yujiro IKEMI in Tokyo on May 19-20, 1984. The main members in the early stage were Y. IKEMI, H. ISHIKAWA, S. TSUTSUI, Taisaku KATSURA, Tetsuya NAKAGAWA. Hiroyuki SUEMATSU and others from Japan and Hsien RIN (Taiwan, Seock Young KANG (Korea, M. MAHADEVAN. B.G. BURTON-BRADLEY and others from other Asian countries. Thereafter, academic congresses of the ICPM-AC, the 2nd to the 9th, were held approximately every two years, in Japan, India, Malaysia, Taiwan, Korea, and China. The name was changed to the Asian College of Psychosomatic Medicine (ACPM, and the 10th to 14th congresses were held in Taiwan, Okinawa (Japan, Australia, Korea, and China. The current president of the Executive Board of ACPM is Chiharu KUBO, the Director of Kyushu University Hospital. The next academic congress is the 15th ACPM and will be hosted by Tserenkhuugyin LKHAGVASUREN in Ulaanbaatar, Mongolia from August 24-26, 2012. Participating countries have expanded to include Asian-Oceanic countries such as Mongolia, Micronesia, Australia and Sri Lanka. The main themes of the congresses have focused on psychosomatic disorders, culture - bound syndromes, oriental medicine, etc... To date,"Health promotion"by raising the level of mental health based on psychoneuroendocrinoimmunomodulation has been very important. Prevention is also

  12. Do personality traits predict outcome of psychodynamically oriented psychosomatic inpatient treatment beyond initial symptoms?

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    Steinert, Christiane; Klein, Susanne; Leweke, Frank; Leichsenring, Falk

    2015-03-01

    Whether personality characteristics have an impact on treatment outcome is an important question in psychotherapy research. One of the most common approaches for the description of personality is the five-factor model of personality. Only few studies investigated whether patient personality as measured with the NEO-Five-Factor Inventory (NEO-FFI, Costa & McCrae [1992b]. Revised NEO-PI-R and NEO-FFI. Professional manual. Odessa, FL: Psychological Assessment Recources) predicts outcome. Results were inconsistent. Studies reporting personality to be predictive of outcome did not control for baseline symptoms, while studies controlling initial symptoms could not support these findings. We hypothesized that after taking into account baseline symptoms, the NEO-FFI would not predict outcome and tested this in a large sample of inpatients at a psychosomatic clinic. Naturalistic, non-controlled study using patients' data for multiple regression analysis to identify predictors of outcome. Data of 254 inpatients suffering primarily from depressive, anxiety, stress, and somatoform disorders were analysed. Personality was assessed at the beginning of therapy. For psychotherapy outcome, changes in anxiety and depression (Hospital Anxiety and Depression Scale; HADS), overall psychopathology (Symptom Checklist-90-R Global Severity Index [GSI]), and interpersonal problems (Inventory of Interpersonal Problems; IIP) were measured. The treatment resulted in significant decreases on all outcome measures corresponding to moderate to large effect sizes (HADS: d = 1.03; GSI: d = 0.90; IIP: d = 0.38). Consistent with our hypothesis, none of the personality domains predicted outcome when baseline symptoms were controlled for. Personality assessment at baseline does not seem to have an added value in the prediction of inpatient psychotherapy outcome beyond initial symptoms. Clinical implications Personality dimensions overlap with symptomatic distress. Rather than serve as predictors of

  13. Intra- and extra-familial adverse childhood experiences and a history of childhood psychosomatic disorders among Japanese university students

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    Munemoto Takao

    2007-04-01

    Full Text Available Abstract Background Japan has been witnessing a considerable increase in the number of children with psychosomatic disorders. The purpose of this study is to examine the relationship between the risk of psychosomatic disorder in adolescents and intra- and extra-familial adverse childhood experiences (ACEs. Methods A retrospective cohort study of 1592 Japanese university students (52% male, mean age 19.9 years who completed a survey about intra- and extra-familial ACEs and the incidence of childhood psychosomatic disorders. Intra-familial ACEs included domestic violence, physical violence, emotional abuse, illness in household, parental divorce, no parental affection, and dysfunctional family. Extra-familial ACEs included physical violence or negative recognition by teachers, being bullied in elementary or junior high school, or sexual violence. Results The frequency of psychosomatic disorders among the respondents was 14.8%. Among the 7 intra-familial ACEs, emotional abuse (relative risk, RR = 1.9 and illness in household (RR = 1.7 increased the risk of psychosomatic disorders. Estimates of the relative risk for the 5 extra-familial ACEs were statistically significant and ranged from 1.5 for being bullied in elementary school or physical violence from teachers to 2.4. Students who had 3 or more intra-familial ACEs and 2 or more extra-familial ACEs had a 3.0 relative risk for psychosomatic disorder. Conclusion These results suggest that intra- and extra-familial ACEs are associated with the development of psychosomatic disorders. Therefore, sufficient evaluation of ACEs should be performed in adolescent patients with psychosomatic disorder.

  14. Intra- and extra-familial adverse childhood experiences and a history of childhood psychosomatic disorders among Japanese university students

    Science.gov (United States)

    Masuda, Akinori; Yamanaka, Takao; Hirakawa, Tadatoshi; Koga, Yasuyuki; Minomo, Ryosuke; Munemoto, Takao; Tei, Chuwa

    2007-01-01

    Background Japan has been witnessing a considerable increase in the number of children with psychosomatic disorders. The purpose of this study is to examine the relationship between the risk of psychosomatic disorder in adolescents and intra- and extra-familial adverse childhood experiences (ACEs). Methods A retrospective cohort study of 1592 Japanese university students (52% male, mean age 19.9 years) who completed a survey about intra- and extra-familial ACEs and the incidence of childhood psychosomatic disorders. Intra-familial ACEs included domestic violence, physical violence, emotional abuse, illness in household, parental divorce, no parental affection, and dysfunctional family. Extra-familial ACEs included physical violence or negative recognition by teachers, being bullied in elementary or junior high school, or sexual violence. Results The frequency of psychosomatic disorders among the respondents was 14.8%. Among the 7 intra-familial ACEs, emotional abuse (relative risk, RR = 1.9) and illness in household (RR = 1.7) increased the risk of psychosomatic disorders. Estimates of the relative risk for the 5 extra-familial ACEs were statistically significant and ranged from 1.5 for being bullied in elementary school or physical violence from teachers to 2.4. Students who had 3 or more intra-familial ACEs and 2 or more extra-familial ACEs had a 3.0 relative risk for psychosomatic disorder. Conclusion These results suggest that intra- and extra-familial ACEs are associated with the development of psychosomatic disorders. Therefore, sufficient evaluation of ACEs should be performed in adolescent patients with psychosomatic disorder. PMID:17407551

  15. [Review Model for the Assessment of Psychometric Instruments--Recommendations of the German College of Psychosomatic Medicine (DKPM)].

    Science.gov (United States)

    Glaesmer, Heide; Forkmann, Thomas; Dinkel, Andreas; Wahl, Inka; Sattel, Heribert; Huber, Dorothea; Spangenberg, Lena; Rabung, Sven; Andreas, Sylke; Tritt, Karin; Franke, Gabriele Helga; Rose, Matthias; Löwe, Bernd

    2015-07-01

    Psychometric instruments are commonly applied in psychotherapeutic research and care for the baseline assessment of symptoms, the planning of therapeutic interventions, the assessment of the longitudinal course of symptoms and outcomes of therapeutic interventions as well as quality management of care. Psychometric properties as well as economic aspects should be considered in the selection of specific instruments. It is assumed that users of psychometric instruments face a great variety of instruments and related information. For that reason, it seems challenging to absorb the current knowledge and to integrate it into clinical practice and research. Thus, it is likely that well-known, established and easily accessible instruments are commonly used, while new developed instruments might not be disseminated in research and healthcare. Based on available international review models, the working group "Psychometrics and Psychodiagnostics" of the German College of Psychosomatic Medicine (DKPM) has developed and tested a review model specifically tailored for psychotherapeutic research and care. The different steps of development, as well as the final review model based on the consensus of the working group are presented. The review model contains 6 generic terms (reliability, validity, objectivity, reference groups and aspects of application) with 21 different criteria to be assessed with 0-3 asterisks (*). The criteria are clearly operationalized and the practical use of the review model is explained and discussed. With the review model for the assessment of psychometric instruments a well-defined evaluation system is made available for research and clinical practice which has been developed by an expert group. The review model facilitates systematic, transparent and comparative evaluation of psychometric instruments along clearly defined criteria. It also supports the selection of psychometric instruments in research and care. Next, the working group aims at

  16. [Oxidative stress in mechanism of psychosomatic disorders realization in duodenal ulcer in students].

    Science.gov (United States)

    Oparin, A G; Oparin, A A

    2005-01-01

    To study the role of oxidative stress in mechanism of psychosomatic disorders involvement in pathogenesis of ulcerogenesis. Psychosomatic disorders (PSD) and oxidative stress (OS) were assessed in 120 students with duodenal ulcer (DU) who had no concomitant pathology. Examination for PSD included interviewing by questionnaires. OS was judged by the level of lipid peroxidation products (malonic dialdehyde and dienic conjugates) and antioxidant activity--by glutathion peroxidase and superoxidedismutase. Melatonin was measured by enzyme immunoassay. A close correlation was discovered between the severity and features of PSD, lowering of melatonin, severity of OS and clinical features of the disease. DU students develop PSD which become leading factors of ulcerogenesis. One of the mechanisms of their participation in ulcerogenesis may be related with lowering of melatonin which is a potent stress regulator and corrector of lipid peroxidation and antioxidant activity.

  17. [Education in psychosomatic medicine/psychotherapy at German universities: a critical evaluation of the current status].

    Science.gov (United States)

    Hölzer, M; Blaser, G; Schüppel, R; Kächele, H

    1995-08-01

    The integration of psychosomatics/psychotherapy into the medical curriculum has not yet resolved the majority of problems in conveying a bio-psycho-social perspective to medical students. A survey, conducted 1992/93 at the university departments of psychosomatics-psychotherapy in Germany yielded that there is no true integration of a bio-psycho-social perspective into the curriculum up until now. A second investigation with students of the university of Ulm in 1993 revealed that there is substantial variety in the quality of teaching and that improvement is possible with resources already available. Consequences with regard to changes to be expected by the 8th renewal of the present teaching regulations ("Approbationsordnung") are discussed. A pilot project aiming at the integration of preclinical and clinical aspects of the psychosocial aspects of medicine is outlined.

  18. Correlates of psychosomatic stress symptoms among farm women: a research note on farm and family functioning.

    Science.gov (United States)

    Berkowitz, A D; Perkins, H W

    1985-01-01

    The relationship between self-reported psychosomatic stress symptoms and dimensions of family and farm functioning were examined in a sample of New York State dairy farm wives (N = 126). The farm women completed a questionnaire assessing home and farm task loads, farm complexity, intrapersonal role conflict, interpersonal role conflict, husband support, and marital satisfaction. The psychosomatic stress symptoms included nervousness, restlessness, insomnia, shortness-of-breath, and fainting. In general, stress symptoms showed little relationship to task loads, farm complexity, and intrapersonal role conflict. Much stronger relationships were found for interpersonal role conflict, husband support, and marital satisfaction. Thus, these findings point to the greater importance of family relationships in preventing or buffering stress in comparison with simple role-related task expectations of farm systems.

  19. Can we really teach psychosomatic medicine? A review of successes and failures.

    Science.gov (United States)

    Lipsitt, D R

    1991-01-01

    Medicine, it seems, is lately in a state of perpetual crisis. Some would attribute the problem, at least in part, to the enduring heritage of Descartes, who imprinted dualistic notions of a separation of mind and body upon medical education and practice. The perspective of psychosomatic medicine has long been hailed as the remedy for flaws in the way medicine has been taught and practiced for at least five decades. If medicine as a humanistic endeavor is to take account of the whole individual, it must encompass biological, social and psychological dimensions of the person. Many attempts at curriculum reform and postgraduate education have had variable success in countering the dualism of medicine. This presentation will discuss the challenge, the problems and the future of psychosomatic teaching, with illustrations from a variety of educational experiments.

  20. In defense of psychosomatic theory: a critical analysis of Allison and Heshka's critical analysis.

    Science.gov (United States)

    Van Strien, T

    1995-04-01

    This article analyses Allison and Heshka's (Internal Journal of Eating Disorders, 13, 289-295, 1993.) critical analysis of studies supporting psychosomatic theory. Questionned first is, Allison and Heshka's contention that the obese overreport emotional eating as a result of effects of demand characteristics, social desirability, and interpersonal expectancies. These effects, however, indicate that a more plausible response would be an underreport of emotional eating. Also addressed is Allison and Heshka's (Eating Disorders: The Journal of Treatment and Prevention, 1, 31-38, 1993.) contention that a high correlation between a measurement instrument and a measure of social desirability invalidates that measurement instrument. Finally, in a rebuttal of Allison and Heshka's critical analysis of studies supporting psychosomatic theory, it is elaborated why emotional eating explains so little variance in weight gain and obesity.

  1. In defense of psychosomatic theory: A critical analysis of Allison and Heshkas critical analysis

    OpenAIRE

    van Strien, T.

    1995-01-01

    This article analyses Allison and Heshka's (International Journal of Eating Disorders, 13, 289–295, 1993.) critical analysis of studies supporting psychosomatic theory. Questionned first is, Allison and Heshka's contention that the obese overreport emotional eating as a result of effects of demand characteristics, social desirability, and interpersonal expectancies. These effects, however, indicate that a more plausible response would be an underreport of emotional eating. Also addressed is A...

  2. [Problem-based teaching and learning. An opportunity for medical psychology, psychosomatic medicine and psychotherapy?].

    Science.gov (United States)

    Köhle, K; Obliers, R; Koerfer, A; Antepohl, W; Thomas, W

    1999-05-01

    All proposals for a reform of the study of medicine recommend problem-based teaching and learning methods. The rapid increase in the number of medical faculties abroad offering experimental courses along these lines is an indicator of their usefulness. The results of empirical research also suggest that departments of medical psychology, psychosomatic medicine and psychotherapy should participate more closely in the introduction and exploration of the advantages of this didactic approach.

  3. An Emerging Dimension in Psychosomatic Research: The Nocebo Phenomenon in the Management of Chronic Pain

    OpenAIRE

    2013-01-01

    Introduction. The nocebo effect consists in delivering verbal suggestions of negative outcomes so that the subject expects clinical worsening. Several studies indicate that negative verbal suggestions may result in the amplification of pain. Amplification style is one of the most important dimensions in psychosomatic research. Methods. One group of pain therapy unit patients was evaluated at baseline and again after 6 months from the beginning of the pain treatment. Results. Only 43% of 86 ch...

  4. Mental and somatic symptoms related to suicidal ideation in patients visiting a psychosomatic clinic in Japan

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    Kouichi Yoshimasu

    2009-08-01

    Full Text Available Kouichi Yoshimasu1, Tetsuya Kondo2,4, Shoji Tokunaga3, Yoshio Kanemitsu2, Hideyo Sugahara2, Mariko Akamine2, Kanichiro Fujisawa2, Kazuhisa Miyashita1, Chiharu Kubo21Department of Hygiene, School of Medicine, Wakayama Medical University, Wakayama, Japan; 2Department of Psychosomatic Medicine, Graduate school of Medical Sciences, Kyushu University, Fukuoka, Japan; 3Department of Medical Informatics, Kyushu University Hospital, Fukuoka, Japan; 4Department of Acupuncture and Moxibustion, Kansai University of Health Sciences, Osaka, JapanAbstract: Patients with suicidal ideation (SI have various mental or somatic symptoms. A questionnaire-based interview elicited details concerning mental and somatic symptoms in patients visiting a psychosomatic clinic in Japan. Univariate logistic regression analyses followed by multiple regression models using a stepwise method were selected for identifying the candidate symptoms. Overall, symptoms related to depression were associated with SI in both sexes. Although women showed more various somatic symptoms associated with SI than men, many of those associations were diminished once severity of the depression was controlled. The current results suggest that a variety of self-reported symptoms, mainly related to depression, might reveal suicidal risk in outpatients with an urban hospital clinical setting.Keywords: suicidal ideation, psychosomatic clinic, subjective symptoms

  5. High-utilizing Crohn's disease patients under psychosomatic therapy*

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    Jantschek Günther

    2008-10-01

    Full Text Available Abstract Objective Few studies have been published on health care utilization in Crohn's disease and the influence of psychological treatment on high utilizers. Methods The present sub study of a prospective multi center investigation conducted in 87 of 488 consecutive Crohn's disease (CD patients was designed to investigate the influence of the course of Crohn's disease on health care utilization (hospital days (HD and sick leave days (SLD collected by German insurance companies and to examine the conditions of high-utilizing patients. Predictors of health care utilization should be selected. Based on a standardized somatic treatment, high health care utilizing patients of the psychotherapy and control groups should be compared before and after a one-year treatment. Results Multivariate regression analysis identified disease activity at randomization as an important predictor of the clinical course (r2 = 0.28, p 2 = 0.15, p = 0.09. The patients' level of anxiety, depression and lack of control at randomization predicted their health-related quality of life at the end of the study (r2 = 0.51, p 2 = 0.22, p Among high utilizers, a significantly greater drop in HD (p Conclusion The course of Crohn's disease is influenced by psychological as well as somatic factors; especially depression seems important here. A significant drop of health care utilization demonstrates the benefit of psychological treatment in the subgroup of high-utilizing CD patients. Further studies are needed to replicate the findings of the clinical outcome in this CD subgroup.

  6. Subjective sleep complaints indicate objective sleep problems in psychosomatic patients: a prospective polysomnographic study

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    Linden M

    2016-08-01

    Full Text Available Michael Linden,1,2 Marie Dietz,1 Christian Veauthier,3 Ingo Fietze3 1Research Group Psychosomatic Rehabilitation, Charité University Medicine Berlin, 2Department of Psychosomatic Medicine, Rehabilitation Centre Seehof, Teltow, 3Interdisciplinary Center of Sleep Medicine, Charité University Medicine Berlin, Berlin, Germany Objective: To elucidate the relationship between subjective complaints and polysomnographical parameters in psychosomatic patients.Method: A convenience sample of patients from a psychosomatic inpatient unit were classified according to the Pittsburgh Sleep Quality Index (PSQI as very poor sleepers (PSQI >10, n=80 and good sleepers (PSQI <6, n=19. They then underwent a polysomnography and in the morning rated their previous night’s sleep using a published protocol (Deutschen Gesellschaft für Schlafforschung und Schlafmedizin morning protocol [MP].Results: In the polysomnography, significant differences were found between very poor and good sleepers according to the PSQI with respect to sleep efficiency and time awake after sleep onset. When comparing objective PSG and subjective MP, the polysomnographical sleep onset latency was significantly positively correlated with the corresponding parameters of the MP: the subjective sleep onset latency in minutes and the subjective evaluation of sleep onset latency (very short, short, normal, long, very long were positively correlated with the sleep latency measured by polysomnography. The polysomnographical time awake after sleep onset (in minutes was positively correlated with the subjective time awake after sleep onset (in minutes, evaluation of time awake after sleep onset (seldom, normal often, and subjective restfulness. The polysomnographical total sleep time (TST was positively correlated with the subjective TST. Conversely, the polysomnographical TST was negatively correlated with the evaluation of TST (high polysomnographical TST was correlated with the subjective

  7. On Henselian valuations and Brauer groups of primarily quasilocal fields

    OpenAIRE

    Chipchakov, Ivan

    2011-01-01

    This paper finds a classification, up-to an isomorphism, of abelian torsion groups realizable as Brauer groups of major types of Henselian valued primarily quasilocal fields with totally indivisible value groups. When $E$ is a quasilocal field with such a valuation, it shows that the Brauer group of $E$ is divisible and embeddable in the quotient group of the additive group of rational numbers by the subgroup of integers.

  8. Psychosomatic status, personality traits, and coping styles of bereaved and non-bereaved survivors of the 2008 Wenchuan Earthquake, China

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    Yanhui eXiang

    2016-03-01

    Full Text Available Objectives: This study examined personality, coping styles, and psychosomatic characteristics and their relationships in bereaved and non-bereaved earthquake survivors. Study design: Cross-sectional surveyMethods: A survey was conducted with a sample of 102 non-bereaved survivors and 79 bereaved survivors from Mianyang, Anyang, and similar districts 2 weeks after Wenchuan earthquake. Survivors completed questionnaires including items about demographics, personality characteristics, coping styles, and psychosomatic status. Results: Bereaved survivors had lower scores for gregariousness, trust, and optimism, but higher scores for depressed mood, loneliness, becoming easily fearful, irritation, and anxiety than non-bereaved survivors. In addition, bereaved participants scored higher for avoiding problems, self-blame, and fantasy coping styles than non-bereaved ones. Personality and coping styles significantly correlated with psychosomatic status in bereaved and non-bereaved survivors. Optimism and openness to feelings personality characteristics, and self-blame, avoiding problems, and rationalization coping styles significantly predicted psychosomatic status of bereaved survivors, while openness to fantasy, optimism, order, and trust personality characteristics, and self-blame and avoiding problems coping styles significantly predicted psychosomatic status of non-bereaved survivors. Conclusion: Earthquake survivors experienced PTSD symptoms and negative emotions. Bereaved survivors experienced more serious PTSD symptoms and negative emotions relative to non-bereaved survivors. Appropriate psychological crisis interventions should be conducted for earthquake survivors, especially bereaved survivors.

  9. Careers in virology: teaching at a primarily undergraduate institution.

    Science.gov (United States)

    Kushner, David B

    2014-10-01

    A faculty position at a primarily undergraduate institution requires working with undergraduates in both the classroom and the research lab. Graduate students and postdoctoral fellows who are interested in such a career should understand that faculty at these institutions need to teach broadly and devise research questions that can be addressed safely and with limited resources compared to a research I university. Aspects of, and ways to prepare for, this career will be reviewed herein. Copyright © 2014, American Society for Microbiology. All Rights Reserved.

  10. More Than the Sum of Its Parts : Meta-Analysis and Its Potential to Discover Sources of Heterogeneity in Psychosomatic Medicine

    NARCIS (Netherlands)

    Tak, Lineke M.; Meijer, Anna; Manoharan, Andiappan; de Jonge, Peter; Rosmalen, Judith G. M.

    2010-01-01

    Meta-analyses may contribute to more reliable knowledge about the existence of certain relations in the area of psychosomatic research. Surprisingly, the increasing popularity of meta-analysis is not reflected in the number of meta-analyses of observational studies published in Psychosomatic Medicin

  11. [Medical education in the field of psychosomatic medicine and psychotherapy at the German universities in 2006].

    Science.gov (United States)

    Schrauth, Markus; Nikendei, Christoph; Martens, Ute; Henningsen, Peter; Herpertz, Stephan; de Zwaan, Martina; Herzog, Wolfgang; Senf, Wolfgang; Zipfel, Stephan

    2006-11-01

    The new licensing regulations for physicians introduced in 2002 place core competencies in the field of Psychosomatic Medicine and Psychotherapy at the centre of medical training and have been considered to constitute a favourable opportunity for psychosocial faculties. To date, no data have been published concerning the consequences of these new regulations. All 34 chairs of Psychosomatic Medicine and Psychotherapy currently held by professors were surveyed by means of a written questionnaire at the beginning of the year 2006, regarding the present teaching situation and changes occurring through the introduction of the new regulations, as well as particular problem areas and respective solutions and suggestions. The rate of return for the questionnaires was 100 %. The consequences of the new regulations were rated predominantly positively. From a content point of view, classes continue to be more heavily weighted in cognitive areas and less so in areas of clinical practice; demands for an emphasis on affective learning objectives hence appear to have not been adequately met thus far. The newly established course formats (cross-sectional areas, obligatory optional courses, tutorials) also appear to have been employed to a rather limited degree. In addition to a lack of resources, the co-ordination with other specialist areas as well as the adequate assessment of teaching content poses a particular problem. The field of Psychosomatic Medicine and Psychotherapy constitutes an important engine for the didactic and content-related advancement of the medical curriculum in Germany. Nevertheless, the opportunities which the new licensing regulations for physicians offer to psychosocial faculties have not yet been entirely made use of. Surveyed individuals consider nationwide agreement concerning learning objectives, an exchange of experiences regarding the efficient and creative use of available resources and the development of suitable assessment methodologies, to be

  12. Effect of cognitive behavioral stress management program on psychosomatic patients’ quality of life

    Science.gov (United States)

    Ghazavi, Zahra; Rahimi, Esmat; Yazdani, Mohsen; Afshar, Hamid

    2016-01-01

    Background: Level of stress and its management affects the dimensions of psychosomatic patients’ quality of life (QoL), which is an important psychological issue. The present study aimed to investigate the effect of cognitive behavioral stress management program on psychosomatic patients’ QoL. In cognitive behavioral method, patients discover thought and behavioral mistakes and recover them. The criterion to evaluate the success of the present study was measurement of the patients’ QoL and its notable improvement after intervention. Materials and Methods: This is a before-and-after clinical trial with a control group. The study participants comprised 70 psychosomatic patients referred to subspecial psychiatry clinic in Isfahan who were selected through convenient sampling and allocated to the study and control groups. Quality of Life Questionnaire (SF36) was adopted to collect the data. The questionnaire was completed by the participants in three stages of before-and-after up to a month after intervention. Cognitive behavioral stress management program was administrated in study group for eight straight sessions, two month, and a month after intervention. Along with this, conventional medical treatments were conducted for both the groups. Data were analyzed by ANOVA. The significance level was P < 0.001. Results: There was no significant difference in QoL mean scores between the two groups before intervention (44, 43.1), but mean scores of QoL were significantly higher in intervention G (55.7, 59.1), compared to control (39.8, 35.7), after intervention (P < 0.001) and one month after intervention (P < 0.001). Conclusions: Cognitive behavioral stress management, conducted in the present study, had a notable effect on QoL. Therefore, designing psychological interventions based on cognitive behavioral stress management is suggested as an efficient clinical intervention. PMID:27904636

  13. Anti-NMDA receptor encephalitis: psychiatric presentation and diagnostic challenges from psychosomatic medicine perspective.

    Science.gov (United States)

    Gulyayeva, Nataliya A; Massie, Mary Jane; Duhamel, Katherine N

    2014-04-01

    We describe two cases of confirmed anti-NMDA receptor encephalitis; one patient initially presented with a clinical picture that resembled delirium and later appeared to present with a conversion reaction and the second patient presented with a first psychotic break followed by the clinical picture of neuroleptic malignant syndrome with catatonia. Neither patient had a previous history of psychiatric illness or recreational drug use. These cases illustrate the diagnostic and treatment challenges associated with this neuropsychiatric condition and underscore the role of psychosomatic medicine psychiatrists in diagnosing anti-NMDA receptor encephalitis.

  14. Human punishment is not primarily motivated by inequality

    Science.gov (United States)

    Marczyk, Jesse

    2017-01-01

    Previous theorizing about punishment has suggested that humans desire to punish inequality per se. However, the research supporting such an interpretation contains important methodological confounds. The main objective of the current experiment was to remove those confounds in order to test whether generating inequality per se is punished. Participants were recruited from an online market to take part in a wealth-alteration game with an ostensible second player. The participants were given an option to deduct from the other player’s payment as punishment for their behavior during the game. The results suggest that human punishment does not appear to be motivated by inequality per se, as inequality that was generated without inflicting costs on others was not reliably punished. Instead, punishment seems to respond primarily to the infliction of costs, with inequality only becoming relevant as a secondary input for punishment decisions. The theoretical significance of this finding is discussed in the context of its possible adaptive value. PMID:28187166

  15. Perceived mental stress in women associated with psychosomatic symptoms, but not mortality: observations from the Population Study of Women in Gothenburg, Sweden

    Directory of Open Access Journals (Sweden)

    Hange D

    2013-04-01

    Full Text Available Dominique Hange,1 Kirsten Mehlig,2 Lauren Lissner,2 Xinxin Guo,3 Calle Bengtsson,1,† Ingmar Skoog,3 Cecilia Björkelund1 1Department of Public Health and Community Medicine/Primary Health Care, 2Department of Public Health and Community Medicine/Public Health Epidemiology, 3Institute of Neuroscience and Physiology, Section of Psychiatry and Neurochemistry, Neuropsychiatric Epidemiology Unit, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden †Calle Bengtsson passed away on 23rd March 2013 Purpose: To investigate possible association between mental stress and psychosomatic symptoms, socioeconomic status, lifestyle, as well as incident mortality in a middle-aged female population followed over 37 years. Methods: A prospective observational study initiated in 1968–1969, including 1462 women aged 60, 54, 50, 46, and 38 years, with follow-ups in 1974–1975, 1980–1981, and 2000–2001, was performed. Measures included self-reported mental stress as well as psychosomatic symptoms and smoking, physical activity, total cholesterol, S-triglycerides, body mass index, waist–hip ratio, blood pressure, socioeconomic status and mortality. Results: Smoking, not being single, and not working outside home were strongly associated with reported mental stress at baseline. Women who reported high mental stress in 1968–1969 were more likely to report presence of abdominal symptoms (odds ratio [OR] = 1.85, 95% confidence interval [CI]: 1.39–2.46, headache/migraine (OR = 2.04, 95% CI: 1.53–2.72, frequent infections (OR = 1.75, 95% CI: 1.14–2.70, and musculoskeletal symptoms (OR = 1.70, 95% CI: 1.30–2.23 than women who did not report mental stress. Women without these symptoms at baseline 1968–1969, but with perceived mental stress were more likely to subsequently report incident abdominal symptoms (OR = 2.15, 95% CI: 1.39–3.34, headache/migraine (OR = 2.27, 95% CI: 1.48–3.48 and frequent infections (OR = 2.21, 95% CI: 1.12

  16. Primarily nonlinear effects observed in a driven asymmetrical vibrating wire

    Science.gov (United States)

    Hanson, Roger J.; Macomber, H. Kent; Morrison, Andrew C.; Boucher, Matthew A.

    2005-01-01

    The purpose of the work reported here is to further experimentally explore the wide variety of behaviors exhibited by driven vibrating wires, primarily in the nonlinear regime. When the wire is driven near a resonant frequency, it is found that most such behaviors are significantly affected by the splitting of the resonant frequency and by the existence of a ``characteristic'' axis associated with each split frequency. It is shown that frequency splitting decreases with increasing wire tension and can be altered by twisting. Two methods are described for determining the orientation of characteristic axes. Evidence is provided, with a possible explanation, that each axis has the same orientation everywhere along the wire. Frequency response data exhibiting nonlinear generation of transverse motion perpendicular to the driving direction, hysteresis, linear generation of perpendicular motion (sometimes tubular), and generation of motion at harmonics of the driving frequency are exhibited and discussed. Also reported under seemingly unchanging conditions are abrupt large changes in the harmonic content of the motion that sometimes involve large subharmonics and harmonics thereof. Slow transitions from one stable state of vibration to another and quasiperiodic motions are also exhibited. Possible musical significance is discussed. .

  17. Minuchin's psychosomatic family model revised: a concept-validation study using a multitrait-multimethod approach.

    Science.gov (United States)

    Kog, E; Vertommen, H; Vandereycken, W

    1987-06-01

    The convergent and discriminant validity of three operationalizations of the psychosomatic family features--enmeshment, rigidity, overprotectiveness, and lack of conflict resolution, as described by Minuchin and colleagues--are tested in families that include patients with eating disorders, especially anorexia nervosa and bulimia. We redefined the family features as dimensions and measured them with two behavioral methods (direct observation and behavioral product) and a self-report method. The two behavioral methods showed convergent as well as discriminant validity for the intensity of intrafamilial boundaries, the degree of the family's adaptability, and the family's way of handling conflicts. The self-report method showed only convergent validity for the latter dimension and discriminant validity for none of them. Besides intrafamilial conflict, the self-report method seemed to measure other constructs. A factor analysis of the family questionnaire indeed yielded three more evaluative constructs: conflict, cohesion, and disorganization. We interpreted these findings according to two usually interwoven mechanisms: the different research context (insider/outsider evaluation) in self-report and behavioral observation, and the different level of specification (micro/global evaluation) of certain operationalizations. We draw some conclusions about the psychosomatic family model and discuss the clinical implications of our findings.

  18. Self-esteem in Children with Psychosomatic Symptoms: Examination of Low Self-esteem and Prognosis

    Directory of Open Access Journals (Sweden)

    Hosogi,Mizuho

    2007-10-01

    Full Text Available Self-esteem is the evaluative feelings one holds for oneself and the sense that one has essential worth. It is evaluated as the difference between the actual self and the ideal self. Healthy self-esteem supports psychological stability and positive social activity and is an essential element in the psychological development of children. The purpose of this study was to evaluate self-esteem in children with psychosomatic symptoms and elucidate a strategy for using such evaluations in therapy. We evaluated self-esteem in 56 patients at the Department of Pediatrics of Okayama University Hospital who were undergoing outpatient therapy for psychosomatic symptoms, using Pope's 5-scale test of self-esteem for children. We examined patient attributes, course of therapy, and social adjustment. Patients with low self-esteem on multiple scales at the first visit were all female, and these patients had a significantly higher frequency of family function problems, such as a family member with a psychiatric disorder, economic hardship, or experience of child abuse. Moreover, the prognosis for these patients was poor regardless of their social adjustment at the first visit.

  19. Self-esteem in children with psychosomatic symptoms: examination of low self-esteem and prognosis.

    Science.gov (United States)

    Hosogi, Mizuho; Okada, Ayumi; Yamanaka, Eriko; Ootyou, Keiko; Tsukamoto, Chiaki; Morishima, Tsuneo

    2007-10-01

    Self-esteem is the evaluative feelings one holds for oneself and the sense that one has essential worth. It is evaluated as the difference between the actual self and the ideal self. Healthy self-esteem supports psychological stability and positive social activity and is an essential element in the psychological development of children. The purpose of this study was to evaluate self-esteem in children with psychosomatic symptoms and elucidate a strategy for using such evaluations in therapy. We evaluated self-esteem in 56 patients at the Department of Pediatrics of Okayama University Hospital who were undergoing outpatient therapy for psychosomatic symptoms, using Pope's 5-scale test of self-esteem for children. We examined patient attributes, course of therapy, and social adjustment. Patients with low self-esteem on multiple scales at the first visit were all female, and these patients had a significantly higher frequency of family function problems, such as a family member with a psychiatric disorder, economic hardship, or experience of child abuse. Moreover, the prognosis for these patients was poor regardless of their social adjustment at the first visit.

  20. [The new reimbursement for psychiatry and psychosomatics - challenges, opportunities and risks of the new financing system].

    Science.gov (United States)

    Häring, B; Kutschis, M; Bleich, S

    2014-01-01

    With the implementation of § 17 d KHG which provides for the introduction of a new, much more performance-based and transparent reimbursement system for psychiatric and psychosomatic hospitals, the Federal Ministry of Health sends the psychiatric and psychosomatic facilities in Germany into a previously unexplored area. Since 2013, there is the possibility of voluntary participation in the new system. Valid from 2015, every other institution will have to deal with the new challenges, opportunities and risks coming along with the structural changes, even though this fact will not have any impact on the individual hospital revenue budget until the end of 2016. There is still some time left to get used to the new system. This paper summarises the key data on the new reimbursement system and explains its content as well as how it works. In addition to that this paper goes into the classification system and clarifies what is essential for a solid preparation. Finally, it comments on the most common criticisms emerging since 2009. How the new system will develop remains to be seen. The fact that it will evolve seems to be certain in terms of a "learning system". It is up to all parties to promote the learning process so as to make effective use of existing potential and keep risks to a minimum.

  1. The Cartesian doctor, François Bayle (1622-1709), on psychosomatic explanation.

    Science.gov (United States)

    Easton, Patricia

    2011-06-01

    There are two standing, incompatible accounts of Descartes' contributions to the study of psychosomatic phenomena that pervade histories of medicine, psychology, and psychiatry. The first views Descartes as the father of "rational psychology" a tradition that defines the soul as a thinking, unextended substance. The second account views Descartes as the father of materialism and the machine metaphor. The consensus is that Descartes' studies of optics and motor reflexes and his conception of the body-machine metaphor made early and important contributions to physiology and neuroscience but otherwise his impact was minimal. These predominately negative assessments of Descartes' contributions give a false impression of the role his philosophy played in the development of medicine and psychiatry in seventeenth-century France and beyond. I explore Descartes' influence in the little-known writings of a doctor from Toulouse, François Bayle (1622-1709). A study of Bayle gives us occasion to rethink the nature and role of psychosomatic explanation in Descartes' philosophy. The portrait I present is of a Cartesian science that had an actual and lasting effect on medical science and practice, and may offer something of value to practitioners today. Copyright © 2010 Elsevier Ltd. All rights reserved.

  2. A REVIEW ON AACHARA RASAYANA W.S.R. TO THE MANAGEMENT OF PSYCHOSOMATIC DISORDERS

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    Gupta Satish Chand

    2012-06-01

    Full Text Available Rasayana is one among the major classification of Ayurvedic therapeutics. It can be advised to both diseased and healthy individual in order to strengthen one’s body as well as mind. Aachaar Rasayana is one among Nitya Rasayana (for using on daily basis which is nothing but the codes and conduct advocated by Acharya Charaka in Rasayana chapter of Charaka Samhita. It is the summarized form of Swasthavritta. In present day medical practice it is observed that major proportion of the population is suffering from the diseases of psychosomatic origin. In present scenario the management of psychosomatic disorders includes the use of psychotropic drugs, psychotherapy, behavior therapy, biofeedback etc. along with concurrent undertaking of the treatment for organic dysfunction. In this regard, ancient Ayurveda Acharyas have given equal consideration to physical, psychological, food and nutritional and behavioral patterns of an individual. When the ancient and modern concepts are reviewed, the biological, psychological and social factors seems to be influential on the state of health and illness of an individual. Aachara Rasayana makes an individual strong (immune physically, mentally, spiritually, socially (personality wise and morally by means of codes and conducts and use of some Nitya Rasayana Dravyas.

  3. The influence of united psychosomatic factors on clinical features of acne vulgaris

    Directory of Open Access Journals (Sweden)

    Dejanović Lidija

    2014-01-01

    Full Text Available Acne is a chronic inflammatory disorder of the pilosebaceal unit. Dermatological disorders are often associated with a variety of psychological problems which the patient have. Psichodermatologic disorders (acne are associated with skin problems that are not directly connected to the mind, but that react to emotional states, such as stress. The aim of this article is to show if there is any psychological characteristic which are common for the whole group of ill-patients from acne, as well as whether there is correlation between any type of acne and psychological parameters. Own exploration consist at thirty patients with three clinical type of acne. Personality test-Kornel index were used for identification and diagnostic psychosomatic disorders. The results are: neurastenic parameters, parameters of conversion and parameters of psychopathy in different percent at both sex, and different clinical features. We show correlation united 2-6 psichosomatic disorders in male sex with softly type of acne. In female sex with any type of acne are responsible 7-12 united findings. The association of several psychosomatic factors could possibly be responsible for the onset of acne at any type.

  4. [Concept of budget-based remuneration system for the fields of psychiatry and psychotherapy, psychosomatic medicine and psychotherapy, child and adolescent psychiatry and psychotherapy].

    Science.gov (United States)

    2015-11-01

    A new remuneration system is currently being developed for the hospital care of people with mental disorders. Last year, because of sharp criticism the option phase of the planned Flat-rate Charges in Psychiatry and Psychosomatics (Pauschalierende Entgelte Psychiatrie und Psychosomatik, PEPP) was extended by 2 years. During this time the Federal Ministry of Health wants to look for alternatives and possible starting points for the further development of care. Now, 16 scientific professional associations and organisations have presented a joint concept for a sustainable solution: the budget-based remuneration system. The system is suitable for ensuring that people with mental disorders are treated according to their particular needs and for promoting the appropriate further development of regional care in all treatment settings. It corresponds with the objectives as formulated in Section 17d of the Hospital Finance Act (Krankenhausfinanzierungsgesetz, KHG) and translates the PEPP system, which is currently being developed and focusses on average prices, into a performance-oriented, transparent budgetary system. The fundamental principle is the separation of the individual hospitals' budgeting on the basis of evidence-based, feature- and performance-related modules and billing in the form of advance payments from the agreed budget.

  5. [A Screening-Tool for Three Dimensions of Work-Related Behavior and Experience Patterns in the Psychosomatic Rehabilitation - A Proposal for a Short-Form of the Occupational Stress and Coping Inventory (AVEM-3D)].

    Science.gov (United States)

    Beierlein, V; Köllner, V; Neu, R; Schulz, H

    2016-12-01

    Objectives: The assessment of work pressures is of particular importance in psychosomatic rehabilitation. An established questionnaire is the Occupational Stress and Coping Inventory (German abbr. AVEM), but it is quite long and with regard to scoring time-consuming in routine clinical care. It should therefore be tested, whether a shortened version of the AVEM can be developed, which is able to assess the formerly described three second-order factors of the AVEM, namely Working Commitment, Resilience, and Emotions, sufficiently reliable and valid, and which also may be used for screening of patients with prominent work-related behavior and experience patterns. Methods: Data were collected at admission from consecutive samples of three hospitals of psychosomatic rehabilitation (N = 10,635 patients). The sample was randomly divided in two subsamples (design and validation sample). Using exploratory principal component analyses in the design sample, items with the highest factor loadings for the three new scales were selected and evaluated psychometrically using the validation sample. Possible Cut-off values ought to be derived from distribution patterns of scores in the scales. Relationships with sociodemographic, occupational and diagnosis-related characteristics, as well as with patterns of work-related experiences and behaviors are examined. Results: The three performed principal component analyses explained in the design sample on the respective first factor between 31 % and 34 % of the variance. The selected 20 items were assigned to the 3-factor structure in the validation sample as expected. The three new scales are sufficiently reliable with values of Cronbach's α between 0,84 and 0,88. The naming of the three new scales is based on the names of the secondary factors. Cut-off values for the identification of distinctive patient-reported data are proposed. Conclusion: Main advantages of the proposed shortened version AVEM-3D are that with a

  6. Improvement of balance between work stress and recovery after a body awareness program for chronic aspecific psychosomatic symptoms

    NARCIS (Netherlands)

    Landsman-Dijkstra, Jeanet J. A.; van Wijck, R; Groothoff, JW

    2006-01-01

    Objective: A 3-day residential body awareness program (BAP) was developed to teach people with chronic aspecific psychosomatic symptoms (CAPS) to react adequately to disturbances of the balance between a daily workload and the capacity to deal with it. The long-term effects of the program in improvi

  7. An Anonymous Survey of Psychosomatic Medicine Fellowship Directors regarding Breaches of Contracts and a Proposal for Prevention

    Science.gov (United States)

    Levenson, James L.; Bialer, Philip

    2010-01-01

    Objective: The authors studied how often applicants accept positions at more than one program, or programs offer positions to applicants who have already signed contracts with other programs. Methods: An anonymous survey was distributed to all psychosomatic medicine fellowship program directors. Results: It is fairly common for applicants to sign…

  8. The relation of vocal fold lesions and voice quality to voice handicap and psychosomatic well-being

    NARCIS (Netherlands)

    Smits, R.; Marres, H.A.; Jong, F. de

    2012-01-01

    BACKGROUND: Voice disorders have a multifactorial genesis and may be present in various ways. They can cause a significant communication handicap and impaired quality of life. OBJECTIVE: To assess the effect of vocal fold lesions and voice quality on voice handicap and psychosomatic well-being. METH

  9. Psychosomatic medicine : A new psychiatric subspecialty in the US focused on the interface between psychiatry and medicine

    NARCIS (Netherlands)

    Lyketsos, Constantine G.; Huyse, Frits J.; Gitlin, David F.; Levenson, James L.

    2006-01-01

    Background and Objectives: In the past, Psychosomatic Medicine (PM) has had ambiguous connotations, and there have been many other names for this specialized fields, including Consultation-Liaison Psychiatry. The objective of this report is to briefly review the background, the history and current s

  10. Characteristics and Risk factors of Psychosomatic Symp-toms Related to Female Tubal Sterilization in Rural Area in Hunan Province, China: A Prospective Study

    Institute of Scientific and Technical Information of China (English)

    刘破资; 岳伟华; 郝伟; 杨德森; 凌天牖; 张友明; 彭光辉; 武昆; 刘红华; 苏中华; 王厚亮; 谢永标

    2002-01-01

    Objectives To study characteristics of psychosomatic symptoms related to sterilization,to find out risk factors and their roles ascribed to psychosomatic symptoms, and toestablish a mathematic model for screening out susceptible women.Methods: This study enrolled 776 women in rural area at three counties of Linxiang,Qiyang, Changsha of Hunan province in China between February 1990 and April1992. Brief Neurosis Screening Scale (BNSS), Symptom Checklist 90 (SCL-90),sensitivity to pain, suggestibility were used to indicate subjects' psychological status.Logistic regression model and retrograde discriminant analysis were applied to developa mathematical model.Results: Prevalence of psychosomatic reactions or symptoms was 54. 8% before steril-ization, 26. 6% at three months and 16. 4% at one year after operation respectively.Psychosomatic symptoms were verified to be the result of joint effects of multiple riskfactors. The following risk factors were associated with postoperative symptoms:anger-hostility (RR= 33. 71), high suggestibility (RR= 4. 53), high neuroticism (RR= 3. 44), sensitivity to pain (RR = 2. 14) and operative sites (RR = 2. 05). A mathe-matical model to estimate the probability of developing psychosomatic symptoms in ster-ilization was established.Conclusions: More than half of women suffered from psychosomatic reactions beforeoperation, and some of them did not recover after operation. The postoperative psycho-somatic symptoms are the joint effect of multiple risk factors.

  11. Research Paradigms in Psychosomatic Medicine with Special Emphasis on Whiplash - Cervical Hyperextension Flexion Injury (CHFI

    Directory of Open Access Journals (Sweden)

    Harold Merskey

    2003-01-01

    Full Text Available There have been a number of attempts, particularly in the last five decades to understand the origins of pain in terms of psychological or psychosomatic patterns. These include psychoanalytic explanations relying on hysterical mechanisms, and psychophysiological proposals. The occurrence of pain in the course of psychiatric illness and its remission after the illness, has long been known and is not a controversial issue. However, the reported explanations of pain without overt and obvious prior psychiatric illness have largely failed to convince a significant portion of the professional establishment. These explanations have very often coincided with the interests of insurance companies, whether those insurance companies were providing medical benefits, disability insurance or workers' or accident compensation. Critical examination of the evidence generated by insurance company related research indicates profound weaknesses in it.

  12. Psychosomatic aspects of the behavior of cancer patients that should be considered in the rehabilitation

    Directory of Open Access Journals (Sweden)

    S. A. Misiak

    2016-01-01

    Full Text Available The article is dedicated to the psychological aspects of the relationship of the organisms of patients suffering from malignisation, and neoplasms, for further study of the disease during the rehabilitation period after standard treatment. If during the treatment of neoplastic disease doctors are encountering with the consequences of illness then the rehabilitation team need to identify the reasons of the disease occurrence. This helps to give the patient rehabilitation in full to improve the life quality and to provide effective socialization. The article analyzes the problems of the psychological characteristics of the origin and course of cancer, psychosomatic theories to explain the origin of the tumor during the illness. Also theories of the models of the patient’s psychological reactions to the presence of the cancer were studied in the article. The rehabilitation period in the cancer patients should include technological methods of psychotherapy.

  13. [Aristoteles redivivus or small repetitorium of Aristotelian methodology regarding problems of psychosomatic medicine].

    Science.gov (United States)

    Bartos, H; Savlík, J

    2006-01-01

    Present-day biological medicine has not reconciled the modern heritage of mechanistic conception of causality, which in many aspects limits the diagnostic and therapeutic potential of contemporary physicians. If such reduced principle of causality is confronted with Aristotelian conception of four types of disease causes and with the possibility to use it in the study of life nature (and therefore also in medicine), non-trivial differences will be revealed, which can at least bring some inspiration to present day physicians. The contemporary psychosomatically thinking physicians are in a similar position from which Aristotle criticized his foregoers for insufficient explanation of the principle of cause and effect. Medical doctors have many common points with Aristotle and that is why it is possible to speak, with certain hyperbole, about renewal of Aristotelian conceptions in some of the new trends of contemporary medicine, where the present-day mechanistic mentality is replaced with ecosystematic thinking.

  14. ["A medicine of human relationship" revisited--Current neurobiological and psychosomatic developments].

    Science.gov (United States)

    Beutel, Manfred I; Huber, Michael

    2007-05-01

    In his programmatic paper published 1989 in this journal, Herbert Weiner held the view that psychosomatic medicine has become a medicine of human relations. The aim of this review is to reflect if current scientific evidence supports his view. Evidence from animal studies suggests that early infant-mother separation or neglect not only has a lasting influence on attachment behaviour, but also on brain development and the ability for stress regulation mediated by environmental as well as genetic factors. Neuronal networks processing affective components of physical pain play a role in signalling painful emotional experiences due to social isolation and separation. A consistent finding across different studies is that physicians who adopt a warm, friendly and reassuring manner help activate patients endogenous opioid system, foster their compliance and promote better therapeutic results. In summary, evidence from neurobiological studies not only support Herbert Weiner's theses but also opens new venues for interdisciplinary research.

  15. The effects of different sources of occupational stress on affective, motivational, and psychosomatic outcomes

    Energy Technology Data Exchange (ETDEWEB)

    Ovalle, N.K. II.

    1991-01-01

    The present study examined the effects of role conflict, role ambiguity, and five additional potential sources of occupational stress on an affective outcome (job satisfaction), a motivational outcome (intent to quit), and two psychosomatic outcomes (mental and physical anxiety). In addition to role conflict and role ambiguity, the five additional sources of occupational stress centered on job characteristics, work pressures, rewards and opportunities, interaction of the job and home life, and lack of job challenge. Data were collected from 85 technicians and managers in a service organization. The results of correlation and multiple regression analyses indicated that each of the sources of stress have significant yet different effects on the outcomes. Moreover, role conflict and ambiguity did not have as much of an effect across all outcomes as the other five sources of stress. These findings could be used to improve the measurement, understanding, and treatment of occupational stress. Other implications are discussed. 23 refs., 2 tabs.

  16. The ambivalence of error: "scientific ideology" in the history of the life sciences and psychosomatic medicine.

    Science.gov (United States)

    Greco, Monica

    2004-02-01

    This paper discusses the concept of "scientific ideology" as it appears in the work of the historian and philosopher of medicine Georges Canguilhem, whose work is becoming increasingly well known and used amongst anglophone social scientists. Whilst addressing the problematic of legitimacy and illegitimacy in the history of science, the concept of "scientific ideology" does something different and more complex than either the opposition between science and false science, or the one between orthodoxy and heresy, allow for. On the one hand, it enables us to preserve a crucial acknowledgment of the specificity of science in general, and of medical science in particular. On the other hand, it also allows us to challenge the sharp contrast between science and non-science by setting that contrast in a diachronic perspective. Drawing also on the work of Isabelle Stengers, the last part of the paper discusses an application of the concept of scientific ideology in relation to the field of psychosomatic medicine and psychoneuroimmunology.

  17. REGULATING THE PSYCHOSOMATIC HEART RATE DISORDERS THROUGH THE USE OF ANTI-STRESS MASSAGE

    Directory of Open Access Journals (Sweden)

    Doina MÂRZA-DĂNILĂ

    2016-09-01

    Full Text Available The symptoms of the so-called functional cardiovascular disorders, in which emotional factors can have an etiological importance, is diverse, comprising tachycardia, anxiety palpitations, various forms of arrhythmia and neurocirculatory asthenia. No matter the causes, they can be related to one's lifestyle, personality and one's own way of perceiving everyday stress and reacting to it. Considering that anti-stress massage can help to achieve mental and physical relaxation in subjects and change their perception of the events they experience, and through this, regulate the psychosomatic heart rate disorders, diminish chronic fatigue and depression and, as such, can help prevent the emergence of the Karōshi syndrome, 19 sessions were applied to 4 subjects, over the course of 4 months. Their results, compared to the ones from other 4 subjects, proved that anti-stress massage has helped to gradually regulate the heart rate of the subjects on which it was applied.

  18. Somatic expressions of grief and psychosomatic illness in the works of William Shakespeare and his coevals.

    Science.gov (United States)

    Heaton, Kenneth W

    2012-10-01

    To find out if Shakespeare, famed for his insights into human nature, is exceptional in how much his characters express grief through somatic symptoms and signs, and by physical illness. The texts of all large-scale works currently attributed to Shakespeare (39 plays, 3 long narrative poems) were systematically searched for bodily changes and for evidence of grief as dominating the character's emotional state at the time. The findings were compared with those from a search of 46 works, similar in genre, by 15 prominent playwrights active at the same time as Shakespeare. In Shakespeare 31 different grief-associated symptoms or signs were found, in 140 instances. They are present in all but two of his plays and long poems and involve most systems of the body. With non-Shakespearean writers there were 26 kinds, 132 instances. Twenty-two changes are common to both groups, including fainting, death (sudden or after a decline), and wrinkled face, and symptoms such as malaise, fatigue, awareness of the heart-beat, and anorexia. Ten somatic expressions of grief were found only in Shakespeare, including hyperventilation, hair turning white and premature childbirth. Four were found only in his contemporaries but were trivial or unconvincing. Deaths and non-fatal illnesses are prevalent in Shakespeare. Grieving Shakespearean characters exhibit many somatic symptoms and signs and a wide range of psychosomatic illnesses. This panoply of psychosomatic phenomena may be an artistic artefact but it also confirms that Shakespeare's empathy with grieving humanity was unrivalled. Copyright © 2012 Elsevier Inc. All rights reserved.

  19. [Blended-learning in psychosomatics and psychotherapy - Increasing the satisfaction and knowledge of students with a web-based e-learning tool].

    Science.gov (United States)

    Ferber, Julia; Schneider, Gudrun; Havlik, Linda; Heuft, Gereon; Friederichs, Hendrik; Schrewe, Franz-Bernhard; Schulz-Steinel, Andrea; Burgmer, Markus

    2014-01-01

    To improve the synergy of established methods of teaching, the Department of Psychosomatics and Psychotherapy, University Hospital Münster, developed a web-based elearning tool using video clips of standardized patients. The effect of this blended-learning approach was evaluated. A multiple-choice test was performed by a naive (without the e-learning tool) and an experimental (with the tool) cohort of medical students to test the groups' expertise in psychosomatics. In addition, participants' satisfaction with the new tool was evaluated (numeric rating scale of 0-10). The experimental cohort was more satisfied with the curriculum and more interested in psychosomatics. Furthermore, the experimental cohort scored significantly better in the multiple-choice test. The new tool proved to be an important addition to the classical curriculum as a blended-learning approach which improves students' satisfaction and knowledge in psychosomatics.

  20. The Concept of the Care Worker : A Clue to the Issue of Care Work

    OpenAIRE

    野中, ますみ

    2010-01-01

    In Europe and the United States, the term "care worker" covers a much wider field than the one it covers in Japan. The job of the care worker in the West, which is not limited to the care for the senior citizen, often includes non-skilled and menial labor. Care workers, including certified ones, not only suffer from chronic unpaid overwork, lumbago, psychosomatic disorder and burnout, but are often exposed to danger of violence and infectious diseases from care receivers. Their poor working c...

  1. [The phenomenon of visual parallel detection. Construction and validation of a test and application to a psychosomatic model].

    Science.gov (United States)

    Montreuil, M; Jouvent, R

    1989-01-01

    A psychometric test of visual detection, based upon the theory of parallel information processing taking place in the left (analytical) and the right (holistic) hemispheres, is presented. The aim of this test is to study the capacity of visual holistic attention during a simultaneous logical distractive task (point to point closure). We first present the validation study on one hundred and four normal subjects. A second study on 20 psychosomatics is then presented, showing significantly inferior results in all subtests in comparison with paired controls. Results are discussed in terms of cognitive psychology, and in particular the link between holistic processing and the emotion processing function of the right hemisphere. This test therefore constitutes a new model of exploration of the cognitivo-emotional process. It should lead to a better evaluation for the study of interhemispheric dysconnexion in neurology as well as psychopathological states such as psychosomatic diseases, where dysconnexion- like phenomena (alexithymia) are thought to play a part.

  2. Is there evidence for the use of art therapy in treatment of psychosomatic disorders, eating disorders and crisis? A comparative study of two different systems for evaluation.

    Science.gov (United States)

    Holmqvist, Gärd; Lundqvist Persson, Cristina

    2012-02-01

    A comparative study of two different systems for evaluation. Scandinavian Journal of Psychology 53, 47-53. As with any type of treatment the requirement for evidence based practice (EBP) has also affected art therapy (AT) when used as an intervention. This review evaluates the available evidence for using AT for psychosomatic disorders, eating disorders and crisis. The search in Cochrane, Best Practice, AMED, CINAHL, PION, PsycINFO and PubMed from 1987 until now resulted in a huge number of articles but only 32 articles met our criteria for evaluations. The articles were assessed with two evaluation systems, the GRADE system used by the Swedish Council on Health Technology Assessment (SBU) and the US Preventive Services Task Force (USPSTF/Task Force). When comparing the results we found that the GRADE evaluation system rejected the quality in 84% of the 32 studies and the USPSTF/Task Force 41% of these studies. An evidence base for AT was found only according to the criteria of USPSTF/Task Force. Hence, the evidence concept is not explicit, which means that effective treatments run a risk of not being implemented in health care. We suggest a broader view of what constitutes evidence in order to make it possible to include different types of research designs and methods.

  3. Explanations for female excess psychosomatic symptoms in adolescence: evidence from a school-based cohort in the West of Scotland

    Directory of Open Access Journals (Sweden)

    West Patrick B

    2007-10-01

    Full Text Available Abstract Background By mid adolescence there is an excess in female physical and/or psychosomatic, as well as psychological morbidity. This paper examines the contribution of a range of factors (self-esteem, body image, gender-role orientation, body mass index, smoking and physical activity to explaining the female excess in three psychosomatic symptoms (headaches, stomach ache/sickness, and dizziness and depressive mood at age 15. Methods A cohort of 2,196 school pupils (analyses restricted to 2,005 with complete data surveyed at age 15. All measures were obtained via self-completion questionnaires, apart from body mass index, derived from measured height and weight. Analyses examined (a sex differences in each potential explanatory factor; (b their associations with the health measures; (c the effect of adjustment for these factors on sex differences in the health measures; and (d the existence of interactive effects between sex and the explanatory factors on the health measures Results Each potential explanatory factor was significantly differentiated by sex. Self-esteem, body image (represented by weight-related worries, smoking and physical activity were related to the health measures. These factors accounted for one third of the female excess in headaches and stomach problems, half the excess in dizziness and almost all that in respect of depressive mood. Self-esteem and body image were the factors most consistently related to health, and adjustment for these resulted in the largest reductions in the odds of a female excess in both the psychosomatic symptoms and depressive mood. Conclusion Adjustment for a range of potential psychosocial and behavioural factors largely explains (statistically excess female depressive mood. These factors also partially explain the female excess in certain psychosomatic symptoms.

  4. On the Essence of Psychosomatic Medicine%论心身医学的“本质”

    Institute of Scientific and Technical Information of China (English)

    何裕民

    2011-01-01

    从20世纪40年代起,有关心身医学的诸多问题就一直争议不断.旨在通过心身医学广义与狭义之辩,心身共轭这种客观存在的阐述,结合临床实践,揭示心身医学的“本质”,即承认且注重心身互动关系(包括健康、疾病及整个生命过程),并试图借助各种方法、手段,促使形成积极的心身互动关系,以利于守住健康,防范疾病或促使康复,使生存质量改善.%From the 1940's, many psychosomatic medicine issues have been controversial. This article aims to reveal the essence of psychosomatic medicine by the discrimination of general and special psychosomatic medicine definition, narrative of the objective existence of the conjugate psychosomatic, and combining with clinical practice. We consider that the essence is "the interaction between mind and body should be recognized and focused, including health, disease and all life course, and a variety of ways and means should be tried to use to promote the formation of a positive interaction between mind and body, in order to keep the health, prevent disease or promote recovery, improve the quality of life".

  5. The Effectiveness of the Unified Protocol on Emotional Dysregulation and Cognitive Emotion Regulation Strategies in Patients with Psychosomatic Disorders

    Directory of Open Access Journals (Sweden)

    Mina Mazaheri

    2014-01-01

    Full Text Available Background: The unified treatment approach (UP is an emotion-focused cognitive-behavioral therapy in which the main object of treatment is emotional processes. The aim of the present research was to examine the effectiveness of The Unified Protocol (UP on emotional dysregulation and cognitive emotion regulation strategies in patients with psychosomatic disorders. Methods: Emotion-focused cognitive behavioral therapy (ECBT, a unified treatment, with 12 weekly group sessions of 2 hours, was presented to 14 patients with psychosomatic complaints at the Subspecialty Center of Psychiatry in Isfahan in 2013. Pre- and post-intervention assessments were done by means of the self-report tests of Difficulties in Emotion Regulation Scale (DERS and Cognitive Emotion Regulation Questionnaire (CERQ. Results: Significant reductions in post-test scores of total emotional dysregulation (P < 0.01 as well as the factors of non-acceptance (P < 0.05 and strategy (P < 0.01 were seen, while the other factors (goal, impulse, awareness, and clarity did not change. Moreover, a significant reduction was observed in the catastrophizing strategy score (P < 0.05, in comparison with other cognitive strategies. Conclusion: This pilot study including 14 patients with psychosomatic disorders indicates that the Unified treatment approach is an effective treatment in improvement of emotional dysregulation and in reduction of utilizing maladaptive cognitive strategies.

  6. Classification diagnostic assessment strategies of psychosomatic medicine%心身医学分类诊断评估策略

    Institute of Scientific and Technical Information of China (English)

    吴爱勤

    2015-01-01

    心身疾病的心理病理与心理生理机理和临床特征不同于精神疾病。影响心身疾病患者的易损性、病程、预后、康复的心理社会因素的评估受到日益关注。提出心身疾病临床多轴诊断系统( MAS),心身医学研究的诊断标准( DCPR)临床诊断概念和结构框架。 DCPR将来源于心身研究的心理变量转变成用以鉴别诊断的可操作性诊断标准。 DCPR是一个简单、有效和可靠的定式访谈工具,可用于筛查、诊断心身疾病和心理生理障碍,补充ICD-10、DSM、CCMD的临床诊断应用的不足。包含了十二组心身疾病综合症,将影响躯体状况预后和治疗价值中的心理变量转化为客观的心身医学研究用诊断标准用工具。十二组症状包括健康焦虑、死亡恐惧症、疾病恐惧症、疾病否认、持续的躯体化症状、转换性障碍、继发于精神障碍的功能性躯体症状、周年反应、精神消沉、易激惹心境、A型行为和述情障碍。%[Abstarct] The psychological pathology and psychological physiological mechanism of psychosomatic diseases are different from mental diseases.So are the clinical characteristics.Evaluation of psychological social factors that affect the vulnerability, the course of the disease, the prognosis and the recovery in patients with psychosomatic disease has been attracted an increasing attention.The con-cept and structure framework of clinical diagnosis such as clinical multiaxial system( MAS) of psychosomatic disease and diagnostic cri-teria for psychosomatic research( DCPR) have been proposed.The DCPR that derives from the psychological variables in psychosomatic research will translate into operational diagnostic criteria for differential diagnosis.DCPR is a simple, effective and reliable stereotypes interview tool that can be used for screening and diagnosing the psychosomatic diseases and psychophysiological disorders.This can also replenish the

  7. Non-pharmacological treatment effects on psychosomatic and immune regulatory mechanisms in patients with rheumatic arthritis

    Directory of Open Access Journals (Sweden)

    Zharikova I.P.

    2014-12-01

    Full Text Available Objective: comparative analysis of the influence of the methods of the lateral ophthalmotilapia and low-intensity magnetic therapy on the Central and peripheral nervous system and the immune status in patients with rheumatoid arthritis. Material and methods: a comparative analysis of the impact of the 44 patients with rheumatoid arthritis aged 18 to 65 years, of which 19 patients (43.2 percent — 1 group received low-frequency low-intensity magnetic therapy and 25 patients (56.8 per cent — group 2, the lateral ophthalmotilapia. Results. In group 1 significantly improved memory both short-term (from 69.2±9.0 to 81,7±12,7, p=0.003, and the reminiscence relating to medium-term characteristics of memory (57,3±22 to 79,0±14,5; p=0.004. In patients of the 2nd group in the course of treatment was observed more pronounced dynamics of improvement of parameters of higher nervous activity, namely short-term memory (79,4±17 to 88,2±12, p=0.003and reminiscences of memory (from 69.4±27 to 82.4±19,5, p=0,0016. Conclusion. Lateral ophthalmotilapia and low-frequency magnetotherapy for help expand the list of rehabilitation programs in rheumatoid arthritis, the disease having dual autoimmune and psychosomatic genesis.

  8. [Helpful Factors of Ambulant Art Therapy in the Group and Changes of Experiences in Psychosomatic Patients].

    Science.gov (United States)

    Oster, Jörg; Moser, Anna Sophie; Danner-Weinberger, Alexandra; von Wietersheim, Jörn

    2016-02-01

    The aim of this study was to analyze the experiences of patients suffering from mostly chronic psychosomatic disorders in an ambulant art therapy in the group. Especially, the focus was on the experienced changes, helpful factors and specifics of the therapy as well as on the experienced benefit. For this, 30 patients were interviewed in a semi-standardized way. Additionally, the symptom-based strain was psychometrically recorded in a part of the patients (21) at the beginning of the therapy and after at least 6 months of participation. The evaluation of those interviews with the qualitative analysis of the therapy subjects surrendered an improvement of the health state in most of the participants. Especially group factors, art as a mean of communication, becoming aware of feelings but also diversion and fun were proved to be beneficial. The art therapy also serves for structuring the week as well as a contact point and a resource in the interpersonal communication of everyday life. Nearly all of the patients referred to some important turning point pictures. Mostly, the benefit was valued as being high. But, in contrast, the psychometric measure did not show any significant change. The results emphasize the stabilizing function of art therapy in the examined patients, whereat the classification of the psychometric result is complicated by the absence of a control group. © Georg Thieme Verlag KG Stuttgart · New York.

  9. [Patients' experiences and picture processes during the art therapy in a psychosomatic day hospital].

    Science.gov (United States)

    Oster, Jörg; Poetsch, Stephanie; Danner-Weinberger, Alexandra; von Wietersheim, Jörn

    2014-02-01

    The aim of this study was the examination of the experiences of patients participating in an art therapy during a psychosomatic day hospital. The data basis were 15 transliterated interviews from the end of the treatment, conducted with a presentation of the pictures painted in the art therapy sessions, as well as the digitised pictures. The evaluation was done with a qualitative analysis of the interviews and an analysis of the pictures, using a specially-developed category system. In the art therapy, most part of the pa-tients dealt with own conflicts. Nearly all pa-tients benefitted from the art therapy and indicated an improvement of their feeling. The picture processes are different; at the beginning, wishes and familiar techniques dominated. Pictures of turning points differed in their dimensions. The art therapy was seen as a part of the complete treatment in which several therapies assembled. The final interviews were experienced as helpful for further reflections. © Georg Thieme Verlag KG Stuttgart · New York.

  10. Psychosomatic disorders in general practice: comparisons of treatment with flupenthixol, diazepam and sulpiride.

    Science.gov (United States)

    Meyers, C; Vranckx, C; Elgen, K

    1985-01-01

    One hundred and thirteen patients diagnosed as suffering from one of four common psychosomatic syndromes (psychogenic headache, cardiac neurosis, functional disturbance of the colon, or pruritus) were treated by two groups of general practitioners with flupenthixol or diazepam or sulpiride. Flupenthixol was compared with diazepam in 58 patients in one group of Belgian practices, and with sulpiride in 55 patients in another group of practices and assessed over a 4-week period for therapeutic response and adverse effects. Flupenthixol was given in a dosage of 0.5 to 2 mg a day, diazepam in a dosage of 2.5 to 10 mg a day and sulpiride 100 to 200 mg a day, in identical capsules. In the flupenthixol/diazepam comparison, there were 7 drop-outs (3 flupenthixol, 4 diazepam). Marked or moderate reduction in global assessment of illness occurred in both treatment groups, but there was no significant difference in the therapeutic effect of the two drugs. The incidence of side-effects was low and similar in the two groups. In the flupenthixol/sulpiride comparison, there were 10 drop-outs (7 flupenthixol, 3 sulpiride). A significant reduction in symptoms occurred in both treatment groups, but this was more rapid in the flupenthixol group. Side-effects were infrequent and mild in both groups.

  11. Bioethical dimensions of cultural psychosomatics: the need for an ethical research approach.

    Science.gov (United States)

    Lolas, Fernando

    2013-01-01

    Contemporary psychosomatics is a research-based technical discipline and its social power depends on how scientific knowledge is obtained and applied in practice, considering cultural contexts. This article presents the view that the dialogical principles on which bioethical discourse is based are more inclusive than professional ethics and philosophical reflection. The distinction is advanced between rule-guided behavior and norm-justifiable acts (substantiation and justification). The practical implications of good practices in the generation of valid, reliable, generalizable and applicable knowledge are emphasized. For practitioners and researchers, the need to reflect on the distinction between patient and research participant can avoid the therapeutic misunderstanding, a form of abuse of the doctor-patient relationship. In addition, in resource-poor settings, the dilemma presented by the know-do gap (inapplicability of research results due to financial or social constraints) is part of the ethics' realm of the profession. Future prospects include a wider use of research results in practice, but avoidance of the know-do gap (the disparity between what is known and what can be done, particularly in settings with limited resources) requires a synthetic and holistic approach to medical ethics, combining moral reflection, theoretical analysis and empirical data.

  12. Assessment and study of changes psychosomatic state of the vegetative nervous system of patients with rosacea

    Directory of Open Access Journals (Sweden)

    Davydova A.V.

    2012-06-01

    Full Text Available

    Aims. The study aimed an identifying of signs of the vegetative nervous system and detailed study of the psychological characteristics of patients with rosacea. Materials and methods. The study included 60 patients with different clinical forms of rosacea at the age from 26 to 56 years and a control group of 60 relatively healthy persons. The assessment of emotional status is carried out with the survey, Test of accentuations of temperament, Diagnostic Questionnaire Quality of Life Index (DILQ, The Zung Self-Rating Depression Scale, reduced multifactorial questionnaire for the study of personality. Vegetative nervous system was investigated using vegetative Kerdo index, Wayne and Solovyova tables and a special questionnaire for signs of vegetative disorders. Conclusions. Syndrome revealed the presence of vegetative-vascular dysfunction in patients with rosacea with a predominance of parasympathetic tone of the autonomic nervous system. Severity of psychoemotional disorders had no direct relationship to the severity of rosacea. But patients with advanced disease had a tighter self-control on the background of increased excitability and stronger internal emotional stress. Those patients were compared with a group of patients with earlier stage disease, which may provoke functional impairments and in case of long existence-the formation of psychosomatic disorders. This comprehensive assessment of vegetative and emotional status is included in the algorithm for evaluation of patients with rosacea and will successfully complement traditional therapy.

  13. RESPECT-Mil: Early Intervention & Outcomes Of PTSD & Depression In Primary Care

    Science.gov (United States)

    2011-03-21

    Primary Care Treatment in the Military 6 3 Component Model systems-based care PREPARED PRACTICE BH SPECIALIST PATIENTCARE MANAGER an extra resource that...based care PREPARED PRACTICE BH SPECIALIST PATIENTCARE MANAGER an extra resource that links patient, provider & specialist Oxman et al, Psychosomatics...Ft Polk, LA) Pascale Guirand, FNP (Ft Bragg, NC) Scientific Advisors Allen Dietrich, MD (Dartmouth) John Williams, MD (Duke & Durham VA) Kurt Kroenke

  14. Naturalistic observation of health-relevant social processes: the electronically activated recorder methodology in psychosomatics.

    Science.gov (United States)

    Mehl, Matthias R; Robbins, Megan L; Deters, Fenne Große

    2012-05-01

    This article introduces a novel observational ambulatory monitoring method called the electronically activated recorder (EAR). The EAR is a digital audio recorder that runs on a handheld computer and periodically and unobtrusively records snippets of ambient sounds from participants' momentary environments. In tracking moment-to-moment ambient sounds, it yields acoustic logs of people's days as they naturally unfold. In sampling only a fraction of the time, it protects participants' privacy and makes large observational studies feasible. As a naturalistic observation method, it provides an observer's account of daily life and is optimized for the objective assessment of audible aspects of social environments, behaviors, and interactions (e.g., habitual preferences for social settings, idiosyncratic interaction styles, subtle emotional expressions). This article discusses the EAR method conceptually and methodologically, reviews prior research with it, and identifies three concrete ways in which it can enrich psychosomatic research. Specifically, it can (a) calibrate psychosocial effects on health against frequencies of real-world behavior; (b) provide ecological observational measures of health-related social processes that are independent of self-report; and (c) help with the assessment of subtle and habitual social behaviors that evade self-report but have important health implications. An important avenue for future research lies in merging traditional self-report-based ambulatory monitoring methods with observational approaches such as the EAR to allow for the simultaneous yet methodologically independent assessment of inner, experiential aspects (e.g., loneliness) and outer, observable aspects (e.g., social isolation) of real-world social processes to reveal their unique effects on health.

  15. Psychosomatic medicine from philosophy to clinical practice%从哲学走向临床的心身医学

    Institute of Scientific and Technical Information of China (English)

    曹建新

    2016-01-01

    The idea of mind-body integration existed in practice of traditional Chinese medicine ( TCM) at the very beginning, and psychosomatic medicine as a special term was from western world. Discussion about psychosomatic medicine was basically limited within philosophy and psychiatrics before 1980s.It did not find extensive application in practice of non-psychiatric medicine to manage psycho-social factors in medical setting until 1980s.Brife history and worldwide development of psychosomatic medicine,the diversification of its definition,its incorporation into clinical practice and the development and expection of its incorporation into clinical gastroenterology will be discussion in the article.%心身合一的医学思想最早起源我国的传统医学,心身医学作为特有的名称或词汇来自西方。20世纪80年代前,关于心身医学的讨论基本停留在哲学层面和精神医学范围;此后心身医学越来越趋向讨论综合医院非精神科的社会心理问题。笔者主要论述世界范围内的心身体医学发展、心身医学定义的多样性、心身医学的临床实践以及心身医学在消化内科的应用。

  16. The perspective of psychosomatic medicine on the effect of religion on the mind-body relationship in Japan.

    Science.gov (United States)

    Nakao, Mutsuhiro; Ohara, Chisin

    2014-02-01

    Shintoism, Buddhism, and Qi, which advocate the unity of mind and body, have contributed to the Japanese philosophy of life. The practice of psychosomatic medicine emphasizes the connection between mind and body and combines the psychotherapies (directed at the mind) and relaxation techniques (directed at the body), to achieve stress management. Participation in religious activities such as preaching, praying, meditating, and practicing Zen can also elicit relaxation responses. Thus, it is time for traditional religions to play an active role in helping those seeking psychological stability after the Great East Japan Earthquake and the ongoing crisis related to the nuclear accident in Fukushima, Japan, to maintain a healthy mind-body relationship.

  17. 从典型案例分析临床心身症状问题%Clinical Analysis of Psychosomatic Symptoms from Typical Case

    Institute of Scientific and Technical Information of China (English)

    何裕民

    2013-01-01

    Based on clinical long-term knowledge in oncology, the author proposed there may be psychosomatic interaction mechanisms for many complex chronic conditions behind the clinical symptoms; in addition, study has made it clear that there is conjugate relationship between body and mind. Therefore, clinicians should have psychosomatic thoughts, made considerations from human psychosomatic wholeness in chronic diseases and their symptoms. Psychosomatic symptoms are intricate and diverse; advocates from psychosomatic angle cut can often help solve the mystery to those clinical symptoms difficult to interpret; also psychosomatic medicine should take into account the intervention and management, which can correct the diagnosis, also help improve the symptoms.%基于长期的肿瘤科临床见闻,笔者提出许多慢性病复杂的临床症状背后,可能存在心身互动机制;且研究已经明确,心身存在着共轭关系.因此,临床应具备心身相关思想,对慢性病及其症状,从人心身整体性做出考量;心身相关性症状的表现是错综且多样化的;对临床难以解释症状,主张从心身相关角度切入,常可帮助解开谜团;同时,处置时还应心身兼顾地进行干预;这样,既可反证诊断正确与否,又可帮助改善症状.

  18. Predictors of nephrectomy in high grade blunt renal trauma patients treated primarily with conservative intent.

    Science.gov (United States)

    Prasad, Narla Hari; Devraj, Rahul; Chandriah, G Ram; Sagar, S Vidya; Reddy, Ch Ram; Murthy, Pisapati Venkata Lakshmi Narsimha

    2014-04-01

    There is no consensus on the optimal management of high grade renal trauma. Delayed surgery increases the likelihood of secondary hemorrhage and persistent urinary extravasation, whereas immediate surgery results in high renal loss. Hence, the present study was undertaken to evaluate the predictors of nephrectomy and outcome of high Grade (III-V) renal injury, treated primarily with conservative intent. The records of 55 patients who were admitted to our institute with varying degrees of blunt renal trauma from January 2005 to December 2012 were retrospectively reviewed. Grade III-V renal injury was defined as high grade blunt renal trauma and was present in 44 patients. The factors analyzed to predict emergency intervention were demographic profile, grade of injury, degree of hemodynamic instability, requirement of blood transfusion, need for intervention, mode of intervention, and duration of intensive care unit stay. Rest of the 40 patients with high grade injury (grade 3 and 4)did not require emergency intervention and underwent a trail of conservative management. 7 of the 40 patients with high grade renal injury (grade 3 and 4), who were managed conservatively experienced complications requiring procedural intervention and three required a delayed nephrectomy. Presence of grade V injuries with hemodynamic instability and requirement of more than 10 packed cell units for resuscitation were predictors of nephrectomy. Predictors of complications were urinary extravasation and hemodynamic instability at presentation. Majority of the high grade renal injuries can be successfully managed conservatively. Grade V injuries and the need for more packed cell transfusions during resuscitation predict the need for emergency intervention.

  19. Predictors of nephrectomy in high grade blunt renal trauma patients treated primarily with conservative intent

    Directory of Open Access Journals (Sweden)

    Narla Hari Prasad

    2014-01-01

    Full Text Available Introduction: There is no consensus on the optimal management of high grade renal trauma. Delayed surgery increases the likelihood of secondary hemorrhage and persistent urinary extravasation, whereas immediate surgery results in high renal loss. Hence, the present study was undertaken to evaluate the predictors of nephrectomy and outcome of high Grade (III-V renal injury, treated primarily with conservative intent. Materials and Methods: The records of 55 patients who were admitted to our institute with varying degrees of blunt renal trauma from January 2005 to December 2012 were retrospectively reviewed. Grade III-V renal injury was defined as high grade blunt renal trauma and was present in 44 patients. The factors analyzed to predict emergency intervention were demographic profile, grade of injury, degree of hemodynamic instability, requirement of blood transfusion, need for intervention, mode of intervention, and duration of intensive care unit stay. Results: Rest of the 40 patients with high grade injury (grade 3 and 4 did not require emergency intervention and underwent a trail of conservative management. 7 of the 40 patients with high grade renal injury (grade 3 and 4, who were managed conservatively experienced complications requiring procedural intervention and three required a delayed nephrectomy. Presence of grade V injuries with hemodynamic instability and requirement of more than 10 packed cell units for resuscitation were predictors of nephrectomy. Predictors of complications were urinary extravasation and hemodynamic instability at presentation. Conclusion: Majority of the high grade renal injuries can be successfully managed conservatively. Grade V injuries and the need for more packed cell transfusions during resuscitation predict the need for emergency intervention.

  20. 12 CFR 225.127 - Investment in corporations or projects designed primarily to promote community welfare.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 3 2010-01-01 2010-01-01 false Investment in corporations or projects designed... equity and debt investments in corporations or projects designed primarily to promote community welfare... not intended to limit projects under § 225.25(b)(6) to that area. Other investments primarily designed...

  1. The short-term effects of a body awareness program : better self-management of health problems for individuals with chronic a-specific psychosomatic symptoms

    NARCIS (Netherlands)

    Landsman-Dijkstra, Jeanet J. A.; van Wijck, R; Groothoff, JW; Rispens, P

    2004-01-01

    A three-day residential Body Awareness Program (BAP) was developed to teach people with Chronic A-specific Psychosomatic Symptoms (CAPS) to react adequately to disturbances of the balance between a daily workload and the capacity to deal with it. The short-term effects of the program for people with

  2. The impact of the voice in relation to psychosomatic well-being after education in female student teachers: a longitudinal, descriptive study.

    NARCIS (Netherlands)

    Meulenbroek, L.F.P.; Opstal, M.J. van; Claes, L.; Marres, H.A.M.; Jong, F.I.C.R.S. de

    2012-01-01

    OBJECTIVE: Voice handicap in relation to psychosomatic well-being after education in female student teachers. METHODS: A longitudinal survey among 90 female students using Voice Handicap Index and Symptom Check List-90 at the start and end of education. RESULTS: Student teachers in fourth grade show

  3. Multi-Province Listeriosis Outbreak Linked to Contaminated Deli Meat Consumed Primarily in Institutional Settings, Canada, 2008.

    Science.gov (United States)

    Currie, Andrea; Farber, Jeffrey M; Nadon, Céline; Sharma, Davendra; Whitfield, Yvonne; Gaulin, Colette; Galanis, Eleni; Bekal, Sadjia; Flint, James; Tschetter, Lorelee; Pagotto, Franco; Lee, Brenda; Jamieson, Fred; Badiani, Tina; MacDonald, Diane; Ellis, Andrea; May-Hadford, Jennifer; McCormick, Rachel; Savelli, Carmen; Middleton, Dean; Allen, Vanessa; Tremblay, Francois-William; MacDougall, Laura; Hoang, Linda; Shyng, Sion; Everett, Doug; Chui, Linda; Louie, Marie; Bangura, Helen; Levett, Paul N; Wilkinson, Krista; Wylie, John; Reid, Janet; Major, Brian; Engel, Dave; Douey, Donna; Huszczynski, George; Di Lecci, Joe; Strazds, Judy; Rousseau, Josée; Ma, Kenneth; Isaac, Leah; Sierpinska, Urszula

    2015-08-01

    A multi-province outbreak of listeriosis occurred in Canada from June to November 2008. Fifty-seven persons were infected with 1 of 3 similar outbreak strains defined by pulsed-field gel electrophoresis, and 24 (42%) individuals died. Forty-one (72%) of 57 individuals were residents of long-term care facilities or hospital inpatients during their exposure period. Descriptive epidemiology, product traceback, and detection of the outbreak strains of Listeria monocytogenes in food samples and the plant environment confirmed delicatessen meat manufactured by one establishment and purchased primarily by institutions was the source of the outbreak. The food safety investigation identified a plant environment conducive to the introduction and proliferation of L. monocytogenes and persistently contaminated with Listeria spp. This outbreak demonstrated the need for improved listeriosis surveillance, strict control of L. monocytogenes in establishments producing ready-to-eat foods, and advice to vulnerable populations and institutions serving these populations regarding which high-risk foods to avoid.

  4. Identity-Related Influences on the Success of Minority Workers in Primarily Nonminority Organizations.

    Science.gov (United States)

    James, Keith; Khoo, Gillian

    1991-01-01

    Reviews literature at the micro- (individual, interpersonal, and small group) and macro- (organizational, societal, and cultural) levels relating to the experiences and outcomes of minorities in work settings populated primarily by members of the majority. Uses Tajfel and Turner's Social Identity Theory as an organizational and integrative…

  5. 29 CFR 780.607 - “Primarily employed” in agriculture.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 3 2010-07-01 2010-07-01 false âPrimarily employedâ in agriculture. 780.607 Section 780... AGRICULTURE, PROCESSING OF AGRICULTURAL COMMODITIES, AND RELATED SUBJECTS UNDER THE FAIR LABOR STANDARDS ACT Employment in Agriculture and Livestock Auction Operations Under the Section 13(b)(13) Exemption Requirements...

  6. Propulsion and control propellers with thruster nozzles primarily for aircraft applications

    Science.gov (United States)

    Pabst, W.

    1986-01-01

    A propulsion and control propeller with thruster nozzles, primarily for aircraft application is described. Adjustability of rotor blades at the hub and pressurized gas expulsion combined with an air propeller increase power. Both characteristics are combined in one simple device, and, furthermore, incorporate overall aircraft control so that mechanisms which govern lateral and horizontal movement become superfluous.

  7. Examining the Effects of Introducing Online Access to ACS Journals at Primarily Undergraduate Institutions

    Science.gov (United States)

    Landolt, R. G.

    2007-01-01

    In collaboration with the Publications Division of the American Chemical Society (ACS), students and faculty at 24 primarily undergraduate institutions were provided online access to ACS primary research journals for a period of 18 months, and a group of eight schools were granted access to use the archives of ACS journals for a year. Resources…

  8. THE ROLE OF PSYCHOPHYSIOLOGIC AND ANTHROPOMETRIC DESCRIPTIONS IN THE BEGINNING OF PSYCHOSOMATIC PATHOLOGY: IS THE DEFICIENCY OF BODY WEIGHT A RISK FACTOR?

    Directory of Open Access Journals (Sweden)

    T.I. Mareeva

    2007-09-01

    Full Text Available In order to find out psychophysiologic preconditions for the beginning of psychosomatic pathology, 264 clinically healthy persons of both sexes were examined (the average age was 22,16 + 2,42. All of them were divided into 2 groups according to their body weight index: the first group had normal body weight index, the second had deficiency of body weight. With the help of psychodiagnostic methods (Reduced Multiple Questionnaire for the examining of the Personality, Psychogeometrical test, Spielberger's test, Subbotin's test, Ekkles's test it was found that persons with deficiency of body weight had had conflicting personality features, which form prepsychosomatic radical of personality. It underlies the development of psychosomatics diseases and deviant behavior.

  9. [Kurt Goldstein's understanding of amnesic aphasia and its underlying disorder - an early model of the pensée opératoire of the French psychosomatic school?].

    Science.gov (United States)

    Danzer, G; Eisenblätter, A; Belz, W; Schulz, A; Klapp, B F

    2002-07-01

    Kurt Goldstein's understanding of amnesic aphasia in some regards anticipated the model of the pensée opératoire, a concept developed during the 60's and 70's by the French psychoanalytical school of psychosomatics. Goldstein interpreted amnesic aphasia within the framework of a "basic disorder". Closely following the philosopher Ernst Cassirer, Goldstein described amnesic aphasia as an expression of a general alteration following localized or generalised brain damage. Due to various historical events (world war, fascism, the holocaust) as well as developments during the 20(th) century (dominance of the English language in many areas of science), these connections were forgotten or were no longer recognised as such. Without wanting to determine the extent to which the concept of pensée opératoire possesses validity, one can interpret Goldstein's reflections on aphasia as a heretofore unreceived preliminary model of the psychosomatic concept of the French School.

  10. 心身疾病新的评估策略:心身医学研究诊断标准%Development of a New Assessment Strategy in Psychosomatic Medicine:The Diagnostic Criteria for Psychosomatic Research

    Institute of Scientific and Technical Information of China (English)

    吴爱勤

    2012-01-01

    The Diagnostic Criteria for Psychosomatic Research (DCPR) are a diagnostic and conceptual framework that was proposed a decade ago by an international group of investigators. The DCPR's rational was to translate psychosocial variables that derived from psychosomatic research into operational tools whereby individual patients could be identified. A set of 12 syndromes was developed: health anxiety, thanatophobia, disease phobia, illness denial, persistent somatization, conversion symptoms, functional somatic symptoms secondary to a psychiatric disorder, anniversary reaction, demoralization, irritable mood, type A behavior and alexithymia. These criteria were meant to be used in a multiaxial approach. The aim of this work is to survey the research evidence which has accumulated on the DCPR, to provide specification for their development and validation and to examine the specific DCPR clusters.%心身研究的诊断标准(DCPR)是由国际调研组提出的心身医学研究临床诊断概念和结构框架.人们对影响躯体疾病的易损性,病程,预后,康复的心理因素的评估受到日益关注.DCPR的研发理论基础是将来源于心身研究的心理变量转变成用以鉴别诊断的可操作性诊断标准.ICPR是一个简单、有效和可靠的定式访谈工具,可用于筛查、诊断心身疾病和心理生理障碍.补充ICD- 10、DSM、CCMD的临床诊断应用的不足.包含了十二组心身综合征,其目的是将影响躯体状况预后和治疗价值中的心理变量转化为客观的心身医学研究用诊断标准用工具.这十二组症状包括健康焦虑,死亡恐惧症,疾病恐惧症,疾病否认,持续的躯体化症状,转换性障碍,继发于精神障碍的功能性躯体症状,周年反应,精神消沉,易激惹心境,A型行为和述情障碍.提出心身疾病临床多轴诊断系统.

  11. The role of self-esteem for the relation between school performance and psychosomatic health in adolescence : Sex differences and gender theoretical interpretations

    OpenAIRE

    Bartonek, Frida

    2012-01-01

    While socioeconomic inequalities in health seem to level out during adolescence, circumstances related to school appears to have increased in importance. Such circumstances include, for example, school performance. The primary aim of this study is to examine the relationship between school performance and psychosomatic health. The moderating role of self-esteem and the presence of any sex differences will additionally be investigated. Data from the Stockholm School Survey in 2004, covering a ...

  12. Social capital in relation to depression, musculoskeletal pain, and psychosomatic symptoms: a cross-sectional study of a large population-based cohort of Swedish adolescents

    OpenAIRE

    Starrin Bengt; Åslund Cecilia; Nilsson Kent W

    2010-01-01

    Abstract Background Social capital has lately received much attention in health research. The present study investigated whether two measures of subjective social capital were related to psychosomatic symptoms, musculoskeletal pain, and depression in a large population of Swedish adolescents. Methods A total of 7757 13-18 year old students anonymously completed the Survey of Adolescent Life in Vestmanland 2008 which included questions on sociodemographic background, neighbourhood social capit...

  13. Psychosomatic symptoms and low psychological well-being in relation to employment status: the influence of social capital in a large cross-sectional study in Sweden

    Science.gov (United States)

    2014-01-01

    Background Unemployment is associated with adverse effects on health. Social capital has been suggested as a promoter of health via several causal pathways that are associated with the known health risk factors of being unemployed. This cross-sectional study investigated possible additive- and interaction effects of unemployment and five different measures of social capital in relation to psychosomatic symptoms and low psychological well-being. Methods A random population sample of 20,538 individuals aged 18–85 years from five counties in Sweden completed a postal survey questionnaire including questions of employment status, psychosomatic symptoms, psychological well-being (General Health Questionnaire-12) and social capital. Results Psychosomatic symptoms and reduced psychological well-being were more frequent among unemployed individuals compared with individuals who were employed. Moreover, low social capital and unemployment had additive effects on ill-health. Unemployed individuals with low social capital—specifically with low tangible social support—had increased ill-health compared with unemployed individuals with high social capital. Moreover, to have low social capital within several different areas magnified the negative effects on health. However, no significant interaction effects were found suggesting no moderating effect of social capital in this regard. Conclusions Elements of social capital, particularly social support, might be important health-protective factors among individuals who are unemployed. PMID:24593256

  14. Social capital in relation to depression, musculoskeletal pain, and psychosomatic symptoms: a cross-sectional study of a large population-based cohort of Swedish adolescents

    Directory of Open Access Journals (Sweden)

    Starrin Bengt

    2010-11-01

    Full Text Available Abstract Background Social capital has lately received much attention in health research. The present study investigated whether two measures of subjective social capital were related to psychosomatic symptoms, musculoskeletal pain, and depression in a large population of Swedish adolescents. Methods A total of 7757 13-18 year old students anonymously completed the Survey of Adolescent Life in Vestmanland 2008 which included questions on sociodemographic background, neighbourhood social capital, general social trust, and ill health. Results Low neighbourhood social capital and low general social trust were associated with higher rates of psychosomatic symptoms, musculoskeletal pain, and depression. Individuals with low general social trust had more than three times increased odds of being depressed, three times increased odds of having many psychosomatic symptoms, and double the odds of having many symptoms of musculoskeletal pain. Conclusions The findings make an important contribution to the social capital - health debate by demonstrating relations between social capital factors and self-reported ill health in a young population.

  15. 情志气机升降失调与眼科心身疾病%Qi Movement Disorders due to Emotions and Ophthalmic Psychosomatic Diseases

    Institute of Scientific and Technical Information of China (English)

    钟舒阳

    2013-01-01

    随着现代医学的不断发展,心身医学的概念已深入人心.作者认为各种精神情志因素导致的“气机升降失调”是心身疾病产生的主要病机,故就“气机升降失调”与眼科心身疾病发病中的关系,从几个方面进行了简单的论述.提出调畅情志和气机对于眼科治未病的重要性.%With the continuous development of modern medicine, the concept of psychosomatic medicine has been firmly established. The author believed that Qi movement disorders of the mental emotional factors are the pathogenesis of psychosomatic diseases. Therefore, in this article, the relationship between Qi-lifting disorders and ophthalmic psychosomatic disease was discussed. It is proposed regulating emotions and Qi movement is important for treating ophthalmology diseases.

  16. Effects of Twenty-four Move Shadow Boxing Combined with psychosomatic relaxation on Depression and Anxiety in Patients with Type-2 Diabetes.

    Science.gov (United States)

    Zheng, Yingying; Zhou, Yiyi; Lai, Qiujia

    2015-06-01

    The aim of the current study was to observe the effects of Twenty-four Move Shadow Boxing combined with psychosomatic relaxation on depression and anxiety in patients with Type-2 Diabetes. One hundred and twenty (120) patients with Type-2 Diabetes and depressive/anxious symptoms were divided into intervention group (60 cases) and control group (60 cases) according to the minimum distribution principle of unbalanced indicators. Twenty-four Move Shadow Boxing group used this intervention combined with psychosomatic relaxation. Control group underwent conventional treatment. All the patients in the two groups completed the Self-rating Depression Scale (SDS) and Self-Rating Anxiety Scale (SAS) before and after treatment. Among the 52 people included in the statistical analysis, the recovery rate was 13.3%. The differences between depression and anxiety scores in the intervention group before and after treatment were statistically significant (PBoxing and psychosomatic relaxation has a beneficial auxiliary therapeutic effect on depression and anxiety accompanying Type-2 Diabetes.

  17. Catamnesis results of an inpatient neuro-otologic and psychosomatic tinnitus therapy 1-5 years after discharge.

    Science.gov (United States)

    Schaaf, H; Weiß, S; Hesse, G

    2017-02-01

    Treating tinnitus with the resources offered in hospitals can become necessary for patients suffering from complex tinnitus if a high symptom severity, usually accompanied by a corresponding psychosomatic comorbidity, is present. For such costly therapies, for example, the neuro-otologic psychosomatic tinnitus therapy (NPT) examined here, the long-term effect is particularly important; however, reliable catamnesis studies for inpatient treatments are not yet available. Data from 169 (from a total of 327 contacted) inpatients suffering from complex tinnitus were analysed here. To assess the tinnitus stress, the Mini-Tinnitus Questionnaire (Mini-TF12-In German language) according to Hiller and Goebel [1], and for the assessment of the anxiety and depression element, the German version of the Hospitality Anxiety and Depression Score (HADS) [2] were analysed at the start of the therapy, at the end of the therapy and at the earliest 1 year (up to 5 years) after discharge from inpatient treatment. The data were correlated with the current hearing status. In addition, the subjectively perceived effect factors of the therapy as well as the therapies continued outside of hospital were queried. On average, the therapy lasted 39.3 days (SD 13.6) = 5.6 weeks, and the mean of the follow-up time was 38.5 months (12-70 months) (SD 18). The therapy focused on daily neuro-otologic counselling, the improvement of the concrete hearing ability, an audio-therapy as well as frequent individual and group psychotherapy based on neuro-otology. 53.8 % of patients experienced relevant hearing loss (according to WHO criteria) which needed to be treated in addition to tinnitus. Both at the end of the therapy and the follow-up consultation, a significant improvement of the tinnitus stress and a continuing significant improvement of the depression and anxiety element could be achieved in the HADS with high effect levels ranging from 1 to 2.5. Patients who did not improve (n = 7) or

  18. The emotional intelligence of a group of critical-care nurses in South Africa

    OpenAIRE

    Amanda Towell; Elzabe Nel; Ann Müller

    2013-01-01

    Critical-care nurses often look after three or more critically-ill patients during a shift. The workload and emotional stress can lead to disharmony between the nurse’s body, mind and spirit. Nurses with a high emotional intelligence have less emotional exhaustion and psychosomatic symptoms; they enjoy better emotional health; gain more satisfaction from their actions (both at work and at home); and have improved relationships with colleagues at work. The question arises: what is the emotiona...

  19. Patient-Provider Engagement and Chronic Pain in Drug-Using, Primarily African American Persons Living with HIV/AIDS.

    Science.gov (United States)

    Mitchell, Mary M; Nguyen, Trang Q; Maragh-Bass, Allysha C; Isenberg, Sarina R; Beach, Mary Catherine; Knowlton, Amy R

    2016-10-27

    Among disadvantaged persons living with HIV/AIDS (PLHIV), patient-provider engagement, which has been defined as patient-provider relationships that promote the use of health care services and are characterized by active listening and supportive decision making, has been associated with antiretroviral therapy (ART) maintenance and viral suppression. However, chronic pain, depression, and substance use, all of which are prevalent in this population, can reduce the quality of patient-provider engagement. We hypothesized a model in which chronic pain, depression, and substance use would be associated with poorer patient-provider engagement, which would be positively associated with adherence, with the latter associated positively with viral suppression. We analyzed data from the BEACON study, which included surveys from 383 PLHIV who were primarily African American, on ART, and had histories of drug use. Due to six missing cases on the chronic pain variable, we used data from 377 respondents in a structural equation model. Chronic pain and depressive symptoms were significantly associated with poorer patient-provider engagement, while substance use was associated with better engagement. Patient-provider engagement in turn was associated with better ART adherence, which was associated with higher viral suppression. Results suggest the role of chronic pain in poor patient-physician engagement in this population, which has potential implications for quality of HIV patient care and health outcomes. Findings suggest the need for attention to patient-provider engagement in PLHIV.

  20. Organ-sparing treatment for primarily disseminated breast cancer with metachronous bilateral involvement

    Directory of Open Access Journals (Sweden)

    Yu. A. Ragulin

    2016-01-01

    Full Text Available Systemic drug therapy remains first-line treatment for primarily disseminated breast cancer (BC. The problem in the use of local methods to treat BC patients with distant metastases has not been fully solved. The most of investigations presented in the modern literature suggest that patients show significantly better survivals after adjuvant systemic therapy with local exposure of a primary tumor, the main goal of which is its local monitoring. At the same time, the choice of optimal treatments and their sequence and combination remain to be explored. The paper describes a case of successful organ-sparing chemoradiation therapy for primarily disseminated BC with metachronous bilateral involvement.

  1. Potentially inappropriate prescribing of primarily renally cleared medications for older veterans affairs nursing home patients.

    Science.gov (United States)

    Hanlon, Joseph T; Wang, Xiaoqiang; Handler, Steven M; Weisbord, Steven; Pugh, Mary Jo; Semla, Todd; Stone, Roslyn A; Aspinall, Sherrie L

    2011-06-01

    Inappropriate prescribing of primarily renally cleared medications in older patients with kidney disease can lead to adverse outcomes. To estimate the prevalence of potentially inappropriate prescribing of 21 primarily renally cleared medications based on 2 separate estimates of renal function and to identify factors associated with this form of suboptimal prescribing in older VA nursing home (NH) patients. Longitudinal study Participants were 1304 patients, aged 65 years or older, admitted between January 1, 2004, and June 30, 2005, for 90 days or more to 1 of 133 VA NHs. Potentially inappropriate prescribing of primarily renally cleared medications determined by estimating creatinine clearance using the Cockcroft Gault (CG) and Modification of Diet in Renal Disease (MDRD) equations and applying explicit guidelines for contraindicated medications and dosing. The median estimated creatinine clearance via CG was 67 mL/min, whereas it was 80 mL/min/1.73m(2) with the MDRD. Overall, 11.89% patients via CG and only 5.98% via MDRD had evidence of potentially inappropriate prescribing of at least 1 renally cleared medication. The most commonly involved medications were ranitidine, glyburide, gabapentin, and nitrofurantoin. Factors associated with potentially inappropriate prescribing as per the CG were age older than 85 (adjusted odds ratio [AOR] 4.24, 95% confidence interval [CI] 2.42-7.43), obesity (AOR 0.26, 95% CI 0.14-0.50) and having multiple comorbidities (AOR 1.09 for each unit increase in the Charlson comorbidity index, 95% CI 1.01-1.19). Potentially inappropriate prescribing of renally cleared medications is common in older VA NH patients. Intervention studies to improve the prescribing of primarily renally cleared medications in nursing homes are needed. Copyright © 2011 American Medical Directors Association. Published by Elsevier Inc. All rights reserved.

  2. Family functioning and illness perception of parents of children with atopic dermatitis, living without skin symptoms, but with psychosomatic symptoms.

    Science.gov (United States)

    Rodríguez-Orozco, Alain R; Kanán-Cedeño, E G; Guillén Martínez, E; Campos Garibay, M J

    2011-03-01

    Emotional factors and a recurrent psychosomatic environment, have been implicated in the evolution of atopic dermatitis. These, in turn, affect the disease. This study was under taken to evaluate the functioning of families with a child that has atopic dermatitis without skin symptoms and the parents' perceptions of their child's disease.Semi-quantitative and cross-sectional study in which questionnaires were applied: one to study family functioning (Espejel et al. scale) and the second to determine aspects of parental perception of their child's atopic dermatitis. Pearson's correlation was used to analyze the correlation between the categories of the Family Function Scale.The most affected categories of family functioning were authority, handling of disruptive conduct, communication, and negative affect. The most significant positive correlations between the categories of family functioning were: authority and support, r=0.867, pparents, 66.4% thought that the pharmacotherapy used for their child's atopic dermatitis was not effective, and 33.3% of parents stated that the disease had affected their child's daily activities.In families of children with atopic dermatitis, various family environment factors facilitate the recurrence of symptoms even when no cutaneous lesions have been found on the child. The identification and use of family resources to face this disease are aspects that should be taken into consideration during the psychotherapeutic management of these families, putting emphasis on the most affected functional categories of these families in a strategy that should be implanted in a multi-disciplinary context.

  3. [Factor structure and psychometric properties of the ICD-10-Symptom-Rating (ISR) in samples of psychosomatic patients].

    Science.gov (United States)

    Fischer, Herbert Felix; Tritt, Karin; Klapp, Burghard F; Fliege, Herbert

    2010-08-01

    The ICD-10-Symptom-Rating (ISR) is a self-rating questionnaire for patients. According to its conceptualization, the instrument was developed to closely represent the syndrome structure of the ICD-10 while assessing the extent of psychological distress an individual suffers from. The results of different factor analyses testing the postulated syndrome structure as well as item and scale characteristics are reported here. Data was collected from a consecutive sample of 1 057 psychosomatic patients of the University Hospital Charité Berlin. Evaluation of the dimensional structure of the questionnaire included exploratory and confirmatory factor analyses each computed with a randomized half of the sample. Multi-Sample-Analyses with different subgroups of the sample were performed to test the stability of the factor structure. The individual factors were constituted by the postulated syndrome units of the ICD-10 involving a high and uniform distribution of accounted variance. They also proved themselves satisfactorily stable over the different subsamples. The scales showed a high degree of internal consistency with relatively small gender and age effects, while psychological disorders had a large effect on the means of the scales. Taking a perspective of test theory, the ICD-10-Symptom-Rating is in accordance with the syndrome structure of the ICD-10 and suitable for the assessment of psychological symptoms. Other aspects pertaining to the reliability and validity of the ISR remain to be proven in future research.

  4. [A 20-year follow-up study of a sample of 50 pairs of twins with neurotic-psychosomatic disorders].

    Science.gov (United States)

    Muhs, A; Schepank, H; Manz, R

    1990-01-01

    As part of a research project, examination was made of a sample of 50 pairs of twins (21 pairs of identical twins, 16 pairs of non-identical twins of the same sex, and 13 pairs of male-female twins [n = 100 test persons]) between 1963 and 1969 and again recently after a period of 20 years. The index twins were drawn from among the patients who made use of the services of an out-patient psychotherapeutic clinic, and they were determined to be either psychoneurotic, character neurotic, or psychosomatically ill. The question examined was again one of nature vs. nurture. Identical twins showed a significantly higher similarity with regard to the seriousness of their neuroses and the manifestation of neurotic symptoms than did non-identical twins. Noticeable similarities existed in cases of depressive disturbances, disturbances of oral and aggressive behavior, and disturbances of interpersonal contact. With regard to the influence of variables in the environment, we examined the effect of factors in early childhood on neurotic development. Lack of a reference person, a negative attitude on the part of parents toward the child, etc., frustration within and outside the family have an effect on the manifestation of neuroses and on the course of their development. The influence of early childhood factors on the degree of neurotic disorder is still to be noted in the current point prevalence.

  5. Aetiology of anorexia nervosa: from a "psychosomatic family model" to a neuropsychiatric disorder?

    Science.gov (United States)

    Herpertz-Dahlmann, Beate; Seitz, Jochen; Konrad, Kerstin

    2011-11-01

    Eating disorders and, in particular, anorexia nervosa (AN) have morbidity and mortality rates that are among the highest of any mental disorders and are associated with significant functional impairment. More than 25 years ago, several researchers hypothesised that the prerequisite for the development of AN was a family process characterised by an overprotective and conflict-avoiding parent-child interaction. Family studies, however, suggest that AN is a complex genetic disorder that is likely expressed primarily by temperament and specific traits during childhood, including inhibition, perfectionism and harm avoidance. Recent studies have described an impaired flexibility and deficits in social cognition that are independent of body weight and the current state of the eating disorder, providing further evidence for a genetic component of AN. The physiological and psychological alterations and the increasing societal demands that occur during puberty may trigger onset. The starvation process itself is associated with severe alterations of central and peripheral metabolism, especially neuroendocrine and neurotransmitter changes, which are thought to affect the adolescent brain during the vulnerable period of neural restructuring. Long-standing malnutrition during adolescence and young adulthood associated with hormonal and neuropeptide dysfunctions may produce "biological scars" that maintain and accelerate the disorder and likely result in chronic mental disorders in adulthood as well as poor social functioning.

  6. Lamin A/C mutation affecting primarily the right side of the heart

    Directory of Open Access Journals (Sweden)

    Laura Ollila

    2013-04-01

    Full Text Available LMNA mutations are amongst the most important causes of familial dilated cardiomyopathy. The most important cause of arrhythmogenic right ventricular cardiomyopathy (ARVC is desmosomal pathology. The aim of the study was to elucidate the role of LMNA mutations among Finnish cardiomyopathy patients. We screened 135 unrelated cardiomyopathy patients for LMNA mutations. Because of unusual phenotype, two patients were screened for the known Finnish ARVC-related mutations of desmosomal genes, and their Plakophilin-2b gene was sequenced. Myocardial samples from two patients were examined by immunohistochemical plakoglobin staining and in one case by electron microscopy. We found a new LMNA mutation Phe237Ser in a family of five affected members with a cardiomyopathy affecting primarily the right side of the heart. The phenotype resembles ARVC but does not fulfill the Task Force Criteria. The main clinical manifestations of the mutation were severe tricuspid insufficiency, right ventricular enlargement and failure. Three of the affected patients died of the heart disease, and the two living patients received heart transplants at ages 44 and 47. Electron microscopy showed nuclear blebbing compatible with laminopathy. Immunohisto - chemical analysis did not suggest desmosomal pathology. No desmosomal mutations were found. The Phe237Ser LMNA mutation causes a phenotype different from traditional cardiolaminopathy. Our findings suggest that cardiomyopathy affecting primarily the right side of the heart is not always caused by desmosomal pathology. Our observations highlight the challenges in classifying cardiomyopathies, as there often is significant overlap between the traditional categories.

  7. To act or not to act, that's the problem: primarily inhibition difficulties in adult ADHD.

    NARCIS (Netherlands)

    Boonstra, A.M.; Kooij, J.J.; Oosterlaan, J.; Sergeant, J.A.; Buitelaar, J.K.

    2010-01-01

    Forty-nine carefully diagnosed adults with persistent attention deficit/hyperactivity disorder (ADHD), who had never been medicated for their ADHD, were compared with 49 normal control adults matched for age and gender on a large battery of tests in five domains of executive functioning (inhibition,

  8. Temporal integration of loudness in listeners with hearing losses of primarily cochlear origin

    DEFF Research Database (Denmark)

    Buus, Søren; Florentine, Mary; Poulsen, Torben

    1999-01-01

    To investigate how hearing loss of primarily cochlear origin affects the loudness of brief tones, loudness matches between 5- and 200-ms tones were obtained as a function of level for 15 listeners with cochlear impairments and for seven age-matched controls. Three frequencies, usually 0.5, 1, and 4......-frequency hearing losses (slopes >50 dB/octave) showed larger-than-normal maximal amounts of temporal integration (40 to 50 dB). This finding is consistent with the shallow loudness functions predicted by our excitation-pattern model for impaired listeners [, in Modeling Sensorineural Hearing Loss, edited by W....... Jesteadt (Erlbaum, Mahwah, NJ, 1997), pp. 187–198]. Loudness functions derived from impaired listeners' temporal-integration functions indicate that restoration of loudness in listeners with cochlear hearing loss usually will require the same gain whether the sound is short or long. ©1999 Acoustical...

  9. N170 Changes Show Identifiable Chinese Characters Compete Primarily with Faces Rather than Houses.

    Science.gov (United States)

    Fan, Cong; He, Weiqi; He, Huamin; Ren, Guofang; Luo, Yuejia; Li, Hong; Luo, Wenbo

    2015-01-01

    Character processing is a crucial cognitive skill that is highly emphasized and industriously cultivated in contemporary society. In the present study, using a competition paradigm, we examined the electrophysiological correlates of different relationships between Chinese characters and faces and between Chinese characters and houses during early visual processing. We observed that identifiable Chinese characters compete primarily with faces rather than houses at an early visual processing stage, with a significantly reduced N170 for faces but not for houses, when they were viewed concurrently with identifiable characters relative to when they were viewed concurrently with unidentifiable characters. Consistent with our previous study, there was a significant increase in N170 after characters have been learned, indicating a modulatory effect of Chinese character identification level on N170 amplitude. Furthermore, we found an enlarged N170 in response to faces compared to houses, indicating that the neural mechanisms for processing faces and houses are different at an early visual processing stage.

  10. Which sensory perception is primarily considered, in consumers’ hedonic evaluation of foods?

    DEFF Research Database (Denmark)

    Andersen, Barbara Vad; Brockhoff, Per B.; Hyldig, Grethe

    2015-01-01

    An analysis of the primary hedonic drivers of liking and sensory satisfaction will provide valuable information to product developers on which sensory properties to emphasise the most. The aims of the present study were: a) to study if liking of the sensory properties: appearance, odour, taste...... and texture were considered equally, when consumers rated overall liking and sensory satisfaction b) to study if the relation depended on, whether liking of sensory properties were related to overall liking or sensory satisfaction, and c) to study individual differences in which sensory properties...... the consumers primarily paid attention to when rating overall liking and sensory satisfaction, respectively. Four apple-cherry fruit drinks were used, varying in: type of sweetener, and addition of aroma and fibre. The fruit drinks were used in a in a cross-over consumer study on 67 subjects together...

  11. Non-Hodgkin's Lymphoma Primarily Presenting with Fanconi Syndrome and Acute Kidney Injury

    Institute of Scientific and Technical Information of China (English)

    Wen-ling Ye; Bing Han; Bing-yan Liu; Chan Meng; Wei Ye; Yu-bing Wen; Hang Li; Xue-mei Li

    2010-01-01

    @@ KIDNEY involvement is common in non-Hodg-kin's lymphoma (NHL) with incidence up to 30%-40% in autopsy studies. However, it us-ually occurs late in the course of the disease and is clinically silent. Clinically overt renal disease in-cluding acute kidney injury (AKI) as its primary manifes-tation is rarely reported, moreover, Fanconi syndrome (FS) is extremely rare as the main manifestation in NHL. In this report, we presented a case of NHL primarily presenting with FS and AKI due to diffuse interstitial infiltration of NHL cells and emphasized the important role of renal biopsy, especially renal immunohistochemical analysis in the di-agnosis of renal diffuse lymphoma.

  12. Consensus guidelines for oral dosing of primarily renally cleared medications in older adults.

    Science.gov (United States)

    Hanlon, Joseph T; Aspinall, Sherrie L; Semla, Todd P; Weisbord, Steven D; Fried, Linda F; Good, C Bernie; Fine, Michael J; Stone, Roslyn A; Pugh, Mary Jo V; Rossi, Michelle I; Handler, Steven M

    2009-02-01

    To establish consensus oral dosing guidelines for primarily renally cleared medications prescribed for older adults. Literature search followed by a two-round modified Delphi survey. A nationally representative survey of experts in geriatric clinical pharmacy. Eleven geriatric clinical pharmacists. After a comprehensive literature search and review by an investigative group of six physicians (2 general internal medicine, 2 nephrology, 2 geriatrics), 43 dosing recommendations for 30 medications at various levels of renal function were created. The expert panel rated its agreement with each of these 43 dosing recommendations using a 5-point Likert scale (1=strongly disagree to 5=strongly agree). Recommendation-specific means and 95% confidence intervals were estimated. Consensus was defined as a lower 95% confidence limit of greater than 4.0 for the recommendation-specific mean score. The response rate was 81.8% (9/11) for the first round. All respondents who completed the first round also completed the second round. The expert panel reached consensus on 26 recommendations involving 18 (60%) medications. For 10 medications (chlorpropamide, colchicine, cotrimoxazole, glyburide, meperidine, nitrofurantoin, probenecid, propoxyphene, spironolactone, and triamterene), the consensus recommendation was not to use the medication in older adults below a specified level of renal function (e.g., creatinine clearance <30 mL/min). For the remaining eight medications (acyclovir, amantadine, ciprofloxacin, gabapentin, memantine, ranitidine, rimantadine, and valacyclovir), specific recommendations for dose reduction or interval extension were made. An expert panel of geriatric clinical pharmacists was able to reach consensus agreement on a number of oral medications that are primarily renally cleared.

  13. Efficient transfection of DNA into primarily cultured rat sertoli cells by electroporation.

    Science.gov (United States)

    Li, Fuping; Yamaguchi, Kohei; Okada, Keisuke; Matsushita, Kei; Enatsu, Noritoshi; Chiba, Koji; Yue, Huanxun; Fujisawa, Masato

    2013-03-01

    The expression of exogenous DNA in Sertoli cells is essential for studying its functional genomics, pathway analysis, and medical applications. Electroporation is a valuable tool for nucleic acid delivery, even in primarily cultured cells, which are considered difficult to transfect. In this study, we developed an optimized protocol for electroporation-based transfection of Sertoli cells and compared its efficiency with conventional lipofection. Sertoli cells were transfected with pCMV-GFP plasmid by square-wave electroporation under different conditions. After transfection of plasmid into Sertoli cells, enhanced green fluorescent protein (EGFP) expression could be easily detected by fluorescent microscopy, and cell survival was evaluated by dye exclusion assay using Trypan blue. In terms of both cell survival and the percentage expressing EGFP, 250 V was determined to produce the greatest number of transiently transfected cells. Keeping the voltage constant (250 V), relatively high cell survival (76.5% ± 3.4%) and transfection efficiency (30.6% ± 5.6%) were observed with a pulse length of 20 μm. The number of pulses significantly affected cell survival and EGFP expression (P electroporation (21.5% ± 5.7%) was significantly higher than those of Lipofectamine 2000 (2.9% ± 1.0%) and Effectene (1.9% ± 0.8%) in this experiment (P electroporation conditions, and the successful electroporation of plasmid DNA into primarily cultured Sertoli cells. Our results indicate that the method of electroporation is more suitable than other approaches for the transfection of Sertoli cells.

  14. Family Functioning and Illness Perception of Parents of Children with Atopic Dermatitis, Living without Skin Symptoms, but with Psychosomatic Symptoms

    Directory of Open Access Journals (Sweden)

    Alain. R. Rodríguez-Orozco

    2011-03-01

    Full Text Available Emotional factors and a recurrent psychosomatic environment, have been implicated in the evolution of atopic dermatitis. These, in turn, affect the disease.This study was under taken to evaluate the functioning of families with a child that has atopic dermatitis without skin symptoms and the parents’ perceptions of their child’s disease.Semi-quantitative and cross-sectional study in which questionnaires were applied: one to study family functioning (Espejel et al. scale and the second to determine aspects of parental perception of their child’s atopic dermatitis. Pearson’s correlation was used to analyze the correlation between the categories of the Family Function Scale.The most affected categories of family functioning were authority, handling of disruptive conduct, communication, and negative affect. The most significant positive correlations between the categories of family functioning were: authority and support, r=0.867, p<.001; disruptive conduct and communication, r=0.798, p<.001; and support and communication, r=0.731, p<.001. Of the parents, 66.4% thought that the pharmacotherapy used for their child’s atopic dermatitis was not effective, and 33.3% of parents stated that the disease had affected their child’s daily activities.In families of children with atopic dermatitis, various family environment factors facilitate the recurrence of symptoms even when no cutaneous lesions have been found on the child. The identification and use of family resources to face this disease are aspects that should be taken into consideration during the psychotherapeutic management of these families, putting emphasis on the most affected functional categories of these families in a strategy that should be implanted in a multi-disciplinary context.

  15. Paediatric trauma care

    African Journals Online (AJOL)

    In this review, paediatric trauma care will be considered primarily for ... to technology increases, injury becomes a major source of childhood ..... reached include the nursing profession, workers in industry, ... New York: Freeman, 1984. 21.

  16. Type D personality is a risk factor for psychosomatic symptoms and musculoskeletal pain among adolescents: a cross-sectional study of a large population-based cohort of Swedish adolescents.

    Science.gov (United States)

    Condén, Emelie; Leppert, Jerzy; Ekselius, Lisa; Åslund, Cecilia

    2013-01-21

    Type D personality, or the "distressed personality", is a psychosocial factor associated with negative health outcomes, although its impact in younger populations is unclear. The purpose of this study was to investigate the prevalence of Type D personality and the associations between Type D personality and psychosomatic symptoms and musculoskeletal pain among adolescences. A population-based, self-reported cross-sectional study conducted in Västmanland, Sweden with a cohort of 5012 students in the age between 15-18 years old. The participants completed the anonymous questionnaire Survey of Adolescent Life in Västmanland 2008 during class hour. Psychosomatic symptoms and musculoskeletal pain were measured through index measuring the presence of symptoms and how common they were. DS14 and its two component subscales of negative affectivity (NA) and social inhibition (SI) were measured as well. There was a difference depending on sex, where 10.4% among boys and 14.6% among girls (p = personality. Boys and girls with a Type D personality had an approximately 2-fold increased odds of musculoskeletal pain and a 5-fold increased odds of psychosomatic symptoms. The subscale NA explained most of the relationship between Type D personality and psychosomatic symptoms and musculoskeletal pain. No interaction effect of NA and SI was found. There was a strong association between Type D personality and both psychosomatic symptoms and musculoskeletal pain where adolescent with a type D personality reported more symptoms. The present study contributes to the mapping of the influence of Type D on psychosomatic symptoms and musculoskeletal pain among adolescents.

  17. The development and characterization of a primarily mineral calcium phosphate - poly(epsilon-caprolactone) biocomposite

    Science.gov (United States)

    Dunkley, Ian Robert

    Orthopaedic reconstruction often involves the surgical introduction of structural implants that provide for rigid fixation, skeletal stabilization, and bone integration. The high stresses incurred by these implanted devices have historically limited material choices to metallic and select polymeric formulations. While mechanical requirements are achieved, these non-degradable materials do not participate actively in the remodeling of the skeleton and present the possibility of long-term failure or rejection. This is particularly relevant in cervical fusion, an orthopaedic procedure to treat damaged, degenerative or diseased intervertebral discs. A significant improvement on the available synthetic bone replacement/regeneration options for implants to treat these conditions in the cervical spine may be achieved with the development of primarily mineral biocomposites comprised of a bioactive ceramic matrix reinforced with a biodegradable polymer. Such a biocomposite may be engineered to possess the clinically required mechanical properties of a particular application, while maintaining the ability to be remodeled completely by the body. A biocomposite of Si-doped calcium phosphate (Si-CaP) and poly(epsilon-caprolactone) (PCL) was developed for application as such a synthetic bone material for potential use as a fusion device in the cervical spine. In this thesis, a method by which high mineral content Si-CaP/PCL biocomposites with interpenetrating matrices of mineral and polymer phases may be prepared will be demonstrated, in addition to the effects of the various preparation parameters on the biocomposite density, porosity and mechanical properties. This new technique by which dense, primarily ceramic Si-CaP/PCL biocomposites were prepared, allowed for the incorporation of mineral contents ranging between 45-97vol%. Polymer infiltration, accomplished solely by passive capillary uptake over several days, was found to be capable of fully infiltrating the microporosity

  18. Šamanství, léčitelství, moderní medicína a psychoterapie I.: Psychosomatické hledisko (Shamanism, Healing, Modern Medicine and Psychotherapy I: The Psychosomatic perspective

    Directory of Open Access Journals (Sweden)

    Jiří Růžička

    2010-09-01

    Full Text Available The relationship between body and mind, so-called psychosomatic problem, is something addressed not only in psychosomatic medicine but also in various contrasting ways in historically traditional treatment systems. In this context the author takes a comparative look at (traditional medicine, shamanism and magic, healing and psychotherapy. In the comparison the basic definition of the sick person emerges in each case. The author points out the reductive features in these definitions. He sees psychotherapy, especially Dasein-analytical psychotherapy as a distinctive and new in its view of the person, the sickness and its treatment.

  19. Notionally steady background noise acts primarily as a modulation masker of speech.

    Science.gov (United States)

    Stone, Michael A; Füllgrabe, Christian; Moore, Brian C J

    2012-07-01

    Stone et al. [J. Acoust. Soc Am. 130, 2874-2881 (2011)], using vocoder processing, showed that the envelope modulations of a notionally steady noise were more effective than the envelope energy as a masker of speech. Here the same effect is demonstrated using non-vocoded signals. Speech was filtered into 28 channels. A masker centered on each channel was added to the channel signal at a target-to-background ratio of -5 or -10 dB. Maskers were sinusoids or noise bands with bandwidth 1/3 or 1 ERB(N) (ERB(N) being the bandwidth of "normal" auditory filters), synthesized with Gaussian (GN) or low-noise (LNN) statistics. To minimize peripheral interactions between maskers, odd-numbered channels were presented to one ear and even to the other. Speech intelligibility was assessed in the presence of each "steady" masker and that masker 100% sinusoidally amplitude modulated (SAM) at 8 Hz. Intelligibility decreased with increasing envelope fluctuation of the maskers. Masking release, the difference in intelligibility between the SAM and its "steady" counterpart, increased with bandwidth from near-zero to around 50 percentage points for the 1-ERB(N) GN. It is concluded that the sinusoidal and GN maskers behaved primarily as energetic and modulation maskers, respectively.

  20. Local field potentials primarily reflect inhibitory neuron activity in human and monkey cortex

    Science.gov (United States)

    Teleńczuk, Bartosz; Dehghani, Nima; Le Van Quyen, Michel; Cash, Sydney S.; Halgren, Eric; Hatsopoulos, Nicholas G.; Destexhe, Alain

    2017-01-01

    The local field potential (LFP) is generated by large populations of neurons, but unitary contribution of spiking neurons to LFP is not well characterised. We investigated this contribution in multi-electrode array recordings from human and monkey neocortex by examining the spike-triggered LFP average (st-LFP). The resulting st-LFPs were dominated by broad spatio-temporal components due to ongoing activity, synaptic inputs and recurrent connectivity. To reduce the spatial reach of the st-LFP and observe the local field related to a single spike we applied a spatial filter, whose weights were adapted to the covariance of ongoing LFP. The filtered st-LFPs were limited to the perimeter of 800 μm around the neuron, and propagated at axonal speed, which is consistent with their unitary nature. In addition, we discriminated between putative inhibitory and excitatory neurons and found that the inhibitory st-LFP peaked at shorter latencies, consistently with previous findings in hippocampal slices. Thus, in human and monkey neocortex, the LFP reflects primarily inhibitory neuron activity. PMID:28074856

  1. Floral biology of two Vanilloideae (Orchidaceae) primarily adapted to pollination by euglossine bees.

    Science.gov (United States)

    Pansarin, E R; Pansarin, L M

    2014-11-01

    Vanilloideae comprises 15 genera distributed worldwide, among which are Vanilla and Epistephium (tribe Vanilleae). Based on field and laboratory investigations, the pollination biology of V. dubia and E. sclerophyllum was analysed. The former was surveyed in a semi-deciduous mesophytic forest at the biological reserve of Serra do Japi and in a marshy forest at the city of Pradópolis, southeastern Brazil. The latter was examined in rocky outcrop vegetation in the Chapada Diamantina, northeastern Brazil. In the studied populations, the tubular flowers of V. dubia and E. sclerophyllum were pollinated by bees. Pollen was deposited on either their scutellum (V. dubia) or scutum (E. sclerophyllum). The mentum region of V. dubia is dry, whereas that of E. sclerophyllum presents a small quantity of dilute nectar. Flowers of E. sclerophyllum are scentless, while those of V. dubia are odoriferous. Although V. dubia is self-compatible, it needs a pollinator to produce fruit. In contrast, E. sclerophyllum sets fruit through spontaneous self-pollination, but biotic pollination also occurs. Both species are primarily adapted to pollination by euglossine bees. Pollination by Euglossina seems to have occurred at least twice during the evolution of Vanilleae. Furthermore, shifts between rewarding and reward-free flowers and between autogamous and allogamous species have been reported among vanillas. © 2014 German Botanical Society and The Royal Botanical Society of the Netherlands.

  2. Hepatitis B virus infection and replication in primarily cultured human fetal hepatocytes

    Institute of Scientific and Technical Information of China (English)

    Min Lin; Qun Chen; Li-Ye Yang; Wen-Yu Li; Xi-Biao Cao; Jiao-Ren Wu; You-Peng Peng; Mo-Rui Chen

    2007-01-01

    AIM:To investigate the infection and replication of hepatitis B virus(HBV)in primarily cultured human fetal hepatocytes(HFHs).METHODS:The human fetal hepatocytes were cultured in serum-free medium,HBV-positive serum was added into the medium to study the susceptibility of hepatocytes to HBV infection.The supernatant was collected for ELISA assay of HBsAg and HBeAg,and quantitative fluorescence PCR for HBV-DNA assay daily.Albumin and HBcAg,CK8 and CK18 expressions were detected by immunohistochemistry in cultured hepatocytes.Content of lactate dehydrogenate(LDH)was measured to find out the integrity of the cell membrane.RESULTS:A stable hepatocyte culture system was established.HBV could infect the hepatocytes and replicate,and HBcAg expression could be detected by immunohistochemistry in hepatocyte-like cells.HBV-DNA in the supernatant could be detected from d 2 to d 18 and HBsAg and HBeAg were positive on d 3-d 18 after HBV infection.HBV in medium increased from d 0 to d 6 and subsequently decreased as the cells were progressively loosing their hepatocyte phenotypes.CONCLUSION:HBV could infect human fetal hepatocytes and replicate.This in vitro model allowed a detailed Study on early events associated with human HBV entry into cells and subsequent replication.

  3. Audiovisual contrast enhancement is articulated primarily via the M-pathway.

    Science.gov (United States)

    Jaekl, Philip M; Soto-Faraco, Salvador

    2010-12-17

    Although it has been previously reported that audiovisual integration can modulate performance on some visual tasks, multisensory interactions have not been explicitly assessed in the context of different visual processing pathways. In the present study, we test auditory influences on visual processing employing a psychophysical paradigm that reveals distinct spatial contrast signatures of magnocellular and parvocellular visual pathways. We found that contrast thresholds are reduced when noninformative sounds are presented with transient, low-frequency Gabor patch stimuli and thus favor the M-system. In contrast, visual thresholds are unaffected by concurrent sounds when detection is primarily attributed to P-pathway processing. These results demonstrate that the visual detection enhancement resulting from multisensory integration is mainly articulated by the magnocellular system, which is most sensitive at low spatial frequencies. Such enhancement may subserve stimulus-driven processes including the orientation of spatial attention and fast, automatic ocular and motor responses. This dissociation helps explain discrepancies between the results of previous studies investigating visual enhancement by sounds.

  4. Spontaneous reports of primarily suspected herbal hepatotoxicity by Pelargonium sidoides: was causality adequately ascertained?

    Science.gov (United States)

    Teschke, Rolf; Frenzel, Christian; Schulze, Johannes; Eickhoff, Axel

    2012-06-01

    Spontaneous reports of primarily assumed hepatotoxicity in connection with the use of Pelargonium sidoides (PS) have been interpreted by the Drug Commission of the German Medical Association (DCGMA) as showing some hepatotoxic potential of PS used to treat common cold and other respiratory tract infections. Causality for PS was assessed using the liver specific, structured, quantitative, and updated scale of the Council for International Organizations of Medical Sciences (CIOMS). In none of the 15 cases was there a highly probable or probable causality for PS. Analysis revealed confounding factors such as numerous final diagnoses unrelated to PS and poor data quality in virtually all cases. In only a minority of the cases were data provided to consider even common other diseases of the liver. For instance, biliary tract imaging data were available in only 3 patients; data to exclude virus infections by hepatitis A-C were provided in 4 cases and by CMV and EBV in 1 case, whereas HSV and VZV virus infections remained unconsidered. Thus, convincing evidence is lacking that PS was a potential hepatotoxin in the analyzed cases.

  5. Pituitary tumor disappearance in a patient with newly diagnosed acromegaly primarily treated with octreotide LAR.

    Science.gov (United States)

    Resmini, E; Murialdo, G; Giusti, M; Boschetti, M; Minuto, F; Ferone, D

    2005-02-01

    We describe the case of an acromegalic patient primarily treated with octreotide LAR in whom the pituitary tumor disappeared after 18 months of treatment. A 68-yr-old woman, with clinical suspicion of acromegaly, was admitted to our Unit with the ultrasonographical evidence of cardiac hypertrophy, arrhythmias, right branch block and interatrial septum aneurism. She referred hands and feet enlargement since the age of 30 and facial disfigurements since the age of 50. At the age of 45 she underwent surgery for carpal tunnel syndrome and at the age of 61 an euthyroid nodular goiter was diagnosed. Hormonal evaluation showed elevated circulating GH levels (25+/-3.2 ng/ml), not suppressible after oral glucose load, and elevated IGF-I levels (646 ng/ml), whereas the remaining pituitary function was normal. Visual perimetry was normal, whereas magnetic resonance imaging (MRI) showed an intrasellar pituitary adenoma with maximal diameter of 9 mm. In order to improve cardiovascular function before surgery, the patient started octreotide LAR 20 mg every 4 weeks for 3 months. Then based on IGF-I values, the dose was adjusted to 30 mg. After 6 months a second MRI showed significant tumor reduction (>50% of baseline maximal diameter), GH and IGF-I were within the normal range and the patient continued the treatment. After one-year therapy, an improvement of cardiac alterations was recorded and the patient was referred to the neurosurgeon. However, she refused the operation. At 18-month follow-up, MRI showed the complete disappearance of direct and indirect signs of pituitary adenoma. To our knowledge, this is the first case of complete radiological remission of pituitary tumor during octreotide LAR treatment in acromegaly.

  6. Preliminary study on psychosomatic status of nuclear power plant operators%核电厂操纵人员心身健康的初步报告

    Institute of Scientific and Technical Information of China (English)

    毕金玲; 刘玉龙; 李元; 卞华慧; 孙义玲; 邱梦悦; 刘春风

    2011-01-01

    Objective To understand the operators'psychosomatic health status in nuclear power plant;and provide the scientific basis of measures for preventing and reducing mental disorders in operators.Methods The Psychosomatic Health Battery(PSHB) was used to assess the psychosomatic health status in 109 operators who were random selected from Qinshan nuclear power plant,etc.They were tested from lie,emotional stability,liveliness,tension,apprehension,mental health,such as psychopathic deviatesuch 7 personality traits.Results Lie < 8,all inspected groups were normal.Psychopathic deviate:98.2% for normal group 0.9% for both of groups occurred possible mental health problems and confirmed mental health problems ;Mental health:80.7% (88/109) for fine mental health ones,29.4% (32/109) for those with excellent mental health,51.4% (56/109) for good mental health ones,13.8% (15/109) for general mental health ones,5.5% (6/109) for poor mental health ones.Age factor could influence the mean values of the factors of apprehension,tension,mental health and psychopathic deviate.Correlation analysis showed that there was a correlation between tension and psychopathic deviate(r = 0.664 ,P < 0.01),and the other correlation coefficient was between apprehension and mental health(r =-0.789 ,P < 0.01).Conclusions There is an excellent condition of psychosomatic health in most of the operators,however,there are still a very small percentage of psychosomatic disorders among these operators,to improve the quality of their psychosomatic health,psychological counseling should be particularly strengthened to those with problems of psychosomatic health.%目的 了解中国核电厂操纵人员的心身健康状况,为制定预防和减少操纵人员心理障碍发生的干预措施提供科学依据,确保核电厂安全运行.方法 采取整群随机取样法随机抽取在秦山核电基地等5家协作单位的109名操纵人员,采用心身健康成套测验(psychosomatic health battery,PSHB)

  7. Plasma Neutrophil Gelatinase-Associated Lipocalin Is Primarily Related to Inflammation during Sepsis: A Translational Approach

    Science.gov (United States)

    Otto, Gordon P.; Hurtado-Oliveros, Jorge; Chung, Ha-Yeun; Knoll, Kristin; Neumann, Thomas; Müller, Hans J.; Herbsleb, Marco; Kohl, Matthias; Busch, Martin; Sossdorf, Maik; Claus, Ralf A.

    2015-01-01

    Acute kidney injury (AKI) during sepsis is common and underestimated. Plasma neutrophil gelatinase-associated lipocalin (plasma-NGAL) is discussed as new biomarker for AKI diagnosis, but during inflammation its function and diagnostic impact remain unclear. The association between plasma-NGAL and inflammatory markers in septic patients, but also in healthy controls and patients with chronic inflammation before and after either maximum exercise test or treatment with an anti-TNF therapy were investigated. In-vitro blood stimulations with IL-6, lipopolysaccharide, NGAL or its combinations were performed to investigate cause-effect-relationship. Plasma-NGAL levels were stronger associated with inflammation markers including IL-6 (Sepsis: r=0.785 PSepsis: r=0.714 Pdetection during severe inflammation - indeed it has to be interpreted carefully within this setting - but additionally might offer therapeutic potential. PMID:25893429

  8. The long-term lasting effectiveness on self-efficacy, attribution style, expression of emotions and quality of life of a body awareness program for chronic a-specific psychosomatic symptoms

    NARCIS (Netherlands)

    Landsman-Dijkstra, Jeanet J. A.; van Wijck, R; Groothoff, JW

    2006-01-01

    Objective: A 3-day residential body awareness program (BAP) was developed to teach people with chronic a-specific psychosomatic symptoms (CAPS) to react adequately to disturbances of the balance between a daily workload and the capacity to deal with it. The long-term effects of the program on body a

  9. Type D personality is a risk factor for psychosomatic symptoms and musculoskeletal pain among adolescents: a cross-sectional study of a large population-based cohort of Swedish adolescents

    Directory of Open Access Journals (Sweden)

    Condén Emelie

    2013-01-01

    Full Text Available Abstract Background Type D personality, or the “distressed personality”, is a psychosocial factor associated with negative health outcomes, although its impact in younger populations is unclear. The purpose of this study was to investigate the prevalence of Type D personality and the associations between Type D personality and psychosomatic symptoms and musculoskeletal pain among adolescences. Methods A population-based, self-reported cross-sectional study conducted in Västmanland, Sweden with a cohort of 5012 students in the age between 15–18 years old. The participants completed the anonymous questionnaire Survey of Adolescent Life in Västmanland 2008 during class hour. Psychosomatic symptoms and musculoskeletal pain were measured through index measuring the presence of symptoms and how common they were. DS14 and its two component subscales of negative affectivity (NA and social inhibition (SI were measured as well. Results There was a difference depending on sex, where 10.4% among boys and 14.6% among girls (p =  Conclusions There was a strong association between Type D personality and both psychosomatic symptoms and musculoskeletal pain where adolescent with a type D personality reported more symptoms. The present study contributes to the mapping of the influence of Type D on psychosomatic symptoms and musculoskeletal pain among adolescents.

  10. Tailoring cancer education and support programs for low-income, primarily African American cancer survivors.

    Science.gov (United States)

    Martin, Michelle Y; Pollack, Lori A; Evans, Mary B; Smith, Judith Lee; Kratt, Polly; Prayor-Patterson, Heather; Watson, Christopher D; Dignan, Mark; Cheney, Lydia C; Pisu, Maria; Liwo, Amandiy; Hullett, Sandral

    2011-01-01

    to identify the information and stress-management topics of most interest to low-income, predominantly African American cancer survivors. descriptive, cross sectional. outpatient oncology clinic in a public hospital in Birmingham, Alabama. 25 patients with cancer; 12 were men, 22 were African Americans, and 16 had a 12th-grade education or less. patients ranked potential topics to be included in an educational curriculum. quantitative rankings of information and stress-management priorities. learning about cancer, understanding cancer treatments, relieving cancer pain, and keeping well in mind and body were the most highly ranked topics among those offered within the American Cancer Society's I Can Cope curriculum, which also included supportive topics such as mobilizing social support. The preferred stress-management topics were humor therapy, music therapy, meditation, and relaxation; lower-ranked topics included pet therapy and art as therapy. cancer survivors appear most interested in topics specific to their illness and treatment versus supportive topics. Stress management also received high rankings. nurses have a key role in providing patient education and support. Tailoring education programs may better target specific needs and improve the quality of cancer care of underserved patients.

  11. Research on Relationship between Psychosomatic Health and Personality in Medical Students%医学生心身健康与人格的关系研究

    Institute of Scientific and Technical Information of China (English)

    马珺

    2015-01-01

    为探讨医学生的心身健康与人格的关系,笔者采用康奈尔医学指数(Cornell Medical Index ,CMI)和艾森克人格问卷(Eysenck Personality Questionnaire ,EPQ )对重庆市两所医科大学的医学生进行测量并进行统计分析。发现精神质和神经质的得分越高,则医学生心身症状的总体得分越高,而外倾性得分越高,则心身症状的总体得分越低;精神质和神经质的得分越高,躯体症状的得分越高;神经质得分越高,精神症状的得分越高,外倾性的得分越高,精神症状的得分越低。因此,医学生的心身健康受其人格因素的影响,培养和塑造健康人格有助于医学生的心身健康水平。%This paper is to explore the relationship between psychosomatic health and personality in medical students .Medical students were investigated by CMI and EPQ .The higher the score of psy‐choticism or neuroticism was ,the higher the score of CMI was ;the higher the score of extraversion was ,then the lower the score of CMI was .The higher the score of psychoticism or neuroticism was , the higher the score of A‐L was .The higher the score of neuroticism was ,the higher the score of M‐R was ;the higher the score of extraversion was ,then the lower the score of M‐R was .Psychosomatic health of medical students was influenced by personality .Cultivating and shaping the healthy person‐ality could aid in psychosomatic health .

  12. Psychosomatic factors in pruritus.

    Science.gov (United States)

    Tey, Hong Liang; Wallengren, Joanna; Yosipovitch, Gil

    2013-01-01

    Pruritus and psyche are intricately and reciprocally related, with psychophysiological evidence and psychopathological explanations helping us to understand their complex association. Their interaction may be conceptualized and classified into 3 groups: pruritic diseases with psychiatric sequelae, pruritic diseases aggravated by psychosocial factors, and psychiatric disorders causing pruritus. Management of chronic pruritus is directed at treating the underlying causes and adopting a multidisciplinary approach to address the dermatologic, somatosensory, cognitive, and emotional aspects. Pharmcotherapeutic agents that are useful for chronic pruritus with comorbid depression and/or anxiety comprise selective serotonin reuptake inhibitors, mirtazapine, tricyclic antidepressants (amitriptyline and doxepin), and anticonvulsants (gabapentin, pregabalin); the role of neurokinin receptor-1 antagonists awaits verification. Antipsychotics are required for treating itch and formication associated with schizophrenia and delusion of parasitosis (including Morgellons disease). Copyright © 2013 Elsevier Inc. All rights reserved.

  13. [Psychosomatics in gastroenterology].

    Science.gov (United States)

    Moser, G

    2000-01-01

    Never before has the correlation between psychosocial factors and digestive diseases or disorders been studied more intensively than in the past decade. The following article will provide you with a survey of the major studies, functional gastrointestinal disorders, gastroesophageal reflux disease, peptic ulcer and chronic inflammatory bowel diseases taking into account psychosocial factors. The biopsychosocial model is a remarkable step forward in the process of learning more about these diseases, The integrated way of looking at biological, psychological and social factors has become an absolute must for those who want to fully understand the development and the severity of symptoms as well as diagnostics and therapy of these disorders.

  14. Plasma Neutrophil Gelatinase-Associated Lipocalin Is Primarily Related to Inflammation during Sepsis: A Translational Approach.

    Directory of Open Access Journals (Sweden)

    Gordon P Otto

    Full Text Available Acute kidney injury (AKI during sepsis is common and underestimated. Plasma neutrophil gelatinase-associated lipocalin (plasma-NGAL is discussed as new biomarker for AKI diagnosis, but during inflammation its function and diagnostic impact remain unclear. The association between plasma-NGAL and inflammatory markers in septic patients, but also in healthy controls and patients with chronic inflammation before and after either maximum exercise test or treatment with an anti-TNF therapy were investigated. In-vitro blood stimulations with IL-6, lipopolysaccharide, NGAL or its combinations were performed to investigate cause-effect-relationship. Plasma-NGAL levels were stronger associated with inflammation markers including IL-6 (Sepsis: r = 0.785 P < 0.001; chronic inflammation after anti-TNF: r = 0.558 P < 0.001, IL-8 (Sepsis: r = 0.714 P<0.004; healthy controls after exercise r = 0.786 P < 0.028; chronic inflammation before anti-TNF: r = 0.429 P < 0.041 and IL-10 (healthy controls before exercise: r = 0.791 P < 0.028 than with kidney injury or function. Correlation to kidney injury or function was found only in septic patients (for creatinine: r = 0.906 P < 0.001; for eGFR: r = -0.686 P = 0.005 and in patients with rheumatic disease after anti-TNF therapy (for creatinine: r = 0.466 P < 0.025. In stimulation assays with IL-6 and lipopolysaccharide plasma-NGAL was increased. Co-stimulation of lipopolysaccharide with plasma-NGAL decreased cellular injury (P < 0.05 and in trend IL-10 levels (P = 0.057. Septic mice demonstrated a significantly improved survival rate after NGAL treatment (P < 0.01. Plasma-NGAL seams to be strongly involved in inflammation. For clinical relevance, it might not only be useful for AKI detection during severe inflammation - indeed it has to be interpreted carefully within this setting - but additionally might offer therapeutic potential.

  15. No departure to "Pandora"? Using critical phenomenology to differentiate "naive" from "reflective" experience in psychiatry and psychosomatic medicine (A comment on Schwartz and Wiggins, 2010

    Directory of Open Access Journals (Sweden)

    Bonnemann Catharina

    2010-10-01

    Full Text Available Abstract The mind-body problem lies at the heart of the clinical practice of both psychiatry and psychosomatic medicine. In their recent publication, Schwartz and Wiggins address the question of how to understand life as central to the mind-body problem. Drawing on their own use of the phenomenological method, we propose that the mind-body problem is not resolved by a general, evocative appeal to an all encompassing life-concept, but rather falters precisely at the insurmountable difference between "natural" and a "reflective" experience built into phenomenological method itself. Drawing on the works of phenomenologically oriented thinkers, we describe life as inherently "teleological" without collapsing life with our subjective perspective, or stepping over our epistemological limits. From the phenomenology it can be demonstrated that the hypothetical teleological qualities are a reflective reconstruction modelled on human behavioural structure.

  16. [Features of oxygen utilization by the body of patients with arterial hypertension in the days of magnetic storms depending on the psychosomatic status and treatment options].

    Science.gov (United States)

    Usenko, G A; Usenko, A G; Vasendin, D V

    2015-01-01

    During magnetic storms the observed increase in γ-background environment and the reduction of the rate of oxygen utilization by the tissues, but the increase in the number of angina attacks per day to magnetic storms the choleric, in the days of magnetic storms in sanguine, for 3-4 days at a phlegmatic, and 4-5 days in the melancholic especially in groups high anxiety phlegmatic and melancholic. Last-risk group severe arterial hypertension and ischemic heart disease. Antihypertensive therapy based on the blockade of the features of the psychosomatic status, significantly reduced the number of attacks and brought the values of the utilization of oxygen and coefficient of oxygen utilization bu the tissues of all the days to those in healthy individual relevant anxiety and temperament.

  17. Therapeutic Function of Music Therapy on Psychosomatic Diseases%论音乐疗法对心身疾病的康复作用

    Institute of Scientific and Technical Information of China (English)

    卞镝; 田辉; 隋月皎; 刘玉丽

    2013-01-01

    音乐疗法是通过生理和心理两方面作用来治疗心身疾病.文章简述了音乐疗法的生理和心理作用机制,旨在引起康复临床对音乐疗法的广泛关注和应用.%The therapeutic functions of music therapy on psychosomatic diseases are through both fields of physiology and psychology.The mechanism of the physiology and psychology action of music therapy is briefly summarized in this article.The purpose is to attract the comprehensive attention and application of rehabilitation clinical.

  18. Teamwork in health care.

    Science.gov (United States)

    Landman, Natalie; Aannestad, Liv K; Smoldt, Robert K; Cortese, Denis A

    2014-01-01

    It is becoming increasingly clear that maintaining and improving the health of the population, and doing so in a financially sustainable manner, requires the coordination of acute medical care with long-term care, and social support services, that is, team-based care. Despite a growing body of evidence on the benefits of team-based care, the health care ecosystem remains "resistant" to a broader implementation of such care models. This resistance is a function of both system-wide and organizational barriers, which result primarily from fragmentation in reimbursement for health care services, regulatory restrictions, and the siloed nature of health professional education. To promote the broader adoption of team-based care models, the health care system must transition to pay for value reimbursement, as well as break down the educational silos and move toward team-based and value-based education of health professionals.

  19. The burnout syndrome on health care professionals

    Directory of Open Access Journals (Sweden)

    Maria Polikandrioti

    2007-01-01

    Full Text Available Burnout syndrome is referred to the experience of exhaustion and diminished interest, that is manifested by the professionals usually in the work context. Health care proffesionals are often at high risk of burnout syndrome and job dissatisfaction. Burn-out syndrome consists a serious multidimensional phenomenon, because it can lead the professionals of health to psychosomatic problems, work-associated withdrawal behaviour and a lower quality of care. The aim of this review was to study the burn out syndrome of health care professionals. The method of this study included bibliography research from both the review and the research international literature, as well as to Greece and was referred to the "burn out syndrome". Results: Most studies focus on the role of work environment of health care professionals, as the main factor for the development of burn out syndrome, in combination with other factors such as personality, critically ill patients, and organizational structure and staff relationships. Furthermore, the results of this study showed the need for referral to an expert, who deals with emotional problems triggered by the daily contacts with patients and the staff nurse, in order to control the professional stress. Conclusively: Early recognition of burnout phenomenon contributes to better professional behaviour and better health care quality for patients. Health care professionals need knowledge and education about how to beat burnout syndrome.

  20. Prognostic cell biological markers in cervical cancer patients primarily treated with (chemo)radiation : a systematic review

    NARCIS (Netherlands)

    Noordhuis, Maartje G; Eijsink, Jasper J H; Roossink, Frank; de Graeff, Pauline; Pras, Elisabeth; Schuuring, Ed; Wisman, G Bea A; de Bock, Geertruida H; van der Zee, Ate G J

    2011-01-01

    The aim of this study was to systematically review the prognostic and predictive significance of cell biological markers in cervical cancer patients primarily treated with (chemo)radiation. A PubMed, Embase, and Cochrane literature search was performed. Studies describing a relation between a cell b

  1. Ruptured episiotomia resutured primarily.

    Science.gov (United States)

    Monberg, J; Hammen, S

    1987-01-01

    In a randomized study, 35 patients with ruptured episiotomy were treated in two ways. One group, treated with Clindamycin and primary resuture, did better than the other group, not resutured but spontaneously healed.

  2. Type D personality is a risk factor for psychosomatic symptoms and musculoskeletal pain among adolescents: a cross-sectional study of a large population-based cohort of Swedish adolescents

    OpenAIRE

    Condén Emelie; Leppert Jerzy; Ekselius Lisa; Åslund Cecilia

    2013-01-01

    Abstract Background Type D personality, or the “distressed personality”, is a psychosocial factor associated with negative health outcomes, although its impact in younger populations is unclear. The purpose of this study was to investigate the prevalence of Type D personality and the associations between Type D personality and psychosomatic symptoms and musculoskeletal pain among adolescences. Methods A population-based, self-reported cross-sectional study conducted in Västmanland, Sweden wit...

  3. Health care technology as a policy issue

    NARCIS (Netherlands)

    Banta, H.D.

    1994-01-01

    Health care technology has become an increasingly visible issue in many countries, primarily because of the rising costs of health care. In addition, many questions concerning quality of care are being raised. Health care technology assessment has been seen as an aid in addressing questions

  4. Analysis of the related factors of general hospital medical personnel cognition of psychosomatic disease%综合医院医务人员对心身疾病认识相关因素分析

    Institute of Scientific and Technical Information of China (English)

    程鎏

    2011-01-01

    Objective: To realize the related factors of influence Shanghai general hospital medical personnel cognition of psychosomatic disease. Methods: The related factors of 1 000 medical personnel in 9 general hospitals of Shanghai urban area were analyzed by questionnaire survey. Results: Education background and work department in hospital were the main factors influenced the Shanghai urban area general hospital medical personnel cognition of psychosomatic disease. Conclusion: General hospital medical personnel need update their knowledge constantly and strengthen the popularity and training of relevant knowledge of psychosomatic medicine%目的:了解影响上海中心城区综合性医院医务人员对心身疾病认识的相关因素.方法:对上海市中心城区9家综合性医院的1 000名医务人员进行问卷调查并对相关影响因素进行分析.结果:学历和在医院从事的工作部门是影响上海中心城区综合性医院医务人员对心身疾病认识的主要因素.结论:综合性医院医务人员需要不断更新知识,加强与心身医学相关知识的普及和培训.

  5. Psychosomatic medicine and"the integration of the body and the spirit"in traditional Chinese medicine%心身医学与中医"形神合一"论

    Institute of Scientific and Technical Information of China (English)

    颜红; 纪宇

    2016-01-01

    "形神合一"是中医学的基本理念,其与西方心身医学看待疾病基本属于同一视角.现代心身医学秉持"心身同治"之原则,结合药物治疗与心理治疗,取得了较为良好的治疗效果.中医情志病学因其强调形神合一的整体观,契合了现代生物-心理-社会医学模式,亦在心身疾病防治中尽显优势.两种医学相互参照,为诊疗疾病开拓了更广阔的思路.%"The integration of the body and the spirit" is the basic concept of traditional Chinese medicine, which has the same connotation of modern psychosomatic medicine. Modern psychosomatic medicine "combined with drug and psychological", and obtain a more favorable therapeutic effect. Chinese medicine emotional diseases emphasize the unity of body and spirit, which have the inherent consistency of biological-psychological-social medical model. The cross-reference of modern psychosomatic medicine and Chinese emotional create a new way for disease diagnosis and treatment.

  6. Medicaid Managed Care Structures and Care Coordination.

    Science.gov (United States)

    Gilchrist-Scott, Douglas H; Feinstein, James A; Agrawal, Rishi

    2017-09-01

    Child enrollment in Medicaid managed care (MMC) has expanded dramatically, primarily through state mandates. Care coordination is a key metric in MMC evaluation because it drives much of the proposed cost savings and may be associated with improved health outcomes and utilization. We evaluated the relationships between enrollment in 2 MMC structures, primary care case management (PCCM) and health maintenance organization (HMO) and access to and receipt of care coordination by children. Using data from the 2011/2012 National Survey of Children's Health and the Medicaid Statistical Information System state data mart, we conducted a retrospective, cross-sectional analysis of the relationships between fee-for-service, PCCM or HMO enrollment, and access to and receipt of care coordination. State-level univariate analyses and individual and state multilevel multivariable analyses evaluated correlations between MMC enrollment and care coordination, controlling for demographic characteristics and state financing levels. In univariate and multilevel multivariable analyses, the PCCM penetration rate was significantly associated with increased access to care coordination (adjusted odds ratio: 1.23, P = .034) and receipt of care coordination (adjusted odds ratio: 1.37, P = .02). The HMO penetration rate was significantly associated with lower access to care coordination (adjusted odds ratio: 0.85, P = .05) and receipt of care coordination (adjusted odds ratio: 0.71, P coordination may be more effective in PCCM than HMO structures. States should consider care coordination outcomes when structuring their Medicaid programs. Copyright © 2017 by the American Academy of Pediatrics.

  7. 慢性疼痛与抑郁的心身医学整合观%Psychosomatic Perspectives on Chronic Pain and Depression

    Institute of Scientific and Technical Information of China (English)

    吴爱勤; 游林林

    2014-01-01

    生物医疗观对慢性疼痛患者的诊疗作用较差。慢性疼痛常因为心理应激、个性、行为和疾病状况而复杂化,增加了患者诊疗的难度。患者常因情感症状、生活压力,而失去信心,陷入无助地痛苦选择冲突中。应用一种系统的跨学科方法重建和保持医生的共情和患者的积极心理,采用疾病状态、生活经历、个性特征和行为模式的四种心身整合观点,综合评估抑郁和慢性疼痛患者。设计综合诊疗方案评定的痛苦作用,在方案制定的过程中认识到这四个观点彼此不同,相互补充,全面阐释影响患者痛苦的生物、心理和社会的多种原因。心身整合观点为设计合理的治疗方案提供了方法,提高了医生成功治疗慢性疼痛患者的可行性。%Biomedical Model has little effect in the treatment of the patient experiencing chronic pain. Chronic pain is often complicated with stress, psychological personality, behavior and disease status, which make it difficult of treating patients. The patient may be demoralized by the syndrome of an affective disorder and stress of their life, helplessly trapped by poor choices conflicts. The physician's interest and the patient's optimism can be restored and sustained by utilizing a systematic interdisciplinary approach utilizing the four psychosomatic integration perspectives of diseases, life stories, dimensions, and behaviors to evaluate the patient who is disabled by depression and chronic pain. The design of a comprehensive treatment plan involves the determination of each perspective's contribution to the patient's suffering. The process of formulation recognizes that the perspectives are distinct from one another but complementary in illuminating the various reasons for a patient's suffering. Psychosomatic integration perspectives offer a recipe for designing a rational treatment plan. This approach improves the feasibility of doctors

  8. Relationship between social cognition bias, personality and psychosomatic symptoms%社会认知偏离与人格特质及心身状态的关系

    Institute of Scientific and Technical Information of China (English)

    朱玲; 张倩; 黄秀琴; 杜士君; 骆利; 彭艳红

    2012-01-01

    目的 探讨社会认知偏离与人格特质及心身状态的关系.方法 采用社会认知偏离量表(Social Cognition Bias Scale,SCBS)、艾森克人格问卷(Eysenek Personality Questionnaire,EPQ)和症状自评量表(Symptom Checklist 90,SCL-90)对3062名中国军队人员进行调查,并进行相关和回归分析.结果 SCBS各分量表与EPQ各维度及SCL-90各因子均有统计学意义上的相关性:社会认知偏离的总分、攻击、抑郁、焦虑与艾森克的内外向(E)呈负相关,与情绪稳定性(N)、神经质(P)和社会掩饰性(L)呈正相关;与症状自评的9个因子均有正相关.回归分析发现,N分对社会认知偏离总分、社会认知攻击、抑郁和焦虑的贡献均为最大.结论 社会认知偏离与人格各因素和多种心身症状均存在有统计学意义的低至高度相关,其中,N分可作为预测社会认知偏离的指标.%Objective To explore the relationship between social cognition bias,assessment of personality characteristics and psychosomatic symptoms. Methods A total of 3062 Chinese military men were tested by Social Cognition Bias Scale( SCBS ), Eysenck Personality Questionnaire( EPQ ), and Symptom Checklist 90 ( SCL-90 ). The correlation and regression analyses were carried out. Results Subscales of SCBS had significant correlation with subscales of EPQ and SCL-90. SCBS-total, SCBS-aggression, SCBS-depression while SCBS-anxiety was negatively related to dimension E ( extroversion ), positively correlated with dimensions N ( neurotism ), P( psychoticism ) and L( lie ), and nine subscales of SCL-90. Regression analysis found that dimension N contributed most to SCBS-total, SCBS-aggression, SCBS-depression and SCBS-anxiety. Conclusion Social cognition bias has significantly low to high levels of relations with the assessment of personality characteristics and psychosomatic symptoms. Dimension N can serve as an index to predict social cognition bias.

  9. Assessment of Vegetation Variation on Primarily Creation Zones of the Dust Storms Around the Euphrates Using Remote Sensing Images

    Directory of Open Access Journals (Sweden)

    Jamil Amanollahi

    2012-06-01

    Full Text Available Recently, period frequency and effect domain of the dust storms that enter Iran from Iraq have increased. In this study, in addition to detecting the creation zones of the dust storms, the effect of vegetation cover variation on their creation was investigated using remote sensing. Moderate resolution image Spectroradiometer (MODIS and Landsat Thematic Mapper (TM5 have been utilized to identify the primarily creation zones of the dust storms and to assess the vegetation cover variation, respectively. Vegetation cover variation was studied using Normalized Differences Vegetation Index (NDVI obtained from band 3 and band 4 of the Landsate satellite. The results showed that the surrounding area of the Euphrates in Syria, the desert in the vicinity of this river in Iraq, including the deserts of Alanbar Province, and the north deserts of Saudi Arabia are the primarily creation zones of the dust storms entering west and south west of Iran. The results of NDVI showed that excluding the deserts in the border of Syria and Iraq, the area with very weak vegetation cover have increased between 2.44% and 20.65% from 1991 to 2009. In the meanwhile, the retention pound surface areas in the south deserts of Syria as well as the deserts in its border with Iraq have decreased 6320 and 4397 hectares, respectively. As it can be concluded from the findings, one of the main environmental parameters initiating these dust storms is the decrease in the vegetation cover in their primarily creation zones.

  10. CLINICAL OBSERVATION ON TREATMENT OF ACUTE BRONCHITIS PRIMARILY WITH PRICKING-CUPPING ON BACK-SHU POINTS

    Institute of Scientific and Technical Information of China (English)

    XU Wei-dong; ZHANG Yong-juan; YANG Jie; CHEN Xiao-xiang; LIU Yong-xiang

    2006-01-01

    Objective: To observe the clinical effect of treatment of acute bronchitis primarily with prickingcupping method on Back-shu points. Methods: The patients of acute bronchitis were randomly divided into 2groups. In the observation group, there were 36 cases, who were treated with the integrated traditional Chinese and western medicine, primarily the pricking-cupping method on Back-shu points; while in the control group, there were 29 cases who were given the conventinal treatment of western medicine. All the 2 groups were treated for 7 days as one treating course. Results: The total effective rate of the observation group was 97.2% while that of the control group was 82.8%, so there is a significant difference between them. On the first and third days the clinical manifestations were more satisfactorily improved in the treatment group than in the control group (P < 0.01 ) and on the fifth and seventh days, the comparison showed no significant difference (P >0.05). Conclusion: The treatment of acute bronchitis by means of the integrated traditional Chinese and western medicine primarily with pricking-cupping method on Back-shu points is of marked therapeutic effect, simple manipulation, and little untoward effects, thus claiming the unique advantage.

  11. A new mean for the study of TCM psychosomatic medicine:electroencephalogram nonlinear analy-sis%中医心身医学研究新手段:脑电非线性分析

    Institute of Scientific and Technical Information of China (English)

    张成; 赵志付

    2013-01-01

    东西方心身医学理论基础均为"心身整体论",两者均认为心理精神因素在健康与疾病中起着重要的作用.大脑对情绪刺激的反应对机体机能活动有着重要影响,脑电图的发现和应用可以客观的记录时刻都在变化的脑功能状态,而脑电非线性研究方法 分析大脑的功能活动状态,克服了脑电传统的肉眼分析,使脑电图的结果 能用定量数学进行表达,扩展了脑电在脑功能方面的研究领域.中医心身医学证候学与之相联系,探讨两者关系,为中医心身医学提供现代科学证据,制定出充分体现辨证施治规律特点的检查指标,以便利于临床诊断和疗效评价,使人们更容易理解和接受中医心身医学.%The theory foundation of both modern and tradilional Chinese medicine (TCM) psychoso-matic medicine is holislic iheory of mind and body, which is that psycho-menial factors play a key role on heallh and diseases. Responses of brain to menial stimuli have a great effect on body activities. Electroencephalogram (EEG) is sensitive observation index of cerebral functions. EEG nonlinear analysis is a kind of quantitative expression by mathematical language, which opens up a whole new area for EEG study. Exploration on correlation of syndrome of TCM psychosomatic medicine and cerebral functions by the method of EEG nonlinear analysis can provide modern science proof for TCM psychosomatic medicine, which will be a useful marker for diagnosis, illness evaluation and therapeutic effect of psychosomatic diseases and a better understanding of the world on TCM psychosomatic medicine.

  12. Emotion Regulation of Neuroticism: Emotional Information Processing Related to Psychosomatic State Evaluated by Electroencephalography and Exact Low-Resolution Brain Electromagnetic Tomography.

    Science.gov (United States)

    Ikeda, Shunichiro; Mizuno-Matsumoto, Yuko; Canuet, Leonides; Ishii, Ryouhei; Aoki, Yasunori; Hata, Masahiro; Katsimichas, Themistoklis; Pascual-Marqui, Roberto D; Hayashi, Takuto; Okamoto, Eika; Asakawa, Tetsuya; Iwase, Masao; Takeda, Masatoshi

    2015-02-27

    Emotion regulation is the process that adjusts the type or amount of emotion when we experience an emotional situation. The aim of this study was to reveal quantitative changes in brain activity during emotional information processing related to psychosomatic states and to determine electrophysiological features of neuroticism. Twenty-two healthy subjects (mean age 25 years, 14 males and 8 females) were registered. Electroencephalography (EEG) was measured during an emotional audiovisual memory task under three conditions (neutral, pleasant and unpleasant sessions). We divided the subjects into two groups using the Cornell Medical Index (CMI): (CMI-I: control group, n = 10: CMI-II, III or IV: neuroticism group, n = 12). We analyzed the digital EEG data using exact low-resolution brain electromagnetic tomography (eLORETA) current source density (CSD) and functional connectivity analysis in several frequency bands (δ, θ, α, β, γ and whole band). In all subjects, bilateral frontal α CSD in the unpleasant session increased compared to the pleasant session, especially in the control group (p neuroticism group was significantly higher than that of the control group in the full band at the amygdala and inferior temporal gyrus, and in the α band at the right temporal lobe (p neuroticism electrophysiologically, which may serve as a neurophysiological marker of this personality trait. © 2015 S. Karger AG, Basel.

  13. Exploration on Stroke Aurae Syndrome from the Thought of Psychosomatic Differentiation and Treatment%中风先兆证从心身论治思路探讨

    Institute of Scientific and Technical Information of China (English)

    刘超

    2012-01-01

    Objective: To investigate the new clinical thoughts of diagnosis and treatment of stroke aurae syndrome. Methods: Based on the characteristics of pathogenesis of stroke aurae syndrome, by emphasizing the impact of psychological stress and other emotional factors on the disease and combining with the psychological status of patients and personality traits, diagnosis and treatment patterns for psychosomatic diseases in TCM internal medicine were used for the differentiation and treatment of stroke aurae syndrome. Results and Conclusion : The differentiation and treatment of stroke aurae syndrome by emphasizing both the the physical and psychological aspects has provided new thoughts for the clinical diagnosis and treatment of this syndrome in order to improve the clinical efficacy and reduce the incidence of stroke.%目的:探讨中风先兆证临床诊疗新思路.方法:基于中风先兆证病机特点,重视心理压力等情志因素对疾病的影响,结合患者心理状况与性格特征,试以中医内科心身疾病诊疗模式论治中风先兆证.结果与结论:心身并重论治中风先兆证,为中风先兆证临床诊疗提供新思路,以求提高临床疗效,降低中风发病率.

  14. Psychosomatic Disorders——Psychological Diseases or Physical Diseases%心身疾病——精神疾病还是躯体疾病

    Institute of Scientific and Technical Information of China (English)

    王铭维

    2012-01-01

    心身疾病涉及了全身各个系统,几乎所有的躯体痰病都有心理因素的影响,而这些精神心理因素决定了其发病、临床表现、持续时间以及对治疗的易感性.心理因素作用于人脑后,通过一定的生理中介机制如自主神经系统、内分泌系统、免疫与应激及心理神经免疫作用于靶器官发生生理改变,最终导致躯体症状或疾病的发生.%Various systems were involved in psychosomatic disorders. Psychological factors may have effects, including morbidity, clinical presentation, duration and therapeutic effects, on nearly all of the physical diseases. Through specific physiological mediators such as autonomic nervous system, endocrine system, immunization and psychoneuroimmunology, physiological changes were developed in target organs, which caused physical symptoms or diseases eventually.

  15. [Facial pain- a rare cause. Impacted lower third molars causing primarily "unclear" facial pain: a case report].

    Science.gov (United States)

    Gander, Thomas; Dagassan-Berndt, Dorothea; Mascolo, Luana; Kruse, Astrid L; Grätz, Klaus W; Lübbers, Heinz-Theo

    2013-01-01

    Orofacial pain often causes special difficulties to patients and dentists. Numerous differential diagnoses require the utilization of a coordinated diagnostic concept. Often, multiple causes lead to the need for a complex treatment plan. Impacted third molars are a potential cause of a variety of complications. Caries, pulp necrosis, and periapical infection are some of the infrequent causes of such pain. The presented case shows just such a constellation, resulting in primarily "unclear" orofacial pain. A diagnostic sequence generally leads to the correct diagnosis and thereby allows for fast and effective therapy. This shows how important structured diagnostics are, especially in cases of "unclear" pain.

  16. Barriers to Care for Depressed Older People: Perceptions of Aged Care among Medical Professionals

    Science.gov (United States)

    McCabe, Marita P.; Davison, Tanya; Mellor, David; George, Kuruvilla

    2009-01-01

    The current study evaluated barriers to detection of depression among older people. Focus groups were conducted with 21 professional carers, 4 nurses, 10 general practitioners, and 7 aged care managers. The results demonstrated that care for older people is primarily focused on physical care. Further, staff resources, a lack of continuity of care,…

  17. Healthy younger and older adults control foot placement to avoid small obstacles during gait primarily by modulating step width

    Directory of Open Access Journals (Sweden)

    Schulz Brian W

    2012-10-01

    Full Text Available Abstract Background Falls are a significant problem in the older population. Most falls occur during gait, which is primarily regulated by foot placement. Variability of foot placement has been associated with falls, but these associations are inconsistent and generally for smooth, level flooring. This study investigates the control of foot placement and the associated gait variability in younger and older men and women (N=7/group, total N=28 while walking at three different speeds (slow, preferred, and fast across a control surface with no obstacles and surfaces with multiple (64 small (10cm long ×13mm high visible and hidden obstacles. Results Minimum obstacle distance between the shoe and nearest obstacle during each footfall was greater on the visible obstacles surface for older subjects because some of them chose to actively avoid obstacles. This obstacle avoidance strategy was implemented primarily by modulating step width and to a lesser extent step length as indicated by linear regressions of step width and length variability on minimum obstacle distance. Mean gait speed, step length, step width, and step time did not significantly differ by subject group, flooring surface, or obstacle avoidance strategy. Conclusions Some healthy older subjects choose to actively avoid small obstacles that do not substantially perturb their gait by modulating step width and, to a lesser extent, step length. It is not clear if this obstacle avoidance strategy is appropriate and beneficial or overcautious and maladaptive, as it results in fewer obstacles encountered at a consequence of a less efficient gait pattern that has been shown to indicate increased fall risk. Further research is needed on the appropriateness of strategy selection when the environmental demands and/or task requirements have multiple possible completion strategies with conflicting objectives (i.e. perceived safety vs. efficiency.

  18. [The Prognostic Significance of ICF Data with Regard to Realization of Recommendations Given in the Medical Discharge Report after In-Patient Psychosomatic Rehabilitation].

    Science.gov (United States)

    Oster, Jörg; von Wietersheim, Jörn; Müller, Gottfried; Braunger, Carina

    2017-05-01

    Target In this trial, the prognostic significance of ICF-related diagnostics compared to social and medical, disease-related and personal factors with regard to realization of recommendations given in the medical discharge report after the in-patient psychosomatic rehabilitation should be examined. Methodology ICF-related, social and medical, disease-related and personal prognostic factors were surveyed by questionnaires and interviews, on admission, discharge and 6 months after discharge from rehabilitation (time of catamnesis). As target criteria, realizations of recommendations from the fields of sports and exercise, psychotherapy and social medicine were chosen, they could be evaluated by telephone from N=344 participants at the time of catamnesis. For determination of relevant predictors, bivariate and multi-variate analyses were performed. Results 70% of patients realized the recommended sports and exercise, 45% the recommended psychotherapy and 44% a social and medical recommendation. With regard to the target criterion for the realization of recommended sports and exercise, the elevated prognostic factors had only a low prognostic value. For the prognosis of the target criterion of realizing a recommended psychotherapy, interpersonal problems and a low ability to interact in groups (Mini-ICF-APP) turned out to be relevant ICF-related predictors. Different problems (e. g., job-related conditions) appeared as relevant, ICF-related predictors concerning the realization of social and medical recommendations. Disturbances of reliability, self-evaluated by means of ICF AT-50 Psych, showed in the bivariate analyses significant correlations with the target criteria. Conclusion Besides other variables, also ICF-supported attributes turned out to be suitable for the prognosis of target criteria. They should be evaluated and considered in the rehabilitation process. © Georg Thieme Verlag KG Stuttgart · New York.

  19. Rlationship between psychosomatic health and both maladjustment and job burnout in military personnel%基层军官心身健康与适应不良及职业倦怠的关系研究

    Institute of Scientific and Technical Information of China (English)

    孔令明; 过伟; 张理义; 姚高峰; 陈春霞

    2012-01-01

    Objective To explore the influence of mental maladjustment and job burnout on the psychosomatic health of military personnel and their relationship and build α path model. Methods A total of 358 military personnel were selected by random cluster sampling. Military Mental Maladjustment Scale (MMMS), Military Job Burnout Scale (MJBS), and Chinese Psychosomatic Health Scale (CPSHS) were applied to collect dad. SPSS (version 17.0) and Amos (version 7,0) were used tot data analysis by correlative analysis, multiple-regression analysis, and path analysis. Results All single factors of job burnout were significantly positively related to interpersonal relationship and emotional disorder due to mental maladjustment (Ppsychosomatic health of military personnel (P<0.0l). Multiple regression analysis showed that somatization, negative cacanny, emotional disorder, and interpersonal relationship entered into tbe regression equation of total psychosomatic health score as dependent variable, and could serve as predictors for military personnel's psychosomatic health (P<0.01), the four independent variables accounted for 45% of the total variance of psychosomatic health. The influence of mental maladjustment on psychosomatic health was enhanced by intervention of job burnout into the path model, the fit indexes of which were as follows: χ2/df=35.2A8 (P=0.000), GFl=0.963, AGFI=0.875, CFU0.902, RMSEA=0.003. Conclusions Emotional disorder, poor interpersonal relationship, somatization, and negative cacanny exert significant effects on military personnel's psychosomatic health. Job burnout mediates the relationship between mental maladjustment and psychosomatic health.%目的 探讨适应不良、职业倦怠对基层军官心身健康的影响及其关系,并建立路径模型.方法 采用随机整群抽样法,选取某军区358名男性基层军官,使用

  20. Analysis of consultation characteristics for elderly patients in the department of psychosomatic medicine in Hospital of TCM%中医医院老年患者心身医学科会诊特点分析

    Institute of Scientific and Technical Information of China (English)

    裴音; 张捷; 陈杰; 范竹青

    2012-01-01

    Objective To analyze the characteristics of consultation for elderly patients in the department of psychosomatic medicine of our hospital. Methods 157 elderly patients accepting consultation in the department of psychosomatic medicine were analyzed. The aspects of analysis included the departments and reasons for consultations,and diagnoses after consultation. Results The most common diseases were cardiovascular, cerebrovascular and digestive diseases in elderly patients complicated with mental disorders;the most common reason for consultation is associated with sleep disorders;the most common diagnoses of consultation is the mixed anxiety-depressive disorder;high risk of delirium was increased in elderly patients. Conclusion Diagnosis and treatment of psychiatric-related diseases provided by the department of psychosomatic medicine for many patients,at the same time,Consultation in Dept. of Psychiatry is also necessary. Therefore, the department of psychosomatic medicine as a bridge can strengthen the link providing comprehensive services for patients.%目的 了解老年患者心身医学科会诊特点.方法 选取我院心身医学科进行会诊的老年患者157例,对会诊科室、会诊原因、会诊后诊断进行分析.结果 伴发精神障碍的老年患者以心脑血管病及消化系统疾病入院最为常见;伴发睡眠障碍为最常见的申请会诊原因;焦虑抑郁共病为最常见的会诊诊断;老年患者出现谵妄的概率较高.结论 院内心身医学科可以为更多的患者提供精神科相关诊治,精神科专科会诊仍十分必要,心身医学科可以加强二者之间的联系,为患者提供更全面的服务.

  1. Human land uses enhance sediment denitrification and N2O production in Yangtze lakes primarily by influencing lake water quality

    Directory of Open Access Journals (Sweden)

    W. Liu

    2015-05-01

    Full Text Available Sediment denitrification in lakes alleviates the effects of eutrophication through removal of nitrogen to the atmosphere as N2O and N2. However, N2O contributes notably to the greenhouse effect and global warming. Human lands uses (e.g., agricultural and urban areas strongly affect lake water quality and sediment characteristics, which, in turn, may regulate lake sediment denitrification and N2O production. In this study, we investigated sediment denitrification and N2O production and their relationships to within-lake variables and watershed land uses in 20 lakes from the Yangtze River basin in China. The results indicated that both lake water quality and sediment characteristics were significantly influenced by watershed land uses. Increased background denitrification rate would result in increased N2O production rate. Background denitrification and N2O production rates were positively related to water nitrogen concentrations but were not significantly correlated with sediment characteristics and plant community structure. A significant positive relationship was observed between background denitrification rate and percentage of human-dominated land uses (HDL in watersheds. Structural equation modelling revealed that the indirect effects of HDL on sediment denitrification and N2O production in Yangtze lakes were mediated primarily through lake water quality. Our findings also suggest that although sediments in Yangtze lakes can remove large quantities of nitrogen through denitrification, they may also be an important source of N2O, especially in lakes with high nitrogen content.

  2. Inverted Papilloma Originating Primarily from the Nasolacrimal Duct: A Case Report and Review of the Pertinent Literature

    Directory of Open Access Journals (Sweden)

    Hussein Z. Walijee

    2015-01-01

    Full Text Available Introduction. Inverted papilloma (IP is an uncommon, benign yet aggressive neoplasm characterised by high recurrence rates and tendency towards malignant transformation. The majority of IP cases originate in the ethmoid region, lateral wall of the nasal fossa, and maxillary sinus. The authors report a case of an IP originating primarily from the nasolacrimal duct (NLD. Case. A 69-year-old Caucasian gentleman presented with a lump in his right medial canthal region, epiphora, and discharge bilaterally. Radiological investigation revealed a well-defined, heterogeneous mass within the proximal NLD eroding the bony canal, protruding into the middle meatus and into the right orbit. The tumour was excised en bloc utilizing a combined external and endoscopic approach based on its location. Histology revealed hyperplastic ribbons of basement membrane-enclosed epithelium growing endophytically into the underlying stroma with no evidence of invasive malignancy. The patient made an uneventful recovery with unchanged visual acuity and normal extraocular movements. Conclusion. The case demonstrates variability within the sinonasal tract that IP can develop and the individuality of each case necessitating tailored operative techniques for complete excision whilst minimising recurrence rates. We also present a combined endoscopic approach for the en bloc resection of a NLD IP with no clinical recurrence at 15-month follow-up.

  3. Chemical and biological studies of a new cigarette that primarily heats tobacco. Part 3. In vitro toxicity of whole smoke.

    Science.gov (United States)

    Bombick, D W; Ayres, P H; Putnam, K; Bombick, B R; Doolittle, D J

    1998-03-01

    Mainstream smoke from Kentucky reference low "tar" (1R4F) and ultra-low "tar" (1R5F) cigarettes and a test cigarette (TOB-HT), that primarily heats tobacco, was compared for cytotoxic and genotoxic potential using cellular smoke exposure technology (CSET). CSET includes a computer controlled 30-port AMESA/Battelle-Geneva smoke generator which exposes cultured mammalian Chinese hamster ovary cells (CHO) to whole smoke. Cytotoxicity was assessed using the neutral red assay and genotoxicity was assessed using the sister chromatid exchange (SCE) assay. Compared on a per cigarette basis, mainstream smoke from 1R5F and the TOB-HT cigarette was significantly less cytotoxic and genotoxic than the smoke from the 1R4F cigarette. The cytotoxic and genotoxic activity of smoke from the TOB-HT cigarettes was slightly greater than the smoke from the ultra-low "tar" Kentucky 1R5F reference cigarettes. In conclusion, in these assays mainstream whole smoke of the TOB-HT cigarette had slightly greater cytotoxic and genotoxic potential compared with an ultra-low "tar" 1R5F Kentucky reference cigarette and significantly less activity compared with the whole mainstream smoke from a low "tar" 1R4F Kentucky reference cigarette, representative of the US market average cigarette for FTC yields of "tar", CO and nicotine.

  4. TUMOR NECROSIS FACTOR ALPHA DECREASES NOS3 EXPRESSION PRIMARILY VIA RHO/RHO KINASE IN THE THICK ASCENDING LIMB

    Science.gov (United States)

    Ramseyer, Vanesa; Hong, Nancy; Garvin, Jeffrey L.

    2013-01-01

    Inappropriate Na+ reabsorption by thick ascending limbs (THALs) induces hypertension. Nitric oxide (NO) produced by NO synthase type 3 (NOS3 or eNOS) inhibits NaCl reabsorption by THALs. Tumor necrosis factor alpha (TNF-α) decreases NOS3 expression in endothelial cells and contributes to increases in blood pressure. However, the effects of TNF-α on THAL NOS3 and the signaling cascade are unknown. TNF-α activates several signaling pathways including Rho/Rho kinase (ROCK) which is known to reduce NOS3 expression in endothelial cells. Therefore, we hypothesized that TNF-α decreases NOS3 expression via Rho/ROCK in rat THAL primary cultures. THAL cells were incubated with either vehicle or 1 nmol/L TNF-α for 24 hrs and NOS3 expression was measured by Western blot. TNF-α decreased NOS3 expression by 51±6% (pNOS3 expression by 30±8% (pNOS3 expression by 66±15 % (pNOS3 expression. We conclude that TNF-α decreases NOS3 expression primarily via Rho/ROCK in rat THALs. These data suggest that some of the beneficial effects of ROCK inhibitors in hypertension could be due to the mitigation of TNF-α-induced reduction in NOS3 expression. PMID:22566503

  5. Adolescent Pornography Use and Dating Violence among a Sample of Primarily Black and Hispanic, Urban-Residing, Underage Youth

    Directory of Open Access Journals (Sweden)

    Emily F. Rothman

    2015-12-01

    Full Text Available This cross-sectional study was designed to characterize the pornography viewing preferences of a sample of U.S.-based, urban-residing, economically disadvantaged, primarily Black and Hispanic youth (n = 72, and to assess whether pornography use was associated with experiences of adolescent dating abuse (ADA victimization. The sample was recruited from a large, urban, safety net hospital, and participants were 53% female, 59% Black, 19% Hispanic, 14% Other race, 6% White, and 1% Native American. All were 16–17 years old. More than half (51% had been asked to watch pornography together by a dating or sexual partner, and 44% had been asked to do something sexual that a partner saw in pornography. Adolescent dating abuse (ADA victimization was associated with more frequent pornography use, viewing pornography in the company of others, being asked to perform a sexual act that a partner first saw in pornography, and watching pornography during or after marijuana use. Approximately 50% of ADA victims and 32% of non-victims reported that they had been asked to do a sexual act that their partner saw in pornography (p = 0.15, and 58% did not feel happy to have been asked. Results suggest that weekly pornography use among underage, urban-residing youth is common, and may be associated with ADA victimization.

  6. Adolescent Pornography Use and Dating Violence among a Sample of Primarily Black and Hispanic, Urban-Residing, Underage Youth

    Science.gov (United States)

    Rothman, Emily F.; Adhia, Avanti

    2015-01-01

    This cross-sectional study was designed to characterize the pornography viewing preferences of a sample of U.S.-based, urban-residing, economically disadvantaged, primarily Black and Hispanic youth (n = 72), and to assess whether pornography use was associated with experiences of adolescent dating abuse (ADA) victimization. The sample was recruited from a large, urban, safety net hospital, and participants were 53% female, 59% Black, 19% Hispanic, 14% Other race, 6% White, and 1% Native American. All were 16–17 years old. More than half (51%) had been asked to watch pornography together by a dating or sexual partner, and 44% had been asked to do something sexual that a partner saw in pornography. Adolescent dating abuse (ADA) victimization was associated with more frequent pornography use, viewing pornography in the company of others, being asked to perform a sexual act that a partner first saw in pornography, and watching pornography during or after marijuana use. Approximately 50% of ADA victims and 32% of non-victims reported that they had been asked to do a sexual act that their partner saw in pornography (p = 0.15), and 58% did not feel happy to have been asked. Results suggest that weekly pornography use among underage, urban-residing youth may be common, and may be associated with ADA victimization. PMID:26703744

  7. Y-Chromosomal Diversity in Europe Is Clinal and Influenced Primarily by Geography, Rather than by Language

    Science.gov (United States)

    Rosser, Zoë H.; Zerjal, Tatiana; Hurles, Matthew E.; Adojaan, Maarja; Alavantic, Dragan; Amorim, António; Amos, William; Armenteros, Manuel; Arroyo, Eduardo; Barbujani, Guido; Beckman, Gunhild; Beckman, Lars; Bertranpetit, Jaume; Bosch, Elena; Bradley, Daniel G.; Brede, Gaute; Cooper, Gillian; Côrte-Real, Helena B. S. M.; de Knijff, Peter; Decorte, Ronny; Dubrova, Yuri E.; Evgrafov, Oleg; Gilissen, Anja; Glisic, Sanja; Gölge, Mukaddes; Hill, Emmeline W.; Jeziorowska, Anna; Kalaydjieva, Luba; Kayser, Manfred; Kivisild, Toomas; Kravchenko, Sergey A.; Krumina, Astrida; Kučinskas, Vaidutis; Lavinha, João; Livshits, Ludmila A.; Malaspina, Patrizia; Maria, Syrrou; McElreavey, Ken; Meitinger, Thomas A.; Mikelsaar, Aavo-Valdur; Mitchell, R. John; Nafa, Khedoudja; Nicholson, Jayne; Nørby, Søren; Pandya, Arpita; Parik, Jüri; Patsalis, Philippos C.; Pereira, Luísa; Peterlin, Borut; Pielberg, Gerli; Prata, Maria João; Previderé, Carlo; Roewer, Lutz; Rootsi, Siiri; Rubinsztein, D. C.; Saillard, Juliette; Santos, Fabrício R.; Stefanescu, Gheorghe; Sykes, Bryan C.; Tolun, Aslihan; Villems, Richard; Tyler-Smith, Chris; Jobling, Mark A.

    2000-01-01

    Clinal patterns of autosomal genetic diversity within Europe have been interpreted in previous studies in terms of a Neolithic demic diffusion model for the spread of agriculture; in contrast, studies using mtDNA have traced many founding lineages to the Paleolithic and have not shown strongly clinal variation. We have used 11 human Y-chromosomal biallelic polymorphisms, defining 10 haplogroups, to analyze a sample of 3,616 Y chromosomes belonging to 47 European and circum-European populations. Patterns of geographic differentiation are highly nonrandom, and, when they are assessed using spatial autocorrelation analysis, they show significant clines for five of six haplogroups analyzed. Clines for two haplogroups, representing 45% of the chromosomes, are continentwide and consistent with the demic diffusion hypothesis. Clines for three other haplogroups each have different foci and are more regionally restricted and are likely to reflect distinct population movements, including one from north of the Black Sea. Principal-components analysis suggests that populations are related primarily on the basis of geography, rather than on the basis of linguistic affinity. This is confirmed in Mantel tests, which show a strong and highly significant partial correlation between genetics and geography but a low, nonsignificant partial correlation between genetics and language. Genetic-barrier analysis also indicates the primacy of geography in the shaping of patterns of variation. These patterns retain a strong signal of expansion from the Near East but also suggest that the demographic history of Europe has been complex and influenced by other major population movements, as well as by linguistic and geographic heterogeneities and the effects of drift. PMID:11078479

  8. Both cell substratum regulation and hormonal regulation of milk protein gene expression are exerted primarily at the posttranscriptional level

    Energy Technology Data Exchange (ETDEWEB)

    Eisenstein, R.S.; Rosen, J.M.

    1988-08-01

    The mechanism by which individual peptide and steroid hormones and cell-substratum interactions regulate milk protein gene expression has been studied in the COMMA-D mammary epithelial cell line. In the presence of insulin, hydrocortisone, and prolactin, growth of COMMA-D cells on floating collagen gels in comparison with that on a plastic substratum resulted in a 2.5- to 3-fold increase in the relative rate of ..beta..-casein gene transcription but a 37-fold increase in ..beta..-casein mRNA accumulation. In contrast, whey acidic protein gene transcription was constitutive in COMMA-D cells grown on either substratum, but its mRNA was unstable and little intact mature mRNA was detected. Culturing COMMA-D cells on collagen also promoted increased expression of other genes expressed in differentiated mammary epithelial cells, including those encoding ..cap alpha..- and ..gamma..-casein, transferrin, malic enzyme, and phosphoenolpyruvate carboxykinase but decreased the expression of actin and histone genes. Using COMMA-D cells, the authors defined further the role of individual hormones in influencing ..beta..-casein gene transcription. With insulin alone, a basal level of ..beta..-casein gene transcription was detected in COMMA-D cells grown on floating collagen gels. Addition of prolactin but not hydrocortisone resulted in a 2.5- to 3.0-fold increase in ..beta..-casein gene transcription, but both hormones were required to elicit the maximal 73-fold induction in mRNA accumulation. The posttranscriptional effect of hormones on casein mRNA accummulation preceded any detectable changes in the relative rate of transcription. Thus, regulation by both hormones and cell substratum of casein gene expression is exerted primarily at the post transcriptional level.

  9. Inward Rectifier K+ Currents Are Regulated by CaMKII in Endothelial Cells of Primarily Cultured Bovine Pulmonary Arteries.

    Directory of Open Access Journals (Sweden)

    Lihui Qu

    Full Text Available Endothelium lines the interior surface of vascular walls and regulates vascular tones. The endothelial cells sense and respond to chemical and mechanical stimuli in the circulation, and couple the stimulus signals to vascular smooth muscles, in which inward rectifier K+ currents (Kir play an important role. Here we applied several complementary strategies to determine the Kir subunit in primarily cultured pulmonary arterial endothelial cells (PAECs that was regulated by the Ca2+/calmodulin (CaM-dependent protein kinase II (CaMKII. In whole-cell voltage clamp, the Kir currents were sensitive to micromolar concentrations of extracellular Ba2+. In excised inside-out patches, an inward rectifier K+ current was observed with single-channel conductance 32.43 ± 0.45 pS and Popen 0.27 ± 0.04, which were consistent with known unitary conductance of Kir 2.1. RT-PCR and western blot results showed that expression of Kir 2.1 was significantly stronger than that of other subtypes in PAECs. Pharmacological analysis of the Kir currents demonstrated that insensitivity to intracellular ATP, pinacidil, glibenclamide, pH, GDP-β-S and choleratoxin suggested that currents weren't determined by KATP, Kir2.3, Kir2.4 and Kir3.x. The currents were strongly suppressed by exposure to CaMKII inhibitor W-7 and KN-62. The expression of Kir2.1 was inhibited by knocking down CaMKII. Consistently, vasodilation was suppressed by Ba2+, W-7 and KN-62 in isolated and perfused pulmonary arterial rings. These results suggest that the PAECs express an inward rectifier K+ current that is carried dominantly by Kir2.1, and this K+ channel appears to be targeted by CaMKII-dependent intracellular signaling systems.

  10. Predator effects on a detritus-based food web are primarily mediated by non-trophic interactions.

    Science.gov (United States)

    Majdi, Nabil; Boiché, Anatole; Traunspurger, Walter; Lecerf, Antoine

    2014-07-01

    Predator effects on ecosystems can extend far beyond their prey and are often not solely lethally transmitted. Change in prey traits in response to predation risk can have important repercussions on community assembly and key ecosystem processes (i.e. trait-mediated indirect effects). In addition, some predators themselves alter habitat structure or nutrient cycling through ecological engineering effects. Tracking these non-trophic pathways is thus an important, yet challenging task to gain a better grasp of the functional role of predators. Multiple lines of evidence suggest that, in detritus-based food webs, non-trophic interactions may prevail over purely trophic interactions in determining predator effects on plant litter decomposition. This hypothesis was tested in a headwater stream by modulating the density of a flatworm predator (Polycelis felina) in enclosures containing oak (Quercus robur) leaf litter exposed to natural colonization by small invertebrates and microbial decomposers. Causal path modelling was used to infer how predator effects propagated through the food web. Flatworms accelerated litter decomposition through positive effects on microbial decomposers. The biomass of prey and non-prey invertebrates was not negatively affected by flatworms, suggesting that net predator effect on litter decomposition was primarily determined by non-trophic interactions. Flatworms enhanced the deposition and retention of fine sediments on leaf surface, thereby improving leaf colonization by invertebrates - most of which having strong affinities with interstitial habitats. This predator-induced improvement of habitat availability was attributed to the sticky nature of the mucus that flatworms secrete in copious amount while foraging. Results of path analyses further indicated that this bottom-up ecological engineering effect was as powerful as the top-down effect on invertebrate prey. Our findings suggest that predators have the potential to affect substantially

  11. Transient activation of microglia following acute alcohol exposure in developing mouse neocortex is primarily driven by BAX-dependent neurodegeneration.

    Science.gov (United States)

    Ahlers, Katelin E; Karaçay, Bahri; Fuller, Leah; Bonthius, Daniel J; Dailey, Michael E

    2015-10-01

    Fetal alcohol exposure is the most common known cause of preventable mental retardation, yet we know little about how microglia respond to, or are affected by, alcohol in the developing brain in vivo. Using an acute (single day) model of moderate (3 g/kg) to severe (5 g/kg) alcohol exposure in postnatal day (P) 7 or P8 mice, we found that alcohol-induced neuroapoptosis in the neocortex is closely correlated in space and time with the appearance of activated microglia near dead cells. The timing and molecular pattern of microglial activation varied with the level of cell death. Although microglia rapidly mobilized to contact and engulf late-stage apoptotic neurons, apoptotic bodies temporarily accumulated in neocortex, suggesting that in severe cases of alcohol toxicity the neurodegeneration rate exceeds the clearance capacity of endogenous microglia. Nevertheless, most dead cells were cleared and microglia began to deactivate within 1-2 days of the initial insult. Coincident with microglial activation and deactivation, there was a transient increase in expression of pro-inflammatory factors, TNFα and IL-1β, after severe (5 g/kg) but not moderate (3 g/kg) EtOH levels. Alcohol-induced microglial activation and pro-inflammatory factor expression were largely abolished in BAX null mice lacking neuroapoptosis, indicating that microglial activation is primarily triggered by apoptosis rather than the alcohol. Therefore, acute alcohol exposure in the developing neocortex causes transient microglial activation and mobilization, promoting clearance of dead cells and tissue recovery. Moreover, cortical microglia show a remarkable capacity to rapidly deactivate following even severe neurodegenerative insults in the developing brain.

  12. 49 CFR 37.195 - Purchase or lease of OTRBs by private entities not primarily in the business of transporting people.

    Science.gov (United States)

    2010-10-01

    ... primarily in the business of transporting people. 37.195 Section 37.195 Transportation Office of the... transporting people. This section applies to all purchases or leases of new vehicles by private entities which are not primarily engaged in the business of transporting people, with respect to buses delivered...

  13. Relaxation Training Affect the Psychosomatic Status of Patients with Preoperative%放松训练对术前患者心身状况的影响

    Institute of Scientific and Technical Information of China (English)

    石瑞梅

    2013-01-01

      Objective To study the relaxation training affect the psychosomatic status of patients with preoperative. Methods 400 patients with &experience choose the surgery were randomly divided into observation group and control group 200 cases each. Two groups of patients were performed preoperative health education, the observation group based on this, the upward relaxation training, namely USES the deep muscles relaxed type suction a resting method for training. After two groups of patients were to determine the surgical treatment on the day of the 1 d before surgery and surgery (preoperative) late yesterday night and morning, assess their anxiety, tension, fear, depression, insomnia, much dream mood reflected, such as measure its breathing, blood pressure, heart rate and other vital signs. Results In anxiety, tension, depression, fear, insomnia, much dream, breathing, blood pressure, heart rate, etc., the observation group compared with control group,with significant difference (al P<0.05).Conclusions Relaxation training can make the preoperative patients emotional stability, smooth breathing, blood pressure, heart rate and other vital signs.%  目的探讨放松训练对术前患者心身状况的影响。方法将400例我科择期手术患者随机分为观察组和对照组各200例。两组患者均行术前健康教育,观察组在此基础上行放松训练,即采用深吸静息式全身肌肉放松的方法进行训练。两组患者均于确定手术治疗后的当天至手术前1d,术前晚及术日晨评定其焦虑、紧张、恐惧、抑郁、失眠多梦等情绪反映,测定其呼吸、血压、心率等生命体征。结果在焦虑、紧张、抑郁、恐惧、失眠多梦、呼吸、血压、心率等方面,观察组与对照组比较,差异有显著性意义(均 P<0.05)。结论放松训练能使术前患者情绪稳定,呼吸、血压、心率等生命体征平稳。

  14. Self-Supporting Personality and Psychosomatic Symptoms:the Mediation Role of Negative Physical Self%自立人格与心理症状:负面身体自我的中介作用

    Institute of Scientific and Technical Information of China (English)

    李俊成; 夏凌翔; 李婧

    2014-01-01

    自立人格、负面身体自我都被认为是与心理症状关系密切的人格因素,为探讨三者之间的关系,依据人格的层次模型,提出了自立人格与心理症状的负面身体自我中介模型,采用青少年学生自立人格量表、青少年负面身体自我量表和症状自评量表,对572名在校大学生进行了调查,运用相关分析、结构方程模型等统计方法考察自立人格、负面身体自我与心理症状三者的关系,结果发现:①除个人灵活以外的9种自立人格特质均与心理症状呈显著负相关;②人际独立、人际责任、人际灵活、个人独立、个人主动、个人开放与负面身体自我显著负相关;③负面身体自我与心理症状显著正相关;④负面身体自我可以部分中介自立人格特质与心理症状的关系。自立人格特质与心理症状的负面身体自我中介模型获得了支持。%Both self‐supporting personality and negative physical self are considered to be personality fac‐tors closely correlated with psychosomatic symptoms .However ,the relationship among the three variables remains largely unexplored .In the present study ,a mediation model of negative physical self concerning self‐supporting personality and psychosomatic symptoms was developed according to the hierarchical model of personality .Five hundred and thirty‐two college students completed Self‐Supporting Personality Scale of Adolescent Students ,Negative Physical Self Scale and Symptom Check List 90 .Then correlation analysis and structural equation model were used to analyze the relationship among the three variables .The results demonstrated that all the 9 self‐supporting personality traits studied ,except personal flexible ,were in sig‐nificant negative correlation with the scores of psychosomatic symptoms ;that interpersonal independence , interpersonal responsibility ,interpersonal flexible ,personal independence ,personal

  15. TRPA1 is functionally expressed primarily by IB4-binding, non-peptidergic mouse and rat sensory neurons.

    Directory of Open Access Journals (Sweden)

    Marie E Barabas

    functionally expressed primarily in the IB4-positive, CGRP-negative subpopulation of small lumbar DRG neurons from rodents. Thus, IB4 binding is a better indicator than neuropeptides for TRPA1 expression.

  16. TRPA1 Is Functionally Expressed Primarily by IB4-Binding, Non-Peptidergic Mouse and Rat Sensory Neurons

    Science.gov (United States)

    Stucky, Cheryl L.

    2012-01-01

    primarily in the IB4-positive, CGRP-negative subpopulation of small lumbar DRG neurons from rodents. Thus, IB4 binding is a better indicator than neuropeptides for TRPA1 expression. PMID:23133534

  17. Monitoring Technology Meets Care Work

    DEFF Research Database (Denmark)

    Kanstrup, Anne Marie; Bygholm, Ann

    2015-01-01

    Monitoring technology, especially sensor-based technology, is increasingly taken into use in care work. Despite the simplicity of these technologies – aimed to automate what appear as mundane monitoring tasks – recent research has identified major challenges primarily related to the technology......'s ability to meet the complexity of care work. Understanding intersectional challenges between these care technologies and care work is fundamental to improve design and use of health informatics. In this paper we present an analysis of interaction challenges between a wet-sensor at the task of monitoring...

  18. [Psychosomatic aspects of cardiac arrhythmias].

    Science.gov (United States)

    Siepmann, Martin; Kirch, Wilhelm

    2010-07-01

    Emotional stress facilitates the occurrence of cardiac arrhythmias including sudden cardiac death. The prevalence of anxiety and depression is increased in cardiac patients as compared to the normal population. The risk of cardiovascular mortality is enhanced in patients suffering from depression. Comorbid anxiety disorders worsen the course of cardiac arrhythmias. Disturbance of neurocardiac regulation with predominance of the sympathetic tone is hypothesized to be causative for this. The emotional reaction to cardiac arrhythmias is differing to a large extent between individuals. Emotional stress may result from coping with treatment of cardiac arrhythmias. Emotional stress and cardiac arrhythmias may influence each other in the sense of a vicious circle. Somatoform cardiac arrhythmias are predominantly of psychogenic origin. Instrumental measures and frequent contacts between physicians and patients may facilitate disease chronification. The present review is dealing with the multifaceted relationships between cardiac arrhythmias and emotional stress. The underlying mechanisms and corresponding treatment modalities are discussed.

  19. [Perception, expression and psychosomatic functions].

    Science.gov (United States)

    Bühler, K E

    1988-01-01

    The investigation starts with the mind/body-problem and with epistemological peculiarities of psychophysical processes. Every monism has to be conceived at least as a dualism of properties. As a special kind of dualism the functionalism is an example against the type/type-identity thesis but not against the token-/token-identity thesis. But the last one is no serious alternative for genuine psychological methods. But also the functionalism does not offer a complete psychological theory: there is an ambivalence concerning the secondary qualities and also concerning intentionality. Bodily expressions were analyzed according the semiotic theory of Charles Sanders Peirce.

  20. [Psychosomatic posttraumatic resonances in refugees].

    Science.gov (United States)

    Ottino, Saskia von Overbeck

    2016-06-22

    The recent flow of refugees in our countries connects the clinician to new challenges: posttraumatic consequences, exile pathologies, cultural differences. Moreover, the psychic pains express themselves often through the body in more or less qualified ways, making a clear understanding of them difficult. From the therapist's side, the confrontation to war violences and cultural differences might create difficulties in establishing an empathic and fruitful therapeutic alliance.

  1. Selected Nanny Child Care Bibliography.

    Science.gov (United States)

    Olsen, Glenn W., Comp.; Williams, Owen E., Comp.

    This bibliography on nanny child care contains approximately 180 references to material about nannies, mother's helpers, au pairs, and governesses. The bibliography is organized by the categories of newspaper articles, journal articles, newsletter articles, books, and audiovisual materials. The items are drawn primarily from U.S. sources, but some…

  2. Tracheostomy care

    Science.gov (United States)

    Respiratory failure - tracheostomy care; Ventilator - tracheostomy care; Respiratory insufficiency - tracheostomy care ... Before you leave the hospital, health care providers will teach you how ... and suction the tube Keep the air you breathe moist Clean ...

  3. Critical Care

    Science.gov (United States)

    Critical care helps people with life-threatening injuries and illnesses. It might treat problems such as complications ... a team of specially-trained health care providers. Critical care usually takes place in an intensive care ...

  4. One-day Investigation of Psychotropic Drugs Use for 149 Inpatients in the Psychosomatic Disorder Department%149例心身障碍科住院患者1日精神药物使用调查

    Institute of Scientific and Technical Information of China (English)

    章凤君; 陈晓燕; 孙皎

    2013-01-01

    Objective: To investigate the one-day use of psychotropic drugs for the patients in the psychosomatic disorder department, and provide guidance for clinical rational medication. Methods: Prescriptions of 149 inpatients were investigated in the psychosomatic disorder department on May 8, 2012 through Hospital Information System (HIS). Results: Top five prescriptions of antidepressants were respectively paroxetine 35(23.49% ) , sertraline 21 ( 14.09% ) , escita-lopram 19(12. 75%) , mirtazapine 17(11.41%) and venlafaxine 15(10. 07%), while the top five anxiolytics were clon-azepam 130(87.25% ) , buspirone hydrochloride 16( 10.74% ), lorazepam 14(9.40% ) , alprazolam 10(6.71% ) and ox-azepam 6(4. 03% ) in order. The antipsychotics that were used most frequently were Sulpiride 68(45. 64% ) , followed by quetiapine 33(22. 15% ), olanzapine 16( 10. 74% ) , risperidone 7(4.70% ) and aripiprazole 3(2.01% ). Simultaneously , inpatients often received a combination of two or three different drugs above in the psychosomatic disorder department. Conclusion: The new generation of antidepressants and anxiolytics which were safe and had fewer side effects were mainly utilized in the psychosomatic disorder department. Most prescriptions in the one - day investigation were rational. However, some problems should be seriously considered, such as high prevalence of Benzodiazepines use, excessive drug combination and lack of the non-medical therapy.%目的:调查某院心身障碍科1日用药情况,为临床合理用药提供客观数据.方法:统计该院心身障碍科2012年5月8日149例住院患者用药信息.结果:抗抑郁药使用频次依次为帕罗西汀35例(23.49%)、舍曲林21例(14.09%)、艾司西酞普兰19例(12.75%)、米氮平17例(11.41%)、文拉法辛15例(10.07%);镇静催眠抗焦虑药前5位的是氯硝西泮130例(87.25%)、丁螺环酮16例(10.74%)、劳拉西泮14例(9.40%)、阿普唑仑10例(6.71%)、奥沙西泮6例(4.03

  5. Legal implications of managed care arrangements.

    Science.gov (United States)

    Knox, W A; Epstein, D M

    1994-09-01

    Prior to the 1980s, managed care was virtually nonexistent as a force in health care. Presently, 64 percent of employees in America are covered by managed care plans, including health maintenance organizations (20 percent) and preferred provider organizations (44 percent). In contrast, only 29 percent of employees were enrolled in managed care plans in 1988 and only 47 percent in 1991. To date, the primary reason for this incredible growth in managed care has been economic-market pressure to reduce health care costs. For the foreseeable future, political pressures are likely to fuel this growth, as managed care is at the center of President Clinton's national health care plan. Although there are numerous legal issues surrounding managed care, this article focuses primarily on antitrust implications when forming managed care entities. In addition, the corporate practice of medicine doctrine, certain tax issues, and the fraud and abuse laws are discussed.

  6. Inter-Professional Palliative Care

    DEFF Research Database (Denmark)

    Madsen, Kirsten Halskov; Henriksen, Jette; Meldgaard, Anette

    2013-01-01

    Chapter 11 by Kirsten Halskov Madsen, Anette Meldgaard and Jette Henriksen deals with the development of palliative care programmes aimed at the basic level of palliative care practice. The need to develop educational opportunities at particularly this level – described as ‘the basic inter......-professional level of palliative care’ – has been increasing for many years where palliative care has conventionally and primarily been associated with specialist training. As the authors show – based on a mapping out of existing educational initiatives in a region of Denmark, a reading of the curriculum...... and a description of the organization of palliative care – there is a need for such inter-professional palliative care that raises the level of competences at the basic level and the sharing of knowledge as well as securing the continuous qualifying of healthcare staff working with palliative care....

  7. [Social inequality in home care].

    Science.gov (United States)

    Möller, A; Osterfeld, A; Büscher, A

    2013-06-01

    Social inequality in Germany is discussed primarily with regard to educational or social welfare issues. There is a political consensus that more action should be taken to ensure equality of chances and fulfillment of basic needs for everyone. In long-term care these considerations have not yet taken place and there are hardly any research studies in this field. However, the startling rise of the need for long-term care will definitely require a discussion of social inequality in various care arrangements. To learn more about social inequality in home care, a qualitative approach was used and 16 home care nurses were interviewed. Our study shows that many care recipients face numerous problems they cannot handle on their own, which may even worsen their situation. In addition, the results reveal that facing social inequalities place a burden on nurses and influence their work performance.

  8. Improvement of norm of Chinese military personnel's psychosomatic health scale%中国军人心身健康常模的建立及其结果分析

    Institute of Scientific and Technical Information of China (English)

    张理义; 姚高峰; 范惠民; 梅贵森; 张志斌; 邹华根; 刘晓辉; 陈继军

    2013-01-01

    Objective To develop psychosomatic health norm for military personnel by means of the Chinese Military Psychosomatic Health Scale.Methods Random cluster sampling design was used to select the samples.A test by Chinese Military Psychosomatic Health Scale was carried out in 11 200 military personnel from the whole army,and the data in valid sample of 10 368 military personnel was analyzed by ANOVA and t test analysis.Results Significant differences of the military personnel psychosomatic health existed in different services except respiratory system (0.42 ± 0.81,0.44 ± 0.76,0.45 ± 0.70),reproductive-endocrine system (0.70 ± 0.90,0.68 ± 0.90,0.71 ±0.88,P<0.05 or 0.01),the entire status of the land force' s psychosomatic health was better than the other' s.(2) In genders,male had the better entire status of psychosomatic health.As compared with female (0.82 ±0.90,1.02 ± 1.35,P<0.05 or 0.01),male had lower scores in reproductive and urinary system(0.68 ± 0.90) and nervous system(0.87 ± 1.35),but higher scores in respiratory system (0.44 ± 0.78) and psychoticism (3.31 ± 1.52) (P < 0.05).(3) In ranks,the soldier' s respiratory symptom (0.40 ± 0.78),cardiovascular symptom (0.37 ± 0.901),alimentary system (0.69 ± 1.349),bone-muscle (2.20 ± 2.54),skin (0.47 ± 0.98),nervous system(0.83 ± 1.35),reproductive-endocrine system(0.67 ± 0.90),anxiety(0.65 ± 1.14)was better than the ofricers' (P < 0.01).Accordingly,4 norms of the Chinese Military Psychosomatic Health Scale,including the whole norm,the service norm,the gender norm and the rank norm,were founded.Conclusion The norms of different services,ranks,genders can be developed.Imaginably,it will be a great useful offer of psychological assistance for the selection of military talent and the screening of psychosomatic disorder as a good tool.%目的 建立中国军人心身健康常模.方法 采用随机整群抽样法抽取10 368名军人,进行中国军人心身健康量表的测评,对样本资

  9. Obstetrics Patients' Assessment of Medical Students' Role in Their Care.

    Science.gov (United States)

    Magrane, Diane

    1988-01-01

    Obstetric patients rated the skills and assessed the roles of students caring for them during a clinical clerkship. They rated skills and attitudes high, generally, with lower ratings for their ability to answer questions and preparation to participate in care. Most felt students improved their care, primarily in supportive ways. (Author/MSE)

  10. Obstetrics Patients' Assessment of Medical Students' Role in Their Care.

    Science.gov (United States)

    Magrane, Diane

    1988-01-01

    Obstetric patients rated the skills and assessed the roles of students caring for them during a clinical clerkship. They rated skills and attitudes high, generally, with lower ratings for their ability to answer questions and preparation to participate in care. Most felt students improved their care, primarily in supportive ways. (Author/MSE)

  11. Nanoparticles affect PCR primarily via surface interactions with PCR components: using amino-modified silica-coated magnetic nanoparticles as a main model

    Science.gov (United States)

    Nanomaterials have been widely reported to affect the polymerase chain reaction (PCR). However, many studies in which these effects were observed were not comprehensive, and many of the proposed mechanisms have been primarily speculative. In this work, we used amino-modified silica-coated magnetic n...

  12. Palliative Care

    Science.gov (United States)

    Palliative care is treatment of the discomfort, symptoms, and stress of serious illness. It provides relief from distressing symptoms ... of the medical treatments you're receiving. Hospice care, care at the end of life, always includes ...

  13. Hospice Care

    Science.gov (United States)

    Hospice care is end-of-life care. A team of health care professionals and volunteers provides it. ... can remain as alert and comfortable as possible. Hospice programs also provide services to support a patient's ...

  14. The emotional intelligence of a group of critical-care nurses in South Africa

    Directory of Open Access Journals (Sweden)

    Amanda Towell

    2013-11-01

    Full Text Available Critical-care nurses often look after three or more critically-ill patients during a shift. The workload and emotional stress can lead to disharmony between the nurse’s body, mind and spirit. Nurses with a high emotional intelligence have less emotional exhaustion and psychosomatic symptoms; they enjoy better emotional health; gain more satisfaction from their actions (both at work and at home; and have improved relationships with colleagues at work. The question arises: what is the emotional intelligence of critical-care nurses? A quantitative survey was conducted. The target population was registered nurses working in critical-care units who attended the Critical Care Congress 2009 (N = 380. Data were collected with the use of the Trait Emotional Intelligence Short Form and analysed using the Statistical Package for the Social Sciences software. The sample (n= 220 was mainly a mature, female and professionally-experienced group of registered nurses. They held a variety of job descriptions within various critical-care units. Statistics indicated that the standard deviations were small and no aberrant aspects such as demographics skewed the findings. The conclusion was made that registered nurses who are older and that have more experience in critical care appear to have a higher range of emotional intelligence.

  15. Collaborative health literate depression care among predominantly Hispanic patients with coronary heart disease in safety net care.

    Science.gov (United States)

    Ell, Kathleen; Oh, Hyunsung; Lee, Pey-Jiuan; Guterman, Jeffrey

    2014-01-01

    To determine whether evidence-based socioculturally health literate-adapted collaborative depression care improves depression care, depressive symptoms, and quality of life among predominantly Hispanic patients with coronary heart disease. The 12-month trial included 97 patients with coronary heart disease (79% of eligible patients) who met the depression criteria assessed by the Patient Health Questionnaire-9. Patients were recruited from 3 safety net clinics and offered depression team care by a bilingual clinical social worker and community patient navigator, a consulting psychiatrist, and a primary care physician. The team provided problem-solving therapy (PST) or pharmacotherapy or both, telephone symptom monitoring and behavioral activation, and patient resource navigation support. Recruited patients were given patient and family member health literacy-adapted educational and community resource materials in Spanish or English. Overall, depression treatment was 74% (PST, 55%; PST plus antidepressant medications, 18%; and antidepressant medications alone, 2%). Nearly half of the patients showed a 50% reduction of the Symptom Checklist-20 (49% at 6 mo and 48% at 12 mo) and of Patient Health Questionnaire-9 score with 47% of patients at 6 months and 43% at 12 months. The 50% improvement in Patient Health Questionnaire and Symptom Checklist-20 score reduction did not vary significantly between patients who received PST or antidepressant only or those who received PST plus antidepressant. The quality of life Short-Form Health Survey SF-12, the Minnesota Living with Heart Failure questionnaire, and the Sheehan Disability Scale outcomes also improved significantly. Socioculturally literacy-adapted collaborative depression care was accepted by patients with coronary heart disease and improved depression care and symptoms, quality of life, and functional outcomes among predominantly Hispanic patients with heart disease. Copyright © 2014 The Academy of Psychosomatic

  16. Better jobs, better care: building the home care work force.

    Science.gov (United States)

    Surpin, R; Haslanger, K; Dawson, S

    1994-08-01

    This paper focuses on providing quality care in the paraprofessional home care industry. Despite government policies that have encouraged home-based care for 20 years, home health care still remains relegated to second-class status by the rest of the health care industry. Home care is unique because it relies primarily on paraprofessional care delivered by a home care aide working alone, essentially as a guest in the client's home. The resulting interpersonal dynamic between patient and caregiver--which develops far from the eyes of the primary physician, regulators, and third-party payers--is one unlike any other patient-caregiver relationship in the health care system. The quality of care received by the client is linked directly to the quality of the paraprofessional's job: "good jobs" are prerequisite for "good service." Good jobs, however, are not enough. They must be supported by paraprofessional agencies that add real value to the home care service. Part I We define quality home care as meeting the client's needs. Unfortunately, since home care is provided in dispersed, minimally supervised settings, measuring quality of service is very difficult. For this reason, we suggest that it is the front-line employee--the home care aide who is present for hours every visit--who can best determine if the client's needs are being met, and who is best positioned to respond accordingly. Part II To best meet client needs, paraprofessional home care must be built around the home care aide. This requires that home care aides (1) be carefully selected during the hiring process, (2) be well trained, and (3) be empowered with considerable responsibility and capacity to respond to the daily needs of the clients. This Model, one that emphasizes the front-line employee, is in full keeping with the "total quality management" innovations that are currently reorganizing America's service industries. Unfortunately this model is not typically reflected in current paraprofessional

  17. Hospice care

    Science.gov (United States)

    ... family a break (called respite care). Doctor services. Nursing care. Home health aide and homemaker services. Counseling. Medical ... may be given in other locations, including: A nursing home A ... in charge of care is called the primary care giver. This may ...

  18. Palliative Care

    Science.gov (United States)

    ... you are a partner with the palliative care team as you all work toward the same goal — providing the best quality of life for your child for as ... Care for Children With Terminal Illness Managing Home Health Care Taking Care of You: Support ...

  19. Psychosocial screening and assessment in oncology and palliative care settings.

    Science.gov (United States)

    Grassi, Luigi; Caruso, Rosangela; Sabato, Silvana; Massarenti, Sara; Nanni, Maria G; The UniFe Psychiatry Working Group Coauthors

    2014-01-01

    Psychiatric and psychosocial disorders among cancer patients have been reported as a major consequence of the disease and treatment. The problems in applying a pure psychiatric approach have determined the need for structuring more defined methods, including screening for distress and emotional symptoms and a more specific psychosocial assessment, to warrant proper care to cancer patients with psychosocial problems. This review examines some of the most significant issues related to these two steps, screening and assessment of psychosocial morbidity in cancer and palliative care. With regard to this, the many different variables, such as the factors affecting individual vulnerability (e.g., life events, chronic stress and allostatic load, well-being, and health attitudes) and the psychosocial correlates of medical disease (e.g., psychiatric disturbances, psychological symptoms, illness behavior, and quality of life) which are possibly implicated not only in "classical" psychiatric disorders but more broadly in psychosocial suffering. Multidimensional tools [e.g., and specific psychosocially oriented interview (e.g., the Diagnostic Criteria for Psychosomatic Research)] represent a way to screen for and assess emotional distress, anxiety and depression, maladaptive coping, dysfunctional attachment, as well as other significant psychosocial dimensions secondary to cancer, such as demoralization and health anxiety. Cross-cultural issues, such as language, ethnicity, race, and religion, are also discussed as possible factors influencing the patients and families perception of illness, coping mechanisms, psychological response to a cancer diagnosis.

  20. Psychosocial screening and assessment in oncology and palliative care settings

    Directory of Open Access Journals (Sweden)

    Luigi eGrassi

    2015-01-01

    Full Text Available Psychiatric and psychosocial disorders among cancer patients have been reported as a major consequence of the disease and treatment. The problems in applying a pure psychiatric approach have determined the need for structuring more defined methods, including screening for distress and emotional symptoms and a more specific psychosocial assessment, to warrant proper care to cancer patients with psychosocial problems. This review examines some of the most significant issues related to these two steps, screening and assessment of psychosocial morbidity in cancer and palliative care. With regard to this , the many different variables, such as the factors affecting individual vulnerability (e.g. life events, chronic stress and allostatic load, well-being, and health attitudes and the psychosocial correlates of medical disease (e.g. psychiatric disturbances, psychological symptoms, illness behavior, and quality of life which are possibly implicated not only in classical psychiatric disorders but more broadly in psychosocial suffering. Multidimensional tools (e.g. and specific psychosocially oriented interview (e.g. the Diagnostic Criteria for Psychosomatic Research - DCPR represent a way to screen for and assess emotional distress, anxiety and depression, maladaptive coping, dysfunctional attachment, as well as other significant psychosocial dimensions secondary to cancer, such as demoralization and health anxiety. Cross-cultural issues, such as language, ethnicity, race, and religion, are also discussed as possible factors influencing the patients and families perception of illness, coping mechanisms, psychological response to a cancer diagnosis.

  1. Interferon-gamma and tumor necrosis factor-alpha sensitize primarily resistant human endometrial stromal cells to Fas-mediated apoptosis

    DEFF Research Database (Denmark)

    Fluhr, Herbert; Krenzer, Stefanie; Stein, Gerburg M

    2007-01-01

    -mediated signaling during early implantation. Here we show that ESCs are primarily resistant to Fas-mediated apoptosis independently of their state of hormonal differentiation. Pre-treatment of ESCs with interferon (IFN)-gamma and tumor necrosis factor (TNF)-alpha sensitizes them to become apoptotic upon stimulation......-inhibitory protein (FLIP, CFLAR) expression in ESCs. Additionally, we observed an activation of caspase 3, caspase 8 and caspase 9 upon apoptotic Fas triggering. In summary, we demonstrate that IFN-gamma and TNF-alpha sensitize primarily apoptosis-resistant ESCs to Fas-mediated cell death. This might be due...... to an upregulation of Fas expression, and apoptosis seems to be mediated by active caspase 3, caspase 8 and caspase 9. The observed pro-apoptotic effect of IFN-gamma and TNF-alpha on ESCs could play an important role in the modulation of early implantation....

  2. Relationship Between Pre-operative Anxiety and Post-operative Psychosomatic Adjustment and Its Related Factors and Nursing Strategies%术前焦虑与术后心身康复的相关性及其心理社会影响因素

    Institute of Scientific and Technical Information of China (English)

    沈晓红; 姜乾金

    2003-01-01

    Objective:To study the relationship between pre-operative anxiety and post-operative psychosomatic adjustment and the related psyehosoeial factors in upper- abdominal surgery patients. Methods: Forty patients undergoing upper- abdominalsurgery were assessed in this report. One day before surgery, the Medical Coping Mode Questionnaire (MCMQ), Perceived Social Support Scale (PSSS), Eysenek Personality Questionnaire (EPQ), State Anxiety Inventory (SAI) of State - Trait Arixiety Invento-ry (STAI) and a self- developed patients'' pre - operative appraisal questionnaire were used. In an hour before operation,the shift of the mean value of the pulse of every ease compared with the base line measured at his (or her ) admission was also recorded. Af-ter surgery, State Anxiety Inventory (SAI) of State- Trait Anxiety Inventory (STAI), a self-developed postoperative appraisal scale were used, and the indexes of somatic adjustment, including intestinal aerofluxus, total dosage of analgesia and so on were recorded. Results:Firstly, pre - operative anxiety was remarkably correlated to many indexes of post - operative psychosomatic adjustment. Secondly, hopelessness about operation, concern over sequela, resignation coping style and psychosis personality were the significant predictors of pre- operative anxiety. Conclusion: Post- operative psychosomatic adjustment could be handicapped by pre - operative anxiety which might be influenced by stress - related psyehosocial factors.

  3. A etiologia do sintoma psicossomático: sua relação com a reincidência traumática e o retraimento autista Etiology of psychosomatic symptoms: its relationship with traumatic recurrence and autistic withdrawal

    Directory of Open Access Journals (Sweden)

    Sebastião Abrão Salim

    2007-08-01

    Full Text Available A etiologia do sintoma psicossomático continua indefinida, apesar de inúmeros estudos de ciências afins. Apresento a hipótese de que este só se desenvolve em paciente portador de personalidade autista como predisposição, isto é, que tenha barreiras autistas - apego às "formas autistas" e aos "objetos autistas" - em resposta a um trauma no período fetal ou do nascimento, que promova sensação de descontinuidade física. Essas formas e objetos são elementos do próprio corpo, como a saliva, a língua, os dedos e as mãos em contato com suas próprias superfícies sensórias, mais a pele. A soma do registro dessas sensações pela memória implícita incipiente ou em desenvolvimento funciona como um ego biológico sem sujeito cognitivamente interpretante. O paciente portador de personalidade autista, diante de um novo trauma com a mesma sensação de morte, retira-se para o estado de homeostase autista, como se já soubesse o caminho, e aí fica hospedado. Dessa forma, seu corpo se converte em uma "mãe suficientemente boa", conforme conceituada por Winnicott. O sintoma psicossomático é uma representação das defesas biológicas e não um representante de conflitos que têm como base elementos sexuais ou destrutivos reprimidos. Inclui a angústia de morte, de deixar de existir. Os fenômenos psicossomáticos escondem, paradoxalmente, uma luta pela vida e, especialmente, pela sobrevivência psíquica do paciente, segundo MacDougall.Etiology of psychosomatic symptoms remains unclear, in spite of many studies by similar sciences. I present the hypothesis that the patient needs to have an autistic personality as predisposition, i.e., he needs to have autistic barriers - attachment to "autistic forms" and to "autistic objects" - in response to a fetal or postpartum trauma that produces a feeling of physical discontinuity. These forms and objects are elements of the body itself, such as saliva, fingers, tongue, and hands in contact with

  4. Access and care issues in urban urgent care clinic patients

    Directory of Open Access Journals (Sweden)

    Adams Jill C

    2009-12-01

    Full Text Available Abstract Background Although primary care should be the cornerstone of medical practice, inappropriate use of urgent care for non-urgent patients is a growing problem that has significant economic and healthcare consequences. The characteristics of patients who choose the urgent care setting, as well as the reasoning behind their decisions, is not well established. The purpose of this study was to determine the motivation behind, and characteristics of, adult patients who choose to access health care in our urgent care clinic. The relevance of understanding the motivation driving this patient population is especially pertinent given recent trends towards universal healthcare and the unclear impact it may have on the demands of urgent care. Methods We conducted a cross-sectional survey of patients seeking care at an urgent care clinic (UCC within a large acute care safety-net urban hospital over a six-week period. Survey data included demographics, social and economic information, reasons that patients chose a UCC, previous primary care exposure, reasons for delaying care, and preventive care needs. Results A total of 1, 006 patients were randomly surveyed. Twenty-five percent of patients identified Spanish as their preferred language. Fifty-four percent of patients reported choosing the UCC due to not having to make an appointment, 51.2% because it was convenient, 43.9% because of same day test results, 42.7% because of ability to get same-day medications and 15.1% because co-payment was not mandatory. Lack of a regular physician was reported by 67.9% of patients and 57.2% lacked a regular source of care. Patients reported delaying access to care for a variety of reasons. Conclusion Despite a common belief that patients seek care in the urgent care setting primarily for economic reasons, this study suggests that patients choose the urgent care setting based largely on convenience and more timely care. This information is especially applicable to

  5. 动机性访谈对脑肿瘤围手术期患者术前心身状况的影响%Effects of motivational interview on preoperative psychosomatic status in intracranial tumor patients during perioperative period

    Institute of Scientific and Technical Information of China (English)

    彭丽丽; 林丽丽; 沈广侠; 于秋红; 郭丽娜

    2013-01-01

    目的 探讨动机性访谈对脑肿瘤患者围手术期心身状况的影响.方法 将60例脑肿瘤患者分为干预组和对照组各30例,对照组进行常规护理,干预组在围手术期进行动机性访谈干预.比较两组干预前、麻醉诱导期、术后第3天焦虑情绪及血清皮质醇水平.结果 两组患者焦虑得分与血清皮质醇水平在麻醉诱导期、术后第3天均高于干预前,干预组患者焦虑得分和血清皮质醇水平在麻醉诱导期、术后第3天时均低于对照组(P<0.01).结论 动机性访谈能有效改善脑肿瘤患者围手术期心身状况,有助于患者康复.%Objective To explore the effects of motivational interview on preoperative psychosomatic status in intracranial tumor patients during perioperative period. Methods Sixty intracranial tumor patients were divided into intervention group and control group. Patients in the control group received routine nursing, and patients in the intervention group received motivational interview. The anxiety scores and serum cortisol level before intervention,during the induction anesthesia, on the third day after surgery were compared between the two groups. Results The patients'anxiety score and serum cortisol level in the induction anesthesia and the third day after surgery were higher than before interventions in both of two groups. In the intervention group, the anxiety score and serum cortisol level in the induction anesthesia and the third day after surgery were lower than those in control group (P <0. 01). Conclusion Motivated interview can effectively improve intracranial tumor patients perioperative psychosomatic status, and can promote the patients'rehabilitation.

  6. Specific components of face perception in the human fusiform gyrus studied by tomographic estimates of magnetoencephalographic signals: a tool for the evaluation of non-verbal communication in psychosomatic paradigms.

    Science.gov (United States)

    Okazaki, Yuka; Ioannides, Andreas A

    2007-12-04

    The aim of this study was to determine the specific spatiotemporal activation patterns of face perception in the fusiform gyrus (FG). The FG is a key area in the specialized brain system that makes possible the recognition of face with ease and speed in our daily life. Characterization of FG response provides a quantitative method for evaluating the fundamental functions that contribute to non-verbal communication in various psychosomatic paradigms. The MEG signal was recorded during passive visual stimulus presentation with three stimulus types - Faces, Hands and Shoes. The stimuli were presented separately to the central and peripheral visual fields. We performed statistical parametric mapping (SPM) analysis of tomographic estimates of activity to compare activity between a pre- and post-stimulus period in the same object (baseline test), and activity between objects (active test). The time course of regional activation curves was analyzed for each stimulus condition. The SPM baseline test revealed a response to each stimulus type, which was very compact at the initial segment of main M(FG)170. For hands and shoes the area of significant change remains compact. For faces the area expanded widely within a few milliseconds and its boundaries engulfed the other object areas. The active test demonstrated that activity for faces was significantly larger than the activity for hands. The same face specific compact area as in the baseline test was identified, and then again expanded widely. For each stimulus type and presentation in each one of the visual fields locations, the analysis of the time course of FG activity identified three components in the FG: M(FG)100, M(FG)170, and M(FG)200 - all showed preference for faces. Early compact face-specific activity in the FG expands widely along the occipito-ventral brain within a few milliseconds. The significant difference between faces and the other object stimuli in M(FG)100 shows that processing of faces is already

  7. 精神科心身病房优质护理服务模式及效果%Model and Effect of High Quality Nursing Service in Psychosomatic Disease Ward, Psychiatric Department

    Institute of Scientific and Technical Information of China (English)

    罗珊霞; 陈晶晶; 余建英; 张宇珊; 唐蕊; 李继平

    2012-01-01

    目的 探讨精神科心身病房优质护理服务模式及效果.方法 2010年7月起心身病房加入优质护理活动,通过了解患者对优质护理的需求,结合精神科专业特色,从培训和提高护理人员业务能力着手,实行医护共同交班制、共同查房制、开展思维纠正和行为训练、加强康复指导等措施建立优质护理服务模式,并对优质护理的效果以满意度进行评价.结果 患者对优质护理的希望与要求集中反映在主动热情服务、沟通好、康复治疗效果好等方面;实施优质护理服务后,患者、医生及护士的满意度均有不同程度上升.结论 心身病房开展优质护理服务,能有效满足患者的需求和体验,提高护士的专科护理技能,达到患者、医生、护士共同满意的良好效果.%Objective To explore the model and effect of high quality nursing service in Psychosomatic Disease Ward of Psychiatric Department. Methods From July 2010, the content of high quality nursing service were surveyed. In combination of professional characteristics of psychiatry, a high quality nursing service model was developed according to the following aspects: training and improving the skills of nurses, the application of doctor-nurse common shift system, doctor-nurse common ward-rounds system, strengthening the instruction of rehabilitation, implementation of thinking correction and behavior training. The effect of high quality nursing service was evaluate with the satisfaction degree. Results The main aspects of high quality nursing service appraised by the patients were active warm service, good communication and effective rehabilitation. After the implementation of high quality nursing service, satisfaction degree of patients, doctors and nurses improved with statistic significant difference. Conclusion The application of high quality nursing service model in Psychosomatic Disease Ward can effectively meet the needs of patients, improve the

  8. Effect of cognitive intervention on psychosomatic rehabilitation of elderly patients with high blood pressure%认知干预对高血压老年病人心身康复的影响分析

    Institute of Scientific and Technical Information of China (English)

    杨君兰; 熊瑞才

    2015-01-01

    目的:探讨认知干预对高血压老年病人心身康复的影响。方法将我院收治的112例老年高血压患者平均分为研究组与对照组。两组患者均采取常规高血压药物治疗,在此基础上研究组患者接受认知干预。结果研究组干预后 SAS 及 SDS 分值显著低于对照组(P <0.05);研究组干预后血压水平显著低于对照组及干预前(P <0.05)。结论认知干预可以显著改善老年高血压病人的焦虑、抑郁状态,降低血压水平,真正体现出“心身同治”的原则,保障了患者的康复质量。%Objective To explore the effect of cognitive intervention on psychosomatic rehabilita-tion of the elderly patient with high blood pressure.Methods One hundred and twelve cases of elderly patients with high blood pressure treated in our hospital were divided into treatment group and control group(56 for each group).The patients in two groups were performed with regular high blood pressure medication,and the patients in treatment group were also received cognitive intervention.Results SAS and SDS score of treatment group after intervention were significantly lower than that of control group and before intervention,with statistically significant difference (P < 0.05 );blood pressure level of treatment group after intervention was significantly lower than that of control group and before intervention,with statistically significant difference(P <0.05).Conclusion Using cognitive intervention can significantly improve anxiety,depression of elderly patients with high blood pressure and lower the blood pressure level,which truly embod-ies the principle of psychosomatic treatment to ensure the quality of patient’s recovery.

  9. Specific components of face perception in the human fusiform gyrus studied by tomographic estimates of magnetoencephalographic signals: a tool for the evaluation of non-verbal communication in psychosomatic paradigms

    Directory of Open Access Journals (Sweden)

    Ioannides Andreas A

    2007-12-01

    Full Text Available Abstract Aims The aim of this study was to determine the specific spatiotemporal activation patterns of face perception in the fusiform gyrus (FG. The FG is a key area in the specialized brain system that makes possible the recognition of face with ease and speed in our daily life. Characterization of FG response provides a quantitative method for evaluating the fundamental functions that contribute to non-verbal communication in various psychosomatic paradigms. Methods The MEG signal was recorded during passive visual stimulus presentation with three stimulus types – Faces, Hands and Shoes. The stimuli were presented separately to the central and peripheral visual fields. We performed statistical parametric mapping (SPM analysis of tomographic estimates of activity to compare activity between a pre- and post-stimulus period in the same object (baseline test, and activity between objects (active test. The time course of regional activation curves was analyzed for each stimulus condition. Results The SPM baseline test revealed a response to each stimulus type, which was very compact at the initial segment of main MFG170. For hands and shoes the area of significant change remains compact. For faces the area expanded widely within a few milliseconds and its boundaries engulfed the other object areas. The active test demonstrated that activity for faces was significantly larger than the activity for hands. The same face specific compact area as in the baseline test was identified, and then again expanded widely. For each stimulus type and presentation in each one of the visual fields locations, the analysis of the time course of FG activity identified three components in the FG: MFG100, MFG170, and MFG200 – all showed preference for faces. Conclusion Early compact face-specific activity in the FG expands widely along the occipito-ventral brain within a few milliseconds. The significant difference between faces and the other object stimuli in MFG

  10. Pedagogical Implications of Partnerships Between Psychiatry and Obstetrics-Gynecology in Caring for Patients with Major Mental Disorders.

    Science.gov (United States)

    Coverdale, John; Roberts, Laura Weiss; Balon, Richard; Beresin, Eugene V

    2015-08-01

    Because there are no formal reviews, the authors set out to identify and describe programs that serve female patients with major mental disorders by integrating mental health care with services in obstetrics and gynecology and to describe the pedagogical implications of those programs. The authors searched PubMed for all articles describing a program in which psychiatry was formally integrated with obstetric or gynecological services, other than standard consultation-liaison programs, in the care of patients with major mental disorders. The search terms used included interdisciplinary, interprofessional, integrated, collaborative care, psychiatry, and obstetrics-gynecology or psychosomatic obstetrics-gynecology. The authors found six distinct integrated programs. These included family planning clinics that were integrated into inpatient psychiatry services; inpatient and outpatient psychiatry services for pregnant mentally ill women in close collaboration with obstetric services; a day hospital for pregnant women with psychiatric disorders in an obstetric setting; an interdisciplinary training site providing care for predominantly depressed, low-income, and minority women; a primary care HIV service for women integrated with departments of obstetrics-gynecology and psychiatry; and an obstetrics-gynecology clinic-based collaborative depression care intervention for socially disadvantaged women. Residents' involvement was described in four of the programs. These innovative and integrated programs potentially enhance the care of vulnerable and culturally diverse women with major mental disorders. The authors discuss how these programs may contribute to the education of residents in psychiatry and obstetrics-gynecology.

  11. Familial Factors Associated with the Use of Multiple Child-Care Arrangements

    Science.gov (United States)

    Morrissey, Taryn W.

    2008-01-01

    This study examined the use of multiple, concurrent, nonparental child-care arrangements among children under 5 with employed mothers in the NICHD Study of Early Child Care and Youth Development (N= 759). Older children, those primarily cared for in informal child care, those living in cohabitating or single-parent households, and those whose…

  12. Models of care and delivery

    DEFF Research Database (Denmark)

    Lundgren, Jens

    2014-01-01

    Marked regional differences in HIV-related clinical outcomes exist across Europe. Models of outpatient HIV care, including HIV testing, linkage and retention for positive persons, also differ across the continent, including examples of sub-optimal care. Even in settings with reasonably good...... outcomes, existing models are scrutinized for simplification and/or reduced cost. Outpatient HIV care models across Europe may be centralized to specialized clinics only, primarily handled by general practitioners (GP), or a mixture of the two, depending on the setting. Key factors explaining...... this diversity include differences in health policy, health insurance structures, case load and the prevalence of HIV-related morbidity. In clinical stable populations, the current trend is to gradually extend intervals between HIV-specific visits in a shared care model with GPs. A similar shared-model approach...

  13. Relaxation - Induced by Vibroacoustic Stimulation via a Body Monochord and via Relaxation Music - Is Associated with a Decrease in Tonic Electrodermal Activity and an Increase of the Salivary Cortisol Level in Patients with Psychosomatic Disorders.

    Science.gov (United States)

    Sandler, Hubertus; Fendel, Uta; Buße, Petra; Rose, Matthias; Bösel, Rainer; Klapp, Burghard F

    2017-01-01

    Vibroacoustic stimulation by a Body Monochord can induce relaxation states of various emotional valence. The skin conductance level (SCL) of the tonic electrodermal activity is an indicator of sympathetic arousal of the autonomic nervous system and thus an indicator of the relaxation response. Salivary cortisol is considered to be a stress indicator of the HPA-axis. The effects of the treatment with a Body Monochord and listening to relaxation music (randomized chronological presentation) on SCL and salivary cortisol in relation to the emotional valence of the experience were examined in patients with psychosomatic disorders (N = 42). Salivary cortisol samples were collected immediately before and after the expositions. Subjective experience was measured via self-rating scales. Overall, both the exposure to the Body Monochord as well as the exposure to the relaxation music induced an improvement of patients' mood and caused a highly significant reduction of SCL. A more emotionally positive experience of relaxation correlated with a slightly stronger reduction of the SCL. Both treatment conditions caused a slight increase in salivary cortisol, which was significant after exposure to the first treatment. The increase of salivary cortisol during a relaxation state is contrary to previous findings. It is possible that the relaxation state was experienced as an emotional challenge, due to inner images and uncommon sensations that might have occurred.

  14. Relaxation – Induced by Vibroacoustic Stimulation via a Body Monochord and via Relaxation Music – Is Associated with a Decrease in Tonic Electrodermal Activity and an Increase of the Salivary Cortisol Level in Patients with Psychosomatic Disorders

    Science.gov (United States)

    Sandler, Hubertus; Fendel, Uta; Buße, Petra; Rose, Matthias; Bösel, Rainer; Klapp, Burghard F.

    2017-01-01

    Vibroacoustic stimulation by a Body Monochord can induce relaxation states of various emotional valence. The skin conductance level (SCL) of the tonic electrodermal activity is an indicator of sympathetic arousal of the autonomic nervous system and thus an indicator of the relaxation response. Salivary cortisol is considered to be a stress indicator of the HPA-axis. The effects of the treatment with a Body Monochord and listening to relaxation music (randomized chronological presentation) on SCL and salivary cortisol in relation to the emotional valence of the experience were examined in patients with psychosomatic disorders (N = 42). Salivary cortisol samples were collected immediately before and after the expositions. Subjective experience was measured via self-rating scales. Overall, both the exposure to the Body Monochord as well as the exposure to the relaxation music induced an improvement of patients’ mood and caused a highly significant reduction of SCL. A more emotionally positive experience of relaxation correlated with a slightly stronger reduction of the SCL. Both treatment conditions caused a slight increase in salivary cortisol, which was significant after exposure to the first treatment. The increase of salivary cortisol during a relaxation state is contrary to previous findings. It is possible that the relaxation state was experienced as an emotional challenge, due to inner images and uncommon sensations that might have occurred. PMID:28114399

  15. Positive Emotional Experience: Induced by Vibroacoustic Stimulation Using a Body Monochord in Patients with Psychosomatic Disorders: Is Associated with an Increase in EEG-Theta and a Decrease in EEG-Alpha Power.

    Science.gov (United States)

    Sandler, H; Tamm, S; Fendel, U; Rose, M; Klapp, B F; Bösel, R

    2016-07-01

    Relaxation and meditation techniques are generally characterized by focusing attention, which is associated with an increase of frontal EEG Theta. Some studies on music perception suggest an activation of Frontal Midline Theta during emotionally positive attribution, others display a lateralization of electrocortical processes in the attribution of music induced emotion of different valence. The present study examined the effects of vibroacoustic stimulation using a Body Monochord and the conventional relaxation music from an audio CD on the spontaneous EEG of patients suffering from psychosomatic disorders (N = 60). Each treatment took about 20 min and was presented to the patients in random order. Subjective experience was recorded via self-rating scale. EEG power spectra of the Theta, Alpha-1 and Alpha-2 bands were analysed and compard between the two treatment conditions. There was no lateralization of electrocortical activity in terms of the emotional experience of the musical pieces. A reduction in Alpha-2 power occurred during both treatments. An emotionally positive attribution of the experience of the vibroacoustically induced relaxation state is characterized by a more pronounced release of control. In the context of focused attention this is interpreted as flow experience. The spontaneous EEG showed an increase in Theta power, particularly in the frontal medial and central medial area, and a greater reduction in Alpha-2 power. The intensity of positive emotional feelings during the CD music showed no significant effect on the increase in Theta power.

  16. 心身并治变应性鼻炎_哮喘综合征临床研究%Clinical Research on Psychosomatic Treatment of Combined Allergic Rhinitis and Asthma Syndrome

    Institute of Scientific and Technical Information of China (English)

    席斌; 席冬青; 蒋西玲; 程延安

    2015-01-01

    Objective:To observe the clinical curative effect of psychosomatic treatment of combined allergic rhinitis and asthma syn_drome( CARAS ). Methods:Patients were selected through the Hamilton anxiety scale( HAMA ) and Hamilton depression scale ( HAMD),a total of 62 cases. They were randomly divided into the study group and the control group. The control group was given by o_ral Chinese medicine decoction,and budesonide aerosol nasal spray,and the study group was given psychological treatment on the basis of control group. 4 weeks as a course of treatment. Asthma control test( ACT)score,rhinitis symptoms score,HAMA score and HAMD score of the two groups before and after treatment were compared. Results:After treatment,ACT score,rhinitis symptoms score,HAMA score,HAMD score of the two groups were improved(P0. 05),the other three showed difference (P0.05),其他三项均有显著差异( P<0.05)。结论:心身并治CARAS临床疗效显著。

  17. 正念疗法在癌症患者身心症状护理中的应用进展%Application progress of mindfulness therapy in psychosomatic symptoms nursing of cancer patients

    Institute of Scientific and Technical Information of China (English)

    周少光

    2016-01-01

    Objective From diagnosis to treatment, cancer patients usually suffered from a series of somatic symptoms( pain, fatigue) and psychologicalsymptoms( depression, anxiety). This article summarized the meaning of mindfulness therapy, the application and effect of mindfulness therapy in psychosomatic symptoms nursing of cancer patients;pointed out the existing problems, and put forward the corresponding suggestions, in order to further popularize the application of mindfulness therapy in clinical nursing of cancer patients.%癌症患者从诊断到治疗会遭遇一系列躯体症状(疼痛、疲乏等)以及心理症状(焦虑、抑郁等)。本文概述了近几年正念疗法的内涵、正念疗法在癌症患者身心症状护理中的应用进展,指出当前研究中存在的问题和面临的挑战,并提出相应建议。

  18. Virtual care

    DEFF Research Database (Denmark)

    Kamp, Annette; Aaløkke Ballegaard, Stinne

    point out how issues of trust and surveillance, which are always negotiated in care relations, are in fact accentuated in this kind of virtual care work. Moreover, we stress that the contemporary institutional context, organization and time schedules have a vast impact on the practices developed....... of retrenchment, promising better quality, empowerment of citizens and work that is smarter and more qualified. Through ethnographic field studies we study the introduction of virtual home care in Danish elderly care, focusing on the implications for relational work and care relations. Virtual home care entails...... the performance of specific home care services by means of video conversations rather than physical visits in the citizens’ homes. As scholars within the STS tradition maintain, technologies do not simply replace a human function; they rather transform care work, redistributing tasks between citizens, technology...

  19. Pin care

    Science.gov (United States)

    ... gov/pubmed/24302374 . Nagy K. Discharge instructions for wound cares. The American Association of the Surgery of Trauma. www.aast.org/discharge-instructions-for-wound-cares . Accessed May 13, 2016.

  20. Spiritual care perspectives of Danish Registered Nurses

    DEFF Research Database (Denmark)

    Christensen, Kirsten Haugaard; Turner, de Sales

    2008-01-01

    respects patients’ values, religion, customs, and spiritual beliefs. Literature however revealed that the phenomenon of spiritual care is complex and variously interpreted, and that there seems to be a lack of conceptual clarity regarding what constitutes spiritual care. A phenomenological and hermeneutic......Spiritual care perspectives of Danish Nurses The purpose of this study was to explore how Danish registered nurses understand the phenomenon of spiritual care and how their understanding impacts on their interventions with their patients. Nurses are responsible for the provision of care which...... would engage in provision of spiritual care. The participants acknowledged that their understanding of spirituality influenced their provision of spiritual care, which was recognized as a challenge requiring the nurse’s initiative and courage. Spirituality was primarily understood as a patient’s private...

  1. Comparing Care

    NARCIS (Netherlands)

    Evert Pommer; Isolde Woittiez; John Stevens

    2007-01-01

    Home care is one of the most important means of compensating for disabilities and ensuring continuity in people's daily functioning. Home care services in the Netherlands have recently been transferred from a national social security provision for long-term care to a local social service. In most ot

  2. Preconception Care and Prenatal Care

    Science.gov (United States)

    ... at risk for complications? How does stress affect pregnancy? NICHD Research Information Clinical Trials Resources and Publications Preconception Care and Prenatal Care: Condition Information Skip sharing on social media links Share this: Page Content What is preconception ...

  3. Who Cares for Care Leavers?

    Science.gov (United States)

    Askew, Julie; Rodgers, Paul; West, Andrew

    2016-01-01

    This chapter describes a programme of learning and development at the University of Sheffield, United Kingdom, to support looked-after children and care leavers (youth previously provided care outside or beyond family) throughout the student lifecycle. In this context, looked-after children are those cared for by a town/city authority where…

  4. Advance care directives

    Science.gov (United States)

    ... advance directive; Do-not-resuscitate - advance directive; Durable power of attorney - advance care directive; POA - advance care directive; Health care agent - advance care directive; Health care proxy - ...

  5. Radical Resection of a Primarily Unresectable Pancreatic Cancer After Neoadjuvant Chemotherapy Using Gemcitabine, TS-1, and Nafamostat Mesilate; Report of a Case

    Science.gov (United States)

    Fujiwara, Yuki; Shiba, Hiroaki; Uwagawa, Tadashi; Futagawa, Yasuro; Misawa, Takeyuki; Yanaga, Katsuhiko

    2015-01-01

    A 58-year-old male visited his primary physician for epigastric and back pain. Abdominal-enhanced computed tomography (CT) revealed a hypovascular pancreatic tumor measuring 17 × 11 mm in the uncinate process of the pancreas extending into the superior mesenteric plexus for greater than 180°. With a diagnosis of unresectable pancreatic cancer, the patient received gemcitabine and TS-1 with arterial infusion of nafamostat mesilate. After 3 courses of chemotherapy, enhanced CT revealed a decrease in size of the pancreatic tumor with no lymph node and distant metastasis and improved invasion of the superior mesenteric plexus down to 120°. The patient underwent R0 pancreaticoduodenectomy. The patient made a satisfactory recovery without complications and was discharged on postoperative day 10. We herein report the first curative resected case of a primarily unresectable pancreatic cancer after neoadjuvant chemotherapy using gemcitabine, TS-1, and nafamostat mesilate. PMID:25692432

  6. Community perceptions of safety in relation to perceived youth violence-delinquency in a primarily native Hawaiian and Asian American community in Hawai'i.

    Science.gov (United States)

    Hishinuma, Earl S; Chang, Janice Y; Soli, Faapisa M

    2012-02-01

    Perception of safety is an important component to the well-being of community members in their own neighborhood. The present study was the first of its kind to model community perception of safety utilizing a primarily Native Hawaiian and Asian American community sample (N = 101) and with perceived youth violence and delinquency as prominent potential influences. The study found that the majority of participants felt that several types of youth violence and delinquency were problems in the community. The overall social-ecological model evidenced a strong fit and indicated that community perception of safety was adversely impacted by perceived youth violence and delinquency and increased through positive relations with neighbors. The implications included the need for a more comprehensive approach to positive youth development and community capacity-building, including incorporation of cultural components, and to determine whether the model is applicable to other minority communities.

  7. Physical Therapy Intervention in the Neonatal Intensive Care Unit

    Science.gov (United States)

    Byrne, Eilish; Garber, June

    2013-01-01

    This article presents the elements of the Intervention section of the Infant Care Path for Physical Therapy in the Neonatal Intensive Care Unit (NICU). The types of physical therapy interventions presented in this path are evidence-based and the suggested timing of these interventions is primarily based on practice knowledge from expert…

  8. User involvement in care work

    DEFF Research Database (Denmark)

    Dybbroe, Betina; Kamp, Annette

    effectiveness and shared responsibility for care pathways. While NPM position users as consumers making their free choice, the user involvement paradigm underlines the users’ active participation in the mastering of their problems and disease. Research is scarce on this theme, and has until now primarily......In recent years user involvement has become a paradigm for transforming the health and social care sector. This development–also labelled empowerment, co-creation, partnership, patient-centeredness - is seen as a means to reform organizations in ways that enhance quality, economic cost...... addressed the way this paradigm affects the users, in specific sectors. However user involvement also affects working life. It may imply change and redistribution of tasks and identities between users and professionals, and may also transform the relations of care. In this paper we explore the possible...

  9. Caring, conversing, and realizing values

    DEFF Research Database (Denmark)

    Hodges, Bert; Steffensen, Sune Vork; Martin, James E.

    2012-01-01

    of this issue, though, is the role of conversations in humans caring for each other and the ecosystems of which they are a part. Emergency medical care, parents and children playing, and students learning a second language, are among the contexts of caring considered. Also considered are ways in which symbol......Language serves many functions for humans, but three of the most important are coordination, learning, and friendship. All of those functions were well served by the conversations from which this special issue emerged, a conference, ‘‘Grounding language in perception and (inter) action’’, held...... at Gordon College in June 2009. The conference brought together researchers primarily from three research traditions, dynamical systems theory, distributed language, and ecological psychology, and each of these perspectives is reviewed and illustrated in this special issue. The particular focus...

  10. Survey on psychosomatic symptoms and analysis of relevant factors among nursing students from a vocational college%高职护理学生心理健康现状调查及影响因素分析

    Institute of Scientific and Technical Information of China (English)

    连燕舒; 汪平

    2011-01-01

    目的 了解高职护理学生心理健康状况及其影响因素,为高职院校开展学生心理干预工作提供科学依据.方法 采用整群抽样的方法对1 087名高职护理学生进行症状自评量表(symptom checklist 90,SCL-90)和自编问卷调查.结果 高职护理学生各因子得分与全国常模的差异均有统计学意义,躯体化、强迫、精神病性因子得分低于江苏省大学生常模,而恐怖因子得分高于江苏省大学生常模.五年制高职护理学生的躯体化、敌对、妄想因子得分高于三年制护理高职生,差异有统计学意义.调查共发现高职护理学生任一因子得分≥3分的心理异常者111人,检出率为10.21%.多因素非条件Logistic回归分析显示,心理异常与年级和专业满意度有关.结论 在高职院校学生管理中应加强心理健康教育,尤其是针对专业课程较重的二年级学生和专业思想不稳定的学生进行重点教育.%Objective To analyze the psychosomatic symptoms and related factors in nursing students from a voca-tional college. Methods Cluster random sampling method was taken in selecting 1 087 nursing students, they were asked to compelete Symptom Checklist 90 (SCL-90) and related factors survey. Results The SCL-90 factor scores of nursing students were significantly higher than Chinese norms (P<0.05). Their scores of sompulsive, hostility, delusion were significantly higher than Jiangsu norm. Their phobic anxiety was lower than Jiangsu norm, three factor scores of five-year students were significantly higher than three-year students (P<0. 05). The detection rate of positive factor in SCL-90 was 10.21 %. Logistic regression analysis showed that psychosomatic of nursing students was influenced by grade and ma-jor satisfaction. Conclusions The vocational college should implement mental health education of nursing students and the targeted preventive interventions should be taken based on the influencing factors.

  11. Investigation and analysis on unmarried adolescents' psychosomatic symptoms among 263 cases of artificial abortion%未婚人工流产女青年263例心理健康状况调查

    Institute of Scientific and Technical Information of China (English)

    宫雯

    2012-01-01

    Objective To investigate the psychosomatic symptoms of 263 unmarried adolescents cases of artificial abortion. Methods Anonymously issued mental symptom checklist 90 (SCL-90) and self-compiled abortion issues related questionnaires survey. The data were analyzed. Results (1) In addition to the coercion and paranoid, the SCL-90 factor scores were higher in 263 cases of research group than that of normal model on average; the difference showed statistical significance between two groups ( P < 0. 05 ) . The somatization, interpersonal relationship, depression, anxiety, fear and hostility and psychotic scores were higher than those of control group, the difference showed statistical significance (P < 0. 05). (2) Abortion-related questionnaire results showed that 76% of unmarried young women can discover the pregnancy but do not understand the hazards of artificial abortion, 23% of young women lack the necessary contraception and reproductive health knowledge. In 263 cases, 20 percent of young unmarried women underwent artificial abortion for two or more times. Artificial abortion has negative impacts on youth unmarried women' psychosomatic symptoms such as self-blame, fear and anxiety. Conclusion Unmarried pregnancy female' s sexual health and safety knowledge level needs to be improved. Actively carry out reproductive health counseling, implement feasible contraceptive measures is the key to reduce adolescent abortion rates and ensure physical and mental health.%目的 探讨未婚人工流产女青年心理健康状况.方法 以匿名方式发放精神症状自评量表(SCL-90)及自编的流产相关问题问卷调查并分析资料.结果 (1)研究组263例的SCL-90各因子除强迫和偏执以外,其余分值均高于全国常模.两者比较,差异有统计学意义(P<0.05);研究组的躯体化、人际关系、抑郁、焦虑、恐惧和敌对性、精神病性分值高于对照组有统计学意义(P<0.05).(2)流产相关问卷结果显示,76%的未

  12. Relationship between psychosocial factors and psychosomatic symptoms of sterilized women%心理应激有关因素与女性绝育术后心身症状的相关性

    Institute of Scientific and Technical Information of China (English)

    童蓉; 姜乾金; 沈颖婕

    2001-01-01

    目的探索心理应激有关因素与绝育后妇女心身症状的相关性。方法以绝育后妇女120例为对象,测定其心身症状以及认知评价、应对方式、社会支持和个性特征等心理应激有关因素以及一般项目,在SPSS软件包支持下作统计分析。结果单因素相关分析显示,心身症状与以下个体心理素质因素有关,包括术前有较多的对后遗症和劳动力影响方面的担心、主观社会支持较低、个性中的情绪不稳定性较高和内向、平时易体验到较多的对生活事件的消极情绪和易采用消极的应对方式等;多元逐步回归分析显示不稳定个性特性、不良的认知体验因素和宗教信仰与心身症状有最主要的关系。结论绝育术后神经症样症状的发生,很可能与个人平时对待各种生活事件的不良的认知、情绪、应对和个性等内部心理特征以及与一定经济文化条件有关。%Objective To study the relationship between the stress-related psychosocial factors and the psychosomatic symptoms of sterilized women. Methods 120 sterilized women were assessed with Symptom Check List 90(SCL-90),Social Supports Questionnaire(SSQ),Eysenck Personality Questionnaire(EPQ),Psychosocial Stress Scale for Group(PSSG)and a self-developed preoperative cognition scale.Data were analysed with SPSS. Results There was a significant correlation between scores of psychosomatic symptoms and stress-related psychosocial factors such as EPQ-N,subjective social support(SSS),negative emotion(NE),positive emotion(PE),negative coping style(NC) and some negative characteristics of pre-operative cognition.Multiple stepwise regression analysis showed that EPQ-N,PE and religion belief were in the equation. Conclusion The results indicated that neurotic syndrome of sterilized women may be mediated or influenced by negative characteristics of cognition,emotion,coping style and personality.

  13. 受欺负初中学生身心健康状况及相关因素分析%Psychosomatic status and related factors of bullied students in junior high schools

    Institute of Scientific and Technical Information of China (English)

    史高岩; 刘金同; 张燕; 张冬冬; 王旸; 李仁军

    2011-01-01

    Objective To explore the psychosomatic status and related factors of bullied students in two junior high schools in Shandong, and to provide reference for the effective measurements. Methods A total of 830 students were assessed with Bully/victim Questionnaire, Self-Rating Anxiety Scale( SAS) , Self-Rating Depression Scale( SDS) , Pittsburgh Sleep Quality Index( PSQI) and Eysenck Personality Questionnaire( EPQ).Results The reporting rate of victim was 17.95% and the rate of boys was significant higher than that of girls. Victims reported more symptoms of anxiety, depression and sleep disorder in comparison with those not involved in bullied behaviors( P <0.05 ). Multiple stepwise regression analysis showed that E and N factors of EPQ, the severity of being bullied related to SAS, and bullied by the relationship, the severity of being bullied related to SDS, and N factor of EPQ and the severity of being bullied related to PSQI. Conclusion The victims have severe anxiety, depression and sleep disorder. Bullied behavior has severe effects on the psychosomatic status of bullied junior high school students.%目的 探讨校园欺负对初中生身心健康的影响及相关影响因素,为制定积极有效的干预措施提供参考.方法 整群抽取山东省2所初中学生830名,采用欺负筛查问卷、焦虑自评量表、抑郁自评量表、匹斯仲堡睡眠质量指数量表和艾森克个性问卷进行问卷调查.结果 初中生受欺负的检出率为17.95%,男生高于女牛.受欺负初中生焦虑、抑郁和睡眠质量得分及检出率均高于一般学生(P值均<0.05).进入受欺负初中生焦虑回归方程的主要有受欺负程度、个性外倾和神经质,进入抑郁回归方程的主要有受欺负程度、受关系欺负,进入睡眠质量回归方程的主要有神经质和受欺负程度.结论 受欺负初中生具有明显的焦虑、抑郁情绪及睡眠障碍.受欺负程度对受欺负初中生的焦虑、抑郁、睡眠均有显著影响.

  14. 认知行为疗法在癌症病人身心症状护理中的应用进展%Progress on application of cognitive behavior therapy in psychosomatic symptoms care of cancer patients

    Institute of Scientific and Technical Information of China (English)

    高健慧; 商丽艳; 徐燕

    2015-01-01

    It summarized the application and effect of domestic and foreign cognitive behavior therapy in com-mon somatic symptoms (pain,fatigue,nausea and vomiting)and psychological symptoms (anxiety,depression) of cancer patients.It pointed out the existing problems and faced challenges in current researches and put for-ward the corresponding suggestions,in order to further popularize the application of cognitive behavior therapy in clinical cancer patients.%概述国内外认知行为疗法在癌症病人常见躯体症状(疼痛、疲乏、恶心呕吐等)以及心理症状(焦虑、抑郁)中的应用情况、效果,指出当前研究中存在的问题和面临的挑战,并提出相应建议,以推广认知行为疗法在临床癌症病人中的应用。

  15. Comparison of long-term care in an acute care institution and in a long-term care institution.

    Science.gov (United States)

    Friedman, R; Kalant, N

    1998-11-03

    Acute care hospitals in Quebec are required to reserve 10% of their beds for patients receiving long-term care while awaiting transfer to a long-term care facility. It is widely believed that this is inefficient because it is more costly to provide long-term care in an acute care hospital than in one dedicated to long-term care. The purpose of this study was to compare the quality and cost of long-term care in an acute care hospital and in a long-term care facility. A concurrent cross-sectional study was conducted of 101 patients at the acute care hospital and 102 patients at the long-term care hospital. The 2 groups were closely matched in terms of age, sex, nursing care requirements and major diagnoses. Several indicators were used to assess the quality of care: the number of medical specialist consultations, drugs, biochemical tests and radiographic examinations; the number of adverse events (reportable incidents, nosocomial infections and pressure ulcers); and anthropometric and biochemical indicators of nutritional status. Costs were determined for nursing personnel, drugs and biochemical tests. A longitudinal study was conducted of 45 patients who had been receiving long-term care at the acute care hospital for at least 5 months and were then transferred to the long-term care facility where they remained for at least 6 months. For each patient, the number of adverse events, the number of medical specialist consultations and the changes in activities of daily living status were assessed at the 2 institutions. In the concurrent study, no differences in the number of adverse events were observed; however, patients at the acute care hospital received more drugs (5.9 v. 4.7 for each patient, p cost per patient-year was $7580 higher at the acute care hospital, attributable to the higher cost of drugs ($42), the greater use of laboratory tests ($189) and, primarily, the higher cost of nursing ($7349). For patients requiring 3.00 nursing hours/day, the acute care

  16. On the Urgency to Change the Disease Diagnose and Treatment Model and Management Model in General Hospitals-Base on the Psychosomatic Disease and Medicine Pattern%综合医院的疾病诊治和管理模式需转变——基于心身疾病和医学模式的观点

    Institute of Scientific and Technical Information of China (English)

    李方澜; 林红; 龙先东; 黄瑾

    2012-01-01

    The outpatient capacity of psychosomatic disease is approximate to one—third of the total outpatient capacity in general hospitals, and the people with serious disease will have psychological problems in a certain degree. Meanwhile, the modern medicine pattern has obvious trend to change from biological to psychology to social medicine pattern. Above change is telling us that the general hospitals need to change the disease diagnose and treatment model and management model: to apply the psychological knowledge during diagnose and treatment of psychosomatic disease, to strengthen the trainings on medical personnel about the medical psychology and psychiatry, to pay attention to assessment of this field to medical personnel; to set up the Social Work Department and Psychosomatic disease Department. Above measures can improve doctor—patient relationships and make the patient recover better.%心身疾病约占综合医院门诊量三分之一,且患重大疾病的患者大都有一定程度的心理问题;同时现代医学模式向生物—心理—社会医学模式转变的趋势明显.这些变化均要求综合医院改变疾病诊治模式和管理模式:在心身疾病的诊断和治疗中要运用心理方面的知识,要加强医务人员关于医学心理学、精神病学的培训,在其考核中要注重这方面的知识;要成立心身疾病科和社工部等.这些措施可以改善医患关系,让患者更好地恢复健康.

  17. Chlamydia trachomatis recombinant MOMP encapsulated in PLGA nanoparticles triggers primarily T helper 1 cellular and antibody immune responses in mice: a desirable candidate nanovaccine

    Directory of Open Access Journals (Sweden)

    Fairley SJ

    2013-05-01

    Full Text Available Stacie J Fairley, Shree R Singh, Abebayehu N Yilma, Alain B Waffo, Praseetha Subbarayan, Saurabh Dixit, Murtada A Taha, Chino D Cambridge, Vida A Dennis Center for NanoBiotechnology Research, Alabama State University, Montgomery, AL, USA Abstract: We recently demonstrated by in vitro experiments that PLGA (poly D, L-lactide-co-glycolide potentiates T helper 1 (Th1 immune responses induced by a peptide derived from the recombinant major outer membrane protein (rMOMP of Chlamydia trachomatis, and may be a promising vaccine delivery system. Herein we evaluated the immune-potentiating potential of PLGA by encapsulating the full-length rMOMP (PLGA-rMOMP, characterizing it in vitro, and investigating its immunogenicity in vivo. Our hypothesis was that PLGA-rMOMP triggers Th1 immune responses in mice, which are desirable prerequisites for a C. trachomatis candidate nanovaccine. Physical-structural characterizations of PLGA-rMOMP revealed its size (approximately 272 nm, zeta potential (−14.30 mV, apparent spherical smooth morphology, and continuous slow release pattern. PLGA potentiated the ability of encapsulated rMOMP to trigger production of cytokines and chemokines by mouse J774 macrophages. Flow cytometric analyses revealed that spleen cells from BALB/c mice immunized with PLGA-rMOMP had elevated numbers of CD4+ and CD8+ T cell subsets, and secreted more rMOMP-specific interferon-gamma (Th1 and interleukin (IL-12p40 (Th1/Th17 than IL-4 and IL-10 (Th2 cytokines. PLGA-rMOMP-immunized mice produced higher serum immunoglobulin (IgG and IgG2a (Th1 than IgG1 (Th2 rMOMP-specific antibodies. Notably, sera from PLGA-rMOMP-immunized mice had a 64-fold higher Th1 than Th2 antibody titer, whereas mice immunized with rMOMP in Freund's adjuvant had only a four-fold higher Th1 than Th2 antibody titer, suggesting primarily induction of a Th1 antibody response in PLGA-rMOMP-immunized mice. Our data underscore PLGA as an effective delivery system for a C

  18. Caring for Participation in STS

    DEFF Research Database (Denmark)

    Nielsen, Karen Dam

    2015-01-01

    In this short report from the EASST Conference 2014, I sketch a handful of presentations that engaged with ‘participation’. Two tracks, in particular, offered interesting analyses and conceptual experiments. The first track contained primarily empirically driven studies of ‘technologies of partic......In this short report from the EASST Conference 2014, I sketch a handful of presentations that engaged with ‘participation’. Two tracks, in particular, offered interesting analyses and conceptual experiments. The first track contained primarily empirically driven studies of ‘technologies...... of participation’ in (health) care and provided illustrations of the conceptual ambiguities and empirical implications that continue to make participation a problematic, yet highly relevant and intriguing STS-topic. The second track featured presentations that more explicitly contributed new analytical tools...

  19. Understanding the Goals of Everyday Instrumental Actions Is Primarily Linked to Object, Not Motor-Kinematic, Information: Evidence from fMRI

    Science.gov (United States)

    Nicholson, Toby; Roser, Matt; Bach, Patric

    2017-01-01

    Prior research conceptualised action understanding primarily as a kinematic matching of observed actions to own motor representations but has ignored the role of object information. The current study utilized fMRI to identify (a) regions uniquely involved in encoding the goal of others’ actions, and (b) to test whether these goal understanding processes draw more strongly on regions involved in encoding object semantics or movement kinematics. Participants watched sequences of instrumental actions while attending to either the actions’ goal (goal task), the movements performed (movement task) or the objects used (object task). The results confirmed, first, a unique role of the inferior frontal gyrus, middle temporal gyrus and medial frontal gyrus in action goal understanding. Second, they show for the first time that activation in the goal task overlaps directly with object- but not movement-related activation. Moreover, subsequent parametric analyses revealed that movement-related regions become activated only when goals are unclear, or observers have little action experience. In contrast to motor theories of action understanding, these data suggest that objects—rather than movement kinematics—carry the key information about others’ actions. Kinematic information is additionally recruited when goals are ambiguous or unfamiliar. PMID:28081175

  20. Hereditary papillary renal cell carcinoma primarily diagnosed in a cervical lymph node: a case report of a 30-year-old woman with multiple metastases

    Directory of Open Access Journals (Sweden)

    Behnes Carl Ludwig

    2013-01-01

    Full Text Available Abstract Background Papillary renal cell carcinoma is a rare cancer. Some cases can be attributed to individuals with hereditary renal cell carcinomas usually consisting of the clear cell subtype. In addition, two syndromes with hereditary papillary renal cell carcinoma have been described. One is the hereditary leiomyomatosis and renal cell carcinoma, which is characterized by cutaneous and uterine leiomyomas and renal cell carcinoma mostly consisting of the papillary renal cell carcinoma type II with a worse prognosis. Case presentation We describe a case of a 30-year-old woman with hereditary leiomyomatosis and renal cell carcinoma syndrome with extensively metastasized papillary renal cell carcinoma, primarily diagnosed in a cervical lymph node lacking leiomyomas at any site. Conclusion Papillary renal cell carcinoma in young patients should be further investigated for a hereditary variant like the hereditary leiomyomatosis and renal cell carcinoma even if leiomyomas could not be detected. A detailed histological examination and search for mutations is essential for the survival of patients and relatives.

  1. Neuroserpin, a brain-associated inhibitor of tissue plasminogen activator is localized primarily in neurons. Implications for the regulation of motor learning and neuronal survival.

    Science.gov (United States)

    Hastings, G A; Coleman, T A; Haudenschild, C C; Stefansson, S; Smith, E P; Barthlow, R; Cherry, S; Sandkvist, M; Lawrence, D A

    1997-12-26

    A cDNA clone for the serine proteinase inhibitor (serpin), neuroserpin, was isolated from a human whole brain cDNA library, and recombinant protein was expressed in insect cells. The purified protein is an efficient inhibitor of tissue type plasminogen activator (tPA), having an apparent second-order rate constant of 6. 2 x 10(5) M-1 s-1 for the two-chain form. However, unlike other known plasminogen activator inhibitors, neuroserpin is a more effective inactivator of tPA than of urokinase-type plasminogen activator. Neuroserpin also effectively inhibited trypsin and nerve growth factor-gamma but reacted only slowly with plasmin and thrombin. Northern blot analysis showed a 1.8 kilobase messenger RNA expressed predominantly in adult human brain and spinal cord, and immunohistochemical studies of normal mouse tissue detected strong staining primarily in neuronal cells with occasionally positive microglial cells. Staining was most prominent in the ependymal cells of the choroid plexus, Purkinje cells of the cerebellum, select neurons of the hypothalamus and hippocampus, and in the myelinated axons of the commissura. Expression of tPA within these regions is reported to be high and has previously been correlated with both motor learning and neuronal survival. Taken together, these data suggest that neuroserpin is likely to be a critical regulator of tPA activity in the central nervous system, and as such may play an important role in neuronal plasticity and/or maintenance.

  2. Is Walking Capacity in Subjects with Multiple Sclerosis Primarily Related to Muscle Oxidative Capacity or Maximal Muscle Strength? A Pilot Study

    Directory of Open Access Journals (Sweden)

    Dominique Hansen

    2014-01-01

    Full Text Available Background and Purpose. Walking capacity is reduced in subjects with multiple sclerosis (MS. To develop effective exercise interventions to enhance walking capacity, it is important to determine the impact of factors, modifiable by exercise intervention (maximal muscle strength versus muscle oxidative capacity, on walking capacity. The purpose of this pilot study is to discriminate between the impact of maximal muscle strength versus muscle oxidative capacity on walking capacity in subjects with MS. Methods. From 24 patients with MS, muscle oxidative capacity was determined by calculation of exercise-onset oxygen uptake kinetics (mean response time during submaximal exercise bouts. Maximal muscle strength (isometric knee extension and flexion peak torque was assessed on dynamometer. All subjects completed a 6-minute walking test. Relationships between walking capacity (as a percentage of normal value and muscle strength (of knee flexors and extensors versus muscle oxidative capacity were assessed in multivariate regression analyses. Results. The expanded disability status score (EDSS showed a significant univariate correlation (r=-0.70, P<0.004 with walking capacity. In multivariate regression analyses, EDSS and mean response time, but not muscle strength, were independently related to walking capacity (P<0.05. Conclusions. Walking distance is, next to disability level and not taking neurologic symptoms/deficits into account, primarily related to muscle oxidative capacity in subjects with MS. Additional study is needed to further examine/verify these findings.

  3. Bacterial diversity shift determined by different diets in the gut of the spotted wing fly Drosophila suzukii is primarily reflected on acetic acid bacteria

    KAUST Repository

    Vacchini, Violetta

    2016-11-25

    The pivotal role of diet in shaping gut microbiota has been evaluated in different animal models, including insects. Drosophila flies harbour an inconstant microbiota among which acetic acid bacteria (AAB) are important components. Here, we investigated the bacterial and AAB components of the invasive pest Drosophila suzukii microbiota, by studying the same insect population separately grown on fruit-based or non-fruit artificial diet. AAB were highly prevalent in the gut under both diets (90 and 92% infection rates with fruits and artificial diet, respectively). Fluorescent in situ hybridization and recolonization experiments with green fluorescent protein (Gfp)-labelled strains showed AAB capability to massively colonize insect gut. High-throughput sequencing on 16S rRNA gene indicated that the bacterial microbiota of guts fed with the two diets clustered separately. By excluding AAB-related OTUs from the analysis, insect bacterial communities did not cluster separately according to the diet, suggesting that diet-based diversification of the community is primarily reflected on the AAB component of the community. Diet influenced also AAB alpha-diversity, with separate OTU distributions based on diets. High prevalence, localization and massive recolonization, together with AAB clustering behaviour in relation to diet, suggest an AAB role in the D. suzukii gut response to diet modification. This article is protected by copyright. All rights reserved.

  4. Negative effects on survival and performance of Norway spruce seedlings colonized by dark septate root endophytes are primarily isolate-dependent.

    Science.gov (United States)

    Tellenbach, Christoph; Grünig, Christoph R; Sieber, Thomas N

    2011-09-01

    Root endophytes are common and genetically highly diverse suggesting important ecological roles. Yet, relative to above-ground endophytes, little is known about them. Dark septate endophytic fungi of the Phialocephala fortinii s.l.-Acephala applanata species complex (PAC) are ubiquitous root colonizers of conifers and Ericaceae, but their ecological function is largely unknown. Responses of Norway spruce seedlings of two seed provenances to inoculations with isolates of four PAC species were studied in vitro. In addition, isolates of Phialocephala subalpina from two populations within and one outside the natural range of Norway spruce were also included to study the effect of the geographic origin of P. subalpina on host response. The interaction of PAC with Norway spruce ranged from neutral to highly virulent and was primarily isolate-dependent. Variation in virulence was much higher within than among species, nonetheless only isolates of P. subalpina were highly virulent. Disease caused by P. subalpina genotypes from the native range of Norway spruce was more severe than that induced by genotypes from outside the natural distribution of Norway spruce. Virulence was not correlated with the phylogenetic relatedness of the isolates but was positively correlated with the extent of fungal colonization as measured by quantitative real-time PCR.

  5. Salinity-induced inhibition of growth in the aquatic pteridophyte Azolla microphylla primarily involves inhibition of photosynthetic components and signaling molecules as revealed by proteome analysis.

    Science.gov (United States)

    Thagela, Preeti; Yadav, Ravindra Kumar; Mishra, Vagish; Dahuja, Anil; Ahmad, Altaf; Singh, Pawan Kumar; Tiwari, Budhi Sagar; Abraham, Gerard

    2017-01-01

    Salinity stress causes adverse physiological and biochemical changes in the growth and productivity of a plant. Azolla, a symbiotic pteridophyte and potent candidate for biofertilizer due to its nitrogen fixation ability, shows reduced growth and nitrogen fixation during saline stress. To better understand regulatory components involved in salinity-induced physiological changes, in the present study, Azolla microphylla plants were exposed to NaCl (6.74 and 8.61 ds/m) and growth, photochemical reactions of photosynthesis, ion accumulation, and changes in cellular proteome were studied. Maximum dry weight was accumulated in control and untreated plant while a substantial decrease in dry weight was observed in the plants exposed to salinity. Exposure of the organism to different concentrations of salt in hydroponic conditions resulted in differential level of Na(+) and K(+) ion accumulation. Comparative analysis of salinity-induced proteome changes in A. microphylla revealed 58 salt responsive proteins which were differentially expressed during the salt exposure. Moreover, 42 % spots among differentially expressed proteins were involved in different signaling events. The identified proteins are involved in photosynthesis, energy metabolism, amino acid biosynthesis, protein synthesis, and defense. Downregulation of these key metabolic proteins appears to inhibit the growth of A. microphylla in response to salinity. Altogether, the study revealed that in Azolla, increased salinity primarily affected signaling and photosynthesis that in turn leads to reduced biomass.

  6. Bacterial diversity shift determined by different diets in the gut of the spotted wing fly Drosophila suzukii is primarily reflected on acetic acid bacteria.

    Science.gov (United States)

    Vacchini, Violetta; Gonella, Elena; Crotti, Elena; Prosdocimi, Erica M; Mazzetto, Fabio; Chouaia, Bessem; Callegari, Matteo; Mapelli, Francesca; Mandrioli, Mauro; Alma, Alberto; Daffonchio, Daniele

    2017-04-01

    The pivotal role of diet in shaping gut microbiota has been evaluated in different animal models, including insects. Drosophila flies harbour an inconstant microbiota among which acetic acid bacteria (AAB) are important components. Here, we investigated the bacterial and AAB components of the invasive pest Drosophila suzukii microbiota, by studying the same insect population separately grown on fruit-based or non-fruit artificial diet. AAB were highly prevalent in the gut under both diets (90 and 92% infection rates with fruits and artificial diet respectively). Fluorescent in situ hybridization and recolonization experiments with green fluorescent protein (Gfp)-labelled strains showed AAB capability to massively colonize insect gut. High-throughput sequencing on 16S rRNA gene indicated that the bacterial microbiota of guts fed with the two diets clustered separately. By excluding AAB-related OTUs from the analysis, insect bacterial communities did not cluster separately according to the diet, suggesting that diet-based diversification of the community is primarily reflected on the AAB component of the community. Diet influenced also AAB alpha-diversity, with separate OTU distributions based on diets. High prevalence, localization and massive recolonization, together with AAB clustering behaviour in relation to diet, suggest an AAB role in the D. suzukii gut response to diet modification. © 2016 Society for Applied Microbiology and John Wiley & Sons Ltd.

  7. STO Feeder Cells Are Useful for Propagation of Primarily Cultured Human Deciduous Dental Pulp Cells by Eliminating Contaminating Bacteria and Promoting Cellular Outgrowth.

    Science.gov (United States)

    Murakami, Tomoya; Saitoh, Issei; Inada, Emi; Kurosawa, Mie; Iwase, Yoko; Noguchi, Hirofumi; Terao, Yutaka; Yamasaki, Youichi; Hayasaki, Haruaki; Sato, Masahiro

    2013-12-30

    STO feeder cells, a line established from mouse SIM embryonic fibroblasts, have been frequently used for establishing embryonic stem cells and maintaining them in an undifferentiated state. There are some reports demonstrating that fibroblastic cells have the ability to phagocytose Gram-positive bacterium (e.g., streptococci and staphylococci). In this study, we examined the possibility that STO cells could phagocytose Streptococcus mutans (a bacteria causing tooth decay), which always contaminates cultures of primarily isolated human deciduous dental pulp cells (HDDPCs). Simple cultivation of the primary HDDPCs in the absence of STO cells allowed S. mutans to massively propagate in the medium, thus leading to an opaque medium. In contrast, there was no bacterial contamination in the cultures containing mitomycin C (MMC)-inactivated STO cells. Furthermore, STO cells indicated bacterial phagocytic activity under fluorescent microscopy with the dye pHrodo. Besides removal of contaminating bacteria, STO feeder cells allowed the HDDPCs to spread out. These data suggest that MMC-treated STO cells can be useful for propagation of HDDPCs by eliminating contaminating bacteria and by promoting cellular outgrowth.

  8. Human peripheral blood antibodies with long HCDR3s are established primarily at original recombination using a limited subset of germline genes.

    Directory of Open Access Journals (Sweden)

    Bryan S Briney

    Full Text Available A number of antibodies that efficiently neutralize microbial targets contain long heavy chain complementarity determining region 3 (HCDR3 loops. For HIV, several of the most broad and potently neutralizing antibodies have exceptionally long HCDR3s. Two broad potently neutralizing HIV-specific antibodies, PG9 and PG16, exhibit secondary structure. Two other long HCDR3 antibodies, 2F5 and 4E10, protect against mucosal challenge with SHIV. Induction of such long HCDR3 antibodies may be critical to the design of an effective vaccine strategy for HIV and other pathogens, however it is unclear at present how to induce such antibodies. Here, we present genetic evidence that human peripheral blood antibodies containing long HCDR3s are not primarily generated by insertions introduced during the somatic hypermutation process. Instead, they are typically formed by processes occurring as part of the original recombination event. Thus, the response of B cells encoding antibodies with long HCDR3s results from selection of unusual clones from the naïve repertoire rather than through accumulation of insertions. These antibodies typically use a small subset of D and J gene segments that are particularly suited to encoding long HCDR3s, resulting in the incorporation of highly conserved genetic elements in the majority of antibody sequences encoding long HCDR3s.

  9. Evidence from Maternity Leave Expansions of the Impact of Maternal Care on Early Child Development

    Science.gov (United States)

    Baker, Michael; Milligan, Kevin

    2010-01-01

    We study the impact of maternal care on early child development using an expansion in Canadian maternity leave entitlements. Following the leave expansion, mothers who took leave spent 48-58 percent more time not working in their children's first year of life. This extra maternal care primarily crowded out home-based care by unlicensed…

  10. Measuring unmet needs to assess the quality of home health care.

    NARCIS (Netherlands)

    Veer, A.J.E. de; Bakker, D.H. de

    1994-01-01

    Until now home care research has been primarily focused on functional limitations. The instrument presented in this article also takes into account needs for psychosocial care, extra information, nursing care, and extra arrangements such as adaptations of the house. Elderly people with a chronic dis

  11. Evidence from Maternity Leave Expansions of the Impact of Maternal Care on Early Child Development

    Science.gov (United States)

    Baker, Michael; Milligan, Kevin

    2010-01-01

    We study the impact of maternal care on early child development using an expansion in Canadian maternity leave entitlements. Following the leave expansion, mothers who took leave spent 48-58 percent more time not working in their children's first year of life. This extra maternal care primarily crowded out home-based care by unlicensed…

  12. Cooperating with a palliative home-care team

    DEFF Research Database (Denmark)

    Goldschmidt, Dorthe; Groenvold, Mogens; Johnsen, Anna Thit;

    2005-01-01

    BACKGROUND: Palliative home-care teams often cooperate with general practitioners (GPs) and district nurses. Our aim was to evaluate a palliative home-care team from the viewpoint of GPs and district nurses. METHODS: GPs and district nurses received questionnaires at the start of home-care and one...... by 91 %, mainly due to improvement in symptom management, 'security', and accessibility of specialists in palliative care. After one month, 57% of the participants reported to have learnt aspects of palliative care, primarily symptom control, and 89% of them found cooperation satisfactory....... Dissatisfaction was caused mainly by lack of information from the home-care team to primary-care professionals. CONCLUSION: GPs and district nurses welcomed the palliative home-care team and most experienced benefits to patients. Strengthened communication, initiated by the home-care team would enhance...

  13. Sitagliptin reduces cardiac apoptosis, hypertrophy and fibrosis primarily by insulin-dependent mechanisms in experimental type-II diabetes. Potential roles of GLP-1 isoforms.

    Directory of Open Access Journals (Sweden)

    Belén Picatoste

    Full Text Available BACKGROUND: Myocardial fibrosis is a key process in diabetic cardiomyopathy. However, their underlying mechanisms have not been elucidated, leading to a lack of therapy. The glucagon-like peptide-1 (GLP-1 enhancer, sitagliptin, reduces hyperglycemia but may also trigger direct effects on the heart. METHODS: Goto-Kakizaki (GK rats developed type-II diabetes and received sitagliptin, an anti-hyperglycemic drug (metformin or vehicle (n=10, each. After cardiac structure and function assessment, plasma and left ventricles were isolated for biochemical studies. Cultured cardiomyocytes and fibroblasts were used for in vitro assays. RESULTS: Untreated GK rats exhibited hyperglycemia, hyperlipidemia, plasma GLP-1 decrease, and cardiac cell-death, hypertrophy, fibrosis and prolonged deceleration time. Moreover, cardiac pro-apoptotic/necrotic, hypertrophic and fibrotic factors were up-regulated. Importantly, both sitagliptin and metformin lessened all these parameters. In cultured cardiomyocytes and cardiac fibroblasts, high-concentration of palmitate or glucose induced cell-death, hypertrophy and fibrosis. Interestingly, GLP-1 and its insulinotropic-inactive metabolite, GLP-1(9-36, alleviated these responses. In addition, despite a specific GLP-1 receptor was only detected in cardiomyocytes, GLP-1 isoforms attenuated the pro-fibrotic expression in cardiomyocytes and fibroblasts. In addition, GLP-1 receptor signalling may be linked to PPARδ activation, and metformin may also exhibit anti-apoptotic/necrotic and anti-fibrotic direct effects in cardiac cells. CONCLUSIONS: Sitagliptin, via GLP-1 stabilization, promoted cardioprotection in type-II diabetic hearts primarily by limiting hyperglycemia e hyperlipidemia. However, GLP-1 and GLP-1(9-36 promoted survival and anti-hypertrophic/fibrotic effects on cultured cardiac cells, suggesting cell-autonomous cardioprotective actions.

  14. Maternal Exposure to Valproic Acid Primarily Targets Interneurons Followed by Late Effects on Neurogenesis in the Hippocampal Dentate Gyrus in Rat Offspring.

    Science.gov (United States)

    Watanabe, Yousuke; Murakami, Tomoaki; Kawashima, Masashi; Hasegawa-Baba, Yasuko; Mizukami, Sayaka; Imatanaka, Nobuya; Akahori, Yumi; Yoshida, Toshinori; Shibutani, Makoto

    2017-01-01

    Valproic acid (VPA) is used to establish models of experimental autism. The present study investigated the developmental exposure effect of VPA on postnatal hippocampal neurogenesis in accordance with the exposure scheme of OECD Test Guideline 426 adopted for developmental neurotoxicity. Pregnant rats were administered drinking water containing 0, 667, or 2000 ppm VPA from gestational day 6 until day 21 post-delivery. In the subgranular zone (SGZ) and granule cell layer (GCL) of offspring, the number of granule cell lineage subpopulations remained unchanged upon weaning. However, in the hilus of the dentate gyrus, the number of reelin(+) interneurons decreased at ≥667 ppm, and the number of PVALB(+) or GAD67(+) interneurons decreased at 2000 ppm. Conversely, Reln and Gad1 transcript levels increased at 2000 ppm, but Pvalb and Grin2d decreased, in the dentate gyrus. At the adult stage, PCNA(+) proliferating SGZ cells, NeuN(+) postmitotic SGZ/GCL neurons, and ARC(+) or COX2(+) GCL neurons increased at ≥667 ppm. In the dentate hilus, decreases in GAD67(+) interneuron subpopulations and Grin2d transcript levels sustained at 2000 ppm. These results suggested that VPA primarily targets interneurons by developmental exposure, and this is followed by late effects on granule cell lineages, likely by influencing SGZ cell proliferation and synaptic plasticity. A reduced population of reelin(+) or PVALB(+) interneurons did not affect distribution of granule cell lineage subpopulations upon weaning. The late effect on neurogenesis, which resulted in increased GCL neurons, might be the result of a sustained decrease in GAD67(+) interneurons expressing NR2D encoded by Grin2d.

  15. Quantity of dietary protein intake, but not pattern of intake, affects net protein balance primarily through differences in protein synthesis in older adults.

    Science.gov (United States)

    Kim, Il-Young; Schutzler, Scott; Schrader, Amy; Spencer, Horace; Kortebein, Patrick; Deutz, Nicolaas E P; Wolfe, Robert R; Ferrando, Arny A

    2015-01-01

    To examine whole body protein turnover and muscle protein fractional synthesis rate (MPS) following ingestions of protein in mixed meals at two doses of protein and two intake patterns, 20 healthy older adult subjects (52-75 yr) participated in one of four groups in a randomized clinical trial: a level of protein intake of 0.8 g (1RDA) or 1.5 g·kg(-1)·day(-1) (∼2RDA) with uneven (U: 15/20/65%) or even distribution (E: 33/33/33%) patterns of intake for breakfast, lunch, and dinner over the day (1RDA-U, 1RDA-E, 2RDA-U, or 2RDA-E). Subjects were studied with primed continuous infusions of L-[(2)H5]phenylalanine and L-[(2)H2]tyrosine on day 4 following 3 days of diet habituation. Whole body protein kinetics [protein synthesis (PS), breakdown, and net balance (NB)] were expressed as changes from the fasted to the fed states. Positive NB was achieved at both protein levels, but NB was greater in 2RDA vs. 1RDA (94.8 ± 6.0 vs. 58.9 ± 4.9 g protein/750 min; P = 0.0001), without effects of distribution on NB. The greater NB was due to the higher PS with 2RDA vs. 1RDA (15.4 ± 4.8 vs. -18.0 ± 8.4 g protein/750 min; P = 0.0018). Consistent with PS, MPS was greater with 2RDA vs. 1RDA, regardless of distribution patterns. In conclusion, whole body net protein balance was greater with protein intake above recommended dietary allowance (0.8 g protein·kg(-1)·day(-1)) in the context of mixed meals, without demonstrated effects of protein intake pattern, primarily through higher rates of protein synthesis at whole body and muscle levels.

  16. Perturbation of the natural killer cell compartment during primary human immunodeficiency virus 1 infection primarily involving the CD56bright subset

    Science.gov (United States)

    Mantegani, Paola; Tambussi, Giuseppe; Galli, Laura; Din, Chiara Tassan; Lazzarin, Adriano; Fortis, Claudio

    2010-01-01

    We investigated the distribution of natural killer (NK) cell subsets, their activating and inhibitory receptors, and their cytolytic potential, in primary human immunodeficiency virus (HIV)-infected (PHI) individuals at baseline and during 1 year of follow-up with or without antiretroviral therapy, and compared the results with those obtained in treatment-naïve, chronically HIV-infected (CHI) individuals, and HIV-seronegative (HN) healthy individuals. The proportion of the CD56dim and CD56bright subsets decreased with disease progression, whereas that of the CD56− CD16+ subset increased. In the CD56dim subset, the proportion of cells with natural cytotoxicity receptors (NCRs) decreased with disease progression, and their cytolytic potential was reduced. Conversely, the CD56bright subset was characterized by a high proportion of NCR-positive, killer cell immunoglobulin-like receptor (KIR)-positive NKG2A+ cells in both CHI and PHI individuals, which was associated with an increase in their cytolytic potential. During the 1 year of follow-up, the PHI individuals with high viraemia levels and low CD4+ T-cell counts who received highly active antiretroviral therapy (HAART) had a similar proportion of NK subsets to CHI individuals, while patients with low viraemia levels and high CD4+ T-cell counts who remained untreated had values similar to those of the HN individuals. Our results indicate a marked perturbation of the NK cell compartment during HIV-1 infection that is multifaceted, starts early and is progressive, primarily involves the CD56bright subset, and is partially corrected by effective HAART. PMID:19824914

  17. Class II integrase mutants with changes in putative nuclear localization signals are primarily blocked at a postnuclear entry step of human immunodeficiency virus type 1 replication.

    Science.gov (United States)

    Lu, Richard; Limón, Ana; Devroe, Eric; Silver, Pamela A; Cherepanov, Peter; Engelman, Alan

    2004-12-01

    Integrase has been implicated in human immunodeficiency virus type 1 (HIV-1) nuclear import. Integrase analyses, however, can be complicated by the pleiotropic nature of mutations: whereas class I mutants are integration defective, class II mutants display additional assembly and/or reverse transcription defects. We previously determined that HIV-1(V165A), originally reported as defective for nuclear import, was a class II mutant. Here we analyzed mutants containing changes in other putative nuclear localization signals, including (186)KRK(188)/(211)KELQKQITK(219) and Cys-130. Previous work established HIV-1(K186Q), HIV-1(Q214L/Q216L), and HIV-1(C130G) as replication defective, but phenotypic classification was unclear and nuclear import in nondividing cells was not addressed. Consistent with previous reports, most of the bipartite mutants studied here were replication defective. These mutants as well as HIV-1(V165A) synthesized reduced cDNA levels, but a normal fraction of mutant cDNA localized to dividing and nondividing cell nuclei. Somewhat surprisingly, recombinant class II mutant proteins were catalytically active, and class II Vpr-integrase fusion proteins efficiently complemented class I mutant virus. Since a class I Vpr-integrase mutant efficiently complemented class II mutant viruses under conditions in which class II Vpr-integrases failed to function, we conclude that classes I and II define two distinct complementation groups and suggest that class II mutants are primarily defective at a postnuclear entry step of HIV-1 replication. HIV-1(C130G) was also defective for reverse transcription, but Vpr-integrase(C130G) did not efficiently complement class I mutant HIV-1. Since HIV-1(C130A) grew like the wild type, we conclude that Cys-130 is not essential for replication and speculate that perturbation of integrase structure contributed to the pleiotropic HIV-1(C130G) phenotype.

  18. (-)Deprenyl and (-)1-phenyl-2-propylaminopentane, [(-)PPAP], act primarily as potent stimulants of action potential-transmitter release coupling in the catecholaminergic neurons.

    Science.gov (United States)

    Knoll, J; Miklya, I; Knoll, B; Markó, R; Kelemen, K

    1996-01-01

    The activity of the catecholaminergic neurons in the rat brain is enhanced significantly 30 min after the subcutaneous injection of very small doses of (-)deprenyl (threshold doses: 0.01 mg/kg for noradrenergic neurons and 0.025 mg/kg for dopaminergic neurons). As a catecholaminergic activity enhancer (CAE) substance (-)deprenyl is about ten times more potent than its parent compound, (-)methamphetamine. While the (+)methamphetamine is 3-5 times more potent than (-)methamphetammine in releasing catecholamines, the (-)methamphetamine is the more potent CAE substance. The mechanism of the CAE effect of (-)deprenyl and (-)PPAP, a deprenyl-derived substance devoid of MAO inhibitory potency, was studied in rats by measuring: a) the release of catecholamines from striatum, substantia nigra, tuberculum olfactorium and locus coeruleus; b) the stimulation induced release of 3H-noradrenaline from the isolated brain stem; and c) the antagonistic effect against tetrabenazine-induced depression of learning in the shuttle box. The CAE effect was found to be unrelated: a) to the inhibition of MAO activity; b) to the inhibition of presynaptic catecholamine receptors; c) to the inhibition of the uptake of catecholamines; and d) to the release of catecholamines. It was concluded that (-)deprenyl and (-)PPAP act primarily as potent stimulants of action potential-transmitter release coupling in the catecholaminergic neurons of the brain. We show that both (-)deprenyl and (-)PPAP enhance the inward Ca2+ current in sino-auricular fibers of the frog heart. (-)PPAP was much more potent than either (+)PPAP or (-)deprenyl in this test.

  19. The elevation of apoB in hypercholesterolemic patients is primarily attributed to the relative increase of apoB/Lp-PLA₂.

    Science.gov (United States)

    Tellis, Constantinos C; Moutzouri, Eliza; Elisaf, Moses; Wolfert, Robert L; Tselepis, Alexandros D

    2013-12-01

    Lipoprotein-associated phospholipase A₂ (Lp-PLA₂) is a risk factor of cardiovascular disease. Plasma Lp-PLA₂ is mainly associated with apolipoprotein (apo)B-containing lipoproteins, primarily with low density lipoproteins (LDLs). Importantly, only a proportion of circulating lipoproteins contain Lp-PLA₂. We determined the plasma levels of Lp-PLA₂-bound apoB (apoB/Lp-PLA₂) in patients with primary hypercholesterolemia. The effect of simvastatin therapy was also addressed. The plasma apoB/Lp-PLA₂ concentration in 50 normolipidemic controls and 53 patients with primary hypercholesterolemia at baseline and at 3 months posttreatment with simvastatin (40 mg/day) was determined by an enzyme-linked immunosorbent assay. The concentration of the apoB-containing lipoproteins that do not bind Lp-PLA₂ [apoB/Lp-PLA₂⁻] was calculated by subtracting the apoB/Lp-PLA₂ from total apoB. The apoB/Lp-PLA₂ levels were 3.6-fold higher, while apoB/Lp-PLA₂⁻ were 1.3-fold higher in patients compared with controls. After 3 months of simvastatin treatment apoB/Lp-PLA₂ and apoB/Lp-PLA₂⁻ levels were reduced by 52% and 33%, respectively. The elevation in apoB-containing lipoproteins in hypercholesterolemic patients is mainly attributed to the relative increase in the proatherogenic apoB/Lp-PLA₂, while simvastatin reduces these particles to a higher extent compared with apoB/Lp-PLA₂⁻. Considering that Lp-PLA₂ is proatherogenic, the predominance of apoB/Lp-PLA₂ particles in hypercholesterolemic patients may contribute to their higher atherogenicity and incidence of cardiovascular disease.

  20. Prostaglandin (PG) E3 synthesis elicted by adrenergic stimuli in guinea-pig trachea (GPT) is mediated primarily by B2 adrenergic receptors

    Energy Technology Data Exchange (ETDEWEB)

    Nadel, G.L.; Malik, K.U.; Lew, D.B. (Univ. of Tennessee, Memphis (United States))

    1990-02-26

    The purpose of this study was to examine arachidonic acid (AA) metabolism and to characterize the type of adrenergic receptor (AR) involved in the production of the major metabolite of this fatty acid. ({sup 14}C)AA was incubated with GPT-rings and the radiolabelled products were extracted and separated by TLC method. The medium was also assayed for radiolabelled immunoreactive PG's (iPG's) and leukotrienes (LT) B4 and C4 by RIA or Enzyme immunoassay (EIA) after exposure to various AR agonists. ({sup 14}C)AA was incorporated into GPT-rings and metabolized mainly into iPGE2 and smaller amounts into PGF2{alpha}. Trace amounts of PGD2 and 6-keto-PGF1{alpha} but not LTB4 or LTC4 were detected by RIA and/or EIA. Incubation of GPT rings for 15 minutes with isoproterenol and salbutamol resulted in a significant increase of PGE2 synthesis (optimum conc: 10{sup {minus}7}, 10{sup {minus}7}M respectively). In contrast, dobutamine, norepinephrine, phenylnephrine and xylazine (up to 10{sup {minus}6}M) did not significantly increase PGE2 production. Isoproterenol-induced iPGE2 production was inhibited by a selective {beta}2 antagonist, butoxamine (70%: 10{sup {minus}7}M, 91%: 10{sup {minus}6}M) and somewhat reduced by {beta}1 antagonists practolol and metoprolol (30-64%:10{sup {minus}6}M). These data suggest that isoproterenol induced iPGE2 synthesis is primarily mediated via activation of {beta}2 adrenergic receptor.

  1. Water deficit in field-grown Gossypium hirsutum primarily limits net photosynthesis by decreasing stomatal conductance, increasing photorespiration, and increasing the ratio of dark respiration to gross photosynthesis.

    Science.gov (United States)

    Chastain, Daryl R; Snider, John L; Collins, Guy D; Perry, Calvin D; Whitaker, Jared; Byrd, Seth A

    2014-11-01

    Much effort has been expended to improve irrigation efficiency and drought tolerance of agronomic crops; however, a clear understanding of the physiological mechanisms that interact to decrease source strength and drive yield loss has not been attained. To elucidate the underlying mechanisms contributing to inhibition of net carbon assimilation under drought stress, three cultivars of Gossypium hirsutum were grown in the field under contrasting irrigation regimes during the 2012 and 2013 growing season near Camilla, Georgia, USA. Physiological measurements were conducted on three sample dates during each growing season (providing a broad range of plant water status) and included, predawn and midday leaf water potential (ΨPD and ΨMD), gross and net photosynthesis, dark respiration, photorespiration, and chlorophyll a fluorescence. End-of-season lint yield was also determined. ΨPD ranged from -0.31 to -0.95MPa, and ΨMD ranged from -1.02 to -2.67MPa, depending upon irrigation regime and sample date. G. hirsutum responded to water deficit by decreasing stomatal conductance, increasing photorespiration, and increasing the ratio of dark respiration to gross photosynthesis, thereby limiting PN and decreasing lint yield (lint yield declines observed during the 2012 growing season only). Conversely, even extreme water deficit, causing a 54% decline in PN, did not negatively affect actual quantum yield, maximum quantum yield, or photosynthetic electron transport. It is concluded that PN is primarily limited in drought-stressed G. hirsutum by decreased stomatal conductance, along with increases in respiratory and photorespiratory carbon losses, not inhibition or down-regulation of electron transport through photosystem II. It is further concluded that ΨPD is a reliable indicator of drought stress and the need for irrigation in field-grown cotton.

  2. HIV/AIDS stigma among a sample of primarily African-American and Latino men who have sex with men social media users.

    Science.gov (United States)

    Garett, Renee; Smith, Justin; Chiu, Jason; Young, Sean D

    2016-01-01

    The recent increase in social media use allows these technologies to rapidly reach communities with higher HIV prevalence, such as African-American and Latino men who have sex with men (MSM). However, no studies have looked at HIV/AIDS stigma among social media users from African-American and Latino MSM communities, or the association between stigma and social media use among these groups. This study sought to assess the level of HIV/AIDS stigma among a sample of social media-using African-American and Latino MSM from Los Angeles. A total of 112 (primarily African-American and Latino, n = 98, 88%) MSM Facebook users completed a survey on demographics, online social network use, and HIV/AIDS stigma. A composite stigma score was created by taking the cumulative score from a 15-item stigma questionnaire. Cumulative logistic models were used to assess the association between HIV/AIDS stigma and online social network use. In general, participants reported a low level of HIV/AIDS stigma (mean = 22.2/75, SD = 5.74). HIV/AIDS stigma composite score was significantly associated with increased time spent on online social networks each day (Adjusted odds ratios (AOR): 1.07, 95% CI: 1.00, 1.15). Among this diverse sample of MSM online social network users, findings suggest that HIV/AIDS stigma is associated with usage of social media. We discuss the implications of this work for future HIV prevention.

  3. Rationale, design and conduct of a randomised controlled trial evaluating a primary care-based complex intervention to improve the quality of life of heart failure patients: HICMan (Heidelberg Integrated Case Management

    Directory of Open Access Journals (Sweden)

    Muth Christiane

    2007-08-01

    Full Text Available Abstract Background Chronic congestive heart failure (CHF is a complex disease with rising prevalence, compromised quality of life (QoL, unplanned hospital admissions, high mortality and therefore high burden of illness. The delivery of care for these patients has been criticized and new strategies addressing crucial domains of care have been shown to be effective on patients' health outcomes, although these trials were conducted in secondary care or in highly organised Health Maintenance Organisations. It remains unclear whether a comprehensive primary care-based case management for the treating general practitioner (GP can improve patients' QoL. Methods/Design HICMan is a randomised controlled trial with patients as the unit of randomisation. Aim is to evaluate a structured, standardized and comprehensive complex intervention for patients with CHF in a 12-months follow-up trial. Patients from intervention group receive specific patient leaflets and documentation booklets as well as regular monitoring and screening by a prior trained practice nurse, who gives feedback to the GP upon urgency. Monitoring and screening address aspects of disease-specific self-management, (nonpharmacological adherence and psychosomatic and geriatric comorbidity. GPs are invited to provide a tailored structured counselling 4 times during the trial and receive an additional feedback on pharmacotherapy relevant to prognosis (data of baseline documentation. Patients from control group receive usual care by their GPs, who were introduced to guideline-oriented management and a tailored health counselling concept. Main outcome measurement for patients' QoL is the scale physical functioning of the SF-36 health questionnaire in a 12-month follow-up. Secondary outcomes are the disease specific QoL measured by the Kansas City Cardiomyopathy questionnaire (KCCQ, depression and anxiety disorders (PHQ-9, GAD-7, adherence (EHFScBS and SANA, quality of care measured by an adapted

  4. Palliative Care

    Science.gov (United States)

    ... symptoms can cause fear and anxiety, the palliative care team usually includes: a physician or nurse who is an expert in prescribing medications or other symptom -relieving measures, behavioral health providers who can help answer your ...

  5. Hospice Care

    Science.gov (United States)

    ... terminally ill individuals live their remaining days with dignity. These programs can assist the family (or other ... to prepare herself and her family for her death. She realized that she wanted to be cared ...

  6. CARES Foundation

    Science.gov (United States)

    ... today and CARES will receive 5% of your purchase! THEIR HISTORY: In 2001, Lauren’s Hope introduced the ... Go to the staff directory Find Us on Facebook Recent Tweets In case you missed it! http:// ...

  7. Dysarthria - care

    Science.gov (United States)

    Speech and language disorder - dysarthria care; Slurred speech - dysarthria; Articulation disorder - dysarthria ... Dysarthria is a condition that occurs when there are problems with the muscles that help you talk. ...

  8. Residential Care

    Science.gov (United States)

    ... Last name: Email: * Zip: * *required We will not sell or share your name. Residential Care Tweet Bookmark ... for the future. Use Alzheimer's Navigator ™ - our free online tool - to guide you as you map out ...

  9. Caring Encounters

    Science.gov (United States)

    Gunn, Alyson

    2012-01-01

    Children with autism may seem to not care about things or have the same range of emotions as those of us who see them and care for them. But they do have empathy and they can be taught how to communicate it, says the author, a teacher of children with autism. We simply need to listen to them, watch them, and be with them in their moment.

  10. Sexual Harassment towards Newcomers in Elder Care

    DEFF Research Database (Denmark)

    Krøjer, Jo; Lehn-Christiansen, Sine; Nielsen, Mette Lykke

    2014-01-01

    Sexual harassment is illegal and may have very damaging effects on the people exposed to it. One would expect organizations, employers, and institutions to take very good care to prevent employees from exposure to sexual harassment from anyone in their workplace. And yet, many people, mostly women......, are exposed to sexual harassment at work. In care work, such behaviour is often directed toward their female caregiver by elderly citizens in need of care. Contemporary Nordic studies of working life and work environment have primarily investigated the interpersonal dimensions of sexual harassment, thus...... focusing on the relation between elderly citizens in need of care and their professional caregivers. In this article, we argue that sexual harassment from the elderly toward newcomers in elder care should also be seen as an effect of institutional practices. Based upon a Foucauldian-inspired notion...

  11. Green Care Farms

    Directory of Open Access Journals (Sweden)

    Simone R. de Bruin PhD

    2015-10-01

    Full Text Available Objective: To explore the value of day services at green care farms (GCFs in terms of social participation for people with dementia. Method: Semi-structured interviews were conducted with people with dementia who attended day services at a GCF (GCF group, n = 21, were on a waiting list (WL for day services at a GCF (WL group, n = 12, or attended day services in a regular day care facility (RDCF group, n = 17 and with their family caregivers. Results: People with dementia in the GCF and WL group were primarily males, with an average age of 71 and 76 years, respectively, who almost all had a spousal caregiver. People with dementia in the RDCF group were mostly females with an average age of 85 years, most of whom had a non-spousal caregiver. For both the GCF and RDCF groups, it was indicated that day services made people with dementia feel part of society. The most important domains of social participation addressed by RDCFs were social interactions and recreational activities. GCFs additionally addressed the domains “paid employment” and “volunteer work.” Conclusion: GCFs are valuable in terms of social participation for a particular group of people with dementia. Matching characteristics of adult day services (ADS centers to the preferences and capacities of people with dementia is of importance. Diversity in ADS centers is therefore desirable.

  12. Petroleum and Health Care: Evaluating and Managing Health Care's Vulnerability to Petroleum Supply Shifts

    Science.gov (United States)

    Bednarz, Daniel; Bae, Jaeyong; Pierce, Jessica

    2011-01-01

    Petroleum is used widely in health care—primarily as a transport fuel and feedstock for pharmaceuticals, plastics, and medical supplies—and few substitutes for it are available. This dependence theoretically makes health care vulnerable to petroleum supply shifts, but this vulnerability has not been empirically assessed. We quantify key aspects of petroleum use in health care and explore historical associations between petroleum supply shocks and health care prices. These analyses confirm that petroleum products are intrinsic to modern health care and that petroleum supply shifts can affect health care prices. In anticipation of future supply contractions lasting longer than previous shifts and potentially disrupting health care delivery, we propose an adaptive management approach and outline its application to the example of emergency medical services. PMID:21778473

  13. Histopathological variables and biomarkers enhancer of zeste homologue 2, Ki-67 and minichromosome maintenance protein 7 as prognosticators in primarily endocrine-treated prostate cancer.

    Science.gov (United States)

    Tolonen, Teemu T; Tammela, Teuvo L J; Kujala, Paula M; Tuominen, Vilppu J; Isola, Jorma J; Visakorpi, Tapio

    2011-11-01

    • To evaluate the prognostic value of histopathological variables and immunostainings of biomarkers enhancer of zeste homologue 2 (EZH2), Ki-67 and minichromosome maintenance protein 7 (MCM7) from core biopsies of hormonally treated patients with prostate cancer. • Biopsies of 247 primarily endocrine-treated patients were analysed for histopathological characteristics and Gleason scores (GS) according to the revised guidelines of International Society of Urologic Pathology (ISUP) consensus conference 2005. • Immunohistochemical stainings were analysed with the aid of digital image analysis. • The prognostic value of the histopathological variables and the biomarkers was analysed with univariate and multivariate Cox regression analysis, with biochemical recurrence as an endpoint. • Biomarkers EZH2 (relative risk [RR] 2.0, 95% confidence interval 1.2-3.3), Ki-67 (3.4, 2.1-5.5) and MCM7 (2.4, 1.5-3.9) were significantly associated with progression-free survival in a univariate analysis. • Ki-67 immunostaining index detected high-risk patients with GS of 7 (9.1, 8.0-10.3). • In a multivariate analysis with non-conventional GS groups 5-7 (3 + 4), 7(4 + 3)-8, and 9-10, the independent prognostic markers were pretreatment GS (2.2, 1.5-3.2), prostate-specific antigen (PSA) level (2.1, 1.1-4.2), perineural invasion (PNI) (1.6, 1.2-2.2), and clinical T-stage (cT) (1.9, 1.0-3.7). • Combination of the independent markers (PSA level > 20 ng/mL or GS >3 + 4 or PNI >3 or cT >2) yielded best risk stratification (RR 11.6, 10.4-12.7). • GS remains one of the most important prognostic factors in prostate cancer. However, the refined guidelines by ISUP 2005 might have shifted the threshold between low-grade and high-grade cancers from GS 6 vs 7 to GS 3 + 4 vs 4 + 3. • PNI is an independent prognostic marker superior to cT. • Ki-67 is the most useful biomarker in detecting patients with GS = 7 at high risk for progression. © 2011 THE AUTHORS. BJU INTERNATIONAL

  14. 13C-metabolic flux ratio and novel carbon path analyses confirmed that Trichoderma reesei uses primarily the respirative pathway also on the preferred carbon source glucose

    Directory of Open Access Journals (Sweden)

    Saloheimo Markku

    2009-10-01

    and respirative activities of the TCA cycle. Conclusion High similarity between the biosynthetic pathways of amino acids in T. reesei and yeast S. cerevisiae was concluded. In vivo flux distributions confirmed that T. reesei uses primarily the respirative pathway also when growing on the repressive carbon source glucose in contrast to Saccharomyces cerevisiae, which substantially diminishes the respirative pathway flux under glucose repression.

  15. Magnetic resonance hypointensive signal primarily originates from extracellular iron particles in the long-term tracking of mesenchymal stem cells transplanted in the infarcted myocardium

    Directory of Open Access Journals (Sweden)

    Huang Z

    2015-03-01

    deposits were detected by pathological examination. However, iron particles were predominantly distributed in the extracellular space, and a minority was distributed within CD68-positive macrophages and other CD68-negative cells. No sex-determining region Y DNA of donor MSCs was detected.Conclusion: CMR hypointensive signal is primarily caused by extracellular iron particles in the long-term tracking of transplanted MSCs after myocardial infarction. Consideration should be given to both the false-positive signal and the potential cardiac toxicity of long-standing iron deposits in the heart. Keywords: superparamagnetic iron oxide nanoparticles, SPIO, cardiac magnetic resonance (CMR, stem cells tracking, extracellular iron particles, myocardial infarction (MI

  16. Clinical character and function of metabolic endocrine of psychosomatic disorders in patients with type 2 diabetes%2型糖尿病心身相关的临床特点及代谢内分泌功能的变化

    Institute of Scientific and Technical Information of China (English)

    潘从清; 李慧吉; 梅妍; 张艳; 武成

    2013-01-01

    [目的]探讨2型糖尿病心理因素相关的中医证候学特征以及神经内分泌功能与心理健康状况的变化.[方法]调查192例2型糖尿病患者,根据四诊资料进行心身相关辨证,结果分为单纯糖尿病组和糖尿病并心身相关组,对两组患者进行一般资料、状态特质焦虑问卷(STAI)、简明心境量表(BPOMS)和代谢内分泌相关指标进行比较,采用logisitic回归分析探讨糖尿病并心身相关的危险因素.[结果]192例2型糖尿病患者合并心身相关证候的暴露水平为81/192(42.19%).糖尿病心身相关组的焦虑状态、焦虑习性因子评分高于糖尿病组和正常对照组,反映心境状态的BPOMS各纬度因子得分高于单纯糖尿病组和正常对照组,差异具有统计学意义(P<0.05或P<0.01),心身相关组糖尿病患者空腹血糖(FPG)、糖化血红蛋白(HbAlc)、胰岛素抵抗(IR)、皮质醇(COR)、促肾上腺皮质激素(ACTH)、胰高血糖素(GLU)均高于单纯糖尿病组(P<0.05或P<0.01),logisitic回归分析显示、FPG、GLU、HbAlc、COR是2型糖尿病心身相关的主要危险因素.[结论]糖尿病患者情绪障碍患病率较高,对血糖控制不佳HbAlc高水平的患者应雷视心身并雷的综合治疗.%[Objective] To explore the characteristics of psychosomatic disorder-related TCM syndrome in patients with type 2 diabetes and the changes of neuroendocrine function and the mental health. [Methods] The 192 patients with type 2 diabetes were investigated. According to the materials obtained from four diagnostic methods the psychosomatic symptom differentiation was performed and the patients were divided into diabetes group and diabetes and psychosomatic disorder groups. The general information, State-Trait Anxiety Inventory (STAI), the mood Scale (BPOMS) and metabolic endocrine-related indicators were compared between these two groups. Using logistic regression analysis the diabetes and psychosomatic disorde

  17. A study on the status and influential factors of psychosomatic health of national defense students with suicidal ideation%国防生有自杀意念者心身健康状况及其危险因素的研究

    Institute of Scientific and Technical Information of China (English)

    张理义; 唐开宏; 魏红辉; 陈春霞; 姚高峰; 孔令明

    2012-01-01

    目的 探讨国防生有自杀意念者心身健康状况及其影响因素,以便有针对性的采取心理干预,提高其心身健康水平.方法 随机整群抽取某高校国防生519名,采用《中国军人心身健康量表》测试心身健康水平,将第63条目“有想死的念头”得分等于1分定义为有自杀意念.同时采用《军人心理疾病预测量表》探讨其危险因素.结果 国防生自杀意念的发生率为10.3%,除呼吸系、消化系和皮肤因子外,有自杀意念组心身健康量表总分、心理健康因子、躯体健康因子以及其余各因子分均显著高于无自杀意念组(P<0.05或0.01);相关分析的结果显示,有自杀意念者的焦虑、抑郁与其成长经历、个性内向、心理防御不良、社会支持缺乏呈显著正相关(r =0.277 ~0.666,P<0.05或0.01),个性内向、心理防御不良、社会支持缺乏、应激源与心身健康总分、心理健康因子分及躯体健康因子分亦呈显著正相关(r =0.292~0.691,P<0.05或0.01);经多元逐步回归分析发现,心理防御不良分别进入以有自杀意念者的心身健康总分、心理健康因子、躯体健康因子、焦虑及抑郁因子分为因变量的多元回归方程(P<0.01).结论 国防生有自杀意念者心身健康状况较差,心理防御不良是自杀意念者心身健康状况的重要影响因素.%Objective To investigate the characters and influencing factors of psychosomatic health of national defense students with suicidal ideation, develop psychological intervention and improve the level of psychosomatic health. Methods By cluster random sampling,519 national defense students were tested by The Chinese Military Psychosomatic Health Scale ( CMPHS) and The Military Mental Disorders Prediction Scale. The 63th item of CMPHS which individual has the ideal of thoughts of death and rates it 1 point defined as suicidal ideation. Results The occurrence of suicidal ideation in

  18. 基于中医身心医学思想谈抑郁症从肾论治%Discussion on Treating Depression by Regulating Kidney-yang based on Psychosomatic Theory of Traditional Chinese Medicine

    Institute of Scientific and Technical Information of China (English)

    杨娟; 李志刚

    2014-01-01

    Depression has become a common disease,and more and more people are suffering both mental and physical torture.It is common to treat the disease with traditional Chinese medicine by regulating liver because it is well accepted that the core pathogenesis of depression is the stagnation of liver qi.But I think that the deficiency of kidney-yang is another significant pathogenesis of depression ac-cording to its clinical manifestation and the traditional Chinese medicine theory.This paper discusses the relationship between the defi-ciency of kidney-yang and depression based on the psychosomatic theory of traditional Chinese medicine and states the importance of kid-ney-yang to the treatment of depression disorder.This article also emphasizes that warming and invigorating kidney-yang would take an important role in treating depression.I hope the viewpoint of the paper may exploit the new thought of treating depression in order to re-lieve physical and mental suffering for patients.%抑郁症已成为一种常见的病症,越来越多的人承受着抑郁症带来的身心双重折磨。中医治疗本病历来多从肝论治,认为其核心病机在于肝气郁结,作者结合中医传统理论及抑郁症的临床表现,认为肾阳虚是抑郁症的重要病机,并结合中医身心医学相关理念,论述了肾阳虚与抑郁症的发病关系,阐述了重视肾阳在治疗抑郁症中的作用,强调在中医辨治抑郁症时需重视振奋肾阳,为临床辨治抑郁症提供新思路,以期更好地改善抑郁诸病,缓解患者身心痛苦。

  19. Value of psychosomatic nursing in recovery of inpatient in obstetrics and gynecology department%心身护理在妇产科住院患者康复中的价值

    Institute of Scientific and Technical Information of China (English)

    宋晓荣; 王红

    2015-01-01

    目的:探讨心身护理对妇产科住院患者日常生活能力及心身状态康复的影响。方法选择2011年7月~2014年6月陕西省咸阳市第一人民医院妇产科手术患者2549例,对其采取心身整体护理措施,干预前后分别采用日常生活活动能力(ADL)量表的Barthel指数、90项症状自评分量表(SCL-90)、社会支持评定量表(SSRS)观察患者日常生活能力、心身状况及社会支持度改善情况。结果护理干预前,客观评分玉级者所占比例(26.21%)低于主观评分玉级者(49.74%),差异有统计学意义(P0.05)。与干预前比较,干预后患者的SCL-90总分、阳性项目数、阳性均分、躯体因子、强迫因子、抑郁因子、焦虑因子、人际因子以及敌对因子得分均明显降低,差异均有统计学意义(P 0.05). Compared with before nursing intervention, the total scores of SCL-90, positive item numbers, positive scores, scores of body factor, forcing factor, depression factor, anxiety factor, interpersonal factor and hostile factor were all lower after intervention, with statistically significant differences (P<0.05). After intervention total scores of SSRS, scores of objective support, subjective support and support availability were higher than before nursing inter-vention, with statistically significant differences (P<0.05). Conclusion Adopting psychosomatic nursing for inpatient in obstetrics and gynecology department can improve patients' ADL scores, reduce SCL-90 score, improve the degree of social support. It is beneficial to patients recovery, improves the prognosis.

  20. Structural Models of Comorbidity among Psychosomatic Disorders Connections to Chronic Pain%心身障碍共病与慢性疼痛关联的结构模型

    Institute of Scientific and Technical Information of China (English)

    吴爱勤

    2014-01-01

    Psychosomatic disorders involving depression and anxiety co‐occur frequently enough that they can be conceptualized as elements within a broad spectrum of internalizing disorders. Patterns of comorbidity among common mental disorders can be understood from the perspective of a model that regards mood ,anxiety and somatization disorders as elements with an internalizing spectrum of disorder ,and substance use and antisocial behavior disorder as elements within a separate externalizing spectrum of disorder. In this article ,we evaluate the possibility of linking this model to literatures on chronic pain. Evidence from psychosocial and biological perspectives points out the mechanisms that link chronic pain to internalizing disorder ,and such evidence indicates that the internalizing‐externalizing model may provide a useful framework for suggesting new directions for research on connections between chronic pain and mood ,anxiety and related disorders and traits.%常见的心身障碍共病可以理解为一种新的精神疾病结构模型:情绪障碍、抑郁、焦虑及躯体化障碍等归为内化性疾病谱系的组成元素,物质滥用和反社会行为障碍归为外化性疾病谱系的组成元素。本文分析探讨评估慢性疼痛与这一模型的联系。社会心理和生物学的研究证据表明慢性疼痛与内化性障碍密切相关,提示内化-外化性疾病模型可以作为一个有效的研究架构,为探讨慢性疼痛与情感、抑郁焦虑及其他相关精神障碍的关联共病机制提供新的研究方向和新思路。

  1. Integrating Palliative Care into Primary Care.

    Science.gov (United States)

    Gorman, Rosemary D

    2016-09-01

    Improved quality of life, care consistent with patient goals of care, and decreased health care spending are benefits of palliative care. Palliative care is appropriate for anyone with a serious illness. Advances in technology and pharmaceuticals have resulted in increasing numbers of seriously ill individuals, many with a high symptom burden. The numbers of individuals who could benefit from palliative care far outweighs the number of palliative care specialists. To integrate palliative care into primary care it is essential that resources are available to improve generalist palliative care skills, identify appropriate patients and refer complex patients to specialist palliative care providers.

  2. Self-Supporting Personality and Psychosomatic Symptoms: The Testing of Trait-Stress-Symptom Congruence and Mediating Model%自立人格与心身症状:特质-应激-症状相符中介模型的检验

    Institute of Scientific and Technical Information of China (English)

    夏凌翔

    2011-01-01

    Self-supporting personality is viewed as an excellent personality factor in traditional Chinese culture and hypothesized as a health personality. In order to explore the role of self-supporting personality resisting psychosomatic symptoms, the trait-stress-symptom congruence and mediation model was developed, which included stress-mediator model hypothesis, trait-stress congruent hypothesis, and trait-symptoms congruent hypothesis.To test this model, the Self-Supporting Personality Scale of Adolescent Students, Life-Events Scale of Adolescence and Symptom Check List90 (SCL-90) were administered to 674 valid subjects.The results indicate: (1) The moderate model was not supported, and some self-supporting personality traits could predict psychosomatic symptoms through the mediating effect of stress. (2) The negative predicting effect of interpersonal self-supporting on psychosomatic symptoms was greater than personal self-supporting. Interpersonal self-supporting could negatively predict interpersonal and personal symptoms independently. Personal self-supporting could not independently predict interpersonal symptoms. (3) The negative predicting effect of personal self-supporting on stress was greater than interpersonal self-supporting. Personal self-supporting could negatively predict interpersonal and personal stress independently. Interpersonal self-supporting could not independently predict personal stress. (4) The modified trait-stress-symptom congruence and mediation model of self-supporting personality could be supported.In sum, it can be concluded that interpersonal self-supporting negatively predicts psychosomatic symptoms through meditation of interpersonal stress. Personal self-supporting negatively predicts personal psychosomatic symptoms through mediation of stress.%自立人格是新近提出的一种新的心身症状的保护性人格因素.为了探索自立人格抵御心身症状的机制,提出了特质-应激-症状相符中介模型.该模型涉

  3. Do clinicians decide relying primarily on Bayesians principles or on Gestalt perception? Some pearls and pitfalls of Gestalt perception in medicine.

    Science.gov (United States)

    Cervellin, Gianfranco; Borghi, Loris; Lippi, Giuseppe

    2014-08-01

    Clinical judgment is a foundation of medical practice and lies at the heart of a physician's knowledge, expertise and skill. Although clinical judgment is an active part of all medical fields, thus including diagnosis and therapy, communication and decision making, it is still poorly defined. It can be considered a synthesis of intuition (mainly based on Gestalt principles) and an analytical approach. Gestalt perception finds its rationale in the evidence that perception of any given object or experience exhibits intrinsic qualities that cannot be completely reduced to visual, auditory, tactile, olfactory, or gustatory components. Thus, perceptions are not constructed in a "bottom-up" fashion from such elements, but are instead globally perceived, in a more "top-down" fashion. Gestalt perception, if cautiously and carefully combined with structured (techno)logical tools, would permit one to defoliate the often too-many-branches built diagnostic trees, and help physicians to better develop their competency. On the other hand, the practice of evidence-based medicine lies in the integration of individual clinical expertise and judgment with the best available external clinical evidence from systematic research. This article is aimed at providing some general concepts about Gestalt perception, and to discuss some aspects of clinical practice potentially influenced by this approach.

  4. Careful science?

    DEFF Research Database (Denmark)

    Jespersen, Astrid P; Bønnelycke, Julie; Eriksen, Hanne Hellerup

    2014-01-01

    the focus to reflect everyday practices would foster better targeted public health campaigns. This article is based on our participation in FINE, a multidisciplinary Danish research project. The core methodology of FINE was a randomised controlled trial in which 61 moderately overweight men were put...... into different exercise groups. In this article we analyse the scientific work of the trial as representing entangled processes of bodywork, where data are extracted and objectified bodies are manipulated and care practices address the emotional, social and mundane aspects of the participants' everyday lives....... Care practices are an inherent part of producing scientific facts but they are removed from the recognised results of scientific practice and thus from common public health recommendations. However, knowledge about the strategic use of care practices in lifestyle interventions is important for public...

  5. Wound Care.

    Science.gov (United States)

    Balsa, Ingrid M; Culp, William T N

    2015-09-01

    Wound care requires an understanding of normal wound healing, causes of delays of wound healing, and the management of wounds. Every wound must be treated as an individual with regard to cause, chronicity, location, and level of microbial contamination, as well as patient factors that affect wound healing. Knowledge of wound care products available and when negative pressure wound therapy and drain placement is appropriate can improve outcomes with wound healing. Inappropriate product use can cause delays in healing. As a wound healing progresses, management of a wound and the bandage material used must evolve.

  6. Cultural care of older Greek Canadian widows within Leininger's theory of culture care.

    Science.gov (United States)

    Rosenbaum, J N

    1990-01-01

    Cultural care themes were abstracted from a large scale study of older Greek Canadian widows conceptualized within Leininger's theory of Cultural Care Diversity and Universality. Ethnonursing, ethnographic, and life health-care history methods were used. Data were collected using observation-participation and interviews in three Greek Canadian communities with 12 widowed key informants and 30 general informants. Enabling tools used were interview inquiry guides, Leininger's Life History Health Care Protocol, Leininger's Acculturation Rating and Profile Scale of Traditional and Non-Traditional Lifeways, and field journal recordings. Data were analyzed using Leininger's phases of analysis for qualitative data. The two major cultural care themes which were abstracted from the raw data and patterns were: (1) Cultural care for Greek Canadian widows meant responsibility for, reciprocation, concern, love, companionship, family protection, hospitality, and helping, primarily derived from their kinship, religious, and cultural beliefs, and values, and (2) Cultural care continuity diminished the spousal care void and contributed to the health of Greek Canadian widows. These findings will stimulate future nursing research related to cultural care of diverse populations and guide nursing practice to provide culturally congruent care which will assist widows to reduce their spousal care void. The author thanks Dr. Madeleine Leininger, Dr. Judith Floyd, Dr. Marjorie Isenberg, and Dr. Bernice Kaplan for their guidance in completing the large scale study on which this article is based.

  7. Effects of music on improving psychosomatic distress in severe patients:a Meta-analysis%音乐对重症患者心身不良应激改善作用的Meta分析

    Institute of Scientific and Technical Information of China (English)

    朱佳清; 戴菲菲; 吕苏珍; 赖美红

    2016-01-01

    目的:评价音乐对重症患者不良情绪的改善作用。方法由2位研究人员独立检索年文献资料,数据库包括中国知网(1979年1月—2014年12月)、维普数据库(1989年1月—2014年12月)及万方数据库(1982年1月—2014年12月),检索主题为音乐对重症患者焦虑、抑郁等的干预作用;对纳入文献提取数据,进行Meta分析。检索策略由第一作者确定,文献检索、Meta分析中产生的分歧,由第三方予以裁定。结果共纳入11篇文献进行定量,研究性质均为随机对照试验。 Meta分析结果显示,焦虑3个量表的合并加权均数差分别为,SAS:-10.13(95%CI:-14.56,-5.69),VAS:-0.73(95%CI:-1.21,-0.24),TAI:-3.71(95%CI:-5.18,-2.25),均提示音乐对焦虑情绪具有保护作用;抑郁量表SDS的合并加权均数差为-0.05(95%CI:-0.08,-0.03),提示音乐对抑郁情绪具有保护作用;孤独量表UCLA的合并加权均数差为:-6.24(95%CI:-8.62,-3.87),提示音乐对孤独情绪具有保护作用;睡眠时间的合并加权均数差为:1.09(95%CI:0.72,1.45),提示音乐可显著延长睡眠时间;觉醒时间的合并加权均数差为:-0.93(95%CI:-1.49,-0.36),提示音乐可显著缩短觉醒时间;血压的合并加权均数差为:-5.41(95%CI:-20.08,9.27),效应值区间跨越正反区位,提示音乐对血压影响不确定;心率的合并加权均数差为:-12.35(95%CI:-14.68,-10.01),提示音乐可显著减慢心率。结论音乐对重症患者的焦虑、抑郁、孤独、睡眠不足等不良应激均有明显的保护作用,值得推广应用。%Objective To evaluate the effects of music on improving psychosomatic distress in severe patients. Methods The data were collected via China national knowledge infrastructure ( From January 1979 to December 2014), Vip journal integration platform (From January 1989 to December 2014) and Wanfang data ( From January 1982 to December 2014 ) , conducted by two researchers

  8. Antifungal susceptibility of 205 Candida spp. isolated primarily during invasive Candidiasis and comparison of the Vitek 2 system with the CLSI broth microdilution and Etest methods.

    Science.gov (United States)

    Bourgeois, N; Dehandschoewercker, L; Bertout, S; Bousquet, P-J; Rispail, P; Lachaud, L

    2010-01-01

    Infections due to Candida spp. are frequent, particularly in immunocompromised and intensive care unit patients. Antifungal susceptibility tests are now required to optimize antifungal treatment given the emergence of acquired antifungal resistance in some Candida species. An antifungal susceptibility automated method, the Vitek 2 system (VK2), was evaluated. VK2 was compared to the CLSI broth microdilution reference method and the Etest procedure. For this purpose, 205 clinical isolates of Candida spp., including 11 different species, were tested for fluconazole, voriconazole, and amphotericin B susceptibility. For azoles, essential agreement ranged from 25% to 100%, depending on the method used and the Candida species tested. Categorical agreements for all of the species averaged 92.2% and ranged from 14.3 to 100%, depending on the 24-h or 48-h MIC reading by the Etest and CLSI methods and on the Candida species. Results obtained for Candida albicans showed excellent categorical and essential agreements with the two comparative methods. For Candida glabrata, the essential agreement was high with the CLSI method but low with the Etest method, and several very major errors in interpretation were observed between VK2 and the Etest method for both azoles. Low MICs of fluconazole were obtained for all of the Candida krusei isolates, but the VK2 expert software corrected all of the results obtained to resistant. Amphotericin B results showed MICs of CLSI), and 202 (Etest) isolates. The AST-YS01 Vitek 2 card system (bioMérieux) is a reliable and practical standardized automated antifungal susceptibility test. Nevertheless, more assays are needed to better evaluate C. glabrata fluconazole sensitivity.

  9. Antifungal Susceptibility of 205 Candida spp. Isolated Primarily during Invasive Candidiasis and Comparison of the Vitek 2 System with the CLSI Broth Microdilution and Etest Methods▿

    Science.gov (United States)

    Bourgeois, N.; Dehandschoewercker, L.; Bertout, S.; Bousquet, P.-J.; Rispail, P.; Lachaud, L.

    2010-01-01

    Infections due to Candida spp. are frequent, particularly in immunocompromised and intensive care unit patients. Antifungal susceptibility tests are now required to optimize antifungal treatment given the emergence of acquired antifungal resistance in some Candida species. An antifungal susceptibility automated method, the Vitek 2 system (VK2), was evaluated. VK2 was compared to the CLSI broth microdilution reference method and the Etest procedure. For this purpose, 205 clinical isolates of Candida spp., including 11 different species, were tested for fluconazole, voriconazole, and amphotericin B susceptibility. For azoles, essential agreement ranged from 25% to 100%, depending on the method used and the Candida species tested. Categorical agreements for all of the species averaged 92.2% and ranged from 14.3 to 100%, depending on the 24-h or 48-h MIC reading by the Etest and CLSI methods and on the Candida species. Results obtained for Candida albicans showed excellent categorical and essential agreements with the two comparative methods. For Candida glabrata, the essential agreement was high with the CLSI method but low with the Etest method, and several very major errors in interpretation were observed between VK2 and the Etest method for both azoles. Low MICs of fluconazole were obtained for all of the Candida krusei isolates, but the VK2 expert software corrected all of the results obtained to resistant. Amphotericin B results showed MICs of ≤1 mg/liter for 201 (VK2), 190 (CLSI), and 202 (Etest) isolates. The AST-YS01 Vitek 2 card system (bioMérieux) is a reliable and practical standardized automated antifungal susceptibility test. Nevertheless, more assays are needed to better evaluate C. glabrata fluconazole sensitivity. PMID:19889902

  10. Building Footprints, Primarily residential, at risk buildings such as hospitals, nursing homes, etc for use in Emergency Management Hazard Mitigation planning., Published in 2010, 1:4800 (1in=400ft) scale, Carroll County Government.

    Data.gov (United States)

    NSGIC Local Govt | GIS Inventory — Building Footprints dataset current as of 2010. Primarily residential, at risk buildings such as hospitals, nursing homes, etc for use in Emergency Management Hazard...

  11. Continuing Care

    Science.gov (United States)

    ... a Mutation That Protects Against the Development of Alzheimer’s Disease to the Effect of Gleevec Newly Inducted Into the Basketball Hall ... a serious, progressive illness. A vast network of social, medical and ... person with Alzheimer’s – and their caregiver(s) – get the best care and ...

  12. Pregnancy care

    Science.gov (United States)

    ... Avoid all alcohol and drug use and limit caffeine. Quit smoking, if you smoke. Go for prenatal visits and tests: You will see your provider many times during your pregnancy for prenatal care. The number of visits and types of exams you receive will change, depending on where you ...

  13. Just caring.

    Science.gov (United States)

    Hussey, Trevor

    2012-01-01

    Social justice is concerned with fair distribution of the benefits and burdens of living together in society. Regarding nursing care, social justice is concerned with who should receive its benefits, how much they should receive, and who should take up the burden of providing and paying for it. A specific thesis is offered: 'Health care, including nursing care, should be distributed on the basis of need, free at the point of use, the cost being born by the community involved.' This thesis is shown to be incompatible with consequentialist (utilitarian) and libertarian approaches to social justice, but reasons are given for rejecting these theories. It is shown that it may be compatible with Rawl's liberal theory of justice and definitely compatible with a version of the teleological (Aristotelian) theory. The thesis is then defended against criticisms concerned with desert and responsibility: that the provident ought not to pay for the improvident, and that those who are responsible for their health do not deserve free care. There are answered by an epistemological argument concerning what we need to know before we can decide what people deserve, and an argument about social cohesion. The conclusion is that the thesis can be offered as a moral principle for a fair society. © 2011 Blackwell Publishing Ltd.

  14. Prenatal Care.

    Science.gov (United States)

    Health Resources and Services Administration (DHHS/PHS), Rockville, MD. Office for Maternal and Child Health Services.

    This booklet is the first in a series of publications designed to provide parents with useful information about childrearing. Contents are organized into three parts. Part I focuses on the pregnancy, prenatal care, development of the baby, pregnant lifestyles, nutrition, common discomforts, and problems of pregnancy. Part II provides information…

  15. Respite Care

    Science.gov (United States)

    ... provided in a home, an adult day-care program or over a weekend in a nursing home or an assisted living facility. For more information on the NFCSP visit the Administration on Aging website at http://www.aoa.gov/ ...

  16. Exploring the Intersections of Trauma, Structural Adversity, and Psychosis among a Primarily African-American Sample: A Mixed-Methods Analysis

    Directory of Open Access Journals (Sweden)

    Cherise Rosen

    2017-04-01

    contributes to a growing literature calling for strengths-based, client-driven approaches to working with distressing voices and beliefs that centers the exploration of the personal and social meaning of such experiences including links to life narratives. Findings also underscore the clinical importance of trauma assessment and trauma-informed care.

  17. Pharmaceutical Care and the Role of a Pharmacist in Space Medicine

    Science.gov (United States)

    Bayuse, Tina

    2007-01-01

    Space medicine is primarily preventative medicine Outcomes of space medicine pharmaceutical care are: a) Elimination or reduction of a patient's symptomatology; b) Arresting or slowing of long term effects from microgravity; and c) Preventing long term effects or symptomatology as a result of microgravity. Space medicine pharmaceutical care is about both the patient and the mission. Pharmaceutical care in the area of space medicine is evolving. A pharmacist serves a critical role in this care. Commercial space travel will require pharmacist involvement.

  18. Education and Health Care Policies in Ghana

    Directory of Open Access Journals (Sweden)

    Ziblim Abukari

    2015-10-01

    Full Text Available Education and health care policies in Ghana since independence have been universalist in approach providing free universal health care and free basic and tertiary education until the early 1980s. Precipitated primarily by a severe drought, stagnant economic growth, mismanagement, and political instability, Ghana undertook major economic reforms with prodding from the World Bank and International Monetary Fund in a bid to salvage the economy. These economic measures included cost recovery and cutback spending in education and health sectors. However, in recent years, purposive targeted interventions have been pursued to address inequalities in education and health care. These new programs include the Education Capitation Grant, school feeding program, and the National Health Insurance Scheme (NHIS, which are propelling Ghana toward the achievement of the Millennium Development Goals. The prospects of these programs in addressing disparities in access to education and health care in the country and recommendations for improved delivery are discussed.

  19. The emerging EU quality of care policy

    DEFF Research Database (Denmark)

    Vollaard, Hans; van de Bovenkamp, Hester M.; Vrangbæk, Karsten

    2013-01-01

    involvement in healthcare policy over the last twenty years. Based on interviews and document and literature analysis we show that the scope of EU involvement has widened from public health and access to care, to quality of care. In this paper we concentrate on the latter. Focusing on the recent EU......Despite the fact that Member States and many citizens of the EU like to keep healthcare a foremost national competence and the EU treaties state that Member States remain primarily responsible for the organization and delivery of health care services, the European Union (EU) has expanded its...... and desirability of the EU's involvement is clearly needed, also considering the differences in quality of care policies between and within EU Member States. Both arguments in favour and against further EU involvement are discussed in this paper...

  20. Clinical study of traditional Chinese medicines based on the regimen of psychosomatic mutual aid treatment in treatment of menstrual disorders women with diminished ovarian reserve%中医心身同治方案对卵巢储备功能下降妇女月经失调的临床疗效

    Institute of Scientific and Technical Information of China (English)

    陈玲; 王小云

    2014-01-01

    目的:观察中医心身同治方案对卵巢储备功能下降妇女月经失调的临床疗效。方法采取随机平行对照临床研究,将50例患者随机分为中医心身同治治疗组25例(中药+情志治疗),对照组25例,采用上市中成药逍遥丸+六味地黄丸治疗。治疗前后观察月经周期、经期、经量状况并对其进行评分量化。同时治疗前后均采用抑郁自评量表( SDS)、焦虑自评量表( SAS)对患者情绪情况进行量化比较。结果治疗后2组SDS评分、SAS均有改善,与治疗前比较差异有统计学意义( P<0.01)。治疗组在改善月经失调积分方面优于对照组,2组差异有统计学意义( P<0.01)。结论中医心身同治方案可以有效改善卵巢储备功能下降妇女月经失调状况,值得推广应用。%Objective To evaluate the clinical efficacy of traditional Chinese medicines based on the regimen of psychosomatic mutual aid treatment in treatment of menstrual disorders women with diminished ovarian reserve . Methods Fifty patients were enrolled and randomized into two groups,namely the experiment group ( using Chinese medicines plus Chinese psychosomatic mutual aid treatment) and the control group( using Xiao yao wan plus Liu wei di huang wan intervention ) . The menstrual cycle, menstrual period and the volume status were evaluated. The self-rating depression scale( SDS) and self-rating anxiety scale( SAS) were used to evaluate patients with emotional situation. Results SDS and SAS scores improved greatly in both groups compared with before treatment(P<0.01). The score of menstrual disorders in the treatment group was higher than that in the control group(P<0.01). Conclusion Chinese medicines based on the regimen of psychosomatic mutual aid treatment can effectively improve the menstrual disorders in women with diminished ovarian reserve,which may be widely applied.

  1. Application of active kinesitherapy for psychosomatic functions to patients with hand dysfunction after surgery for hand injury%心身机能活性运动疗法在术后手功能障碍患者中的应用

    Institute of Scientific and Technical Information of China (English)

    韩荣云

    2013-01-01

    目的:探讨心身机能活性运动疗法在手外伤术后手功能障碍患者中的应用方法及效果.方法:将196例手外伤术后手功能障碍患者按照入院顺序随机分为观察组和对照组各98例,观察组采用心身机能活性运动疗法,对照组采用单纯运动疗法.随访3个月,评价两组患者康复效果.结果:观察组患者手功能恢复总有效率明显高于对照组(P<0.05).结论:心身机能活性运动疗法能有效提高患者术后手功能恢复效果,提高患者术后生活质量.%Objective:To explore the methods and effect of active kinesitherapy for psychosomatic functions to patients with hand dysfunction after surgery for hand injury.Methods:196 patients with hand dysfunction after surgery were randomly divided into the observation group and the control group (98 cases in each group) according to the order of admission.The active kinesitherapy for psychosomatic functions was adopted in the observation group and the simple exercise therapy was used in the control group.The rehabilitation effect of the patients was evaluated in the two groups after 3-month follow-up.Results:The total effective rate of hand function recovery of the patients was higher in the observation group than the control group (P < 0.05).Conclusion:The active kinesitherapy for psychosomatic functions can effectively improve the rehabilitation effect of hand function and the quality of life of the patients after surgery for hand injury.

  2. 心身护理对妇产科住院患者日常生活能力及心身状态的影响%The impact of mental nursing on patients' daily living and psychosomatic state in the department of obstetrics and gynecology

    Institute of Scientific and Technical Information of China (English)

    李井秋

    2015-01-01

    Objective:To investigate the impact of mental nursing on patients’ daily living and psychosomatic state in the department of obstetrics and gynecology.Methods:500 patients admitted to the department of obstetrics and gynecology were selected,then we observed the improvement on daily life ability,the social support and psychosomatic status evaluation of patients before and after the intervention.Results:Before the intervention,the difference between the subjective score and the objective score was statistically significant(P<0.05);When compared before nursing intervention,the total score and positive average were reduced obviously after the intervention,in addation,the body factor,depression factor,interpersonal factor and anxiety factor also reduced,the differences had statistical significence(P<0.05).Conclusion:Giving psychosomatic nursing on patients in the department of obstetrics and gynecology can improve their ability of daily life and the state of mental and physical remarkably.%目的:探讨心身护理对妇产科住院患者日常生活能力以及心身状态的影响。方法:收治妇产科住院患者500例,观察在干预前后患者日常生活能力的改善情况、社会支持度的改善及心身状况评估情况等。结果:在护理干预前,客观评分与主观评分比较差异具有统计学意义(P<0.05);与护理干预之前相比,干预后的总分、阳性均分、躯体因子、抑郁因子、人际因子以及焦虑因子均具有明显的降低,差异具有统计学意义(P<0.05)。结论:对妇产科患者进行心身护理对改善其日常生活能力与心身状态具有显著的作用。

  3. Collaborative Treatment for the Psychosomatic Couple

    Science.gov (United States)

    Thoburn, John; Hoffman-Robinson, Gwynith; Shelly, Lauren J.; Sayre, George

    2009-01-01

    This article reflects on the conceptualization and treatment strategies associated with a systems perspective of the somatic couple. It is suggested that resistance to change, nurturance of the somatic patient by his or her partner, and rigid role taking serve to promote relationship stability and individual pseudopower at the cost of patient…

  4. [Embodied inequalities: challenges for psychosomatic medicine].

    Science.gov (United States)

    Richter, Matthias

    2013-01-01

    Even though highly criticized, the reductionist biomedical paradigm dominates medicine until today. This downplays that we as humans are not only biological organisms but simultaneously also social beings which live in socially organized societies. Disease and premature mortality are thus embodied expressions of the conditions under which we live and work. The paper outlines that a large part of prevailing diseases are strongly influenced by social, economic and political determinants and analyses how social inequalities get under the skin and cause adverse health. Considering social as well as biological processes can generate new evidence, how we biologically incorporate our lived experience and thus create social patterns of health and illness not only in societies but also between societies.

  5. PSYCHOSOMATIC CONSEQUENCES OF TEACHERS’ OCUPPATIONAL STRESS

    Directory of Open Access Journals (Sweden)

    Romanowska-Tołłoczko Anna

    2013-06-01

    Full Text Available The need to adapt to the ever-increasing socio-professional requirements carries many risks to human health, both in somatic and psychological aspects. Strong stress associated with work leads to the occurrence of burnout syndrome. Persons performing so called aid professions, where teachers belong to a special group, are usually vulnerable to this syndrome. The aim of this paper is to present the causes, course and consequences of teacher burnout and to highlight the multidimensional nature of the phenomenon, indicating possible corrective and preventive actions. Among the that contribute to burnout important are environmental , organizational and subjective factors. Subjective factors like professional training and personality dispositions, are treated as the primary determinants of resistance or susceptibility of individuals to stress. They can intensify or protect against burning out. The lack of ability to counter stress is considered crucial in the formation and accumulation of burnout symptoms.

  6. [Spirituality and ethics in psychosomatic medicine].

    Science.gov (United States)

    Irmiš, Felix

    2015-01-01

    A patient has to cope with an illness on a physical, mental and spiritual level. There exists a difference between religiousness and spirituality even though the approach has a common foundation. Nonreligious spirituality relates to an inner experience, transcendent states of consciousness, meaningfulness, responsibility, sympathy, ethics, humanisation, faith. We encounter the spiritual point of view in humanistic psychotherapy, pastoral medicine, work of hospital chaplains, New Age, psychotherapies with religious and alternative aspects, transpersonal psychotherapy, psycho-spiritual crises, unusual states of consciousness, in meditation, Yoga, relaxation, kinesiology, ethicotherapy, reincarnation therapy, positive motivation, holotropic breathing, etc. There is description of different degrees of spiritual development, rational and irrational feeling of spirituality, Quantum Physics, spiritual intelligence, neuro-theology, physiological change, effects on improving adaptation during stress, drugs addiction, etc. Spirituality in relation with ethics is discussed in terms of socio-biology, evolution, emotions, aggressivity, genetics and social influence. The work analyses the effect of stressful situations on the deterioration of moral attitudes: during lack of time, obedience to authority and order. It is described how temperament and personality disorders can affect perception of spirituality, guilt feeling and conscience. Stressful situations, lack of time, relying only on the auxiliary objective methods leads to alienation of physician with a patient. Spirituality can partially improve the doctor-patient relationship, communication and sense of responsibility.

  7. FastStats: Hospice Care

    Science.gov (United States)

    ... Day Services Centers Home Health Care Hospice Care Nursing Home Care Residential Care Communities Screenings Mammography Pap Tests Disability ... Care National Study of Long-Term Care Providers Nursing Home Care Residential Care Communities Centers for Medicare and Medicaid ...

  8. Preventing Obesity among Preschool Children: How Can Child-Care Settings Promote Healthy Eating and Physical Activity? Research Synthesis

    Science.gov (United States)

    Larson, Nicole; Ward, Dianne; Neelon, Sara Benjamin; Story, Mary

    2011-01-01

    Child-care settings provide numerous opportunities to promote healthy eating and physical activity behaviors among preschool children. The majority of U.S. children are placed in some form of non-parental care during their preschool years. While approximately 15 percent of preschool children are primarily cared for by their relatives, most…

  9. [Guideline 'Wound Care': recommendations for 5 challenging areas].

    Science.gov (United States)

    Brölmann, Fleur E; Vermeulen, Hester; Go, Peter M N Y H; Ubbink, Dirk T

    2013-01-01

    The interdisciplinary evidence-based guideline 'Wound Care' covers the treatment and management of acute wounds in adults and children and by all wound care disciplines. This guideline answers 5 basic questions with 38 recommendations covering wound cleansing, pain relief, instructing the patient, various dressings and the organisational aspects of wound care. The guideline recommendations include not to cleanse wounds that are primarily closed, to cleanse acute open wounds with clean tap water, to use the WHO pain ladder as the basis for the choice of analgesics for continuous wound pain, to administer lidocaine or prilocaine for localized pain relief during manipulation, not to cover primarily closed wounds with dressings, to use simple dressings for open wounds and to give the patient clear instructions. The guideline also advises about wound registration, documentation and hand-over of wound care, and recommends making clear agreements about referrals and responsibilities.

  10. [Postacute care].

    Science.gov (United States)

    Admetlla Falgueras, Margarita; Fusté Sugrañes, Josep

    2014-07-07

    The aging of the population and changes in family and social structures have led to increasing care needs for elderly persons following an acute disease or accident, with consequent concerns regarding costs and sustainability within the public health system. The main objective of postacute care (PAC) is to restore the functional capabilities of the patient after an acute event and contribute to determine the patient's outcome and future healthcare requirements. With this background, we carried out a systematic review of the published literature from 1990 to 2011 focused on the following aspects of PAC: a) objectives; b) estimations of the need and the indicators for access to it, and c) transfer strategies from acute care to PAC. The results of this review indicate that PAC is an efficient approach to improve patients' quality of life and to sustain the public healthcare system. The choice of candidates for PAC should be based on both health and social indicators, and the overall process viewed in a cross-sectional manner in order to avoid increases in total cost. Copyright © 2013 Elsevier España, S.L. All rights reserved.

  11. Correlation between psychosomatic symptoms in asthmatic children's mothers and parental rearing patterns%哮喘儿童母亲心理健康状况及其与父母养育方式的相关性

    Institute of Scientific and Technical Information of China (English)

    王莉华; 郭庆辉; 李朝霞; 马宇; 王育龙

    2013-01-01

    [Objective] To explore the correlation between psychosomatic symptoms in asthmatic children’s mothers and parental rearing patterns.[Methods] Egna Minnen Barndoms Uppfostran(EMBU) was applied to 50 asthmatic children and 31 healthy children.State-Trait Anxiety Inventory(STAI-form Y),Self-Rating Depression Scale (SDS) were applied to their mothers.[Results] The scores of state anxiety,trait anxiety,depression in asthmatic children's mothers were significantly higher than in healthy children's mothers (P all<0.01).The parental rearing patterns between asthmatic children and healthy children were almost the same.The asthmatic children's mothers with lower educational degree had stronger tendency of punishment and sternness.The asthmatic children's fathers with higher educational degree had stronger tendency of excessive interference.The state anxiety and trait anxiety in asthmatic children's mothers were negatively related to emotional warmth and understanding (mother and father).Depression in asthmatic children's mothers was negatively related to emotional warmth and understanding (father).[Conclusion] Pediatricians should pay attention to psychological help and support of asthmatic children's mothers,improving parental rearing patterns and the life's quality of children and their mothers.%[目的]探讨哮喘儿童母亲心理健康状况特点、哮喘儿童父母养育方式及两者之间的相关性. [方法]采用父母养育方式评价量表测查50例哮喘患儿,并与31例健康儿童对照,采用状态-特质焦虑问卷、自评抑郁量表对上述儿童母亲进行测查. [结果]哮喘儿童母亲状态焦虑、特质焦虑、抑郁分值显著高于健康儿童母亲(P均<0.01).哮喘儿童与健康儿童父母养育方式基本一致.受教育程度低的哮喘儿童母亲对子女有更多惩罚严厉倾向,受教育程度高的哮喘儿童父亲有更多过分干涉倾向.哮喘儿童母亲状态焦虑、特质焦虑与父亲情感温暖与

  12. The attitude of nurses towards the care of elderly people

    Directory of Open Access Journals (Sweden)

    J. N. Gwala

    1995-05-01

    Full Text Available The number of nurses entering the nursing profession is decreasing, but demands placed upon the Health Services are increasing primarily due to the increasing number of people in our society. People are living longer and it is apparent that some extra provision must be made to care effectively for the elderly members of our society. Various studies have shown that care of the elderly is an unpopular clinical field for nurses. (Shape, 1986. Notter, 1992. Vickels 1982.

  13. The attitude of nurses towards the care of elderly people

    OpenAIRE

    J. N. Gwala; B. M. Zungu; B. B. Ntombela

    1995-01-01

    The number of nurses entering the nursing profession is decreasing, but demands placed upon the Health Services are increasing primarily due to the increasing number of people in our society. People are living longer and it is apparent that some extra provision must be made to care effectively for the elderly members of our society. Various studies have shown that care of the elderly is an unpopular clinical field for nurses. (Shape, 1986. Notter, 1992. Vickels 1982).

  14. Integration Strategies of Pharmacists in Primary Care-Based Accountable Care Organizations: A Report from the Accountable Care Organization Research Network, Services, and Education.

    Science.gov (United States)

    Joseph, Tina; Hale, Genevieve M; Eltaki, Sara M; Prados, Yesenia; Jones, Renee; Seamon, Matthew J; Moreau, Cynthia; Gernant, Stephanie A

    2017-05-01

    benefits and overcome barriers to the integration of pharmacists into patient care, programs involve pharmacists will become an increasingly common approach to improve outcomes and reduce the total cost of care and will improve the financial viability of primary care-based ACOs. No outside funding supported this research. The authors report no conflicts of interest related to this manuscript. Study concept and design were contributed by Joseph, Hale, and Eltaki, with assistance from the other authors. Prados and Jones took the lead in data collection and data interpretation and analysis, with assistance from the other authors. The manuscript was written primarily by Joseph and Hale, along with the other authors, and revised primarily by Seamon and Gernant, along with the other authors.

  15. The Four-year Follow-up of Psychosomatic Health and Its Related Factors of Colle ge Students%大学生心身健康水平及其相关因素的四年追踪观察

    Institute of Scientific and Technical Information of China (English)

    赵虎; 刘少文; 张强; 丘东友; 郭沈昌; 王永华; 杨凤霞

    2001-01-01

    Objective: To investigate psychosomatic health and related factors o f college students during school over a period of 4 years. Methods:Using CPSHS (China Psychosomatic Health Scale),EPQ(Eysenck Personality Questionnaire),DSQ(De fensive Style Questionnaire),LES(life Event Scale) and SSRS(Social Support Ratin g Scale), the authors selected 442 students by randomized block sampling and tes ted them during enrollment, at 3 months after enrollment and at graduation resp ectively. Results:The incidence of psychosomatic disorders was higher at gradua tion (14.0%) than at enrollment (9.0%). EPQ-P scores of male students were found to be increasing with years of schooling. The students used more immature defen sive style and less mature defensive style from 3 months after enrollment. The f reshmen had more interpersonal relationship and other events, but undergraduates have much more family-related events. Conclusion:The high er incidence of psych osomatic disorders in undergraduates was related to their personality type, fami ly-related stress, subjective social support, sex and age. Social support consti tuted a protective factor for psychosomatic health of students.%目的:追踪观察大学生自入学至毕业约四年内的心身健康水平 及其相关因素的动态变化。方法:以群体分层抽样法,共抽取受试 样本541人,实际有效样本442人。采用中国身心健康量表(CPSHS)、艾森克个性问卷(EPQ)、 防御方式问卷(DSQ)、生活事件量表(LES)、社会支持评定量表(SSRS),大学生在入学体检 时 、入学三个月和毕业前分别进行测试。结果:毕业前学生心身障碍 的检出率(14%)明显高于入学时(9.0%)。男生EPQ-P,入学后随校龄 增加而递增,并以毕业前分值最高。从入学三个月始,大学生对不成熟防御机制的动用频率 逐步增高。毕业前大学生的生活事件明显多于其它时段,并以家庭问题为主,而入学时则以 社交与其

  16. Attitudes regarding the safety of health care provider attire.

    Science.gov (United States)

    Garvin, Kanishka W; Lipira, Lauren; Neradilek, Moni; Fox, Anna; Ali, Fatima; Pottinger, Paul S

    2014-11-01

    The majority of medical providers, nurses, and patients agree that appearance is important for patient care. However, at our institution, concerns regarding providers' white coats as fomites are expressed primarily by providers and nurses, not by patients. We provide a framework for approaching this important issue through a structured quality-improvement process.

  17. Setting standards at the forefront of delivery system reform: aligning care coordination quality measures for multiple chronic conditions.

    Science.gov (United States)

    DuGoff, Eva H; Dy, Sydney; Giovannetti, Erin R; Leff, Bruce; Boyd, Cynthia M

    2013-01-01

    The primary study objective is to assess how three major health reform care coordination initiatives (Accountable Care Organizations, Independence at Home, and Community-Based Care Transitions) measure concepts critical to care coordination for people with multiple chronic conditions. We find that there are major differences in quality measurement across these three large and politically important programs. Quality measures currently used or proposed for these new health reform-related programs addressing care coordination primarily capture continuity of care. Other key areas of care coordination, such as care transitions, patient-centeredness, and cross-cutting care across multiple conditions are infrequently addressed. The lack of a comprehensive and consistent measure set for care coordination will pose challenges for healthcare providers and policy makers who seek, respectively, to provide and reward well-coordinated care. In addition, this heterogeneity in measuring care coordination quality will generate new information, but will inhibit comparisons between these care coordination programs.

  18. Home Care Services

    Science.gov (United States)

    Home care is care that allows a person with special needs stay in their home. It might be for people who are getting ... chronically ill, recovering from surgery, or disabled. Home care services include Personal care, such as help with ...

  19. What is palliative care?

    Science.gov (United States)

    Comfort care; End of life - palliative care; Hospice - palliative care ... The goal of palliative care is to help people with serious illnesses feel better. It prevents or treats symptoms and side effects of disease and ...

  20. Medical Care during Pregnancy

    Science.gov (United States)

    ... 1- to 2-Year-Old Medical Care During Pregnancy KidsHealth > For Parents > Medical Care During Pregnancy Print ... both moms and their babies. Prenatal Care Before Pregnancy Prenatal care should start before you get pregnant. ...

  1. Medical Care during Pregnancy

    Science.gov (United States)

    ... 1- to 2-Year-Old Medical Care During Pregnancy KidsHealth > For Parents > Medical Care During Pregnancy A ... both moms and their babies. Prenatal Care Before Pregnancy Prenatal care should start before you get pregnant. ...

  2. Recollections of parental care and quality of intimate relationships : The role of re-evaluating past attachment experiences

    NARCIS (Netherlands)

    Gerlsma, C.

    2000-01-01

    Attachment theory predicts that lack of parental care in childhood may affect the ability to relate in adulthood. While original attachment formulations have primarily focused on actual parenting experiences, more recently attachment writers increasingly emphasize the role of individual differences

  3. Client's Perspective on Quality of Audiology Care: development of the Consumer quality index (CQI) Audiology Care for measuring client experiences.

    NARCIS (Netherlands)

    Hendriks, M.; Dahlhaus-Booij, J.; Plass, A.M.

    2017-01-01

    Objective: Clients’ perspective on the quality of audiology care has not been investigated thoroughly. Research has focused primarily on satisfaction with, and limitations of hearing aids. We developed a Consumer Quality Index (CQI) questionnaire ‘Audiology Care’ to systematically assess client

  4. [Aspects of economic responsibility in health care].

    Science.gov (United States)

    Hauke, Eugen

    2007-01-01

    According to the final consensus of a panel of intense discussions, the health care system should/can not be excluded from the economic laws of efficiency. Appropriate adaptation of various methods and instruments of economics make these tools applicable for use in the health care system. Due to errors in the implementation of economic methods, though, the question arises who is economically responsible in the health care system. The answer is found at three different levels of the health care system. The physician plays a leading role, both personally and professionally, in being primarily responsible for the direct medical treatment of the patient. The physician's dependence, however, on the health care system reduces his independence, which markedly affects his decision-making and treatment. Management of and in health care institutions is largely independent of the profession learned. Managers and physicians acting as managers must be appropriately and duly educated in the necessary specific talents and knowledge. The organisation of a health care system should also be reserved for trained specialists where the physicians as well as other professionals are obliged to acquire the skills necessary.

  5. Hospital information technology in home care.

    Science.gov (United States)

    Zhang, Xiao-Ying; Zhang, Pei-Ying

    2016-10-01

    The utilization of hospital information technology (HIT) as a tool for home care is a recent trend in health science. Subjects gaining benefits from this new endeavor include middle-aged individuals with serious chronic illness living at home. Published data on the utilization of health care information technology especially for home care in chronic illness patients have increased enormously in recent past. The common chronic illnesses reported in these studies were primarily on heart and lung diseases. Furthermore, health professionals have confirmed in these studies that HIT was beneficial in gaining better access to information regarding their patients and they were also able to save that information easily for future use. On the other hand, some health professional also observed that the use of HIT in home care is not suitable for everyone and that individuals cannot be replaced by HIT. On the whole it is clear that the use of HIT could complement communication in home care. The present review aims to shed light on these latest aspects of the health care information technology in home care.

  6. Physical Therapy Observation and Assessment in the Neonatal Intensive Care Unit

    Science.gov (United States)

    Byrne, Eilish; Campbell, Suzann K.

    2013-01-01

    This article presents the elements of the Observation and Assessment section of the Infant Care Path for Physical Therapy in the Neonatal Intensive Care Unit (NICU). The types of physical therapy assessments presented in this path are evidence-based and the suggested timing of these assessments is primarily based on practice knowledge from expert…

  7. An Empirical Typology of Residential Care/Assisted Living Based on a Four-State Study

    Science.gov (United States)

    Park, Nan Sook; Zimmerman, Sheryl; Sloane, Philip D.; Gruber-Baldini, Ann L.; Eckert, J. Kevin

    2006-01-01

    Purpose: Residential care/assisted living describes diverse facilities providing non-nursing home care to a heterogeneous group of primarily elderly residents. This article derives typologies of assisted living based on theoretically and practically grounded evidence. Design and Methods: We obtained data from the Collaborative Studies of Long-Term…

  8. A student's perspective on the ethics of international charity dental care.

    Science.gov (United States)

    Bohnert, Malorie

    2014-01-01

    A senior dental student describes the deep sense of personal satisfaction from participating in a weeklong charity dental care trips to the Dominican Republic. Care, primarily consisting of extractions, was provided to individuals living in conditions that encourage dental disease at the same time the availability of oral healthcare services are essentially nonexistent.

  9. Diagnosis of a missed central line guidewire using critical care ultrasound

    Directory of Open Access Journals (Sweden)

    Ali Al Bshabshe

    2016-01-01

    Full Text Available Central venous catheterization, though an imperative tool in the management of critically ill patient, is associated with a variety of complications and some of which can be life-threatening. Here, we report an index case in the field of critical care of detecting a missed guidewire primarily using a bedside critical care ultrasound.

  10. PHARMACEUTICALS AND PERSONAL CARE PRODUCTS ...

    Science.gov (United States)

    While the point-source emissions of pollutants from manufacturing waste streams have long been monitored and subject to controls, the environmental impact of the public's (i.e., the individual's) activities regarding the use of chemicals is more difficult to assess. Of particular question is the widespread release to sewage and surface/ground waters of pharmaceuticals and personal care products after their ingestion, external application, or disposal. Certain pharmaceutically active compounds (e.g., caffeine, nicotine, and aspirin) have been known for over 20 years to enter the environment by a variety of routes - primarily via treated and untreated sewage effluent. A larger picture, however, has emerged only more recently, where it is evident that numerous personal care products (such as fragrances and sunscreens) and drugs from a wide spectrum of therapeutic classes can occur in the environment and drinking water (albeit at very low concentrations), especially in natural waters receiving sewage. Nearly all ecological monitoring studies for pharmaceuticals and personal care products (informally referred to as

  11. Embedding care management in the medical home: a case study.

    Science.gov (United States)

    Daaleman, Timothy P; Hay, Sherry; Prentice, Amy; Gwynne, Mark D

    2014-04-01

    Care managers are playing increasingly significant roles in the redesign of primary care and in the evolution of patient-centered medical homes (PCMHs), yet their adoption within day-to-day practice remains uneven and approaches for implementation have been minimally reported. We introduce a strategy for incorporating care management into the operations of a PCMH and assess the preliminary effectiveness of this approach. A case study of the University of North Carolina at Chapel Hill Family Medicine Center used an organizational model of innovation implementation to guide the parameters of implementation and evaluation. Two sources were used to determine the effectiveness of the implementation strategy: data elements from the care management informatics system in the health record and electronic survey data from the Family Medicine Center providers and care staff. A majority of physicians (75%) and support staff (82%) reported interactions with the care manager, primarily via face-to-face, telephone, or electronic means, primarily for facilitating referrals for behavioral health services and assistance with financial and social and community-based resources. Trend line suggests an absolute decrease of 8 emergency department visits per month for recipients of care management services and an absolute decrease of 7.5 inpatient admissions per month during the initial 2-year implementation period. An organizational model of innovation implementation is a potentially effective approach to guide the process of incorporating care management services into the structure and workflows of PCMHs.

  12. Palliative wound care: principles of care.

    Science.gov (United States)

    Dale, Barbara; Emmons, Kevin R

    2014-01-01

    Home care nursing occurs in a complex care environment. Nurses working in this setting care for a wide array of individuals who often are sicker and more complex than ever before. The high prevalence of wounds among these individuals requires that home care nurses have a certain level of knowledge to provide excellent care. Many times, individuals with wounds do not have the capacity to heal or are burdened with numerous symptoms affecting quality of life. In these cases, the home care nurse must understand concepts of palliative wound care to alleviate symptoms with the goal of improving quality of life.

  13. Who cares?

    DEFF Research Database (Denmark)

    Petersen, Morten Krogh

    and solve problems. Design thinking tends to be depicted as a wonder cure resulting in not only commercial success, but also democratic inclusion and, possibly, environmentally sustainable solutions. While the many promises are certainly problematic (e.g. Kimbell 2011; 2012), this paper suggests that STS...... practices. If that is the case, the great challenge is to “come up with ingenious solutions to the problem of how to become interesting enough for practices to care about” (ibid: 72). Through ethnographic fieldwork encounters with Radicand Design Collaboratory, a collaborative product development...... consultancy located in Silicon Valley’s Redwood City, the paper suggests that design thinking as it unfolds at Radicand has a lot to offer STS in overcoming this challenge. Notably, through an absolute and irrefutable commitment to rapid prototyping, Radicand cultivates an attitude towards the configuration...

  14. [Brodie abscess. Primarily misinterpreted as traumatic lesion].

    Science.gov (United States)

    Nicolajsen, K; Jørgensen, P S; Tørholm, C

    1996-01-01

    Two case histories are presented. In the first, a 49 year-old man fell on his right hip. He was able to walk, but because of pain he came to our emergency room. Radiographics gave an impression of an undislocated intertrochanteric fracture, scintigraphy confirmed the suspicion. There were no signs of infection. On starting osteosynthesis with the drilling of a hole in the lateral cortex, discharge of pus was observed and curettage of the abscess cavity was performed. In the second, a 21 year-old man hit his right knee against a table. Because of pain he was admitted to hospital. Primary signs of a lesion of the lateral meniscus were found and arthroscopy was scheduled. When readmitted we found signs of an infection and X-ray revealed a Brodie's abscess in the proximal tibia. The abscess cavity was opened and curettage was performed. Radiographics, scintigraphics, blood parameters and pathological and microbiological investigations revealed primary chronic osteomyelitis in both patients. Antibiotic therapy was instituted and six weeks after primary operation bone transplantation was performed. The further course was uncomplicated.

  15. Preliminary Data on a Care Coordination Program for Home Care Recipients.

    Science.gov (United States)

    Dean, Katie M; Hatfield, Laura A; Jena, Anupam B; Cristman, David; Flair, Michael; Kator, Kylie; Nudd, Geoffrey; Grabowski, David C

    2016-09-01

    Home care recipients are often hospitalized for potentially avoidable reasons. A pilot program (Intervention in Home Care to Improve Health Outcomes (In-Home)) was designed to help home care providers identify acute clinical changes in condition and then manage the condition in the home and thereby avoid a costly hospitalization. Caregivers answer simple questions about the care recipient's condition during a telephone-based "clock-out" at the end of each shift. Responses are electronically captured in the agency management software that caregivers use to "clock-in," manage care, and "clock-out" on every shift. These are transmitted to the agency's care manager, who follows up on the change in condition and escalates appropriately. A description of the In-Home model is presented, and pilot data from 22 home care offices are reported. In the pilot, caregivers reported a change in condition after 2% of all shifts, representing an average of 1.9 changes per care recipient in a 6-month period. Changes in behavior and skin condition were the most frequently recorded domains. Interviews with participating caregivers and care managers suggested positive attitudes regarding the intervention; challenges included resistance to change on the part of home care staff and difficulties in applying a uniform intervention to individuals with varying needs in home care offices with varying capacities. In an ongoing randomized trial, the success of the overall program will be measured primarily according to the potential reduction in avoidable hospitalizations of home care recipients and the effect this potential reduction has on spending and healthcare outcomes. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

  16. Perioperative Care of Prisoners: Providing Safe Care.

    Science.gov (United States)

    Smith, Francis Duval

    2016-03-01

    Correctional nurses are trained to care for prisoners in a controlled security environment; however, when a convict is transferred to a noncorrectional health care facility, the nurses there are often unfamiliar with custody requirements or how to safely care for these patients. The care of prisoners outside of prison has not been adequately investigated, and a gap exists between research and nursing education and practice. Nurses rarely have to consider how providing care for a prisoner in custody affects their practice, the potential dissonance between routine nursing care and the requirements to maintain security, or that care of prisoners in unsecured clinical areas places the nurse and other personnel at risk for physical assault or prisoner escape. Educating perioperative nurses in the care of prisoners in a public hospital environment is important for the provision of safe care and prevention of physical and emotional repercussions to personnel.

  17. Differentiating the barriers to adequate prenatal care in Missouri, 1987-88.

    OpenAIRE

    Sable, M R; Stockbauer, J W; Schramm, W F; Land, G H

    1990-01-01

    Inadequate prenatal care has previously been identified as a significant risk factor for women who have low birth weight infants and infants who die during the neonatal period. Postpartum interviews with 1,484 primarily low-income women were conducted during 1987-88 in three areas of Missouri with the highest rates of inadequate prenatal care. The purpose of the study was to identify barriers to prenatal care and to determine which barriers differentiated between women receiving adequate and ...

  18. Managing high-risk patients: the Mass General care management programme

    OpenAIRE

    Dennis L. Kodner

    2015-01-01

    The Massachusetts General Care Management Program (Mass General CMP or CMP) was designed as a federally supported demonstration to test the impact of intensive, practice-based care management on high-cost Medicare fee-for-service (FFS) beneficiaries—primarily older persons—with multiple hospitalisations and multiple chronic conditions. The Massachusetts General Care Management Program operated over a 6-year period in two phases (3 years each). It started during the first phase at Massachusett...

  19. Mothers’ Satisfaction With Two Systems of Providing Care to Their Hospitalized Children

    OpenAIRE

    Hosseinian, Masoumeh; Mirbagher Ajorpaz, Neda; Esalat Manesh, Soophia

    2015-01-01

    Background: Despite the paramount importance of the patient’s satisfaction, there are limited data on mothers’ satisfaction with the nursing care provided to their children in Iranian clinical settings. Objectives: This study aimed to evaluate mothers’ satisfaction with two systems of providing care to their hospitalized children. Patients and Methods: This research was a two-group quasi-experimental study. Primarily, the basics of the case method and the functional care delivery systems were...

  20. A new long-term care manifesto.

    Science.gov (United States)

    Kane, Robert L

    2015-04-01

    This article argues for a fresh look at how we provide long-term care (LTC) for older persons. Essentially, LTC offers a compensatory service that responds to frailty. Policy debate around LTC centers on costs, but we are paying for something we really don't want. Building societal enthusiasm (or even support) for LTC will require re-inventing and re-branding. LTC has three basic components: personal care, housing, and health care (primarily chronic disease management). They can be delivered in a variety of settings. It is rare to find all three done well simultaneously. Personal care (PC) needs to be both competent and compassionate. Housing must provide at least minimal amenities and foster autonomy; when travel time for PC raises costs dramatically, some form of clustered housing may be needed. Health care must be proactive, aimed at preventing exacerbations of chronic disease and resultant hospitalizations. Enhancing preferences means allowing taking informed risks. Payment incentives should reward both quality of care and quality of life, but positive outcomes must be defined as slowing decline. Paying for services but not for housing under Medicaid would automatically level the playing field between nursing homes (NH) and community-based services. Regulations should achieve greater parity between NH and community care and include both positive and negative feedback. Providing post-acute care should be separate from LTC. Using the tripartite LTC framework, we can create innovative flexible approaches to providing needed services for frail older persons in formats that are both desirable and affordable. Such care will be more socially desirable and hence worth paying for.

  1. Acne - self-care

    Science.gov (United States)

    Acne vulgaris - self-care; Cystic acne - self-care; Pimples - self-care; Zits - self-care ... If daily skin care does not clear up blemishes, try over-the-counter acne medicines that you apply to your skin. These products ...

  2. Understanding palliative care.

    Science.gov (United States)

    Martin, Caren McHenry

    2006-09-01

    While most pharmacists and other health care practitioners are familiar with the programs and philosophy of hospice, they may lack a clear understanding of palliative care. Because myths and misconceptions about palliative care abound, a review of the definitions and components of palliative care can enhance the practice of all practitioners who care for patients with chronic diseases.

  3. Your cancer care team

    Science.gov (United States)

    ... gov/ency/patientinstructions/000929.htm Your cancer care team To use the sharing features on this page, ... help your body heal. Working with Your Care Team Each member of your care team plays an ...

  4. Office of Child Care

    Science.gov (United States)

    ... for Children & Families Office of Child Care By Office Administration for Native Americans (ANA) Administration on Children, ... Care Partnerships. Review the profiles. > What is the Office of Child Care (OCC)? The Office of Child ...

  5. Adult Day Care

    Science.gov (United States)

    ... Evening care Exercise Health screening Meals Medical care Physical therapy Recreation Respite care Socialization Supervision Transportation Medication management Back to top Center Operations Centers are usually open during normal business ...

  6. Adoption & Foster Care

    Science.gov (United States)

    ... Family Life > Family Dynamics > Adoption & Foster Care Adoption & Foster Care Article Body ​Each year, many children join families through adoption and foster care. These families may face unique challenges. The acceptance ...

  7. Emergency care toolkits.

    Science.gov (United States)

    Black, Steven

    2004-06-01

    Emergency care services are the focus of a series of toolkits developed by the NHS National electronic Library for Health to provide resources for emergency care leads and others involved in modernising emergency care, writes Steven Black.

  8. Developing the Care in Pharmaceutical Care.

    Science.gov (United States)

    Fjortoft, Nancy F.; Zgarrick, David P.

    The purpose of this study was to assess the level of caring ability of a sample of pharmacy students and assess the relationship between selected predictor variables and pharmacy students' caring ability. Caring was viewed as the ability to assume responsibility for the protection and welfare of another without being perfunctory or begrudging.…

  9. Developing interprofessional care plans in chronic care

    NARCIS (Netherlands)

    Jerôme Jean Jacques van Dongen; Marloes Amantia van Bokhoven; Trudy van der Weijden; Anna Beurskens; Wencke Emonts; Ramon Daniëls

    2016-01-01

    Background: The number of people suffering from one or more chronic conditions is rising, resulting in an increase in patients with complex health care demands. Interprofessional collaboration and the use of shared care plans support the management of complex health care demands of patients with

  10. Relationship among A-type behavior,job burnout and psychosomatic health in grassroots officers and soldiers stationed in Xinjiang%驻疆基层官兵A型行为、职业倦怠与心身健康的关系

    Institute of Scientific and Technical Information of China (English)

    丁魁; 孟新珍; 刘晓明; 赵小强; 宋永斌

    2015-01-01

    目的 调查了解驻疆基层官兵A型行为、职业倦怠与心身健康的关系,为维护其心理健康提供理论依据.方法 采用分层整群随机抽样方法,抽取驻疆基层官兵1 939名,进行A型行为类型问卷、军人职业倦怠量表和简易军人心身健康量表进行测评.结果 ①驻疆官兵心身健康总分及各因子与职业倦怠量表总分及各因子、时间匆忙感(time hurry,TH)、竞争性和敌意情绪(competitive and hostility,CH)间呈显著正相关(r=0.170~0.716,P<0.01).②职业倦怠进入心身健康回归方程(β=0.195,t=32.211,P<0.01),可解释68.6%的变异量;TH、CH进入职业倦怠回归方程(t=4.925,4.427),可解释29.5%的变异量.③TH通过职业倦怠间接影响心身健康,其中介效应量为0.27×0.83=0.2241;CH通过职业倦怠间接影响心身健康,其中介效应量为0.30×0.83=0.2490.结论 职业倦怠在TH、CH与心身健康间具有完全中介作用.%Objective To investigate the relationship among A-type behavior,job burnout and psychosomatic health in grassroots officers and soldiers stationed in Xinjiang, which provides the theoretical basis to maintain their psychosomatic health.Methods Evaluation was carried out with A-type behavior questionnaire, military job burnout scale and simple soldiers psychosomatic health scale in 1 939 grassroots officers and soldiers chosen by random cluster sampling method from army stationed in Xinjiang.Results ①The total scores and each factor scores of the scale had significant positive correlation among the physical scale, the job buruout scale and time hurry (TH) ,competitive and hostility (CH) (r=0.170-0.716, P<0.01).②Job burnout entered into the physical and mental health regression equation and could explain 68.6% of the variance(β=0.195, t=32.211, P<0.01);TH, CH entered the regression equation of job burnout and could explain 29.5% of the variance(t=4.925,4.427).③ TH indirectly affected physical and mental

  11. Quality of Care Provided by a Comprehensive Dementia Care Comanagement Program.

    Science.gov (United States)

    Jennings, Lee A; Tan, Zaldy; Wenger, Neil S; Cook, Erin A; Han, Weijuan; McCreath, Heather E; Serrano, Katherine S; Roth, Carol P; Reuben, David B

    2016-08-01

    Multiple studies have shown that quality of care for dementia in primary care is poor, with physician adherence to dementia quality indicators (QIs) ranging from 18% to 42%. In response, the University of California at Los Angeles (UCLA) Health System created the UCLA Alzheimer's and Dementia Care (ADC) Program, a quality improvement program that uses a comanagement model with nurse practitioner dementia care managers (DCM) working with primary care physicians and community-based organizations to provide comprehensive dementia care. The objective was to measure the quality of dementia care that nurse practitioner DCMs provide using the Assessing Care of Vulnerable Elders (ACOVE-3) and Physician Consortium for Performance Improvement QIs. Participants included 797 community-dwelling adults with dementia referred to the UCLA ADC program over a 2-year period. UCLA is an urban academic medical center with primarily fee-for-service reimbursement. The percentage of recommended care received for 17 dementia QIs was measured. The primary outcome was aggregate quality of care for the UCLA ADC cohort, calculated as the total number of recommended care processes received divided by the total number of eligible quality indicators. Secondary outcomes included aggregate quality of care in three domains of dementia care: assessment and screening (7 QIs), treatment (6 QIs), and counseling (4 QIs). QIs were abstracted from DCM notes over a 3-month period from date of initial assessment. Individuals were eligible for 9,895 QIs, of which 92% were passed. Overall pass rates of DCMs were similar (90-96%). All counseling and assessment QIs had pass rates greater than 80%, with most exceeding 90%. Wider variation in adherence was found among QIs addressing treatments for dementia, which patient-specific criteria triggered, ranging from 27% for discontinuation of medications associated with mental status changes to 86% for discussion about acetylcholinesterase inhibitors. Comprehensive

  12. Putting the 'care' back into aged care.

    Science.gov (United States)

    Beadnell, Cathy

    2006-04-01

    Aged care is well and truly back on the political agenda in Australia. While the mainstream media has recently exposed a number of horrific cases of alleged abuse in aged care facilities it has done little to highlight the failings of social policy over time or to foster debate on how to improve the care of older Australians. What are the barriers to providing safe and quality aged care to a growing number of our citizens and how do we overcome them? If you relied on the recent media coverage for your impression of aged care you could be forgiven for thinking it is all bad news. But there are facilities providing high quality care and stories of nurses working wonders in the face of adversity. Cathy Beadnell considers some of the broader cultural and workforce issues in aged care.

  13. Variations in the management of fibromyalgia by physician specialty: rheumatology versus primary care

    Science.gov (United States)

    Able, Stephen L; Robinson, Rebecca L; Kroenke, Kurt; Mease, Philip; Williams, David A; Chen, Yi; Wohlreich, Madelaine; McCarberg, Bill H

    2016-01-01

    Purpose To evaluate the effect of physician specialty regarding diagnosis and treatment of fibromyalgia (FM) and assess the clinical status of patients initiating new treatment for FM using data from Real-World Examination of Fibromyalgia: Longitudinal Evaluation of Costs and Treatments. Patients and methods Outpatients from 58 sites in the United States were enrolled. Data were collected via in-office surveys and telephone interviews. Pairwise comparisons by specialty were made using chi-square, Fisher’s exact tests, and Student’s t-tests. Results Physician specialist cohorts included rheumatologists (n=54), primary care physicians (n=25), and a heterogeneous group of physicians practicing pain or physical medicine, psychiatry, neurology, obstetrics and gynecology, osteopathy, or an unspecified specialty (n=12). The rheumatologists expressed higher confidence diagnosing FM (4.5 on a five-point scale) than primary care physicians (4.1) (P=0.037). All cohorts strongly agreed that recognizing FM is their responsibility. They agreed that psychological aspects of FM are important, but disagreed that symptoms are psychosomatic. All physician cohorts agreed with a multidisciplinary approach including nonpharmacological and pharmacological treatments, although physicians were more confident prescribing medications than alternative therapies. Most patients reported moderate to severe pain, multiple comorbidities, and treatment with several medications and nonpharmacologic therapies. Conclusion Physician practice characteristics, physician attitudes, and FM patient profiles were broadly similar across specialties. The small but significant differences reported by physicians and patients across physician cohorts suggest that despite published guidelines, treatment of FM still contains important variance across specialties.

  14. Supply and demand for long-term care services from the perspective of leaders of health care institutions1

    Science.gov (United States)

    Samoliński, Bolesław

    2015-01-01

    Introduction Poland's transition into the stage of intensive population aging imposes changes in demand for different forms of care (including long-term). The proportion of dependent persons (requiring care) in the population continues to increase. The number of people aged 80 and above (in 2013 – 1.48 million) will double by 2050 and reach 3.54 million. The research objective was to gain knowledge on the supply and demand of different institutionalized forms of care services from the healthcare system perspective. Material and methods A computer-assisted personal interview (CAPI) survey was carried out on a Poland-wide quota sample of health care and nursing centres operating within the healthcare system. The respondent group consisted of 96 directors of health care facilities. Results In the opinion of more than a half of surveyed directors, supply of health care and nursing centres in their region is insufficient in terms of the needs of both patients and elderly people. In the context of patients, the deficit is observed primarily in health care and treatment centres, long-term nursing care and health care institutions, whereas for the elderly people the main concern is availability of nursing care, day care or social aid centres. More than half of surveyed institutions admit patients requiring care on an ongoing basis; however, in the case of health care and treatment centres more than a year-long waiting time proved to be a frequent phenomenon. In the opinion of the surveyed directors, the key factors influencing the number of available places and waiting time are insufficient financing and personnel deficit. Conclusions Introduction of multiple changes to the operation of the care system in Poland is necessary in order to improve its availability, effectiveness and quality. Achievement of this objective requires implementation of a cohesive and integrated system dedicated to monitoring and diagnosing both the supply and demand for different forms of care

  15. Effect of Low Mountain Climate Convalescence Nursing on the Psychosomatic Health of the Eld-erly Hypertensive Patients%低山带疗养护理对老年高血压患者心身健康的影响

    Institute of Scientific and Technical Information of China (English)

    赵晓红; 姚萍; 曹莉芬; 李清红; 朱开梅; 冯小力

    2014-01-01

    Objective To discuss the effect of low mountain climate convalescence nursing on psychoso-matic health status of elderly hypertensive patients.Methods 68 elderly hypertensive patients nursing in Jigong Mountain from July to September in 2012 were selected.Blood pressure,heart rate,oxyhemoglobin saturation,body mass index and psychological health status before and after the convalescence were investi-gated and compared respectively.Results After the convalescence,systolic pressure and oxyhemoglobin saturation were all better than before convalescence (all P 0.05). There were significant differences of the scores of somatization,depression,anxiety,phobic anxiety and sleeping and eating disorders compared with pre-convalescence (all P 0.05).Conclusion Convalescence in low mountain climate has a positive effect on the blood pressure and the psychosomatic health status in elderly hypertensive patients.%目的:探讨低山带疗养护理对老年高血压患者心身健康的影响.方法2012年7-9月,广州军区武汉疗养院对在鸡公山疗养地疗养的68名老年高血压患者疗养前后的血压、心率、血氧饱和度、体质指数及心理健康状况等进行了研究并比较.结果疗养后,老年高血压患者的收缩压及血氧饱和度均优于疗养前(均 P <0.01),舒张压、心率、BMI 等与疗养前比较,差异均无统计学意义(均 P >0.05);躯体化、抑郁、焦虑、恐怖、睡眠饮食障碍等5项因子均分与疗养前的差异均有统计学意义(均 P <0.05),其余因子的评分与疗养前的差异均无统计学意义(均 P >0.05).结论低山带气候疗养护理对老年高血压患者的血压及心身健康状况有积极的影响.

  16. Forging community partnerships to improve health care: the experience of four Medicaid managed care organizations.

    Science.gov (United States)

    Silow-Carroll, Sharon; Rodin, Diana

    2013-04-01

    Some managed care organizations (MCOs) serving Medicaid beneficiaries are actively engaging in community partnerships to meet the needs of vulnerable members and nonmembers. We found that the history, leadership, and other internal factors of four such MCOs primarily drive that focus. However, external factors such as state Medicaid policies and competition or collaboration among MCOs also play a role. The specific strat­egies of these MCOs vary but share common goals: (1) improve care coordination, access, and delivery; (2) strengthen the community and safety-net infrastructure; and (3) prevent illness and reduce disparities. The MCOs use data to identify gaps in care, seek community input in designing interventions, and commit resources to engage community organiza­tions. State Medicaid programs can promote such work by establishing goals, priorities, and guidelines; providing data analysis and technical assistance to evaluate local needs and community engagement efforts; and convening stakeholders to collaborate and share best practices.

  17. Care Partnerships: Toward Technology to Support Teens’ Participation in Their Health Care

    Science.gov (United States)

    Hong, Matthew K.; Wilcox, Lauren; Machado, Daniel; Olson, Thomas A.; Simoneaux, Stephen F.

    2016-01-01

    Adolescents with complex chronic illnesses, such as cancer and blood disorders, must partner with family and clinical caregivers to navigate risky procedures with life-altering implications, burdensome symptoms and lifelong treatments. Yet, there has been little investigation into how technology can support these partnerships. We conducted 38 in-depth interviews (15 with teenage adolescents with chronic forms of cancer and blood disorders, 15 with their parents, and eight with clinical caregivers) along with nine non-participant observations of clinical consultations to better understand common challenges and needs that could be supported through design. Participants faced challenges primarily concerning: 1) teens’ limited participation in their care, 2) communicating emotionally-sensitive information, and 3) managing physical and emotional responses. We draw on these findings to propose design goals for sociotechnical systems to support teens in partnering in their care, highlighting the need for design to support gradually evolving partnerships in care. PMID:28164178

  18. Missed Opportunity: Hospice Care and the Family.

    Science.gov (United States)

    Tabler, Jennifer; Utz, Rebecca L; Ellington, Lee; Reblin, Maija; Caserta, Michael; Clayton, Margaret; Lund, Dale

    2015-01-01

    A typical mission statement of hospice services is to provide quality, compassionate care to those with terminal illness and to support families through caregiving and bereavement. This study explored the ways that bereavement needs of caregivers, either predeath or postdeath of their spouse/partner, were addressed using qualitative retrospective phone interviews with 19 caregivers whose spouse/partner was enrolled in hospice care for cancer. Overall, participants expressed high satisfaction with hospice care, most often noting a high satisfaction with the quality of care provided to their spouse/partner. During the predeath phase, caregivers recalled being so focused on their spouse/partner's needs that they rarely spoke with hospice staff about their own personal needs and emotions. Participants said that bereavement counseling occurred primarily after the death of the spouse/partner, in the form of generic pamphlets or phone calls from someone they had not met during prior interactions with hospice staff. These findings suggest that caregivers' high satisfaction with hospice may be more associated with the quality of care provided to the spouse/partner than with bereavement support they received. Our findings illustrated a potential missed opportunity for hospices to address the family-oriented goals that are commonly put forward in hospice mission statements.

  19. Financial incentive schemes in primary care

    Directory of Open Access Journals (Sweden)

    Gillam S

    2015-09-01

    Full Text Available Stephen Gillam Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, Cambridge, UK Abstract: Pay-for-performance (P4P schemes have become increasingly common in primary care, and this article reviews their impact. It is based primarily on existing systematic reviews. The evidence suggests that P4P schemes can change health professionals' behavior and improve recorded disease management of those clinical processes that are incentivized. P4P may narrow inequalities in performance comparing deprived with nondeprived areas. However, such schemes have unintended consequences. Whether P4P improves the patient experience, the outcomes of care or population health is less clear. These practical uncertainties mirror the ethical concerns of many clinicians that a reductionist approach to managing markers of chronic disease runs counter to the humanitarian values of family practice. The variation in P4P schemes between countries reflects different historical and organizational contexts. With so much uncertainty regarding the effects of P4P, policy makers are well advised to proceed carefully with the implementation of such schemes until and unless clearer evidence for their cost–benefit emerges. Keywords: financial incentives, pay for performance, quality improvement, primary care

  20. General practitioners' reasoning about using mobile distance-spanning technology in home care and in nursing home care.

    Science.gov (United States)

    Wälivaara, Britt-Marie; Andersson, Staffan; Axelsson, Karin

    2011-03-01

    The trend for health care and nursing care turns from hospital to health care and nursing care at home. Studies have shown that health care professionals have no access to patient records in home and nursing home settings. Technological development creates opportunities for a host of mobile technology solutions. The aim of this study was to describe the reasoning among general practitioners (GPs) about the use of mobile distance-spanning technology (MDST) in care at home and in nursing homes. Seventeen GPs were divided in five groups for a group interview. The interviews were tape-recorded and transcribed verbatim. The qualitative content analysis resulted in four areas about the MDST, MDST has an impact on GPs' work, the nurses' profession, and the patient and the family, with nine adherent categories. The findings were interpreted and formulated in the theme: MDST should be used with caution. The results show quite a few expressions about the MDST as useful and valuable in health care at home and in nursing home settings; however, in every category, there were text that we interpreted as caution when using the MDST. The MDST cannot be used in all situations and cannot replace human meetings in health care and nursing care at home and in nursing homes. The MDST should primarily be a tool for the profession, and understanding the professions' reasoning about technology use in health care at home and in nursing home settings must be the base for implementing MDST.

  1. Effectiveness of two types of intervention on antibiotic prescribing in respiratory tract infections in Primary Care in Spain. Happy Audit Study

    Directory of Open Access Journals (Sweden)

    Carles Llor

    2014-11-01

    Conclusions: Active participation of GPs with the performance of point-of-care tests in the clinic is accompanied by a drastic reduction of antibiotic use in RTIs, primarily in infections considered as mainly viral.

  2. Managing high-risk patients: the Mass General care management programme

    Directory of Open Access Journals (Sweden)

    Dennis L Kodner

    2015-09-01

    Full Text Available The Massachusetts General Care Management Program (Mass General CMP or CMP was designed as a federally supported demonstration to test the impact of intensive, practice-based care management on high-cost Medicare fee-for-service (FFS beneficiaries—primarily older persons—with multiple hospitalisations and multiple chronic conditions. The Massachusetts General Care Management Program operated over a 6-year period in two phases (3 years each. It started during the first phase at Massachusetts General Hospital, a major academic medical centre in Boston, Massachusetts in collaboration with Massachusetts General Physicians Organisation. During the second phase, the programme expanded to two more affiliated sites in and around the Boston area, including a community hospital, as well as incorporated several modifications primarily focused on the management of transitions to post-acute care in skilled nursing facilities. At the close of the demonstration in July 2012, Mass General Massachusetts General Care Management Program became a component of a new Pioneer accountable care organisation (ACO. The Massachusetts General Care Management Program is focused on individuals meeting defined eligibility criteria who are offered care that is integrated by a case manager embedded in a primary care practice. The demonstration project showed substantial cost savings compared to fee-for-service patients served in the traditional Medicare system but no impact on hospital readmissions. The Massachusetts General Care Management Program does not rest upon a “whole systems” approach to integrated care. It is an excellent example of how an innovative care co-ordination programme can be implemented in an existing health-care organisation without making fundamental changes in its underlying structure or the way in which direct patient care services are paid for. The accountable care organisation version of the Massachusetts General Care Management Program

  3. Managing high-risk patients: the Mass General care management programme

    Directory of Open Access Journals (Sweden)

    Dennis L Kodner

    2015-09-01

    Full Text Available The Massachusetts General Care Management Program (Mass General CMP or CMP was designed as a federally supported demonstration to test the impact of intensive, practice-based care management on high-cost Medicare fee-for-service (FFS beneficiaries—primarily older persons—with multiple hospitalisations and multiple chronic conditions. The Massachusetts General Care Management Program operated over a 6-year period in two phases (3 years each. It started during the first phase at Massachusetts General Hospital, a major academic medical centre in Boston, Massachusetts in collaboration with Massachusetts General Physicians Organisation. During the second phase, the programme expanded to two more affiliated sites in and around the Boston area, including a community hospital, as well as incorporated several modifications primarily focused on the management of transitions to post-acute care in skilled nursing facilities. At the close of the demonstration in July 2012, Mass General Massachusetts General Care Management Program became a component of a new Pioneer accountable care organisation (ACO. The Massachusetts General Care Management Program is focused on individuals meeting defined eligibility criteria who are offered care that is integrated by a case manager embedded in a primary care practice. The demonstration project showed substantial cost savings compared to fee-for-service patients served in the traditional Medicare system but no impact on hospital readmissions. The Massachusetts General Care Management Program does not rest upon a “whole systems” approach to integrated care. It is an excellent example of how an innovative care co-ordination programme can be implemented in an existing health-care organisation without making fundamental changes in its underlying structure or the way in which direct patient care services are paid for. The accountable care organisation version of the Massachusetts General Care Management Program

  4. 浅谈骨科患者的心理护理%Brief Talk on Psychological Care of Orthopedic Patients

    Institute of Scientific and Technical Information of China (English)

    赵泽艳; 邹家柳

    2013-01-01

      骨科患者心理状态与一般患者相比具有不同的心理特点和不同的生理、心理需求,往往表现为不能面对事实,心理表现异常等。而正确运用全面的心理学知识,了解不同层次、不同职业各治疗阶段患者的心理状态,能使患者获得较好的心身整体护理,促进病情的恢复。%The mental state of orthopedic patients is different from other general patients in psy-chological characteristics and needs of physiological and psychological, which often manifests as not facing facts or abnormal psychological manifestations. The correctly use of comprehensive knowledge of psychology can help to know about patients’mental state in different treatment phas-es of different levels of different careers, help patients get a better psychosomatic overall care to pro-mote the recovery of disease.

  5. Spiritual Care Education of Health Care Professionals

    Directory of Open Access Journals (Sweden)

    Donia Baldacchino

    2015-05-01

    Full Text Available Nurses and health care professionals should have an active role in meeting the spiritual needs of patients in collaboration with the family and the chaplain. Literature criticizes the impaired holistic care because the spiritual dimension is often overlooked by health care professionals. This could be due to feelings of incompetence due to lack of education on spiritual care; lack of inter-professional education (IPE; work overload; lack of time; different cultures; lack of attention to personal spirituality; ethical issues and unwillingness to deliver spiritual care. Literature defines spiritual care as recognizing, respecting, and meeting patients’ spiritual needs; facilitating participation in religious rituals; communicating through listening and talking with clients; being with the patient by caring, supporting, and showing empathy; promoting a sense of well-being by helping them to find meaning and purpose in their illness and overall life; and referring them to other professionals, including the chaplain/pastor. This paper outlines the systematic mode of intra-professional theoretical education on spiritual care and its integration into their clinical practice; supported by role modeling. Examples will be given from the author’s creative and innovative ways of teaching spiritual care to undergraduate and post-graduate students. The essence of spiritual care is being in doing whereby personal spirituality and therapeutic use of self contribute towards effective holistic care. While taking into consideration the factors that may inhibit and enhance the delivery of spiritual care, recommendations are proposed to the education, clinical, and management sectors for further research and personal spirituality to ameliorate patient holistic care.

  6. Pediatric intensive care.

    Science.gov (United States)

    Macintire, D K

    1999-07-01

    To provide optimal care, a veterinarian in a pediatric intensive care situation for a puppy or kitten should be familiar with normal and abnormal vital signs, nursing care and monitoring considerations, and probable diseases. This article is a brief discussion of the pediatric intensive care commonly required to treat puppies or kittens in emergency situations and for canine parvovirus type 2 enteritis.

  7. Health care operations management

    NARCIS (Netherlands)

    Carter, M.W.; Hans, Elias W.; Kolisch, R.

    2012-01-01

    Health care operations management has become a major topic for health care service providers and society. Operations research already has and further will make considerable contributions for the effective and efficient delivery of health care services. This special issue collects seven carefully

  8. Do Consultation Psychiatrists, Forensic Psychiatrists, Psychiatry Trainees, and Health Care Lawyers Differ in Opinion on Gray Area Decision-Making Capacity Cases? A Vignette-Based Survey.

    Science.gov (United States)

    Armontrout, James; Gitlin, David; Gutheil, Thomas

    2016-01-01

    Previous research in the area of medical decision-making capacity has demonstrated relatively poor agreement between experienced evaluators in "gray area" cases. We performed a survey to determine the level of agreement about gray area decision-making capacity case scenarios within and between individuals of different professional backgrounds. Participants received a survey consisting of 3 complicated decision-making capacity vignettes with an accompanying "yes/no" question regarding capacity and a certainty scale for each vignette. Participants were identified from mailing lists of professional organizations and local hospitals. We received responses from psychiatry trainees, consultation-liaison psychiatrists, forensic psychiatrists, and lawyers with experience in health care law. Results were analyzed using SPSS. Across the 3 vignettes, the percentage agreeing that the individual described had capacity to refuse medical treatment ranged between 35% and 40% for trainees, 33% and 67% for consult psychiatrists, 41% and 76% for forensic psychiatrists, and 40% and 83% for health care lawyers. Only question 2 reached significance between-group differences (Pearson χ(2) = 11.473, p decision-making than were forensic psychiatrists and lawyers. As found in previous research, agreement among experienced evaluators appears generally low in gray area capacity cases. It is noteworthy that individuals of different professional backgrounds at times offer divergent between-group opinions on capacity. Copyright © 2016 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.

  9. About Skin-to-Skin Care (Kangaroo Care)

    Science.gov (United States)

    ... Size Email Print Share About Skin-to-Skin Care Page Content Article Body You may be able ... care, also called kangaroo care. What is Kangaroo Care? Kangaroo care was developed in South America as ...

  10. Care, Europeanization and Gender

    DEFF Research Database (Denmark)

    Freudendal-Pedersen, Malene

    This book adresses the recent underexamined developments concerning care in Europe, including the negotiations about care at the top EU level to that of individual workers. Through a comparative and interdisciplinary approach, this collection examines and further develops current theoretical...... and political debares about complexities of care and the impact of multilevel changes in Europe. It provides a foundation for understanding the major restructuring of care that is taking place at the European level as related to the global phenonomena of care markets....

  11. The Influence of Organizational Systems on Information Exchange in Long-Term Care Facilities: An Institutional Ethnography.

    Science.gov (United States)

    Caspar, Sienna; Ratner, Pamela A; Phinney, Alison; MacKinnon, Karen

    2016-06-01

    Person-centered care is heavily dependent on effective information exchange among health care team members. We explored the organizational systems that influence resident care attendants' (RCAs) access to care information in long-term care (LTC) settings. We conducted an institutional ethnography in three LTC facilities. Investigative methods included naturalistic observations, in-depth interviews, and textual analysis. Practical access to texts containing individualized care-related information (e.g., care plans) was dependent on job classification. Regulated health care professionals accessed these texts daily. RCAs lacked practical access to these texts and primarily received and shared information orally. Microsystems of care, based on information exchange formats, emerged. Organizational systems mandated written exchange of information and did not formally support an oral exchange. Thus, oral information exchanges were largely dependent on the quality of workplace relationships. Formal systems are needed to support structured oral information exchange within and between the microsystems of care found in LTC.

  12. The Affordable Care Act and integrated care.

    Science.gov (United States)

    Kuramoto, Ford

    2014-01-01

    The Patient Protection and Affordable Care Act (ACA) of 2010 offers a comprehensive, integrated health insurance reform program for those who are eligible to enroll. A core feature of the ACA is the integration of primary health, behavioral health, and related services in a new national program for the first time. This article traces the history of past federal services integration efforts and identify varying approaches for implementing them to improve care, especially for underserved populations. The business case for integrated care, reducing escalating health care costs and overcoming barriers to implementation, is also discussed.

  13. Integrated complex care coordination for children with medical complexity: A mixed-methods evaluation of tertiary care-community collaboration

    Directory of Open Access Journals (Sweden)

    Cohen Eyal

    2012-10-01

    Full Text Available Abstract Background Primary care medical homes may improve health outcomes for children with special healthcare needs (CSHCN, by improving care coordination. However, community-based primary care practices may be challenged to deliver comprehensive care coordination to complex subsets of CSHCN such as children with medical complexity (CMC. Linking a tertiary care center with the community may achieve cost effective and high quality care for CMC. The objective of this study was to evaluate the outcomes of community-based complex care clinics integrated with a tertiary care center. Methods A before- and after-intervention study design with mixed (quantitative/qualitative methods was utilized. Clinics at two community hospitals distant from tertiary care were staffed by local community pediatricians with the tertiary care center nurse practitioner and linked with primary care providers. Eighty-one children with underlying chronic conditions, fragility, requirement for high intensity care and/or technology assistance, and involvement of multiple providers participated. Main outcome measures included health care utilization and expenditures, parent reports of parent- and child-quality of life [QOL (SF-36®, CPCHILD©, PedsQL™], and family-centered care (MPOC-20®. Comparisons were made in equal (up to 1 year pre- and post-periods supplemented by qualitative perspectives of families and pediatricians. Results Total health care system costs decreased from median (IQR $244 (981 per patient per month (PPPM pre-enrolment to $131 (355 PPPM post-enrolment (p=.007, driven primarily by fewer inpatient days in the tertiary care center (p=.006. Parents reported decreased out of pocket expenses (p© domains [Health Standardization Section (p=.04; Comfort and Emotions (p=.03], while total CPCHILD© score decreased between baseline and 1 year (p=.003. Parents and providers reported the ability to receive care close to home as a key benefit. Conclusions Complex

  14. Genital herpes - self-care

    Science.gov (United States)

    Herpes - genital -self-care; Herpes simplex - genital - self-care; Herpesvirus 2 - self-care; HSV-2 - self-care ... genital herpes can be treated. Follow your health care provider's instructions for treatment and follow-up.

  15. Care Aides' Relational Practices and Caring Contributions.

    Science.gov (United States)

    Andersen, Elizabeth A; Spiers, Jude

    2016-11-01

    HOW TO OBTAIN CONTACT HOURS BY READING THIS ARTICLE INSTRUCTIONS 1.2 contact hours will be awarded by Villanova University College of Nursing upon successful completion of this activity. A contact hour is a unit of measurement that denotes 60 minutes of an organized learning activity. This is a learner-based activity. Villanova University College of Nursing does not require submission of your answers to the quiz. A contact hour certificate will be awarded once you register, pay the registration fee, and complete the evaluation form online at http://goo.gl/gMfXaf. To obtain contact hours you must: 1. Read the article, "Care Aides' Relational Practices and Caring Contributions" found on pages 24-30, carefully noting any tables and other illustrative materials that are included to enhance your knowledge and understanding of the content. Be sure to keep track of the amount of time (number of minutes) you spend reading the article and completing the quiz. 2. Read and answer each question on the quiz. After completing all of the questions, compare your answers to those provided within this issue. If you have incorrect answers, return to the article for further study. 3. Go to the Villanova website listed above to register for contact hour credit. You will be asked to provide your name; contact information; and a VISA, MasterCard, or Discover card number for payment of the $20.00 fee. Once you complete the online evaluation, a certificate will be automatically generated. This activity is valid for continuing education credit until October 31, 2019. CONTACT HOURS This activity is co-provided by Villanova University College of Nursing and SLACK Incorporated. Villanova University College of Nursing is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation. ACTIVITY OBJECTIVES 1. Define the application of Swanson's Middle Range Theory of Caring in care aides' relational care practices for nursing home

  16. Veterans’s Medical Care: FY2014 Appropriations

    Science.gov (United States)

    2013-08-14

    Veterans Benefits Administration ( VBA ), and the National Cemetery Administration (NCA). This report focuses on funding for the VHA. The VHA is primarily...administrations and the Board of Veterans Appeals (BVA).9 The Veterans Benefits Administration ( VBA ) is responsible for, among other things, providing...Congress begins with the formulations of the budget based on the Enrollee Health Care Projection Model (EHCPM).31 The model estimates the amount of

  17. Live kidney donations and the ethic of care.

    Science.gov (United States)

    Kane, Francis; Clement, Grace; Kane, Mary

    2008-09-01

    In this paper, we seek to re-conceptualize the ethical framework through which ethicists and medical professionals view the practice of live kidney donations. The ethics of organ donation has been understood primarily within the framework of individual rights and impartiality, but we show that the ethic of care captures the moral situation of live kidney donations in a more coherent and comprehensive way, and offers guidance for practitioners that is more attentive to the actual moral transactions among donors and recipients. A final section offers guidelines for the practice of live kidney transplants that emerge from an ethic of care.

  18. Research in cardiovascular care

    DEFF Research Database (Denmark)

    Jaarsma, Tiny; Deaton, Christi; Fitzsimmons, Donna

    2014-01-01

    To deliver optimal patient care, evidence-based care is advocated and research is needed to support health care staff of all disciplines in deciding which options to use in their daily practice. Due to the increasing complexity of cardiac care across the life span of patients combined...... of the body of knowledge that is needed to further improve cardiovascular care. In this paper, knowledge gaps in current research related to cardiovascular patient care are identified, upcoming challenges are explored and recommendations for future research are given....

  19. Personal Care in Learning Health Care Systems.

    Science.gov (United States)

    Miller, Franklin G; Kim, Scott Y H

    2015-12-01

    The idea of a "learning health care system"--one that systematically integrates clinical research with medical care--has received considerable attention recently. Some commentators argue that under certain conditions pragmatic comparative effectiveness randomized trials can be conducted ethically within the context of a learning health care system without the informed consent of patients for research participation. In this article, we challenge this perspective and contend that conducting randomized trials of individual treatment options without consent is neither necessary nor desirable to promote and sustain learning health care systems. Our argument draws on the normative conception of personal care developed by Charles Fried in a landmark 1974 book on the ethics of randomized controlled trials.

  20. Caring for caregivers: facing up to tough challenges.

    Science.gov (United States)

    Williams, A Paul; Peckham, Allie; Watkins, Jillian; Warrick, Natalie; Tam, Tommy; Rudoler, David; Spalding, Karen

    2014-01-01

    This paper, the first in a series of three, sets the stage for two accompanying papers detailing a pair of groundbreaking initiatives to support "at risk" caregivers of high-needs older persons and children in Toronto. Although caregiver burden and stress are often conceptualized primarily as a function of the needs of cared-for persons and the capacity of caregivers, fragmented formal care systems also play a key role. Solutions must take individual-level and system-level factors into account; clarify expectations about what we expect unpaid caregivers to do; redefine the unit of care to include caregivers; and think beyond short-term fixes to mechanisms, such as interdisciplinary teams and integrated care plans, that promote forward planning, accountability, best practices and crisis avoidance.

  1. A Multicenter Collaborative to Reduce Unnecessary Care in Inpatient Bronchiolitis.

    Science.gov (United States)

    Ralston, Shawn L; Garber, Matthew D; Rice-Conboy, Elizabeth; Mussman, Grant M; Shadman, Kristin A; Walley, Susan C; Nichols, Elizabeth

    2016-01-01

    Evidence-based Guidelines for acute viral bronchiolitis recommend primarily supportive care, but unnecessary care remains well documented. Published quality improvement work has been accomplished in children's hospitals, but little broad dissemination has been reported outside of those settings. We sought to use a voluntary collaborative strategy to disseminate best practices to reduce overuse of unnecessary care in children hospitalized for bronchiolitis in community settings. This project was a quality improvement collaborative consisting of monthly interactive webinars with online data collection and feedback. Data were collected by chart review for 2 bronchiolitis seasons, defined as January, February, and March of 2013 and 2014. Patients aged bronchiolitis and without chronic illness, prematurity, or intensive care use were included. Results were analyzed using run charting, analysis of means, and nonparametric statistics. There were 21 participating hospitals contributing a total of 1869 chart reviews to the project, 995 preintervention and 874 postintervention. Mean use of any bronchodilator declined by 29% (P = .03) and doses per patient decreased 45% (P < .01). Mean use of any steroids declined by 68% (P < .01), and doses per patient decreased 35% (P = .04). Chest radiography use declined by 44% (P = .05). Length of stay decreased 5 hours (P < .01), and readmissions remained unchanged. A voluntary collaborative was effective in reducing unnecessary care among a cohort of primarily community hospitals. Such a strategy may be generalizable to the settings where the majority of children are hospitalized in the United States. Copyright © 2016 by the American Academy of Pediatrics.

  2. The activation of p38 MAPK primarily contributes to UV-induced RhoB expression by recruiting the c-Jun and p300 to the distal CCAAT box of the RhoB promoter

    Energy Technology Data Exchange (ETDEWEB)

    Ahn, Jiwon [Genome Research Center, KRIBB, Daejeon 305-806 (Korea, Republic of); Department of Microbiology, Chungnam National University, Daejeon 305-764 (Korea, Republic of); Choi, Jeong-Hae; Won, Misun [Genome Research Center, KRIBB, Daejeon 305-806 (Korea, Republic of); Kang, Chang-Mo [Laboratory of Cytogenetics and Tissue Regeneration, KIRAMS, Seoul 139-706 (Korea, Republic of); Gyun, Mi-Rang [Genome Research Center, KRIBB, Daejeon 305-806 (Korea, Republic of); Functional Genomics, Korea University of Science and Technology, Daejeon 305-350 (Korea, Republic of); Park, Hee-Moon [Department of Microbiology, Chungnam National University, Daejeon 305-764 (Korea, Republic of); Kim, Chun-Ho, E-mail: chkim@kirams.re.kr [Laboratory of Cytogenetics and Tissue Regeneration, KIRAMS, Seoul 139-706 (Korea, Republic of); Chung, Kyung-Sook, E-mail: kschung@kribb.re.kr [Genome Research Center, KRIBB, Daejeon 305-806 (Korea, Republic of)

    2011-06-03

    Highlights: {yields} Regulation of transcriptional activation of RhoB is still unclear. {yields} We examine the effect of p38 MAPK inhibition, and c-Jun and RhoB depletion on UV-induced RhoB expression and apoptosis. {yields} We identify the regions of RhoB promoter necessary to confer UV responsiveness using pRhoB-luciferase reporter assays. {yields} c-Jun, ATF2 and p300 are dominantly associated with NF-Y on the distal CCAAT box. {yields} The activation of p38 MAPK primarily contribute to UV-induced RhoB expression by recruiting the c-Jun and p300 proteins on distal CCAAT box of RhoB promoter. -- Abstract: The Ras-related small GTP-binding protein RhoB is rapidly induced in response to genotoxic stresses caused by ionizing radiation. It is known that UV-induced RhoB expression results from the binding of activating transcription factor 2 (ATF2) via NF-Y to the inverted CCAAT box (-23) of the RhoB promoter. Here, we show that the association of c-Jun with the distal CCAAT box (-72) is primarily involved in UV-induced RhoB expression and p38 MAPK regulated RhoB induction through the distal CCAAT box. UV-induced RhoB expression and apoptosis were markedly attenuated by pretreatment with the p38 MAPK inhibitor. siRNA knockdown of RhoB, ATF2 and c-Jun resulted in decreased RhoB expression and eventually restored the growth of UV-irradiated Jurkat cells. In the reporter assay using luciferase under the RhoB promoter, inhibition of RhoB promoter activity by the p38 inhibitor and knockdown of c-Jun using siRNA occurred through the distal CCAAT box. Immunoprecipitation and DNA affinity protein binding assays revealed the association of c-Jun and p300 via NF-YA and the dissociation of histone deacetylase 1 (HDAC1) via c-Jun recruitment to the CCAAT boxes of the RhoB promoter. These results suggest that the activation of p38 MAPK primarily contributes to UV-induced RhoB expression by recruiting the c-Jun and p300 proteins to the distal CCAAT box of the RhoB promoter in

  3. Improving trauma care in Trinidad and Tobago.

    Science.gov (United States)

    Adam, R; Stedman, M; Winn, J; Howard, M; Williams, J I; Ali, J

    1994-06-01

    Identification of trauma as a major cause of morbidity and mortality in Trinidad and Tobago prompted the establishment of a training programme aimed at improving trauma care in this developing country. An Advanced Trauma Life Support (ATLS) programme for physicians, funded through the Canadian International Development Agency resulted in a statistically significant improvement of in-hospital trauma patient outcome at the Port-of-Spain General Hospital (observed to expected mortality ratio of 3.16 pre-ATLS compared to 1.94 post-ATLS). A recent analysis of all motor vehicle injuries for a shorter period did not confirm this positive impact of the ATLS programme, primarily because a large number of these patients died in the pre-hospital period. Pre-hospital trauma care therefore required urgent attention to complement the positive in-hospital impact of the ATLS programme. A second training programme (the Pre-Hospital Trauma Life Support or PHTLS) for paramedical personnel was thus instituted in 1990. Over 250 physicians have been trained in the ATLS programme and to date over 100 paramedical personnel have been trained in the PHTLS programme. Attempts have also been made to equip the ambulances with more appropriate resuscitative devices in order to improve pre-hospital care. The combination of the PHTLS and the ATLS programme should result in further improvement in the care of patients sustaining major injuries in Trinidad and Tobago.

  4. The potential of the internet for alternative caring practices for health.

    Science.gov (United States)

    Atkinson, Sarah; Ayers, Andrew

    2010-04-01

    The practices of health care in late modernity are informed by competing visions of the ideal human and the nature of care. Western societies typically characterise the ideal human as independent and self-reliant. The resultant welfare systems provide temporary havens away from the everyday, competitive spaces of capitalist societies, termed here the enclave model. Social scientists problematise this model on several grounds: the construction of pathologised and medicalised body forms; the neglect of caring practices that are gendered, invisible and primarily private; the de-politicisation of caring practices. Policy calls reject reference to care and its associations with dependency, make visible and value informal care work or invoke a caring citizenship as a policy goal not just a means. Into this field of contested notions of care enters a well-documented rise in access to, and consultation through, the internet in everyday lives for a vast range of issues. Health care encountered online reflects a similar range in form as that encountered offline and much that is innovative, whilst clearly of benefit, does nothing to challenge the existing dominance of the enclave model of social care. However, certain groups of sites create spaces through which participants can both express and extract caring relationships that are otherwise unforthcoming. The paper argues that these sites afford the potential to develop an alternative model of caring, to reframe questions of how to care about distant others and to demonstrate the centrality of caring relations to human life.

  5. Fruiting Season Length Restricts Global Distribution of Female-Only Parental Care in Frugivorous Passerine Birds.

    Directory of Open Access Journals (Sweden)

    Sahas Barve

    Full Text Available Food availability is known to influence parental care and mating systems in passerine birds. Altricial chicks make uni-parental care particularly demanding for passerines and parental investment is known to increase with decreasing food availability. We expect this to limit uni-parental passerines to habitats with the most consistent food availability. In passerine birds, species having uni-parental care are primarily female-only parental care (female-only care and most passerine birds with female-only care are frugivores. We predict that frugivorous passerines with female-only care should be restricted to the most stable habitats characterized by longer fruiting season length. At a global scale, female-only care frugivores were distributed in areas with significantly longer fruiting seasons than non-female-only care frugivores. Female-only care species richness had a stronger spatial relationship with longer fruiting season than non-female-only care species richness. Verifying the lack of a phylogenetic signal driving this pattern, our findings indicate that the geographic distribution of female-only care, a geographically and phylogenetically widespread parental care system, is restricted by an extrinsic factor: fruiting season length. This reinstates the importance of food availability on the evolution and maintenance of parental care systems in passerine birds.

  6. Fruiting Season Length Restricts Global Distribution of Female-Only Parental Care in Frugivorous Passerine Birds.

    Science.gov (United States)

    Barve, Sahas; La Sorte, Frank A

    2016-01-01

    Food availability is known to influence parental care and mating systems in passerine birds. Altricial chicks make uni-parental care particularly demanding for passerines and parental investment is known to increase with decreasing food availability. We expect this to limit uni-parental passerines to habitats with the most consistent food availability. In passerine birds, species having uni-parental care are primarily female-only parental care (female-only care) and most passerine birds with female-only care are frugivores. We predict that frugivorous passerines with female-only care should be restricted to the most stable habitats characterized by longer fruiting season length. At a global scale, female-only care frugivores were distributed in areas with significantly longer fruiting seasons than non-female-only care frugivores. Female-only care species richness had a stronger spatial relationship with longer fruiting season than non-female-only care species richness. Verifying the lack of a phylogenetic signal driving this pattern, our findings indicate that the geographic distribution of female-only care, a geographically and phylogenetically widespread parental care system, is restricted by an extrinsic factor: fruiting season length. This reinstates the importance of food availability on the evolution and maintenance of parental care systems in passerine birds.

  7. 超12小时面部软组织创伤Ⅰ期修复临床观察%clinical observation of repairing primarily for over 12-houred facial soft tissue injury

    Institute of Scientific and Technical Information of China (English)

    孙秀锋; 王洪燕; 郑妍丽; 姜涛

    2012-01-01

    目的:探讨Ⅰ期整形修复超12小时面部软组织创伤的方法和经验.方法:选择我院急诊面部软组织创伤超过12h病例17例,采用积极扩创和整形外科技术Ⅰ期修复,观察治疗效果.结果:伤口均甲级愈合,无明显瘢痕增生,无功能障碍,不需要Ⅱ期修复,美容效果良好.结论:超12h面部软组织创伤,采用积极扩创和整形缝合,可获Ⅰ期修复和满意的美容效果,值得临床应用和深入研究.%Objective To explore the clinical method and experience of repairing over 12-houred emergency facial soft tissue trauma primarily with plastic surgical techniques. Methods The over 12-houred emergency facial soft tissue injuries of 17 patients were selected. They had been expanded debrided and repaired primarily with plastic surgical techniques. Healing effects were observed and compared. Results All cases were primary healing.There were no obvious scar formative or function problems.Second stage reconstruction was not needed, the cosmetic effect was perfect. Conclusion The facial soft tissue injury of over 12-hours can require primary healing and- satisfactory cosmetic result with active expanded debride and plastic surgical techniques. It is worth clinical applying and deeply researching.

  8. Does Care Matter?

    DEFF Research Database (Denmark)

    Loft, Lisbeth Trille Gylling; Hogan, Dennis P.

    2014-01-01

    employment during the first 36 weeks following a birth, and its association with experienced non-parental child care use before labor force entry. Using data from the Early Childhood Longitudinal Survey – Birth Cohort (N = 10,400 mothers), results from discrete-time hazard models show that use of non......The aim of this study is to introduce the concept of care capital and provide an example of its application in the context of child care and maternal employment using the currently most suitable American data. We define care capital as the nexus of available, accessible, and experienced resources...... for care. The American setting is an ideal context to investigate the linkages between child care capital and maternal employment as the patterns of child care use tend to be more diverse compared to other national context. In the presented application of care capital, we examine mothers’ entry to paid...

  9. US EPA CARE Grants

    Data.gov (United States)

    U.S. Environmental Protection Agency — This is a provisional dataset that contains point locations for the subset of Community Action for a Renewed Environment (CARE) grants given out by the US EPA. CARE...

  10. Day Care Centers

    Data.gov (United States)

    Department of Homeland Security — This database contains locations of day care centers for 50 states and Washington D.C. and Puerto Rico. The dataset only includes center based day care locations...

  11. Dental Care in Pregnancy

    Science.gov (United States)

    Share with Women Dental Care in Pregnancy Why is dental care in pregnancy important? During pregnancy, you are more likely to have problems ... There are 2 major reasons women can have dental problems during pregnancy: Pregnancy gingivitis— During pregnancy, changes ...

  12. Surgical Critical Care Initiative

    Data.gov (United States)

    Federal Laboratory Consortium — The Surgical Critical Care Initiative (SC2i) is a USU research program established in October 2013 to develop, translate, and validate biology-driven critical care....

  13. Children's hospice care.

    Science.gov (United States)

    Armstrong-Dailey, A

    1990-01-01

    Facing the inevitable death of a child is a difficult reality for many parents and health care providers as well. Children's Hospice International offers a variety of information and education services to support the provision of children's hospice care.

  14. Prenatal Care Checkup

    Science.gov (United States)

    ... report card Careers Archives Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal care Is it safe? Labor & ... Careers Archives Health Topics Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal care Is it safe? Labor & ...

  15. Office of Child Care

    Science.gov (United States)

    ... for Children & Families Office of Child Care By Office Administration for Native Americans (ANA) Administration on Children, ... Learn more about this project > What is the Office of Child Care (OCC)? The Office of Child ...

  16. National Health Care Survey

    Science.gov (United States)

    This survey encompasses a family of health care provider surveys, including information about the facilities that supply health care, the services rendered, and the characteristics of the patients served.

  17. Empowering and caring professionals

    DEFF Research Database (Denmark)

    Hansen, Agnete Meldgaard

    workers negotiate professional identities and understandings of meaningful care work, in the new regime of rehabilitative elderly care – how they manage the ambiguities of a simultaneously empowering and interventionist practice. The paper’s analytical framework draws on an understanding of empowerment...... as a form of advanced liberal government. Also included are perspectives on historically shifting understandings of care and professional care work, that serve as a repertoire of meaning and identity for care workers, who are shown to be actively constructing identities and ‘crafting’ their jobs in relation...... to the new practice of rehabilitative elderly care. The care workers are found to be balancing complex and contradicting identities as ‘paradigm shifters’ who are reforming traditional understandings of care; as facilitators of the choices and control of citizens; as promoters of responsibility and guards...

  18. FastStats: Home Health Care

    Science.gov (United States)

    ... Day Services Centers Home Health Care Hospice Care Nursing Home Care Residential Care Communities Screenings Mammography Pap Tests Disability ... Care National Study of Long-Term Care Providers Nursing Home Care Residential Care Communities Centers for Medicare and Medicaid ...

  19. Leadership for patient care.

    Science.gov (United States)

    Nackel, J G; Shelley, S R

    1991-01-01

    In an era of change in health-care delivery and, particularly, change in patient care, leadership is the cornerstone of change management. The environment of the 1990s will challenge even the most sophisticated and capable health-care executives. This paper discusses key aspects of leadership and models them to the patient-care setting. Leadership will be the differentiating factor as organizations seek competitive advantage.

  20. Access to health care: solidarity and justice or egoism and injustice?

    Science.gov (United States)

    Prudil, Lukas

    2008-09-01

    The aim of this paper is to answer the question whether there is a real demand for equal access to health care or--better--to medical care and which interest groups (patients, health care professionals, policy makers and others) are interested in equal access. The focus is on EU countries including recent case law from the European Court of Justice and the European Court of Human Rights. We discuss whether there is a need to have legislative safeguards to protect equal access to medical care and whether such norms really work. The paper concludes that some of the key players in medical care are not primarily governed by a real willingness to have equal and just access to medical care, but by rather egoistic approaches. It seems that policy makers and politicians are the only ones who, surprisingly, must at least formally call for and enforce equal access to medical care. Interests of other groups seem to be different.