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PubMed1977

Federal constraints: earned or unearned?

The author discusses the evolution of federal constraints on medical, behavioral, and social science research. There has been only one court decision related to behavioral research and none in medical research. The burden of consent procedures can be lightened somewhat by careful consideration of the potential risks and nature of the research; questions are presented that can be used to determine whether constraints apply. The author notes that although there are good reasons for regulations in both behavioral and medical research, the appropriateness of current and proposed constraints is still a matter of debate.

Behavior↗
PubMed1999

The homoerotic behavior that never evolved.

The emerging field of evolutionary psychology provides fascinating new insights into many salient human behaviors, but homosexual behavior is not among these. The new field perpetuates old stereotypes, and useful evolutionary analysis of homosexual behavior is largely nonexistent. In this article, the treatment of homosexual behavior in the field of evolutionary psychology is reviewed, and the factors contributing to this treatment are identified. Recommendations are made to help foster the development of alternative evolutionary models of homosexual behavior.

Biological Evolution↗
PubMed1993

[The epidemiological situation of Hansen's disease and its contacts in Campinas].

Leprosy is a highly prevalent, endemic disease in this country. Due to its long evolution, it gives rise to an extremely important social issue. This paper analyses the epidemiologic status of Leprosy in the municipality of Campinas. The epidemiologic framework indicates that control of leprosy communicants in Campinas remains inefficient, showing the need for further studies upon these social actors, important links in the epidemiologic sequence of this disease.

Adolescent↗
PubMedDate not supplied

[Territorial experiment: inter-relational evolution of a group of inmates in the course of an extra-institutional working experiment].

The Authors analize the interrelational evolution of a group of inmates during an outside working activity, with relation to the resocializing experiences which consider the insertion in the area of individuals subjected to detentive security measures. Such evolution, in relation with the influences of the social enviornment one was associated with, was associated with, was marked by an initial cohesion stage between members (of defensive significance), followed by a gradual research of a personal autonomy, in parallel with the acquisition of a reassuring and stabilized role. The utilization of a social space according to the conventional parameters used in the area (with particular concern towards syndical dynamics and rules), reached at the cost of self-exposure, has confirmed the reached maturity and the self balance in proposing themselves to the others as subjects active in their own resocialization, sharing the acquired social rights. Beside the situation concerning the side of the group in its insertion progress, the Authors take into examination the side of the free community in tis receptivity and availability towards the group members, analizing the interactions with the environment as therapeutical moment.

Humans↗
PubMed1998

[Not Available].

Explore the source record for details and available documents.

Civilization↗
PubMed1989

[The Quebec-Ontario fertility differential].

"Various economic, political, social and demographic factors may explain the different evolution of fertility in Quebec and Ontario. After a brief historical outlook, the author analyses more specifically the distribution of the population according to place of birth. This leads to the conclusion that the high proportion of immigrant women in Ontario, jointly with their above-average fertility, has played a major role in increasing the fertility gap between Quebec and Ontario at the beginning of the 1980's." (SUMMARY IN ENG AND SPA)

Americas↗
PubMedDate not supplied

[Caregiver burden in relatives of persons with schizophrenia: an overview of measure instruments].

The high prevalence and chronic evolution of schizophrenia are responsible for a major social cost. The adverse consequences of such psychiatric disorders for relatives have been studied since the early 1950s, when psychiatric institutions began discharging patients into the community. According to Treudley (1946) "burden on the family" refers to the consequences for those in close contact with a severely disturbed psychiatric patient. Grad and Sainsbury (1963) and Hoenig and Hamilton (1966) developed the first burden scales for caregivers of severely mentally ill patients, and a number of authors further developed instruments trying to distinguish between "objective" and "subjective" burden. Objective burden concerns the patient's symptoms, behaviour and socio-demographic characteristics, but also the changes in household routine, family or social relations, work, leisure time, physical health.... Subjective burden is the mental health and subjective distress among family members. While the first authors referred to those problems which are deemed to be related to, or caused by the patient, Platt et al. (1983) tried to distinguish between the occurrence of a problem, its alleged aetiology, and the perceived distress, when developing the SBAS questionnaire. These authors also proposed separate evaluations of behavioral disturbance and social performance by relatives, and a report of extra-disease stressors in family life. The SBAS is actually the most complete, but also complex instrument for evaluating burden in caregivers. Since 1967 Pasamanick and others proposed questionnaires for burden evaluation in relatives of schizophrenic patients. Relatives may be included in specific psychoeducational programs, but few of these programs have been evaluated in terms of caregiver burden. The theoretical approach in schizophrenia was not different from that one adopted in mentally ill population. Some instruments were validated first in a mentally ill group and then adapated for schizophrenic population. This paper describes the available data about intruments measuring caregiver burden in relatives of schizophrenic patients. Measures are summarized according to purpose, content and psychometric properties. Sixteen instruments have been collected from the litterature (1955-2001), and 2 instruments developed for relatives of mentally ill have also been taken into account. A group of 5 instruments focuses on the measurement of behavioural disturbance in persons with schizophrenia as perceived by their family members. Eleven scales include behavioural disturbance in a more complete decription of objective burden. Thirteen questionnaires also report the subjective distress in caregivers. One instrument has been developed in french language. Few of these instruments have been developed from a verbatim and really describe the caregiver's point of view. Most of them rely on experts point of view or on previously published studies. The content and domains explored by these instruments are variable. The psychometric properties are poorly documented for a number of them and no information is published about responsiveness. Some validated instruments are the Perceived Family Burden Scale (PFBS) the Involvement Evaluation Questionnaire (IEQ) and the Experience of Caregiving Inventory (ECI). In past studies, researchers more or less agreed about the dimensions that comprise the family burden. There was less agreement with regard to the definition of objective and subjective burden, and quite no agreement about the theoretical approach to the concept of burden. The evaluation of behavioural disturbance should now be excluded from the objective burden dimension. It is a specific domain, both objective and subjective, which can be described as a stressor in the stress-appraisal-coping model. A good approach of this domain can be found in the PFBS. It comprises 24 items and the principal components analysis produces 2 factors ("active" and "passive"), explaining 35% of the variance, with good consitency and acceptable test-retest reliability. The evaluation is both objective (presence or absence) and subjective (induced distress). The Behavior Disturbance Scale (BDS) may also be taken into account, although it is less validated. This scale derives from the SBAS, modified as a self-questionnaire, with both objective and subjective evaluations of all items. The concept of burden was recently modified in a new theoretical approach by Schene, when developing the IEQ. According to this author, the burden scale is supposed to exclude stressors (patient's behaviors), as well as outcome variables (distress or psychological impairment in caregiver). The "caregiving consequences" section comprises 36 items, which focus on the subjective aspects of the caregiver's experience. Principal component factor analysis generates 4 factors which explain 45% of the variance: tension, supervision, worrying, urging. The overall caregiving score substantially explains the connection between patient, caregiver, relationship variables and the caregiver's distress. This scale is a valid and simple instrument for caregiving eveluation The ECI also introduces a new approach of caregiving and rejects the notion of burden. The 66 item version is composed of 10 factors (8 "negative" and 2 "positive") with good internal consistency. The introduction of two positive factors (rewarding personal experiences, good aspects of the relationship with the patient) might be the basis of a useful outcome measure for intervention aimed at promoting caregiver well-being. Nevertheless, the authors fail to develop an overall score that includes these factors, and focus on the negative dimensions as predictors of morbidity and well-being. None of the variables included in the regression model explain a significant percent of the variance of the ECI positive score. None of these instruments was employed for evaluating programs or treatments, even psychoeducational programs for caregivers. This may be partly due to the lack of data about sensitivity to change. No instrument is now available for evaluating therapeutics from the caregiver's point of view. Developing such an instrument is necessary, in view of the increasing role of families in care for schizophrenic patients. These data and the review of the literature leeds us to propose the development of a self-administered questionnaire for evaluating subjective health-related quality of life in caregivers of schizophrenic patients. The instrument should be developed from the caregiver's point of view and be derived from qualitative interviews with relatives of patients suffering from schizophrenia. It's responsiveness should be documented before inclusion in clinical trials or evaluation of psychoeducational programs. We are now working with the National Union of Friends and Families of Patients to validate an instrument in french language.

Caregivers↗
PubMed2005

Factors contributing to the decline of leprosy in Spain in the second half of the twentieth century.

BACKGROUND: Leprosy is a chronic infectious disease that is considered to be declining, though it still remains prevalent in many parts of the world. A study was made to explore the health and socioeconomic factors that most influenced the trend of the disease in a typical Mediterranean country. MATERIALS AND METHODS: An ecological study was conducted, investigating possible social, economic and health factors related to the evolution of leprosy incidence. The time period considered was 50 years--the second half of the twentieth century in Spain. RESULTS: The variables showing the strongest correlation to evolution of the incidence of the disease were employment, the number of physicians, and the gross domestic product (GDP), with negative coefficients--while tuberculosis showed a positive coefficient. However, the GDP showed the highest coefficient (0.5). The model that best explained the evolution of leprosy over the last 50 years comprised a 6-year lag period between the socioeconomic factors and the incidence of leprosy--explaining 57% of the data obtained. The annual decrease in leprosy incidence was 1.6%. CONCLUSIONS: Socioeconomic development, assessed in terms of the GDP, was the most important factor in explaining the evolution of leprosy incidence.

Employment↗
PubMed1989

[Experience in the differential diagnosis of infectious diseases].

It is stated that social and scientific progress in the course of evolution gives rise to marked changes in infectious pathology. The changes are obvious from reduced incidence of epidemic diseases, distinct clinical appearance of infection, different cyclic pattern of a number of nosological entities. Such newly recognized diseases as hemorrhagic fever, adenovirus and herpes virus infections, yersiniosis, rotavirus gastroenteritis, legionellosis, AIDS have advanced to the forefront. Previously unknown affections are likely to emerge in various areas of the world and become prevalent in extreme conditions. In addition to virological and immunological examinations, differential diagnosis of the above infections should include a comprehensive analysis of medical histories and clinicoepidemiological evidence in order to provide early detection, hospitalization, high therapeutic response.

Diagnosis, Differential↗