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PubMedDate not supplied

[Schizophrenia patients' daily life after the use of clozapine and group accompaniment: Family's view].

This study described the daily life of schizophrenia patients after the use of clozapine and group accompaniment from the perspective of family members. The research population consisted of 11 family members who most frequently accompanied 11 schizophrenia patients who participate in the group and use clozapine. With a view to data collection, interviews oriented by a script were held in April 2003, which were taped and fully transcribed afterwards. Results indicated an improvement in patients' symptoms, demonstrated by decreased social isolation, resumption of home/work activities and study as well as by participation in social events. These results point towards the need for a new view on patients who suffer from mental disorder and their family members, with a view to seeking therapeutic attitudes that act in the production of life with a view to a new existential meaning, in the different forms of social contact and sociability.

Activities of Daily Living↗

PubMed1993

Evaluating housing systems for veal calves.

Limitations of space, diet, and social environment can impair the welfare of veal calves reared in intensive farms compared with those calves allowed to pasture with their dams. In intensive farms most of the animals are housed in tether stalls or in crates. Stalls that greatly restrict the behavior of calves are not an adequate housing system. If the crates are small enough to prevent calves from lying in a comfortable position, they also impair the welfare of calves and lower their growth rate and disease resistance. Social contacts are limited in crates with solid partitions, but even if this social isolation seems unnecessary, it does not have the long-term effects on social and maternal behavior previously described. Because mortality rate is lower in crates than in group pens, and considering the time a calf spends grooming itself and lying with its legs stretched, large crates with open partitions are an acceptable alternative to group housing. However, improving group pens by providing adequate floors and automated feeding systems should make that type of housing better than crates. Other types of veal production such as the rearing of the calves by their dams could also be promoted. Other factors interact with housing system to affect the welfare status of veal calves. Milk-only diets should be avoided, and it is necessary to provide calves with adequate roughage as a way to enrich their environment. Friesian calves adapt better to veal calf operations than do Salers calves, and this difference between breeds must be considered when designing housing systems. The age of veal calves at slaughter should be considered to avoid maintaining calves in a preruminant physiological state beyond the point of the naturally occurring transition.

Animal Welfare↗

PubMed2006

[Vulnerability and National Health Service].

Safegarding health has been an objective of every learned civilization, ancient and modern. In modern times, at least in the western world, the increase in longevity associated with social isolation has created further vu1nerability for the older individua1. Today, healthcare is a social burden of extremely high cost. Among us this service is provided by the National Health Service in accordance to the Constituição da República Portuguesa (Constitution of the Portuguese Republic). Despite the constitutional guarantees of equa1ity in health there are obvious discrepancies in access to health care and the conditions that promote health such as education and wealth. In a poor country, even with limited resources, inequa1ity can be minimized via policies and practical measures founded in equa1ity and social responsibility, not only the principles of economic efficiency. Only in this way can we guarantee equa1 access to health and the distribution of available resources in accordance to health care necessities. Yet, the investment in high technology among us seems out of fase with the investment in the area concerning functional recovery from high morta1ity illness, such as stroke. In Portugal the problem is extremely bad. Life expectancy has been extended but qua1ity of life is still very low. Victims of the social order, the elderly live alone without family who can care for them; on the other hand, the lack of investment in recovery and social integration of individua1s with disabling scars, Turns the ends of their life's into a nightmare for themselves and their kin. It follows stating the necessity to analyse and define the criteria to be used when allocating resources in order to guarantee equality in health and relief from suffering and also to stop discrimination of vu1nerable populations in access to healthcare. Whatever the criteria, it must be pre-defined and its principles widely discussed, reiterating, only that longevity cannot be an acceptable criteria to value life. The article concludes drawing attention to the need to invest in health education, which is just as important as the fair distribution of precious health care resources in reducing harmful risks to the most vulnerable patients.

Aged↗

PubMed1980

Serologic evidence for parainfluenzavirus infection during isolation at South Pole Station, Antarctica.

Two distinct mid-winter outbreaks of respiratory tract illness (RTI) occurred among South Pole Station personnel during the winterover period of 1976. One outbreak began early in May eight weeks after total isolation began, the second occurred in August and September after 20 weeks of complete social isolation. Sequential sera collected from 16 of the 18 subjects wintering at South Pole during 1976 were tested by hemagglutination inhibition for antibody against parainfluenzavirus types 1 and 3. Serologic responses were detected against parainfluenzavirus 1 and 3 antigens during the outbreak that occurred in May, and one subject showed a response to parainfluenzavirus 1 in September. Serologic responses occurred in both symptomatic and asymptomatic subjects and were chronologically compatible with the observed illnesses. Throat swabs collected both routinely during the winter and during each outbreak of illness and maintained at -70 C failed to reveal the causative agent when inoculated into cell culture at the home laboratory the following year. Outbreaks of mid-winter RTI and serologic responses in adult subjects isolated at South Pole Station suggest persistence of parainfluenzavirus in the human adult. Confirmation of this observation will require recovery of the virus during outbreaks of RTI within this isolated community.

Adult↗

PubMed1988

Effect of isolation on dopaminergic agonist-induced penile erections and stretching and yawning in male rats.

Adult male rats reared in social isolation for 28 +/- 2 days were compared with animals housed in groups and pairs for frequency of penile erection (PE) and stretching and yawning (SY) elicited by dopaminergic (DA) autoreceptorial doses of B-HT 920 and n-N-propylnorapomorphine (NPA). PE and SY were consistently lower in the isolated group with respect to the other two groups, which did not differ significantly. The present experiments show the importance of housing conditions in modulating behavioural responses to DA agonists, a result that was confirmed when adult male rats, isolated or paired immediately after weaning until the day of tests (56 +/- 2 days), were treated with B-HT 920. In this case, however, not only isolated but also paired rats differed from grouped rats of the same age in their response to B-HT 920.

Animals↗

PubMed2004

Social support and its relationship to morbidity and mortality after acute myocardial infarction: systematic overview.

Among the commonly understood socioeconomic determinants of health, social change, disorganization, and poverty have been associated with an increased risk of morbidity and mortality. One of the postulated mechanisms through which these determinants have been linked to health and illness is their relationship to social support. The health determinant, social isolation or lack of a social support network (SSN), and its effects on premature mortality after acute myocardial infarction mandate further scrutiny by the cardiovascular community for several reasons. First, as a predictor of 1-year mortality, low SSN is equivalent to many of the classic risk factors, such as elevated cholesterol level, tobacco use, and hypertension. Second, treatment of acute myocardial infarction is costly. Because low social support is associated with an increased 1-year mortality, neglecting the role of the SSN may diminish the possible gains accrued during acute-phase treatment. Therefore, lack of an SSN should be considered a risk factor for subsequent morbidity and mortality after a myocardial infarction. Finally, cardiac rehabilitation programs and other extant prevention strategies can be better used to reduce mortality after myocardial infarction. This article systematically reviews recent evidence related to SSNs to provide an update on the role of social support in cardiovascular disease-related outcomes.

Aged↗

PubMed1981

An autoradiographic map of (3H)diprenorphine binding in rat brain: effects of social interaction.

(3H)Diprenorphine binding was analyzed autoradiographically in the brains of 33 day old rat pups. A photographic atlas of diprenorphine binding in the coronal plane is provided to highlight the dispersion of opioid receptor systems through the brain. To determine whether brain opioid release may be induced by social interactions, half the animals were sacrificed following a 30 min period of social interaction while the other half were sacrificed following 30 min of social isolation. Opioid binding was higher in isolate-tested animals than socially-tested ones, suggesting that social interaction may promote endogenous brain opioid release.

Animals↗

PubMed2006

Female monozygotic twins with selective mutism--a case report.

Selective mutism is a rare social anxiety disorder characterized by a total lack of speech in certain specific situations despite the ability to speak in others. Both genetic and psychosocial factors are thought to be involved in its presentation, persistence, and response to treatment. This case report describes a case of young female monozygotic twins who presented with selective mutism and their treatment spanning a 2-year period. It highlights the strong genetic association along with environmental factors such as social isolation and consequences of maternal social phobia, all contributing to treatment resistance, despite an intensive multimodal biopsychosocial approach. General issues related to the difficulties in treating monozygotic twins are also addressed.

Anxiety↗

PubMed1993

The influence of social factors on the response to stress.

The studies described in this paper provide evidence for the importance of social factors in determining the response of the hypothalamic-pituitary-adrenal (H-P-A) system to stress. The presence of familiar social partners can reduce or eliminate the cortisol response to either loss of a significant social relationship or to fear inducing stimulus. In contrast, disruptions of ongoing social behavior can be a potent activator of the H-P-A axis. Social isolation, the formation of new social groups of unfamiliar monkeys, and disruption of social behavior under conditions of high demand food seeking, all result in elevations of circulating cortisol. Of importance is that these elevation persist for protracted periods of time and represents an animal model of chronic stress.

Animals↗

PubMed1983

Chronic psychiatric patients in the community.

A feasibility study is presented which describes a cohort of 102 chronic psychiatric patients. The cases were selected on the criterion of four or more new admissions to psychiatric services in the Hamilton-Wentworth region during the year 1977. The group was predominately in the age 20-39 year range and both sexes were represented about equally. The diagnostic labels were personality disorder, schizophrenia, depression and alcoholism in descending order of frequency. The large majority were socially isolated and had contact with social agencies and the police. Seven deaths occurred in the cohort during the year of study.

Adult↗

PubMed2003

Older women's response to residential relocation: description of transition styles.

Older women relocating to institutional facilities are at risk for negative outcomes such as poorer health, decreased self-esteem, increased sense of social isolation and loneliness, loss of social support, and depression. However, little is known about relocation to congregate living facilities (CLF), the relocation transition process, or factors that contribute to outcomes. The perspectives of 31 women on their relocation experiences to CLF were elicited using a naturalistic approach. The Schumacher & Meleis nursing model of transitions was used to focus the study. Three distinct relocation transition styles emerged: Full Integration (45%), Partial Integration (42%), and Minimal Integration (13%). By understanding the characteristics and risk factors of relocation, unhealthy outcomes can be minimized and healthy outcomes promoted.

Adaptation, Psychological↗

PubMed1991

The COSTAR programme. 1: Improving social networks of the long-term mentally ill.

The present study examined the socio-demographic, clinical, cognitive, social behaviour and social network characteristics of the 97 patients in contact with the COSTAR programme--a mobile treatment and case management service for the long-term mentally ill in inner-city Baltimore. Compared with shorter-contact patients, those in contact for more than one year showed no change in symptoms, or in cognitive or global function. They did manifest improved social function, especially for slowness, personal hygiene and posturing. The long-contact group showed improvements in the quality and quantity of their social networks. Our results suggest that a home-based treatment system can help patients to reverse a vicious cycle of social isolation and to establish supportive social contacts.

Activities of Daily Living↗

PubMed2001

Nutritional risk in an urban homebound older population. The nutrition and healthy aging project.

PURPOSE: To establish the prevalence of nutritional problems and their related socio-demographic and health-related risk factors in the homebound elderly population. METHODS: Subjects included 239 men and women, ages 65 to 105 years. Trained, two-person field teams conducted comprehensive in-home assessments. Medical record reviews assessed co-morbidity and medication use. RESULTS: The majority of these urban study subjects are of very advanced age (mean age 81 years), female (72%), non-white (73%), living alone (51%), of low income (76%), and somewhat socially isolated (26% had no weekly social contact). More older women than men were widowed (60 vs. 33%, respectively) and poor (80 vs. 67%). The disease burden and functional dependency were both high in men and women; 77% had three or more chronic medical conditions; 76% were functionally dependent in one or more ADL's and 95% in one or more IADL's. Poor dietary quality was universal in these older men and women; half or more consumed diets that deviated from recommended standards for at least 13 of the 24 nutritional guidelines studied. Five percent of subjects were underweight (Body Mass Index (BMI) <18.5); 22% were overweight (BMI 25.0-29.9); and 33% were obese (BMI >30.0). Fasting albumin, hemoglobin, and absolute lymphocyte concentrations were borderline to very low in 18-32%. Dyslipidemia was more common in women; however, men and women had similar Total:HDL cholesterol ratios. CONCLUSIONS: Nutritional status is poor in homebound persons of very advanced age with substantial co-morbidity and functional dependency. The complexities of nutritional risk necessitate multi-disciplinary and individualized nutritional intervention strategies.

Activities of Daily Living↗

PubMedDate not supplied

Boston's Codman Square Community Partnership for Health Promotion.

The Codman Square Community Partnership for Health Promotion is a program designed to promote changes in individual behavior and community relationships to reduce the morbidity and mortality associated with the many problems affecting poor, minority communities in the United States. Problems of particular concern to be addressed by the program include violence, injuries, substance abuse, acquired immunodeficiency syndrome (AIDS), infant mortality, child abuse and neglect, and cardiovascular disease. The failure of traditional health promotion approaches to poor communities has created a literature supporting community-based action directed at broad social forces. The Codman Square Community Partnership for Health Promotion uses a variety of models--community participation, community organization, empowerment education, and community-oriented primary care--to encourage new coalitions that can ameliorate the social isolation and health-averse social norms linked to poverty and poor health. The program uses local residents trained as lay health workers to deliver home-based health services and to help create the necessary partnerships, linkages, and communication networks to foster the reorganization of the community to better address its health problems.

Boston↗

PubMed1993

The influence of urinary incontinence on the quality of life of elderly women.

The quality of life assessed by the Nottingham Health Profile Questionnaire was compared in a group of women (n = 120) suffering from urinary incontinence (age 75.4 +/- 1.9, range 65-84 years) and an age-matched representative sample of the total population (n = 313). There were no significant differences between the two groups of women in occurrence of other illnesses or social characteristics. Women suffering from urinary incontinence obtained higher scores in the domains of emotional disturbances (p < 0.05) and social isolation (p < 0.001) than women from the control group. When subdividing the incontinent women by type of incontinence it was found that women suffering from urge and mixed incontinence reported emotional disturbances (p < 0.05) more than women from the control group. There was, however, no difference within the domain of emotional disturbances between stress-incontinent women and the control group. Women suffering from urge incontinence reported more disturbance of sleep (p < 0.05) than the control group. Women suffering from all types of urinary incontinence (p < 0.05) were socially more isolated than those from the age-matched group of women from the total population. Urinary incontinence in women has a detrimental effect on their daily lives and causes them to avoid social contacts.

Aged↗

PubMed1996

Continence management.

The elderly, critically ill patient is particularly prone to transient and established fecal or urinary incontinence. With proper management, these devastating problems can be managed, alleviated, or prevented promptly. Care of incontinence is not simply a hygienic consideration. Elderly persons who experience loss of bladder or bowel control frequently are depressed, isolated, and fearful of discovery. Left untreated, these individuals are prone to mental and social deterioration that may lead to social isolation or institutionalization. With adequate awareness and prompt management, however, the critical care nurse can prevent transient incontinence from becoming an established pattern, and he or she can serve as a resource for the elderly patient who seeks care and understanding for this significant condition.

Age Factors↗

PubMed1992

Effects of centrally administered corticotropin-releasing factor (CRF) and alpha-helical CRF on the vocalizations of isolated guinea pig pups.

Intraventricular corticotropin-releasing factor (CRF) was administered to guinea pig pups both with a freehand injection technique and via indwelling cannula. Behavioral effects depended upon the technique used. The highest dose of CRF (5 micrograms) inhibited the vocalizing of pups in a subsequent isolation test only when CRF was given by freehand injection. The possibility that disturbance attendant to the freehand procedure can account for this difference is discussed. To determine the effect of endogenous CRF in the absence of additional disturbance, the CRF antagonist alpha-helical CRF (ahCRF) was administered with the indwelling cannula procedure. ahCRF enhanced vocalizing during the first 10 min, and enhanced locomotor activity during the last 10 min, of a 30-min isolation test. Overall, the results indicate that endogenous CRF reduces vocalizing and locomotion during social isolation and that under certain injection conditions exogenous CRF can exacerbate the behavioral effect. The results also demonstrate the potential impact of the technique used to administer exogenous CRF. Further, the prevailing view, that CRF mediates stress-related behavioral responses, is supported only if behavioral inhibition, rather than vocalizing or locomotor activity, is viewed as the stress-related response in this situation.

Animals↗

PubMed1999

Sequential analysis of juvenile isolation-induced decreased social behavior in the adult rat.

The consequences of juvenile isolation on adult social behavior were studied in detail using two different analysis methods: frequency, duration, and latency of behavioral elements, and sequential analysis. Rats were either isolated or socially housed during weeks 4 and 5 of age, and after the isolation period housed in pairs with a rat of identical housing condition until the time of testing at 12 weeks of age. Juvenile isolation caused marked effects on the frequency, duration, and latency of various social behavioral elements, whereas the non-social activities such as ambulation, rearing, and self-grooming were hardly affected. Juvenile isolation reduced social exploration, anogenital sniffing, and approach/following and increased the latency to the first occurrence of these social behavioral elements. In contrast, the sequential analysis revealed that the structure of social behavior was barely affected by juvenile isolation. Some transitions were less pronounced in juvenile isolated rats compared to non-isolated rats, but no significant differences were observed in transitions between social elements. Thus, juvenile isolation bisected the time spent on adult social interactions, whereas it did not disrupt the sequential structure of social behavior. The present data suggest that juvenile isolation reduced the motivation for adult social behavior, but when social contact is initiated, a relatively normal social behavioral pattern is displayed.

Aging↗