The management of depressed elderly care recipients : family perspectives on the skills of professional carers

Recent studies have identified high levels of depression among older people, both those in their own homes and those in residential care. With the world\u27s population ageing, it is timely for health service providers to consider how the escalating population of depressed elderly people will be managed. Although treating general practitioners may be the health professionals most expected to detect, treat, and monitor depression among the elderly, professional carers are well placed to assist in the detection and monitoring of the disorder. This study conducted individual interviews with 15 family members of depressed aged-care recipients to determine their perceptions of the skills and knowledge of depression of professional carers. Family members reported that carers are more likely to avoid than engage with their clients about depressive symptomatology and do not communicate their concerns with managers or general practitioners (GPs). Family members believed that, in general, professional carers were undertrained in these areas. The implications of these findings for health service planning and staff training are discussed. <br /

Depression:Diagnosis and suffering as process

The high rates of depression – as well as the widespread diagnosis of depression – are both controversial and contested in contemporary late-modern society. Issues of flawed definition have been voiced to account for the bourgeoning rates of depression and the diagnosis has been subject to criticism of medicalization and pharmaceuticalization. Others have stated that the actualization of depression is to be seen in light of societal and structural transformations. Be that as it may, depression is affecting more and more people and the diagnosis is prevalent. In this context, a more nuanced understanding of how people relate to, experience and ascribe meaning to their suffering as depression and being diagnosed as such is needed. This article draws on qualitative interviews from Denmark and Norway to explore lay accounts of depression in contemporary late-modern society. The findings reveal that lay accounts of suffering, including living with the diagnosis of depression is a dynamic process, meaning that people vacillate in and out of various perspectives of suffering and categorization to make it fit their specific life situation and prospects of the future. In this article we thus highlight the perspectives of thoroughly analyzing suffering and the diagnostic experience by applying the overall concept of process, which takes on different meanings in the course of the analysis. The final version of this research has been published in Nordic Psychology. © 2017 Taylor & Franci

Exploratory Case‐Control Analysis of Psychosocial Factors and Adult Periodontitis

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/141163/1/jper1060.pd

Anti-inflammatory properties of desipramine and fluoxetine

This is an Open Access article distributed under the terms of the Creative Commons Attribution Licens

Measuring inequality: tools and an illustration

BACKGROUND: This paper examines an aspect of the problem of measuring inequality in health services. The measures that are commonly applied can be misleading because such measures obscure the difficulty in obtaining a complete ranking of distributions. The nature of the social welfare function underlying these measures is important. The overall object is to demonstrate that varying implications for the welfare of society result from inequality measures. METHOD: Various tools for measuring a distribution are applied to some illustrative data on four distributions about mental health services. Although these data refer to this one aspect of health, the exercise is of broader relevance than mental health. The summary measures of dispersion conventionally used in empirical work are applied to the data here, such as the standard deviation, the coefficient of variation, the relative mean deviation and the Gini coefficient. Other, less commonly used measures also are applied, such as Theil's Index of Entropy, Atkinson's Measure (using two differing assumptions about the inequality aversion parameter). Lorenz curves are also drawn for these distributions. RESULTS: Distributions are shown to have differing rankings (in terms of which is more equal than another), depending on which measure is applied. CONCLUSION: The scope and content of the literature from the past decade about health inequalities and inequities suggest that the economic literature from the past 100 years about inequality and inequity may have been overlooked, generally speaking, in the health inequalities and inequity literature. An understanding of economic theory and economic method, partly introduced in this article, is helpful in analysing health inequality and inequity

Realising the Olympic dream: vision, support and challenge

The sporting arena is replete with examples and anecdotes of great inspirational coaches that have led teams to success, often in the face of adversity and against seemingly better opponents. The role of the coach in developing and motivating athletes has also been the focus of much research in sport psychology (e.g., Challaduria 1990; Smith & Smoll, 2007). Despite the ease with which one readily accepts that coaches can be inspirational, the sport coaching literature is somewhat devoid of research on inspirational coaches and the effects of such coaches on athletic success. The purpose of the current paper is to theoretically delineate the inspirational effects of coaches in sport. Given the relative paucity of inspiration-related research in sport we draw upon contemporary theories of leadership from organisational and military psychology (e.g., transformational and charismatic leadership theories). We propose a sport-specific model of leadership that centres around the vision, support, and challenge meta-cognitive model developed by Arthur and Hardy in military contexts. The model posits that �great� coaches inspire their athletes by: (a) creating an inspirational vision of the future; (b) providing the necessary support to achieve the vision; and (c) providing the challenge to achieve the vision. The underlying proposition is that the vision provides meaning and direction for followers� effort. That is, the vision serves as the beacon around which all the sweat, pain and sacrifice involved in achieving success at the highest level in sport is directed. At the heart of this model is the notion that athletes can achieve their dreams provided they are inspired to do so; this is because all other things being equal the person who is motivated to practice longer and train harder will ultimately be the best. The current paper will delineate the coach�s role in inspiring the athlete to train harder and longer

Developing a community based psychosocial intervention with older people and third sector workers for anxiety and depression: a qualitative study

Background: One-in-five people in the UK experience anxiety and/or depression in later life. However, anxiety and depression remain poorly detected in older people, particularly in those with chronic physical ill health. In the UK, a stepped care approach, to manage common mental health problems, is advocated which includes service provision from non-statutory organisations (including third/voluntary sector). However, evidence to support such provision, including the most effective interventions, is limited. The qualitative study reported here constitutes the first phase of a feasibility study which aims to assess whether third sector workers can deliver a psychosocial intervention to older people with anxiety and/or depression. The aim of this qualitative study is to explore the views of older people and third sector workers about anxiety and depression among older people in order to refine an intervention to be delivered by third sector workers. Methods: Semi-structured interviews with participants recruited through purposive sampling from third sector groups in North Staffordshire. Interviews were digitally recorded with consent, transcribed and analysed using principles of constant comparison. Results: Nineteen older people and 9 third sector workers were interviewed. Key themes included: multiple forms of loss, mental health as a personal burden to bear, having courage and providing/receiving encouragement, self- worth and the value of group activities, and tensions in existing service provision, including barriers and gaps. Conclusions: The experience of loss was seen as central to feelings of anxiety and depression among community- dwelling older people. This study contributes to the evidence pointing to the scale and severity of mental health needs for some older people which can arise from multiple forms of loss, and which present a significant challenge to health, social care and third sector services. The findings informed development of a psychosocial intervention and training for third sector workers to deliver the intervention

Endoscopic procedures for removal of foreign bodies of the aerodigestive tract: The Bugando Medical Centre experience

<p>Abstract</p> <p>Background</p> <p>Foreign bodies in the aerodigestive tract continue to be a common problem that contributes significantly to high morbidity and mortality worldwide. This study was conducted to describe our own experience with endoscopic procedures for removal of foreign bodies in the aerodigestive tract, in our local setting and compare with what is described in literature.</p> <p>Methods</p> <p>This was a prospective descriptive study which was conducted at Bugando Medical Centre between January 2008 and December 2009. Data were collected using a structured questionnaire and analyzed using SPSS computer software version 15.</p> <p>Results</p> <p>A total of 98 patients were studied. Males outnumbered females by a ratio of 1.1:1. Patients aged 2 years and below were the majority (75.9%). The commonest type of foreign bodies in airways was groundnuts (72.7%) and in esophagus was coins (72.7%). The trachea (52.2%) was the most common site of foreign body's lodgment in the airways, whereas cricopharyngeal sphincter (68.5%) was the commonest site in the esophagus. Rigid endoscopy with forceps removal under general anesthesia was the main treatment modality performed in 87.8% of patients. The foreign bodies were successfully removed without complications in 90.8% of cases. Complication rate was 7.1% and bronchopneumonia was the most common complication accounting for 42.8% of cases. The mean duration of hospital stay was 3.4 days and mortality rate was 4.1%.</p> <p>Conclusion</p> <p>Aerodigestive tract foreign bodies continue to be a significant cause of childhood morbidity and mortality in our setting. Rigid endoscopic procedures under general anesthesia are the main treatment modalities performed. Prevention is highly recommended whereby parents should be educated to keep a close eye on their children and keep objects which can be foreign bodies away from children's reach.</p