Давньогрецький поліс в контексті соціально-політичних поглядів Платона та Аристотеля

У статті здійснено аналіз соціально-політичних засад розбудови грецького поліса в контексті поглядів Платона та Аристотеля.In this article accomplishes analyses of social and political bases of Greek polis development in the context of Platoon’s and Aristotle’s views

Patients with persistent medically unexplained symptoms in general practice: characteristics and quality of care

<p>Abstract</p> <p>Background</p> <p>Medically unexplained physical symptoms (MUPS) are common in general practice (GP), and are even more problematic as they become persistent. The present study examines the relationship between persistent MUPS in general practice on the one hand and quality of life, social conditions, and coping on the other hand. Additionally, it is examined how patients with persistent MUPS evaluate the quality of GP-care.</p> <p>Methods</p> <p>Data were used from a representative survey of morbidity in Dutch general practice, in which data from the electronic medical records were extracted. A random sample of patients participated in an extensive health interview and completed self-reported measures on social isolation, coping and the quality of GP-care. Patients with persistent MUPS (N = 192) were compared with general practice patients not meeting the criteria for persistent MUPS (N = 7.314), and with a group of patients that visited the GP in comparable rates for medical diagnoses (N = 2.265). Multiple logistic regression analyses were used to control for relevant socio-demographic variables and chronic diseases.</p> <p>Results</p> <p>After adjustment for demographics and chronic diseases, patients with persistent MUPS reported more psychological distress, more functional impairment, more social isolation, and they evaluated the quality of GP-care less positive than the other two patient groups. Although the majority of MUPS patients were positive about the quality of GP-care, they more often felt that they were not taken seriously or not involved in treatment decisions, and more often reported that the GP did not take sufficient time. The three groups did not differ with respect to the statement that the GP unnecessarily explains physical problems as psychological ones.</p> <p>Conclusion</p> <p>Strengthening MUPS patients' social network and encouraging social activities may be a meaningful intervention in which the GP may play a stimulating role. To further improve MUPS patients' satisfaction with GP-care, GPs may pay extra attention to taking sufficient time when treating MUPS patients, taking the problems seriously, and involving them in treatment decisions.</p

Severe MUPS in a sick-listed population: a cross-sectional study on prevalence, recognition, psychiatric co-morbidity and impairment

Background: Medically unexplained physical symptoms (MUPS) have a high prevalence in the general population and are associated with psychiatric morbidity. There are indications that MUPS are an important determinant of frequent and long-term disability. The primary objective was to assess the prevalence of MUPS in sick-listed-employees and its associations with depressive disorders, anxiety disorders, health anxiety, distress and functional impairment. Secondary objectives were to investigate the classification of the occupational health physicians (OHPs), their opinions about the causes as well as the attributions of the employee. Methods: In a cross- sectional study of 489 sick-listed employees from 5 OHP group practices, MUPS, depressive disorders, anxiety disorders, health anxiety, distress and functional impairment were assessed with the Patient Health Questionnaire (PHQ), the Whitely Index (WI), the Four-Dimensional Symptom Questionnaire (4DSQ) and the Short-Form 36 Health Survey (SF-36). We used a cut off score of 15 on the PHQ for the categorisation of severe MUPS. The opinions of the OHPs were evaluated by means of a separate questionnaire with regard to the presence of employees physical symptoms, and the symptoms attributions, and the diagnoses of the OHPs. Results: Severe MUPS had a prevalence of 15.1% in this population of sick-listed employees. These employees had 4-6 times more depressive and anxiety disorders, and were more impaired. Female gender and PHQ-9 scores were determinants of severe MUPS. Most of the time the OHPs diagnosed employees with severe MUPS as having a mental disorder. The employees attributed their physical symptoms in 66% to mental or to both mental and physical causes. Conclusion: The prevalence of severe MUPS is higher in long-term sick-listed employees than in the non-sick-listed working population and at least equals the prevalence in the general practice population. Severe MUPS are associated with psychiatric morbidity and functional impairment and must therefore be specifically recognised as such. Validated questionnaires, such as the PHQ-15, are useful instruments in order to help OHPs to recognise severe MUPS

Follow-up of contacts of middle east respiratory syndrome coronavirus–infected returning travelers, the Netherlands, 2014

Notification of 2 imported cases of infection with Middle East respiratory syndrome coronavirus in the Netherlands triggered comprehensive monitoring of contacts. Observed low rates of virus transmission and the psychological effect of contact monitoring indicate that thoughtful assessment of close contacts is prudent and must be guided by clinical and epidemiologic risk factors

Receiving Social Support after Short-term Confinement: How Support Pre- and During-confinement Contribute

Objectives: To test the independent links between social support that exists prior to and during confinement with support after release for adult males incarcerated for an average of 11 months in the Netherlands. Methods: Longitudinal data from a large study on consequences of confinement, the Prison Project, are used to describe instrumental (live with) and expressive (core network) support before and after confinement from four sources (parent, partner, other family, friend) and during-confinement visits by the same groups. Multiequation models examine the contribution of preconfinement support and visits to postconfinement support, while also describing the interrelationship of support sources. Results: Preconfinement support is consistently related to receiving the same type after release. Receiving visits during confinement has a unique relationship with receiving postconfinement expressive support across all relational groups. Only visits from partners has an additional influence on instrumental support after release. Postconfinement support across provider groups is interrelated, with a positive correlation across providers for expressive support and a substitution effect for instrumental support between parents and partners. Conclusions: After controlling for important preconfinement differences in support, visits remain significantly related to postconfinement expressive support, suggesting a possible mechanism by which visits help improve reentry outcomes.Criminal Justice: Legitimacy, accountability, and effectivit

A social building? Prison architecture and staff-prisoner relationships

Relationships between correctional officers and prisoners are crucial to life in prison, and affect prison order and prisoners' well-being. Research on factors influencing staff-prisoner relationships is scarce and has not included the design of prison buildings. This study examined the association between prison architecture and prisoners' perceptions of their relationships with officers. Data were used from the Prison Project, a large-scale study in which 1,715 prisoners held in 117 units in 32 Dutch remand centers were surveyed. Multilevel analyses showed that prison layout was related to officer-prisoner relationships: Prisoners in panopticon layouts were less positive than prisoners in other layouts. In addition, prisoners housed in older units and in units with more double cells were less positive about officer-prisoner interactions

Risk governance for infectious diseases: Exploring the feasibility and added value of the IRGC-framework for Dutch infectious disease control

The quality of the Dutch system for control of infectious diseases is considered to be high. However, sometimes (e.g. during the Mexican flu and HPV vaccination in 2009, during the Q-fever outbreak from 2008 to 2011) the system encounters problems in terms of perceived effectiveness and public acceptance. This raises the question: Are other governance arrangements available that could contribute to a higher effectiveness and acceptance of infectious disease control? If so, how feasible are these arrangements in the light of the high time pressure in the case of an emergent outbreak of infectious diseases? In this paper, we explore the feasibility and added value of the International Risk Governance Council (IRGC)-framework. This framework aims to improve risk governance by tailoring the risk governance approach to the specific characteristics of the risk (the IRGC distinguishes between simple, complex, uncertain and ambiguous risks). Two recent infectious disease episodes - Q-fever and Schmallenberg virus (SBV) - were analysed. The actual risk governance approach was compared with a hypothesized situation, in which the IRGC-framework would have been applied. Data were collected by means of a review of literature, policy documents, newspaper articles and interviews with risk assessors and risk managers. This exploratory study revealed that Dutch infectious disease control incorporates many elements of the IRGC-Approach, although some of these elements are used in an intuitive rather than in an explicit manner. Few elements are lacking. Incorporation of these elements (e.g. concern assessment) would have been both feasible and useful during the Q-fever epidemic (ambiguous risk), but not during the SBV outbreak (uncertain risk). We expect that primarily in cases of ambiguous infectious disease risks an explicit risk characterization and the further incorporation of concern assessment could strengthen Dutch infectious disease control. To assess whether a risk is (becoming) ambiguous remains a challenge to be operationalized

Risk governance for infectious diseases : Exploring the feasibility and added value of the IRGC-framework for Dutch infectious disease control

The quality of the Dutch system for control of infectious diseases is considered to be high. However, sometimes (e.g. during the Mexican flu and HPV vaccination in 2009, during the Q-fever outbreak from 2008 to 2011) the system encounters problems in terms of perceived effectiveness and public acceptance. This raises the question: Are other governance arrangements available that could contribute to a higher effectiveness and acceptance of infectious disease control? If so, how feasible are these arrangements in the light of the high time pressure in the case of an emergent outbreak of infectious diseases? In this paper, we explore the feasibility and added value of the International Risk Governance Council (IRGC)-framework. This framework aims to improve risk governance by tailoring the risk governance approach to the specific characteristics of the risk (the IRGC distinguishes between simple, complex, uncertain and ambiguous risks). Two recent infectious disease episodes - Q-fever and Schmallenberg virus (SBV) - were analysed. The actual risk governance approach was compared with a hypothesized situation, in which the IRGC-framework would have been applied. Data were collected by means of a review of literature, policy documents, newspaper articles and interviews with risk assessors and risk managers. This exploratory study revealed that Dutch infectious disease control incorporates many elements of the IRGC-Approach, although some of these elements are used in an intuitive rather than in an explicit manner. Few elements are lacking. Incorporation of these elements (e.g. concern assessment) would have been both feasible and useful during the Q-fever epidemic (ambiguous risk), but not during the SBV outbreak (uncertain risk). We expect that primarily in cases of ambiguous infectious disease risks an explicit risk characterization and the further incorporation of concern assessment could strengthen Dutch infectious disease control. To assess whether a risk is (becoming) ambiguous remains a challenge to be operationalized