Pretherapy symptom level changes

Prezentując wyniki powyższego badania autor uwydatnia transformację obrazu zaburzeń nerwicowych w okresie oczekiwania na leczenie. Dotyczy ona zarówno pojawiania się nowych, znikania istniejących objawów nerwicowych, jak również globalnej zmiany ich nasilenia, mimo braku w tym okresie oddziaływań terapeutycznych.Aim, Description o f global neurotic symptom level present during pre-therapy waiting. Material: Case records of 2589 patients containing two symptom checklists filled in before treatment in a day-hospital. Method. Analysis of symptom change, by comparison of symptom checklists "0" filled in whilst waiting for therapy - at first diagnostic ambulatory visit and on the day of psychotherapy admission. Results. Change of global symptom level during pre-therapy assessment and pre-therapy waiting were not large but they were composed of frequent changes in both incidence and intensity of particular symptoms. On average only 40-60% of symptoms (the same) were present in both measurement points during pre-therapy waiting. Similar rates of such changes were observed in women and men. Conclusions. Global symptom changes among individuals waiting for therapy were in most cases relatively small. However, in particular symptoms many different and very heterogenous transformations were observed. Patterns of change were gender-independent in the global symptom intensity as well as in the particular

Power and Purchasing: Why Strategic Purchasing Fails

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/162754/2/milq12471.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/162754/1/milq12471_am.pd

Traumatic childhood sexual events and secondary sexual health complaints in neurotic disorders

Aim. Assessment of the association between self-reported sexual complaints and recalled childhood sexual adversities in a sample of psychotherapy patients. Material and methods. Coexistence of memories concerning traumatic events and minor sexual adversities and the currently present symptoms were analyzed on the basis of KO”0” Symptom Checklist and Life Inventory completed prior to treatment in the day hospital for neurotic disorders. Questionnaires from 3929 psychotherapy patients were analyzed. Logistic regression analyses were performed on biographical and symptom items. Odds ratios for men and women were determined separately. Results. Associations between sexual adverse events, and current sexual health complaints, as estimated by OR coefficients, showed to be statistically significant. In the subgroups of patients who reported two categories of sexual adversities e.g. were both punished for masturbation and were not educated about sex, the risk of sexual complaints was further increased. Discussion. Both self-reported traumatic sexual events and sexual problems are quite common in the patient population and are strongly associated. Our study has replicated other’s findings in a large sample of outpatients suffering from neurotic disorders. Conclusions. Deficits in sex education, the trauma of incest, punishment for sexual play or masturbation, or too early or unwanted sexual initiation, are important risk factors of sexual symptoms accompanying neurotic syndromes. Results strongly suggest that studies focusing on the effects of sexual traumatic events should take into consideration the co-occurrence of multiple adversities

Symptoms of overactive bladder (OAB) in patients treated for depressive disorders

Aim: The aim of the study was to investigate the correlation between symptoms of overactive bladder (OAB) and severity of depressive symptoms in patients treated for depression. Method: 102 patients (43 males, 59 females) aged 20–67 (M = 46.1±11,3) treated for depression were included in this cross-sectional analysis. OAB symptoms were examined with the International Prostate Symptom Score (IPSS) and International Consultation on Incontinence Questionnaire Overactive Bladder Module (ICIQOAB). OAB-related quality of life was assessed with the International Consultation on Incontinence Questionnaire Overactive Bladder Quality of Life Module (ICIQ-OABqol). Depressive symptoms were assessed with the 17-item Hamilton Depression Rating Scale (HDRS) and Quick Inventory of Depressive Symptomatology - Self Report (QIDS-SR). Results: Symptoms of OAB assessed with IPSS and ICIQ-OAB were more severe in women than in men. In the entire group highest scores in IPSS of assessed OAB symptoms were observed in nocturia (1,53±1,64) followed by urinary frequency (1,19±1,48) and lowest in urgency (0,80±1,28). Symptoms of OAB (based on the ICIQOABqol total score) were more bothersome in women (48,74±29,18), than in men (39,18±17,70). In the whole group and in women the QIDS-SR total score correlated with the ICIQ-OAB score ( p < 0,05). The total QIDS-SR score correlated with the ICIQ-OABqol score in entire group (p < 0,05), in women (p < 0,05) and in men (p < 0,05). Patients suffering from at least moderate depression assessed with QIDS-SR had significantly more pronounced symptoms of urinary frequency (p = 0,005) and urgency (p = 0,039). A number of other significant (p < 0.05) correlations were observed between the total ICIQ-OAB score and certain items’ scores in the GHQ-30 both in women. Conclusions: OAB symptoms are common among patients treated for depressive disorders. There is a correlation between severity of depressive symptoms and OAB. OAB is bothersome and affects the quality of life in patients treated for depression. Comorbidity of OAB and depression has clinical significance and that should enhance interdisciplinary treatment approaches. Due to limitations of this study, further researches are essential to reveal more details of the correlation between OAB and depression

System Models for Resilience in Gerontology: Application to the COVID-19 Pandemic

The care needs for aging adults are increasing burdens on health systems around the world. Efforts minimizing risk to improve quality of life and aging have proven moderately successful, but acute shocks and chronic stressors to an individual’s systemic physical and cognitive functions may accelerate their inevitable degradations. A framework for resilience to the challenges associated with aging is required to complement on-going risk reduction policies, programs and interventions. Studies measuring resilience among the elderly at the individual level have not produced a standard methodology. Moreover, resilience measurements need to incorporate external structural and system-level factors that determine the resources that adults can access while recovering from aging-related adversities. We use the National Academies of Science conceptualization of resilience for natural disasters to frame resilience for aging adults. This enables development of a generalized theory of resilience for different individual and structural contexts and populations, including a specific application to the COVID-19 pandemic