Withdrawal and exclusion : a study of the spoken word as means of understanding schizophrenic patients

There are literally thousands of people living among us who suffer from chronic and severe mental illness. There may be as many as one out of 100 that might be described with the diagnosis of schizophrenia. This means that most of us are likely to know, or know of, at least one person who suffers from schizophrenia. Nevertheless, most people perceive it as both distant and elusive. The diagnostic description and characterization of Schizophrenia (DSM-IV, 1994:273ff; ICD-10, 1994:F20), says little about the experience of the illness or of the individuality of persons within the group (of Mishara, 1994). It says little concerning who the patients are as persons, what their lives are like and how they experience themselves and others. It is easy to forget that schizophrenia is an illness that strikes individuals. The experience of schizophrenia thus will be unique for each person (Strauss, 1989; Strauss, 1996; Strauss, 1994). This study was triggered by the question of what is it like to experience a disorder like schizophrenia and the isolation that is associated with it. The intention of this study is to describe some aspects of the condition and the suffering that schizophrenia represents. I was therefore granted access to a rehabilitation unit in a hospital in order to enter into dialogue with patients and staff about schizophrenia and the suffering involved. I also wanted to study how it manifests itself in everyday life

Subjective experiences of compulsory treatment from a qualitative study of early implementation of the Mental Health (Care and Treatment)(Scotland) Act 2003

Compulsory psychiatric treatment is highly contested, and little research has focused specifically on direct experiences. The Mental Health (Care & Treatment) (Scotland) Act, 2003 introduced new roles and provisions including community treatment orders, and was designed to increase participation, ensure treatment was beneficial and was the ‘least restrictive’ alternative. This article draws on findings from semistructured interviews with 49 individuals who had experienced compulsion under this new legislation during 2007-08, that were part of a broader cohort study. Interviews with service users were conducted at two stages with 80% agreeing to be interviewed twice. The sample included people on a variety of compulsory orders from four Health Board areas, some of whom had been detained for the first time, while others reported ‘revolving door’ experiences. Peer researchers who were mental health service users carried out the interviews with professional researchers. The findings suggest that legislation had a limited impact on participation in the process of compulsion. Consensus was that although service users felt there was increased opportunity for their voices to be heard, this was not matched by having increased influence over professional decision-making, especially in relation to drug treatments. According to people's direct experiences, the passing of the legislation in itself had done little to change the dominant psychiatric paradigm. While providing a foundation for improving the process of compulsion, the findings suggest that as well as legislative reform, fundamental shifts in practice are needed both in terms of the nature of therapeutic relationships, and in embracing more holistic and recovery perspectives

"The lady in the Coffin" - Delusions and Hearing Voices: A Narrative Performance of Insight

Artikkelen handler om innsikt i egen helse og behandling blant mennesker diagnostisert med psykiske lidelser.Artikkelen er en del av en avhandling om brukermedvirkning og innsikt blant brukere av distriktspsykiatriske tjenester i Nord- Norge. Innsikt i egen helse og behandling er i fokus, og forfatteren argumenterer for en relasjonell tilnærming til innsikt

Características del financiamiento y rentabilidad de la micro y pequeña empresa, sector comercio rubro ferretería “Multinegocios Tito” E.I.R.L. - Ayacucho, 2020.

La investigación tuvo como problemática: ¿Cuáles son las características principales del financiamiento y rentabilidad de la micro y pequeña empresa, sector comercio Rubro Ferretería “Multinegocios Tito” E.I.R.L. - Ayacucho, 2020?, el cual es desarrollado bajo el objetivo principal: Determinar las características principales del financiamiento y rentabilidad de la micro y pequeña empresa, sector comercio Rubro Ferretería “Multinegocios Tito” E.I.R.L. - Ayacucho, 2020. La metodología utilizada es de tipo Cuantitativa, no experimental, descriptivo, Bibliográfica y Documental. La población y muestra está conformada por 6 trabajadores. Se obtuvo el siguiente resultado: MYPE: Tabla 1, nos da a conocer que la empresa está en el rubro ferretero, presenta una calificación muy de acuerdo en un 16.7% y de acuerdo en un 83.3%. Financiamiento: Tabla 6, nos da a conocer que acudirían a entidades bancarias para adquirir un préstamo, presenta una calificación muy de acuerdo en un 16.7%, de acuerdo en un 50.0% y ni de acuerdo ni desacuerdo en un 33.3%. Rentabilidad: Tabla y Gráfico 13, nos da a conocer que la calidad es un factor que incide en la rentabilidad, presenta una calificación muy de acuerdo en un 16.7% y de acuerdo en un 83.3%. Tabla 14, nos da a conocer que la rentabilidad de la empresa mejoraría gracias al financiamiento, presenta una calificación muy de acuerdo en un 16.7%, de acuerdo en un 50.0%. Finalmente se concluye, que se logró determinar las características principales del financiamiento y rentabilidad en la MYPE.Tesi

User participation in district psychiatry. The social construction of ‘users’ in handovers and meetings

An ideal in mental health care is user participation. This implies inclusion and facilitation by clinicians to enable users to participate in decisions about themselves and in the design of suitable treatment. However, much of the work of clinicians consists of handovers and other meetings where patients are not present. It is therefore interesting to study how the patient perspective is handled in such meetings and whether it forms a basis for user participation. We conducted fieldwork in three different inpatient wards in Norwegian District Psychiatric Centres. We used an interactional perspective in our analysis, where speech acts, framing and footing were key concepts. The findings show that the talk in the handovers and meetings contained five main themes and that there was a clear correlation between what was said and how it was said, and whether clinicians related to the content in a decisive, person-centred or indecisive manner. We discuss potential participation statuses for patients and their limited opportunity to influence the talk and possible decisions about themselves. Our conclusion is that handover meetings primarily function as an aid in organising clinicians' work and could ultimately be seen as counteracting user participation

Efecto del guano de islas en la producción de dos variedades de coliflor (Brassica oleracea var. Botrytis L.) en condiciones de fitotoldo. Carahuain - Yanahuanca – Pasco

El presente trabajo de investigación se llevó a cabo en el Caserío de Carahuain comprensión del distrito de Yanahuanca, cuyo objetivo principal fue evaluar el efecto de aplicación del guano de islas en la producción de dos variedades de coliflor (Brassica oleracea var. botrytis) en condiciones de fitotoldo en el caserío de Carahuain - Yanahuanca - Pasco, el diseño utilizado fue de Bloques Completos al Azar con factores de 2 x 3 (dos variedades de coliflor y tres aplicaciones de guano de islas), el guano de islas se aplicó en tres momentos; el primero a los 40 días del trasplante, el segundo a los 15 días del primero y el tercero a los 15 días del segundo, las dosis de guano de isla aplicadas son de 60,75 y 90 gramos por planta. De los resultados obtenidos en esta investigación, se establece que concerniente a la producción y variedades, la variedad de snowall obtuvo 65.74 t/ha, en cuanto al efecto del guano de islas la aplicación 3 t/ha obtuvo 58.06 t/ha, concerniente a las interacciones se precisa que la interacción variedad chou-fleur - 3000 k/ha de guano de islas obtuvo 73.89 t/ha, mientras que el T1 variedad snowball - 2000 k/ha de guano de islas, obtuvo el último lugar con 25.78 t/ha.Tesi

Building and sustaining therapeutic relationships across treatment settings: a qualitative study of how patients navigate the group dynamics of mental healthcare

Background - Therapeutic relationships are vital for patients with complex and long-term psychosocial needs, yet such patients often face fragmented and unstable relationships within mental healthcare. These patients are more often than others moved between treatment settings and caregiving teams. Statutory obligations strain the relationships with frequent hospitalizations adding to the burden This study explores how these patients perceive and navigate therapeutic relationships, highlighting both positive and negative experiences across various treatment settings. Methods - This is a qualitative study with a narrative approach utilizing in-depth interviews focusing on participants personal experiences and perceptions. We utilized purposive sampling to recruit patients with extensive hospitalization experience, operationalized as more than four admissions within one year or more than four successive weeks of hospitalization. Our sample consisted of 16 participants, twelve women and four men. The interviews were analyzed using a holistic-content approach. Results - We found that therapeutic relationships were built on healthcare professionals recognizing and addressing patients’ needs and advocating for their interests within the service system. Participants described therapeutic relationships as sources of collaboration, stability, and support but found them challenging to sustain due to fear of rejection and institutional barriers. Successful relationships worked as a vital buffer, offering protection against malpractices and depersonalized care. Conclusion - Therapeutic relationships play a crucial role in supporting patients with complex needs, but relational dilemmas and malignant group dynamics often impede their development. Mental healthcare services have an ethical responsibility to foster and maintain therapeutic environments and professional cultures that enable personalized care, while maintaining boundaries through reflective practices

Self-reported health as a predictor of mortality: A cohort study of its relation to other health measurements and observation time.

Self-reported health (SRH) is widely used as an epidemiological instrument given the changes in public health since its introduction in the 1980s. We examined the association between SRH and mortality and how this is affected by time and health measurements in a prospective cohort study using repeated measurements and physical examinations of 11652 men and 12684 women in Tromsø, Norway. We used Cox proportional hazard regression to estimate hazard ratios (HRs) of death for SRH, controlling for pathology, biometrics, smoking, sex and age. SRH predicted mortality independently of other, more objective health measures. Higher SRH was strongly associated with lower mortality risk. Poor SRH had HR 2.51 (CI: 2.19, 2.88). SRH is affected by disease, mental health and other risk factors, but these factors had little impact on HRs (Poor SRH: HR 1.99; CI: 1.72, 2.31). SRH predicted mortality, but with a time-dependent effect. Time strongly affected the hazard ratio for mortality, especially after ten-year follow-up (Poor SRH HR 3.63 at 0-5 years decreased to HR 1.58 at 15-21 years). SRH has both methodological and clinical value. It should not be uncritically utilised as a replacement instrument when measures of physical illness and other objective health measures are lacking

The association of religious factors with mental health-service utilisation and satisfaction in a mixed Sámi and Norwegian adult population: Adopting the SAMINOR 2 Questionnaire Survey

The Indigenous Sámi have poorer mental health than the majority population and fairly equal access to professional mental healthcare. Despite this condition, certain studies indicate that this group is underrepresented among the users of such services. Religion or spirituality (R/S) often influences mental health-service utilisation and satisfaction among other Indigenous peoples and ethnic minorities. Thus, this study examines the situation in Sámi-Norwegian areas. We utilised cross-sectional data from the population-based SAMINOR 2 Questionnaire Survey (2012; subsample n = 2,364; 71% non-Sámi) in mixed Sámi-Norwegian regions of Northern and Central Norway. We analysed the associations between R/S factors and past-year mental health-service utilisation and satisfaction among individuals reporting mental health problems, substance use, or addictive behaviours. Multivariable-adjusted regression models considering sociodemographic factors, including Sámi ethnicity, were applied. Religious attendance was significantly associated with infrequent past-year use of mental health services (OR = 0.77) and fewer mental health problems, indicating that the R/S fellowship may buffer mental distress and represent an alternative psychological support to professional services. R/S was not significantly associated with lifetime mental health-service satisfaction. We found no ethnic differences in service utilisation or satisfaction

The effects of exceeding low-risk drinking thresholds on self-rated health and all-cause mortality in older adults: The Tromsø Study 1994-2020

Background Based on findings of increasing alcohol consumption in older adults, it is important to clarify the health consequences. Using data from the Tromsø study, we aimed to investigate the relationship between different levels of alcohol consumption in old adulthood and self-rated health trajectories and all-cause mortality. Methods This is an epidemiological study utilizing repeated measures from the Tromsø study cohort. It allows followup of participants from 1994 to 2020. A total of 24,590 observations of alcohol consumption were made in older adults aged 60–99 (53% women). Primary outcome measures: Self-rated health (SRH) and all-cause mortality. SRH was reported when attending the Tromsø study. Time of death was retrieved from the Norwegian Cause of Death Registry. The follow-up time extended from the age of study entry to the age of death or end of follow-up on November 25, 2020. Predictor: Average weekly alcohol consumption (non-drinker, Results We found that women who consumed ≥100g/week had better SRH than those who consumed Conclusions There was no clear evidence of an independent negative effect on either self-rated health trajectories or all-cause mortality for exceeding an average of 100g/week compared to lower drinking levels in this study with up to 25 years follow-up. However, some sex-specifc risk factors in combination with the highest level of alcohol consumption led to adverse efects on self-rated health. In men it was the use of sleeping pills or tranquilisers and≥20 years of smoking, in women it was physical illness and older age