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

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

Responsabilidad extracontractual del estado por el incumplimiento de funciones de las entidades públicas frente a el acoso escolar en Colombia.

This document presents the result of an investigative study that I seek centrally, to establish whether the State can be legally imputed under the regime of extra-contractual liability for the action and omission in the fulfillment of functions, objectives and responsibilities of the public entities that must give observance and obedience to the legal framework on bullying in Colombia, for this it was proposed to solve the following problem question: Is the State liable extracontractually for the action and omission in the fulfillment of functions, objectives and responsibilities of the public entities that must give observance and obedience to the legal framework on bullying in Colombia? For its development, and to respond to the proposed proposal, a legal methodology was used, since a study of the legal system is made in relation to school v i o l e n c e a n d t h e t h e o r y o f S t a t e responsibility and a documentary technique is used. Therefore, to achieve the objective, it was carried out through a review, study, analysis of the norm, the Constitution, jurisprudence and doctrine. En el presente escrito se presenta el resultado de un estudio investigativo que busco centralmente, Establecer si el Estado puede ser imputado jurídicamente bajo el r é g i m e n d e R e s p o n s a b i l i d a d extracontractual por la acción y omisión en el cumplimiento de funciones, objetivos y responsabilidades de las entidades públicas que deben dar observancia y obediencia al marco jurídico sobre el acoso escolar en Colombia, para ello se propuso resolver la siguiente pregunta problema ¿Es el Estado responsable extracontractualmente por la acción y omisión en el cumplimiento de funciones, objetivos y responsabilidades de las entidades públicas que deben dar observancia y obediencia al marco jurídico sobre el acoso escolar en Colombia? Para su desarrollo, y dar respuesta a la propuesta planteada, se utilizó una metodología de carácter jurídico, pues se hace un estudio del ordenamiento jurídico con relación a la violencia escolar y la teoría de la responsabilidad del Estado y se utiliza una técnica de carácter documental, pues para alcanzar el objetivo se realizó a través de revisión, estudio, análisis de la norma, la Constitución, la jurisprudencia y la doctrina

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

Extracontractual Responsibility of the State for the Unfulfillment of Functions of Public Entities Against Bullying in Colombia.

En el presente escrito se presenta el resultado de un estudio investigativo que busco centralmente, Establecer si el Estado puede ser imputado jurídicamente bajo el régimen de Responsabilidad extracontractual por la acción y omisión en el cumplimiento de funciones, objetivos y responsabilidades de las entidades públicas que deben dar observancia y obediencia al marco jurídico sobre el acoso escolar en Colombia, para ello se propuso resolver la siguiente pregunta problema ¿Es el Estado responsable extracontractualmente por la acción y omisión en el cumplimiento de funciones, objetivos y responsabilidades de las entidades públicas que deben dar observancia y obediencia al marco jurídico sobre el acoso escolar en Colombia? Para su desarrollo, y dar respuesta a la propuesta planteada, se utilizó una metodología de carácter jurídico, pues se hace un estudio del ordenamiento jurídico con relación a la violencia escolar y la teoría de la responsabilidad del estado y se utiliza una técnica de carácter documental, pues para alcanzar el objetivo se realizó a través de revisión, estudio, análisis de la norma, la Constitución, la jurisprudencia y la doctrina.Universidad Libre Seccional Socorro -- Facultad de derecho, ciencias políticas y sociales -- Especialización en derecho administrativoThis document presents the result of an investigative study that I seek centrally, to establish whether the State can be legally imputed under the regime of extra-contractual liability for the action and omission in the fulfillment of functions, objectives and responsibilities of the public entities that must give observance and obedience to the legal framework on bullying in Colombia, for this it was proposed to solve the following problem question: Is the State liable extracontractually for the action and omission in the fulfillment of functions, objectives and responsibilities of the public entities that must give observance and obedience to the legal framework on bullying in Colombia? For its development, and to respond to the proposed proposal, a legal methodology was used, since a study of the legal system is made in relation to school violence and the theory of State responsibility and a documentary technique is used. Therefore, to achieve the objective, it was carried out through a review, study, analysis of the norm, the Constitution, jurisprudence and doctrine

Abordagem da lombalgia ocupacional na Atenção Primária

A high incidence of low back pain in the population generates high expenses with crises at the secondary and tertiary levels. That said, the research sought to understand what are the currently recommended approaches needed for the condition. A survey was carried out on the PubMed platform, using the keywords "occupational", "low back pain", "primary care" and "approach", where it recorded 22 results related to the last 5 years, 9 of which were discarded for not understanding the relevant issues in search. From this review, we might to show effective approaches in the scope of primary care to optimize person-centered care based on the latest available literature. The selected results point to the need for further studies on the condition, since disagreements were found between approaches indicated by the most recent literature and currently indicated by the Clinical Protocol of Therapeutic Guidelines of the Ministry of Health.A grande incidência de lombalgia na população leva a uma grande demanda de tratamento no nível básico, além de gerar gastos com crises agudas nos níveis secundário e terciário. Essa revisão sistemática busca entender quais abordagens seriam pertinentes à condição para que o médico da atenção primária consiga ter a conduta mais adequada e resolutiva. A pesquisa foi realizada na plataforma PubMed utilizando-se descritores “occupational”, “low back pain”, “primary care” e “approach”, onde obteve-se 24 resultados posteriores a 2014 dos quais descartou-se 16 por não compreenderem o objetivo inicial. A partir da leitura buscou-se trazer abordagens eficientes no âmbito da atenção primária de modo a otimizar a resolutividade com base na literatura mais recente disponível. Os resultados apontaram a adoção de uma conduta multidisciplinar, bem como a associação de fármacos adjuvantes a analgésicos no tratamento farmacológico, como preconizado pelo Ministério da Saúde

Post-traumatic stress disorder among heart disease patients: a clinical follow-up of individuals with myocardial infarction in the Tromsø Study

Background Myocardial infarction is likely to be experienced as a life-threatening and potentially traumatic event. Approximately one-third of patients with myocardial infarction experience clinically significant symptoms of anxiety/ depression. However, it is unclear how many of these patients experience these symptoms because of post-traumatic stress disorder (PTSD). We conducted a clinical screening of individuals with a confirmed myocardial infarction diagnosis. Our goal was to examine the prevalence of PTSD in myocardial infarction patients and study how PTSD symptoms were associated with exposure to potentially traumatic events. Method This is epidemiological research with a cross-sectional design following up participants from the Tromsø Study with a confirmed diagnosis of myocardial infarction. We sent invitations to participants in the Tromsø Study with clinically significant self-reported anxiety or depression symptoms following myocardial infarction. A cross-sectional sample of N=79 participants (61 men and 18 women) was collected. During an interview, participants completed the Stressful Life Events Screening Questionnaire and the PTSD checklist PCL-5. Results We found nine participants (11.6%) with probable PTSD. This was significantly higher than the postulated population prevalence in Norway (pConclusion PTSD prevalence in myocardial infarction patients was related to lifetime exposure to traumatic events, not the myocardial infarction event alone. More research is required to examine the interaction between myocardial infarction and PTSD. Clinicians should be aware that anxiety or depression symptoms after MI could be secondary symptoms of PTSD