Aetiology of anxiety and depressive disorders in an inner-city population. 2. Comorbidity and adversity

1993 ◽  
Vol 23 (1) ◽  
pp. 155-165 ◽  
Author(s):  
G. W. Brown ◽  
T. O. Harris ◽  
M. J. Eales
Keyword(s):  
Inner City ◽  
Depressive Disorders ◽  
Critical Role ◽  
Adult Life ◽  
Childhood And Adolescence ◽  
Adverse Experiences ◽  
City Population ◽  
Major Loss

SynopsisAn earlier paper documented that adverse experiences in childhood and adolescence considerably raise risk of both depressive and anxiety conditions (with the exception of mild agoraphobia and simple phobia) in adult life. This paper deals with the same inner-city women with children at home. Consideration of adverse experiences throughout adulthood as a whole (excluding the period just before onset) particularly involving major prior losses suggests that rather different aetiological processes may be involved. Depression appears to be often linked to experiences of major loss in adulthood as a whole and to be particularly susceptible to shortcomings in the quality of ongoing social support. For anxiety only early adverse experiences appeared to be critical. (However, the onset of both conditions is often provoked by a severely threatening event in the most recent period – particularly ‘loss’ in depression, and ‘danger’ in anxiety.) Finally the critical role of early experience for both anxiety and depression explains to a considerable extent why they so often occur together; and social factors not studied in the present enquiry may account for some of the remaining unexplained comorbidity.

Aetiology of anxiety and depressive disorders in an inner-city population. 1. Early adversity

1993 ◽  
Vol 23 (1) ◽  
pp. 143-154 ◽  
Author(s):  
G. W. Brown ◽  
T. O. Harris
Keyword(s):  
Inner City ◽  
Single Mothers ◽  
Depressive Disorders ◽  
Adult Life ◽  
Anxiety And Depression ◽  
Early Adversity ◽  
Childhood And Adolescence ◽  
Depression And Anxiety ◽  
Adverse Experiences ◽  
City Population

SynopsisA survey of an inner-city population of working-class and single mothers is described and the prevalence of anxiety and depression reported using two related diagnostic schemes, Bedford College caseness and DSM-III-R. This acts as an introduction to an analysis which indicates that adverse experiences in childhood and adolescence (involving parental indifference, and sexual and physical abuse) considerably raise risk of both depression and anxiety conditions (with the exception of mild agoraphobia and simple phobia) in adult life.

scholarly journals Gender differences in depression

2000 ◽  
Vol 177 (6) ◽  
pp. 486-492 ◽  
Author(s):  
Marco Piccinelli ◽  
Greg Wilkinson
Keyword(s):  
Gender Differences ◽  
Depressive Disorders ◽  
Adult Life ◽  
Childhood And Adolescence ◽  
Depression And Anxiety ◽  
Psychological Attributes ◽  
Adverse Experiences ◽  
Poor Social Support ◽  
And Coping ◽  
Morbidity Risk

BackgroundWith few exceptions, the prevalence, incidence and morbidity risk of depressive disorders are higher in females than in males, beginning at mid-puberty and persisting through adult life.AimsTo review putative risk factors leading to gender differences in depressive disorders.MethodA critical review of the literature, dealing separately with artefactual and genuine determinants of gender differences in depressive disorders.ResultsAlthough artefactual determinants may enhance a female preponderance to some extent, gender differences in depressive disorders are genuine. At present, adverse experiences in childhood, depression and anxiety disorders in childhood and adolescence, sociocultural roles with related adverse experiences, and psychological attributes related to vulnerability to life events and coping skills are likely to be involved. Genetic and biological factors and poor social support, however, have few or no effects in the emergence of gender differences.ConclusionsDeterminants of gender differences in depressive disorders are far from being established and their combination into integrated aetiological models continues to be lacking.

Deliberation in Communication Studies

2018 ◽  
pp. 501-517
Author(s):  
John Gastil ◽  
Laura Black
Keyword(s):  
Critical Role ◽  
Ancient Greece ◽  
Communication Studies ◽  
Face To Face ◽  
The Public ◽  
Contemporary Work ◽  
Social Scientific ◽  
The Public Sphere

The discipline of communication encompasses a broad spectrum of humanistic, interpretive, and social scientific approaches to studying public deliberation. Early work engaged Habermasian theories of the public sphere, and rhetorical scholarship has foregrounded the deliberative threads running back to the discipline’s earliest history in ancient Greece. The bulk of contemporary work, however, has examined the dynamics of deliberation, particularly in the context of face-to-face discussions and dialogues in small groups. These studies have revealed the importance of narrative and dialogic exchanges during deliberation, as well as the critical role of facilitation and the maintenance of deliberative norms. Research has also assessed the practical consequences of participating in deliberation. The discipline’s practical orientation has led some scholars to seek ways to optimize deliberative designs to maximize simultaneously the quality of their decision outputs and their civic impacts on participants.

Hybrid Image Segmentation Within a Computer Vision Hierarchy

1993 ◽  
Vol 30 (1) ◽  
pp. 51-64
Author(s):  
Ray Thomas ◽  
Fariborz Zahedi
Keyword(s):  
Computer Vision ◽  
Image Segmentation ◽  
Vision System ◽  
Critical Role ◽  
Generic Model ◽  
Test Results ◽  
Segmentation Approach ◽  
Edge Based

Hybrid image segmentation within a computer vision hierarchy A generic model of a computer vision system is presented which highlights the critical role of image segmentation. A hybrid segmentation approach, utilising both edge-based and region-based techniques, is proposed for improved quality of segmentation. An image segmentation architecture is outlined and test results are presented and discussed.

Reducing overuse by recognising the unintended harms of good intentions

2019 ◽  
pp. bmjebm-2019-111247
Author(s):  
David Slawson ◽  
Allen F Shaughnessy
Keyword(s):  
Decision Making ◽  
Medical Decision Making ◽  
Clinical Care ◽  
Critical Role ◽  
Medical Decision ◽  
Wide Acceptance ◽  
Hierarchy Of Evidence ◽  
Healthcare Interventions

Overdiagnosis and overtreatment—overuse—is gaining wide acceptance as a leading nosocomial intervention in medicine. Not only does overuse create anxiety and diminish patients’ quality of life, in some cases it causes harm to both patients and others not directly involved in clinical care. Reducing overuse begins with the recognition and acceptance of the potential for unintended harm of our best intentions. In this paper, we introduce five cases to illustrate where harm can occur as the result of well-intended healthcare interventions. With this insight, clinicians can learn to appreciate the critical role of probability-based, evidence-informed decision-making in medicine and the need to consider the outcomes for all who may be affected by their actions. Likewise, educators need to evolve medical education and medical decision-making so that it focuses on the hierarchy of evidence and that what ‘ought to work’, based on traditional pathophysiological, disease-focused reasoning, should be subordinate to what ‘does work’.

Outcome Data and Quality: The Critical Role of Policy

2003 ◽  
Vol 31 (2) ◽  
pp. 2-6
Author(s):  
Russell Renhard
Keyword(s):  
Quality Improvement ◽  
Health Outcomes ◽  
Control Strategies ◽  
Critical Role ◽  
Outcome Data ◽  
Policy Debate ◽  
Australian Health ◽  
Clinical Level

Health outcomes data are a major focus of the Australian health policy debate and the national research agenda. There is general agreement that health outcomes data should be collected. Outcomes data have been shown to be a powerful stimulant to service quality at the clinical level. It is argued here that policy which places health outcomes data at the centre of resource allocation and competitive cost control strategies is likely to undermine its capacity to stimulate quality at the clinical level. Policy is needed to support the role of health outcomes data so that it is relevant to clinicians and is seen as being fundamental to quality improvement processes at the organisational level. Governments and other funding bodies require that services be accountable for the quality of their services. By using health outcomes data this quality guarantee can be based on evidence that the data are analysed routinely and, where appropriate, clinical services are modified and improved. Without this clear role for health outcomes data, they may become yet another ‘top-down’ accountability tool that has little relevance to clinicians and therefore loses its value as a stimulant to quality improvement.

Informatics for Patient Safety: A Nursing Research Perspective

2006 ◽  
Vol 24 (1) ◽  
pp. 219-254 ◽  
Author(s):  
Suzanne Bakken
Keyword(s):  
Health Care ◽  
Information Technology ◽  
Patient Safety ◽  
Health Information ◽  
Quality Of Health Care ◽  
Critical Role ◽  
Nursing Research ◽  
National Framework

In Crossing the Quality Chasm, the Institute of Medicine (IOM) Committee on Quality of Health Care in America identified the critical role of information technology in designing a health system that produces care that is “safe, effective, patient-centered, timely, efficient, and equitable” (Committee on Quality of Health Care in America, 2001, p. 164). A subsequent IOM report contends that improved information systems are essential to a new health care delivery system that “both prevents errors and learns from them when they occur” (Committee on Data Standards for Patient Safety, 2004, p. 1). This review specifically highlights the role of informatics processes and information technology in promoting patient safety and summarizes relevant nursing research. First, the components of an informatics infrastructure for patient safety are described within the context of the national framework for delivering consumer-centric and information-rich health care and using the National Health Information Infrastructure (NHII) (Thompson & Brailer, 2004). Second, relevant nursing research is summarized; this includes research studies that contributed to the development of selected infrastructure components as well as studies specifically focused on patient safety. Third, knowledge gaps and opportunities for nursing research are identified for each main topic. The health information technologies deployed as part of the national framework must support nursing practice in a manner that enables prevention of medical errors and promotion of patient safety and contributes to the development of practice-based nursing knowledge as well as best practices for patient safety. The seminal work that has been completed to date is necessary, but not sufficient, to achieve this objective.

scholarly journals Hand hygiene implementation: an easy step to improve public health

2020 ◽  
Vol 16 (3) ◽  
Author(s):  
Carolina Fankhauser-Rodriguez ◽  
Chloé Guitart ◽  
Didier Pittet
Keyword(s):  
Public Health ◽  
Critical Role ◽  
Nurse Staffing ◽  
World Health ◽  
Health Organization ◽  
Healthcare Associated ◽  
Nurses And Midwives ◽  
Trained Nurse

The World Health Organization has declared 2020 the “Year of the Nurse and Midwife”. On May 5th of this year, for the annual celebration of the SAVE LIVES: Clean Your Hands campaign, the WHO highlighted the critical role of nurses and midwives in promoting public health. Increasing well-trained nurse staffing will enable nurses and midwives to improve quality of care and prevent infections. The implications for improved nursing and health policy are many. Investing in nurses ensures better care for patients, reduces infections and the economic burden of healthcare-associated infections on countries' economies.

scholarly journals Untreated Depressive Symptoms Significantly Worsen Quality of Life of the Elderly and may Lead to the Misdiagnosis of Dementia: A Cross-Sectional Study

2020 ◽  
Author(s):  
Viktor Voros ◽  
Sandor Fekete ◽  
Tamas Tenyi ◽  
Zoltan Rihmer ◽  
Ilona Szili ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cognitive Impairment ◽  
Depressive Symptoms ◽  
Depressive Disorders ◽  
Early Recognition ◽  
The Elderly ◽  
Screening Tools ◽  
Adequate Treatment

Abstract Background: Several studies demonstrated the role of depressive mood and cognitive impairment in the background of elevated mortality and decreased Quality of Life (QoL) of the elderly.Methods: In the framework of the ICT4Life project self-administered questionnaires and clinical screening tools were used to assess QoL, depressive symptoms and cognitive functions of 60 elderly over the age of 65.Results: Males found to be depressed and cognitively declined more frequently; and had higher scores on the depression and lower on the QoL scales. Depressed elderly had lower cognitive levels and their QoL was significantly poorer than that of the non-depressed subjects. Depressive disorders were detected in a quarter of the elderly, and the majority of them did not receive adequate antidepressant medication.Conclusions: Close correlation between depression and cognitive impairment was confirmed, as well as the key role of depression in the background of QoL decline. Results also highlighted the problems of recognition and adequate treatment of depression and cognitive decline in elderly, which can be further complicated by the common symptoms of depressive pseudo-dementia. Early recognition of depressive symptoms is important not only to treat the underlying mood disorder, but also to improve QoL of the elderly.

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