A Structured Psychiatric Interview for Use in Epidemiological Studies of Mental Disorder

1970 ◽  
Vol 1 (4) ◽  
pp. 339-348 ◽  
Author(s):  
John Warder
Keyword(s):  
Mental Disorder ◽  
Clinical Skills ◽  
Individual Case ◽  
Epidemiological Studies ◽  
Medical Patients ◽  
Structured Interviews ◽  
Individual Subject ◽  
Psychiatric Interview ◽  
Additional Information ◽  
The Individual

The Structured Psychiatric Interview is intended for use in surveys of population subgroups defined in terms of nonpsychiatric criteria including, for example, general medical patients. Its purpose is to elicit evidence of current mental pathology, utilizing the essential clinical skills of the examiner within the context of a structured situation. No diagnostic inferences are made at this stage. (Such inferences would be both inappropriate and unwise without additional information about the individual subject.) Unlike some existing structured interviews, it does not purport to be a “psychological test for psychopathology,” thus avoiding questionable assumptions about the propriety of summating molecular behaviors to arrive at a “quantitative evaluation of the individual for psychopathology.” Insofar as it represents an organized phenomenological examination, it will be of value in the individual case, but it remains primarily an epidemiological instrument for economic measurements of mental disorder within and between populations.

scholarly journals Group assessment of residents’ clinical skills using Case-based Discussions is feasible, highly valued and moreover fosters learning

2020 ◽  
Author(s):  
Rakel Fuglsang Johansen ◽  
René Buch Nielsen ◽  
Bente Malling ◽  
Hanne Storm
Keyword(s):  
Clinical Skills ◽  
Assessment Process ◽  
Structured Interviews ◽  
Medical Department ◽  
Group Assessment ◽  
Individual Assessment ◽  
New Knowledge ◽  
One To One ◽  
The Individual ◽  
Case Based

Abstract Background Assessment of residents’ clinical skills using Case-based Discussion traditionally involves a one-to-one discussion with a supervisor. This entails a subjective, and maybe unequal, assessment of the resident, which can only be overcome with the use of multiple assessors. The purpose of this study was to explore residents’ and assessors’ perception of a group-assessment concept.Methods Eleven to fifteen residents in a medical department met 4 times (every 3rd month) over 1 year for 5 hours each time. The residents took turns presenting clinical cases within a predefined topic and discussed it with peers and assessors (diagnosis, differential diagnosis, ethical considerations etc.). Four assessors (specialists in internal medicine) participated in the discussion and together assessed the residents` clinical skills. An external consultant observed the group-assessment several times and conducted semi-structured interviews with the residents as well as the assessors. Notes from the observations and transcribed interviews were analyzed using an inductive approach looking for participants’ perceptions of the concept.Results Both residents and assessors preferred the group-assessment to the individual assessment. Since there were several assessors, the group-assessments were more consistent and regarded more resource-efficient and manageable than one-to-one assessments. The level of discussion was perceived to be higher in the group discussions compared to one-to-one discussions. All residents gained new knowledge during their assessment and in addition, also reported having learned from listening to the assessment of their peers. Assessors reported gaining new knowledge as well.Conclusions Group-assessment through Case-based Discussions is a good way to structure assessment of residents` clinical skills. The quality of the assessment process seems to be increased and is likely to be more objective than individual assessment. Group-assessment is feasible and acceptable, and additionally fosters learning for all participating doctors in the department.

Shoulder Pain at Work: Causation Analysis

2017 ◽  
Vol 22 (1) ◽  
pp. 11-16
Author(s):  
Joel Weddington ◽  
Charles N. Brooks ◽  
Mark Melhorn ◽  
Christopher R. Brigham
Keyword(s):  
Epidemiological Data ◽  
Case Law ◽  
Individual Case ◽  
Shoulder Injury ◽  
Work Related ◽  
Clear Cut ◽  
The Individual ◽  
Causation Analysis ◽  
Injury Causation ◽  
Relevant Factors

Abstract In most cases of shoulder injury at work, causation analysis is not clear-cut and requires detailed, thoughtful, and time-consuming causation analysis; traditionally, physicians have approached this in a cursory manner, often presenting their findings as an opinion. An established method of causation analysis using six steps is outlined in the American College of Occupational and Environmental Medicine Guidelines and in the AMA Guides to the Evaluation of Disease and Injury Causation, Second Edition, as follows: 1) collect evidence of disease; 2) collect epidemiological data; 3) collect evidence of exposure; 4) collect other relevant factors; 5) evaluate the validity of the evidence; and 6) write a report with evaluation and conclusions. Evaluators also should recognize that thresholds for causation vary by state and are based on specific statutes or case law. Three cases illustrate evidence-based causation analysis using the six steps and illustrate how examiners can form well-founded opinions about whether a given condition is work related, nonoccupational, or some combination of these. An evaluator's causal conclusions should be rational, should be consistent with the facts of the individual case and medical literature, and should cite pertinent references. The opinion should be stated “to a reasonable degree of medical probability,” on a “more-probable-than-not” basis, or using a suitable phrase that meets the legal threshold in the applicable jurisdiction.

Stasis Anxiety

2017 ◽  
Author(s):  
Andrew van der Vlies
Keyword(s):  
South Africa ◽  
Civil War ◽  
Black Writers ◽  
Political Rights ◽  
Ancient Greek ◽  
Individual Subject ◽  
Starting Point ◽  
The Individual ◽  
Past Experiences ◽  
Contemporary Writing

Two recent debut novels, Songeziwe Mahlangu’s Penumbra (2013) and Masande Ntshanga’s The Reactive (2014), reflect the experience of impasse, stasis, and arrested development experienced by many in South Africa. This chapter uses these novels as the starting point for a discussion of writing by young black writers in general, and as representative examples of the treatment of ‘waithood’ in contemporary writing. It considers (spatial and temporal) theorisations of anxiety, discerns recursive investments in past experiences of hope (invoking Jennifer Wenzel’s work to consider the afterlives of anti-colonial prophecy), assesses the usefulness of Giorgio Agamben’s elaboration of the ancient Greek understanding of stasis as civil war, and asks how these works’ elaboration of stasis might be understood in relation to Wendy Brown’s discussion of the eclipsing of the individual subject of political rights by the neoliberal subject whose very life is framed by its potential to be understood as capital.

scholarly journals A Multiple Stakeholder Perspective for Evaluating Community-Based Dementia Care

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 60-61
Author(s):  
Johan Suen
Keyword(s):  
Dementia Care ◽  
Structural Constraints ◽  
Care Provision ◽  
Care Providers ◽  
Structured Interviews ◽  
Community Based ◽  
Relational Factors ◽  
Care Relationships ◽  
The Individual ◽  
The Impact

Abstract For holistic interventions and research on dementia, it is fundamental to understand care experiences from the perspectives of carers, care recipients, and care professionals. While research on care dyads and triads have highlighted the effects of communication and interactional aspects on care relationships, there is a lack of knowledge on how individual-contextual and relational factors shape the provision and receipt of care in terms of decision-making processes, resource allocation, and expectations of care outcomes. Thus, this paper sheds light on (i) how carers negotiate care provision with other important life domains such as employment, household/family roles and conflicts, as well as their own health problems, life goals, values, and aspirations for ageing; (ii) how older adults with dementia perceive support and those who provide it; (iii) the structural constraints faced by care professionals in delivering a team-based mode of dementia care; and, taken together, (iv) how community-based dementia care is impeded by barriers at the individual, relational, and institutional levels. Findings were derived from semi-structured interviews and observational data from fieldwork conducted with 20 persons with dementia (median age = 82), 20 of their carers (median age = 60), and 4 professional care providers. All respondents were clients and staff of a multidisciplinary and community-based dementia care system in Singapore. Our analysis indicates the impact of dementia care is strongly mediated by the interplay between institutional/familial contexts of care provision and the various ‘orientations’ to cognitive impairment and seeking support, which we characterised as ‘denial/acceptance’, ‘obligated’, ‘overprotective’, and ‘precariously vulnerable’.

scholarly journals Physical Activity and Redox Balance in the Elderly: Signal Transduction Mechanisms

2021 ◽  
Vol 11 (5) ◽  
pp. 2228
Author(s):  
Daniela Galli ◽  
Cecilia Carubbi ◽  
Elena Masselli ◽  
Mauro Vaccarezza ◽  
Valentina Presta ◽  
...  
Keyword(s):  
Physical Activity ◽  
Molecular Mechanisms ◽  
Vascular Tissue ◽  
The Elderly ◽  
Redox Balance ◽  
Antioxidant Systems ◽  
Targeted Prevention ◽  
Individual Subject ◽  
Aged People ◽  
The Individual

Reactive Oxygen Species (ROS) are molecules naturally produced by cells. If their levels are too high, the cellular antioxidant machinery intervenes to bring back their quantity to physiological conditions. Since aging often induces malfunctioning in this machinery, ROS are considered an effective cause of age-associated diseases. Exercise stimulates ROS production on one side, and the antioxidant systems on the other side. The effects of exercise on oxidative stress markers have been shown in blood, vascular tissue, brain, cardiac and skeletal muscle, both in young and aged people. However, the intensity and volume of exercise and the individual subject characteristics are important to envisage future strategies to adequately personalize the balance of the oxidant/antioxidant environment. Here, we reviewed the literature that deals with the effects of physical activity on redox balance in young and aged people, with insights into the molecular mechanisms involved. Although many molecular pathways are involved, we are still far from a comprehensive view of the mechanisms that stand behind the effects of physical activity during aging. Although we believe that future precision medicine will be able to transform exercise administration from wellness to targeted prevention, as yet we admit that the topic is still in its infancy.

scholarly journals Developing HIV assisted partner notification services tailored to Mexican key populations: a qualitative approach

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Heleen Vermandere ◽  
Santiago Aguilera-Mijares ◽  
Liliane Martínez-Vargas ◽  
M. Arantxa Colchero ◽  
Sergio Bautista-Arredondo
Keyword(s):  
Partner Notification ◽  
Key Populations ◽  
Structured Interviews ◽  
Hiv Diagnosis ◽  
Serostatus Disclosure ◽  
Hiv Epidemic ◽  
Contact Information ◽  
Hiv Awareness ◽  
Sex With Men ◽  
The Individual

Abstract Background Assisted partner notification services (APNS) may increase HIV testing, early diagnosis, and treatment, but they are not formally implemented in Mexico, where the HIV epidemic is concentrated in men who have sex with men (MSM) and transwomen (TW). This study aimed to explore the awareness of and need for HIV partner notification, as well as to outline potential strategies for APNS based on identified barriers and facilitators. Methods We conducted semi-structured interviews to explore partner notification with MSM, TW, and counselors. Afterwards, brainstorm sessions were carried out to produce strategies for implementing APNS. Results Most participants reported experiences with informal partner notification and serostatus disclosure, but not with APNS. Only one counselor indicated assisting notification systematically. The main barriers for notifying or disclosing mentioned by both MSM and TW included fear of (violent) reactions, discrimination and lacking contact information of casual partners. Participants thought it was easier to inform a formal partner, conditional of being well informed about HIV. Given current stigma and lack of awareness, it was suggested that APNS should be preceded by HIV awareness efforts, and be provided by counselors or peers to mitigate potential rejection or violent reactions. Conclusions While APNS are not formally implemented in Mexico, all participants supported the service, indicating that APNS could potentially enhance early HIV diagnosis in Mexico. Strategies to implement such services need to be flexible addressing the individual needs of participants, guaranteeing the safety of more vulnerable participants.

Judicial Lawmaking, Discourse Theory, and the ICTY on Belligerent Reprisals

2011 ◽  
Vol 12 (5) ◽  
pp. 1261-1278 ◽  
Author(s):  
Milan Kuhli ◽  
Klaus Günther
Keyword(s):  
International Criminal Court ◽  
International Criminal ◽  
International Criminal Tribunal ◽  
Individual Case ◽  
Criminal Court ◽  
Discourse Theory ◽  
Criminal Courts ◽  
Normative Expectations ◽  
Judicial Lawmaking ◽  
The Individual

Without presenting a full definition, it can be said that the notion of judicial lawmaking implies the idea that courts create normative expectations beyond the individual case. That is, our question is whether courts' normative declarations have an effect which is abstract and general. Our purpose here is to ask about judicial lawmaking in this sense with respect to international criminal courts and tribunals. In particular, we will focus on the International Criminal Tribunal for the Former Yugoslavia (ICTY). No other international criminal court or tribunal has issued so many judgments as the ICTY, so it seems a particularly useful focus for examining the creation of normative expectations.

Prevalenza dei disturbi affettivi (DSM-IIIR) nei pazienti di un reparto di medicina geriatrica. Uno studio epidemiologico con controlli della popolazione generale

1993 ◽  
Vol 2 (1) ◽  
pp. 47-52
Author(s):  
Cesare Turrina ◽  
Maria Steinmayr ◽  
Orazio Piasere ◽  
Orazio Siciliani
Keyword(s):  
Mental State ◽  
Specific Treatment ◽  
Adjustment Disorder ◽  
Depressive Mood ◽  
High Risk Group ◽  
Dysthymic Disorder ◽  
Medical Patients ◽  
Psychiatric Interview ◽  
Community Controls ◽  
State Examination

SummaryObjective - To investigate the rate of DSM-IIIR main affective disorders in a sample (52) of elderly medical patients consecutively admitted to a geriatric ward; to look for risk factors associated with depression; to compare the rate of depression with the one detected in community controls (117 subjects). Design - All consecutive patients admitted during January-February 1990 were assessed with a standardized psychiatric interview (Geriatric Mental State Examination) and with the Mini-Mental State Examination. Setting - The IV Geriatric Division (ward and day-hospital), Ospedale Civile Maggiore of Verona, which cares for elderly affected by medical illnesses. Main outcome measures - Depression was diagnosed according to the main DSM-IIIR categories for mood disorders. Results - Overall, an affective disorder was diagnose in 25% of the subjects (major depression 5,7%, dysthymic disorder 3,8%, n.o.s. depression 13,4%, adjustment disorder with depressive mood 1,9%). This rate was significantly higher when compared with the prevalence detected in community controls (25% vs. 11,1%). Older age, female sex, physical disability and distressing events were not associated with affective illness, while the lack of social support was significantly associated with depression. Conclusions - Elderly medical patients turned out to be an high risk group for depression, which deserves psychiatric screening and specific treatment.

A Qualitative Study of Developing Competency in Thyroid Surgery: A Resident’s Perspective With 5 Year Follow Up

2021 ◽  
pp. 000348942199691
Author(s):  
Gabriela DeVries ◽  
Megan Rudolph ◽  
Howard David Reines ◽  
Philip E. Zapanta
Keyword(s):  
Qualitative Study ◽  
Learning Strategies ◽  
Thyroid Surgery ◽  
Washington Dc ◽  
Structured Interviews ◽  
Self Directed Learning ◽  
Surgical Specialty ◽  
Long Term Follow Up ◽  
The Individual

Objectives: The Accreditation Council for Graduate Medical Education has guidelines on assessing surgical qualifications based on experience. Attending surgeons have various assumptions on how their trainees learn and acquire surgical skills. This study primarily investigates the resident’s perspective on gaining experience and achieving competency in thyroid surgical procedures. Methods: A qualitative study using semi-structured interviews was designed to derive themes that discuss the acquisition of competency in thyroid surgery. After IRB approval, data was collected from 2012 to 2014 at 4 academic centers in the Washington, DC area. Fourteen chief residents specializing in either general surgery or otolaryngology were interviewed until saturation was achieved. These semi-structured interviews were transcribed and broken up into codes utilizing Moustakas’ analysis. A comprehensive list of master themes in regards to achieving competency in thyroid surgery was developed. A follow up survey of the surgeons was undertaken at 5 years to determine if the perceptions during residency persisted in practice. Results: Surgical specialty residents experience and learn thyroid surgery in 5 learning themes: 1. Self—directed learning is significant during residency. 2. Repetition with graduated autonomy is key. 3. Effective mentors are competent surgeons who challenge residents and use positive teaching techniques. 4. Residents employ active learning through the “see one, do one, teach one” philosophy. 5. Learning from complexity is of importance to residency training. After several years in practice, the most important theme in learning after residency was repetition of cases. Conclusions: This study demonstrates how residents progress in approaching competency in thyroid surgery. Adult learning strategies are preferred, and programs should incorporate tailored techniques to meet the individual needs of the residents. Perceptions of what is most important shifted in long-term follow up. Further study is needed to assure competency in residency and in practice.

scholarly journals The value of domiciliary medication reviews: a thematic analysis of patient views

2021 ◽  
Author(s):  
Patricia McCormick ◽  
Bridget Coleman ◽  
Ian Bates
Keyword(s):  
Thematic Analysis ◽  
Outcome Measure ◽  
Service Users ◽  
Structured Interviews ◽  
Main Outcome Measure ◽  
Healthcare Settings ◽  
Medication Reviews ◽  
Informal Carers ◽  
The Individual ◽  
Patient Centric

AbstractBackground Medication reviews are recognised as essential to tackling problematic polypharmacy. Domiciliary medication reviews (DMRs) have become more prevalent in recent years. They are proclaimed as being patient-centric but published literature mainly focuses on clinical outcomes. However, it is not known where the value of DMRs lies for patients who participate in them. Objective To determine the value of domiciliary medication reviews to service users. Setting Interviews took place with recipients of domiciliary medication reviews residing in the London boroughs of Islington and Haringey. Method Semi-structured interviews analysed using thematic analysis. Main outcome measure Themes and sub-themes identified from interview transcripts. Results Five themes were identified: advantages over traditional settings, attributes of the professional, adherence, levels of engagement and knowledge. Conclusion For many patients, the domiciliary setting is preferred to traditional healthcare settings. Patients appreciated the time spent with them during a DMR and felt listened to. Informal carers felt reassured that the individual medication needs of their relative had been reviewed by an expert.

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