991 resultados para non-Anglo psychiatry


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Sociocultural messages about the ideal body build have been studied predominantlyamong White adolescent girls. In the current study we examined the relationships between perceived sociocultural influences, body image concerns, and body change strategies among 47 (22 boys and 25 girls) Indigenous Australian adolescents. These relationships were compared to those from 47 non-Indigenous adolescents (predominantly from an Anglo-Saxon background), who were matched on gender, age, and school grade. Overall, the sociocultural influences were found to be associated with body image concerns and body change strategies among both cultural groups. The only exception was that the sociocultural influences were not associated with the Indigenous girls levels of body dissatisfaction or body image importance. These findings are discussed in relation to past studies of White and Black girls.

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In this paper I describe the discursive strategies related to the writer–reader textual reciprocity. I focus on one way of achieving such reciprocity -- the employment by the writer of facilitative schematic structures and metalanguage where one text segment signposts information conveyed in the segment that follows. I refer to these facilitative schematic structures as "organising relational schemata". I see organising relations as the most explicit components of the rhetorical structure of texts: they illuminate the main message and aid the reader's cognitive processes in the orientation of how information is conveyed by text.
This paper discusses the way the choices of organising relations and associated metalanguage by the writers in different cultures and different discourse communities contribute to the communicative homeostasis in the world of text. It shows how the influence of a native culture and intellectual style together with the forces operating within the writer's international disciplinary community interact in the authorial guidance in the scholarly prose.
I introduce and exemplify three types of organising relational structures: Advance Organisers, Introducers and Enumerators. I trace the utilisation of these three types of relations in sociology research papers written in English and produced in "Anglo" and Polish academic discourse comunities by native English speaking and native Polish speaking scholars. The relational typology adopted is based on a study by Golebiowski (2002), which proposed a theoretical framework for the examination of discoursal structure of research papers, referred to as FARS – Framework for the Analysis of the Rhetorical Structure of Texts. FARS entails a relational taxonomy which displays a pattern of rhetorical relations utilised by the writer to achieve textual coherence.
I describe intertextual differences in the frequency of occurrence of organising relations, their degree of explicitness and their positioning in the hierarchical structure of texts. Differences in the mode of employment of textual organisers suggest that the rhetorical structure of English research prose produced by non-native speakers cannot escape being shaped by the characteristics and conventions of the authors’ first language. They are also attributed to cultural norms and conventions as well as educational systems prevailing within the discourse communities which constitute the social contexts of texts.

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Objective: To explore trends in the practice of mother-infant psychotherapy among perinatal psychiatry clinicians based in Melbourne.Methods: A cross-sectional survey with a purpose designed self-report questionnaire was used to assess the attitudes and practices of 47 perinatal and infant psychiatry clinicians in their use and understanding of mother-infant psychotherapy.Results: Seventy per cent of clinicians in this field of psychotherapy who responded to the questionnaire subscribe to a psychodynamic model, although cognitive behavioural models are also used. The interventions were mostly used in conjunction with other interventions, would be more accurately described as 'parent-infant psychotherapy', and non-psychiatrists in the area tended to be more likely to be formally trained in psychotherapy, but only 4% were formally trained in specific mother-infant psychotherapy. There was a unanimous request for further clinical training in this area.Conclusions: The emerging field of perinatal psychiatry needs to develop coherent therapeutic models and conduct outcome trials on specific interventions. Specific trainings in these models, in assessment and in diagnostic frameworks are required to enhance clinical efficacy, for research and service development purposes.

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The first aim of the research was to determine the applicability of certain variables from the Health Belief Model (HBM), the Theory of Reasoned Action (TRA), the risk dimensions from the Psychometric Paradigm, the Common-Sense Model of Illness Representations and the Locus of Control to Italian women’s beliefs and behaviours in relation to screening mammography. These models have predominantly been derived and evaluated with English-speaking persons. The study used quantitative and qualitative methods to enable explanation of research-driven and participant-driven issues. The second aim was to include Italian women in health behaviour research and to contrast the Italian sample with the Anglo-Australian sample to determine if differences exist in relation to their beliefs. In Australia many studies in health behaviour research do not include women whose first language is not English. The third aim was to evaluate the Anti-Cancer Council of Victoria’s (ACCV) Community Language Program (CLP) by: (a) identifying the strengths and weaknesses of the program as seen by the participants; and (b) assessing the impact of the program on women’s knowledge and beliefs about breast cancer, early detection of breast cancer, self-reported and intended breast screening behaviours. The CLP is an information service that uses women’s first language to convey information to women whose first language is not English. The CLP was designed to increase knowledge about breast and cervical cancer. The research used a pre-test-intervention-post-test design with 174 Italian-born and 138 Anglo-Australian women aged 40 years and over. Interviews for the Italian sample were conducted in Italian. The intervention was an information session that related to breast health and screening mammography. Demographic variables were collected in the Pre-Test only. Qualitative open-ended questions that related specifically to the information session were collected in the Post-Test phase of the study. Direct logistic regression was used with the participants’ beliefs and behaviours to identify the relevant variables for language (Italian speaking and English-speaking), attendance to an information session, mammography screening and breast self-examination (BSE) behaviour. Pre- and Post-Test comparisons were conducted using chi-square tests for the non-parametric data and paired sample t-tests for the parametric data. Differences were found between the Italian and Anglo-Australian women in relation to their beliefs about breast cancer screening. The Italian women were: (1) more likely to state that medical experts understood the causes of breast cancer; (2) more likely to feel that they had less control over their personal risk of getting breast cancer; (3) more likely to be upset and frightened by thinking about breast cancer; (4) less likely to perceive breast cancer as serious; (4) more likely to only do what their doctor told them to do; and (5) less likely to agree that there were times when a person has cancer and they don’t know it. A pattern emerged for the Italian and Anglo-Australian women from the logistic regression analyses. The Italian women were much more likely to comply with medical authority and advice. The Anglo-Australian women were more likely to feel that they had some control over their health. Specifically, the risk variable ‘dread’ was more applicable to the Italian women’s behaviour and internal locus of control variable was more relevant to the Anglo-Australian women. The qualitative responses also differed for the two samples. The Italian women’s comments were more general, less specific, and more limited than that of the Anglo-Australian women. The Italian women talked about learning how to do BSE whereas the Anglo-Australian women said that attending the session had reminded them to do BSE more regularly. The key findings and contributions of the present research were numerous. The focus on one cultural group ensured comprehensive analyses, as did the inclusion of an adequate sample size to enable the use of multivariate statistics. Separating the Italian and Anglo-Australian samples in the analyses provided theoretical implications that would have been overlooked if the two groups were combined. The use of both qualitative and quantitative data capitalised on the strengths of both techniques. The inclusion of an Anglo-Australian group highlighted key theoretical findings, differences between the two groups and unique contributions made by both samples during the collection of the qualitative data. The use of a pre-test-intervention-post-test design emphasised the reticence of the Italian sample to participate and talk about breast cancer and confirmed and validated the consistency of the responses across the two interviews for both samples. The inclusion of non-cued responses allowed the researcher to identify the key salient issues relevant to the two groups. The limitations of the present research were the lack of many women who were not screening and reliance on self-report responses, although few differences were observed between the Pre- and Post-Test comparisons. The theoretical contribution of the HBM and the TRA variables was minimal in relation to screening mammography or attendance at the CLP. The applicability of these health behaviour theories may be less relevant for women today as they clearly knew the benefits of and the seriousness of breast cancer screening. The present research identified the applicability of the risk variables to the Italian women and the relevance of the locus of control variables to the Anglo-Australian women. Thus, clear cultural differences occurred between the two groups. The inclusion of the illness representations was advantageous as the responses highlighted ideas and personal theories salient to the women not identified by the HBM. The use of the illness representations and the qualitative responses further confirmed the relevance of the risk variables to the Italian women and the locus of control variables to the Anglo-Australian women. Attendance at the CLP did not influence the women to attend for mammography screening. Behavioural changes did not occur between the Pre- and Post-Test interviews. Small incremental changes as defined by the TTM and the stages of change may have occurred. Key practical implications for the CLP were identified. Improving the recruitment methods to gain a higher proportion of women who do not screen is imperative for the CLP promoters. The majority of the Italian and Anglo-Australian women who attended the information sessions were women who screen. The fact that Italian women do not like talking or thinking about cancer presents a challenge to promoters of the CLP. The key theoretical finding that Italian women dread breast cancer but comply with their doctor provides clear strategies to improve attendance at mammography screening. In addition, the inclusion of lay health advisors may be one way of increasing attendance to the CLP by including Italian women already attending screening and likely to have attended a CLP session. The present research identified the key finding that improving Anglo-Australian attendance at an information session is related to debunking the myth surrounding familial risk of breast cancer and encouraging the Anglo-Australian women to take more control of their health. Improving attendance for Italian women is related to reducing the fear and dread of breast cancer and building on the compliance pattern with medical authority. Therefore, providing an information session in the target language is insufficient to attract non-screeners to the session and then to screen for breast cancer. Suggestions for future research in relation to screening mammography were to include variables from more than one theory or model, namely the risk, locus of control and illness representations. The inclusion of non-cued responses to identify salient beliefs is advantageous. In addition, it is imperative to describe the profile of the cultural sample in detail, include detailed descriptions of the translation process and be aware of the tendency of Italian women to acquiesce with medical authority.

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This paper reports the investigation of the organisational structure of introductory sections of research papers written by Polish authors in English and Polish. The aim of the study was to test whether in view of cultural differences, reflected in the Anglo-American and Polish intellectual styles, the rhetorical pattern of research papers would vary between the two cultures. The selected texts were analysed in terms of Swales' Creating a Research Space (CARS) model (Swales 1990). On application of the model in the analysis of articles from the English corpus, it was found that it could only be employed in very generic terms. The analysis of the Polish corpus revealed that the Variation between Anglo-American and Polish schematic patterns was too significant to justify the implementation of the same investigative tool.

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Non-suicidal self-injury has been classed as having both impulsive and compulsive characteristics (Simeon & Favazza, 2001). These constructs have been related to disordered eating behaviors such as vomiting (Favaro & Santonastaso, 1998). Utilizing an international sample of adult females, this paper further explored this model, aiming to identify whether all types of disordered eating could be classified as impulsive or compulsive, and whether the impulsive and compulsive groupings reflect underlying trait impulsivity and compulsivity. The hypothesized impulsive and compulsive dimensions did not emerge from the data. Notably however, all self-injurious and disordered eating behaviors were linked to Urgency (an impulsivity facet) to varying degrees; no relationship with trait compulsivity was found. These findings are discussed, study limitations are noted, and relevance for clinical practice is outlined.

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BACKGROUND: Historically, the focus of Non Communicable Disease (NCD) prevention and control has been cardiovascular disease (CVD), type 2 diabetes mellitus (T2DM), cancer and chronic respiratory diseases. Collectively, these account for more deaths than any other NCDs. Despite recent calls to include the common mental disorders (CMDs) of depression and anxiety under the NCD umbrella, prevention and control of these CMDs remain largely separate and independent. DISCUSSION: In order to address this gap, we apply a framework recently proposed by the Centers for Disease Control with three overarching objectives: (1) to obtain better scientific information through surveillance, epidemiology, and prevention research; (2) to disseminate this information to appropriate audiences through communication and education; and (3) to translate this information into action through programs, policies, and systems. We conclude that a shared framework of this type is warranted, but also identify opportunities within each objective to advance this agenda and consider the potential benefits of this approach that may exist beyond the health care system.

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AIMS: Failure to complete high school predicts substantial economic and social disadvantage in adult life. The aim of this study was to determine the longitudinal association of mid-adolescent polydrug use and high school non-completion, relative to other drug use profiles. DESIGN: A longitudinal analysis of the relationship between polydrug use in three cohorts at grade 9 (age 14-15 years) and school non-completion (reported post-high school). SETTING: A State-representative sample of students across Victoria, Australia. PARTICIPANTS: A total of 2287 secondary school students from 152 high schools. The retention rate was 85%. MEASUREMENTS: The primary outcome was non-completion of grade 12 (assessed at age 19-23 years). At grade 9, predictors included 30-day use of eight drugs, school commitment, academic failure and peer drug use. Other controls included socio-economic status, family relationship quality, depressive symptoms, gender, age and cohort. FINDINGS: Three distinct classes of drug use were identified-no drug use (31.7%), mainly alcohol use (61.8%) and polydrug use (6.5%). Polydrug users were characterized by high rates of alcohol, tobacco and cannabis use. In the full model, mainly alcohol users and polydrug users were less likely to complete school than non-drug users [odds ratio (OR) = 1.54, 95% confidence interval (CI) = 1.17-2.03) and OR = 2.51, 95% CI = 1.45-4.33), respectively, P < 0.001]. These effects were independent of school commitment, academic failure, peer drug use and other controls. CONCLUSIONS: Mid-adolescent polydrug use in Australia predicts subsequent school non-completion after accounting for a range of potential confounding factors. Adolescents who mainly consume alcohol are also at elevated risk of school non-completion.

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The aim of this study was to determine the influence of climatic conditions on the hematological profile of Saanen and mixed-breed (1/2 Saanen x 1/2 Anglo-Nubian) goats, as well as to define reference values for these animals bred in Ceara, Brazil. Thirty goats were utilized and blood samples were collected monthly during the rainy (February to May) and dry (August to November) periods to obtain an erythrogram a leukogram. The averange were compared by the t-Student test and Mann Whitney test, with parametric and non-parametric distribution of the data, respectively, where p<0.05 was considered significant. A study was carried out of simple Pearson correlations of the hematological parameters with environmental and physiological variables. The number of red blood cells (RBCs) was higher in the Saanen goats and in the rainy period, while the hematocrit was higher in the dry period (p<0.05). The leukocytes and lymphocytes were higher in the 1/2S1/2 AN goats in the two periods (p<0.05). In the two genotypes, the leukocytes and lymphocytes were higher in the dry season and the segmented neutrophils higher in the rainy season (p<0.05). The other parameters did not differ (p>0.05). The RBCs and segmented neutrophils displayed a negative correlation with air temperature, but positive with relative humidity and rectal temperature (p<0.05). The hematocrit positively correlated with air temperature and respiratory rate (p<0.05). The leukocytes and lymphocytes showed a negative correlation with rectal temperature (p<0.05). It was therefore concluded that Saanen females are more affected by climatic variations and that the rainy season has a greater negative impact on hematological parameters. The values obtained could serve as a reference for these genotypes in Ceara.

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Major depressive disorder (MDD) trials - investigating either non-pharmacological or pharmacological interventions - have shown mixed results. Many reasons explain this heterogeneity, but one that stands out is the trial design due to specific challenges in the field. We aimed therefore to review the methodology of non-invasive brain stimulation (NIBS) trials and provide a framework to improve clinical trial design. We performed a systematic review for randomized, controlled MDD trials whose intervention was transcranial magnetic stimulation (rTMS) or transcranial direct current stimulation (tDCS) in MEDLINE and other databases from April 2002 to April 2008. We created an unstructured checklist based on CONSORT guidelines to extract items such as power analysis, sham method, blinding assessment, allocation concealment, operational criteria used for MDD, definition of refractory depression and primary study hypotheses. Thirty-one studies were included. We found that the main methodological issues can be divided in to three groups: (1) issues related to phase II/small trials, (2) issues related to MDD trials and, (3) specific issues of NIBS studies. Taken together, they can threaten study validity and lead to inconclusive results. Feasible solutions include: estimating the sample size a priori; measuring the degree of refractoriness of the subjects; specifying the primary hypothesis and statistical tests; controlling predictor variables through stratification randomization methods or using strict eligibility criteria; adjusting the study design to the target population; using adaptive designs and exploring NIBS efficacy employing biological markers. In conclusion, our study summarizes the main methodological issues of NIBS trials and proposes a number of alternatives to manage them. Copyright (C) 2011 John Wiley & Sons, Ltd.

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Background: Frailty in older adults is a multifactorial syndrome defined by low metabolic reserve, less resistance to stressors, and difficulty in maintaining organic homeostasis due to cumulative decline of multiple physiological systems. The relationship between frailty and cognition remains unclear and studies about Mini-Mental State Examination (MMSE) performance and frailty are scarce. The objective was to examine the association between frailty and cognitive functioning as assessed by the MMSE and its subdomains. Methods: A cross-sectional population-based study (FIBRA) was carried out in Ermelino Matarazzo, a poor subdistrict of the city of Sao Paulo, Brazil. Participants were 384 community dwelling older adults, 65 years and older who completed the MMSE and a protocol to assess frailty criteria as described in the Cardiovascular Health Study (CHS). Results: Frail older adults had significantly worse performance on the MMSE (p < 0.001 for total score). Linear regression analyses showed that the MMSE total score was influenced by age (p < 0.001), education (p < 0.001), family income (p < 0.001), and frailty status (p < 0.036). Being frail was associated more significantly with worse scores in Time Orientation (p < 0.004) and Immediate Memory (p < 0.001). Conclusions: Our data suggest that being frail is associated with worse cognitive performance, as assessed by the MMSE. It is recommended that the assessment of frail older adults should include the investigation of their cognitive status.

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This project considered the second stage of transforming local administration and public service management to reflect democratic forms of government. In Hungary in the second half of the 1990s more and more public functions delegated to local governments have been handed over to the private or civil sectors. This has led to a relative decrease of municipal functions but not of local governments' responsibilities, requiring them to change their orientation and approach to their work so as to be effective in their new roles of managing these processes rather than traditional bureaucratic administration. Horvath analysed the Anglo-Saxon, French and German models of self-government, identifying the differing aspects emphasised in increasing the private sector's role in the provision of public services, and the influence that this process has on the system of public administration. He then highlighted linkages between actors and local governments in Hungary, concluding that the next necessary step is to develop institutional mechanisms, financial incentives and managerial practices to utilise the full potential of this process. Equally important is the need for conscious avoidance of restrictive barriers and unintended consequences, and for local governments to confront the social conflicts that have emerged in parallel with privatisation. A further aspect considered was a widening of the role of functional governance at local level in the field of human services. A number of different special purpose bodies have been set up in Hungary, but the results of their work are unclear and Horvath feels that this institutionalisation of symbiosis is not the right path in Hungary today. He believes that the change from local government to local governance will require the formulation of specific public policy, the relevance of which can be proven by processes supported with actions.