Functional limitations and quality of life in schizophrenia and other psychotic disorders

There is substantial evidence of the decreased functional capacity, especially everyday functioning, of people with psychotic disorder in clinical settings, but little research about it in the general population. The aim of the present study was to provide information on the magnitude of functional capacity problems in persons with psychotic disorder compared with the general population. It estimated the prevalence and severity of limitations in vision, mobility, everyday functioning and quality of life of persons with psychotic disorder in the Finnish population and determined the factors affecting them. This study is based on the Health 2000 Survey, which is a nationally representative survey of 8028 Finns aged 30 and older. The psychotic diagnoses of the participants were assessed in the Psychoses of Finland survey, a substudy of Health 2000. The everyday functioning of people with schizophrenia is studied widely, but one important factor, mobility has been neglected. Persons with schizophrenia and other non-affective psychotic disorders, but not affective psychoses had a significantly increased risk of having both self-reported and test-based mobility limitations as well as weak handgrip strength. Schizophrenia was associated independently with mobility limitations even after controlling for lifestyle-related factors and chronic medical conditions. Another significant factor associated with problems in everyday functioning in participants with schizophrenia was reduced visual acuity. Their vision was examined significantly less often during the five years before the visual acuity measurement than the general population. In general, persons with schizophrenia and other non-affective psychotic disorder had significantly more limitations in everyday functioning, deficits in verbal fluency and in memory than the general population. More severe negative symptoms, depression, older age, verbal memory deficits, worse expressive speech and reduced distance vision were associated with limitations in everyday functioning. Of all the psychotic disorders, schizoaffective disorder was associated with the largest losses of quality of life, and bipolar I disorder with equal or smaller losses than schizophrenia. However, the subjective loss of qualify of life associated with psychotic disorders may be smaller than objective disability, which warrants attention. Depressive symptoms were the most important determinant of poor quality of life in all psychotic disorders. In conclusion, subjects with psychotic disorders need regular somatic health monitoring. Also, health care workers should evaluate the overall quality of life and depression of subjects with psychotic disorders in order to provide them with the basic necessities of life.

From Habits to Social Structures : Pragmatism and Contemporary Social Theory

Pragmatism has sometimes been taken as a catchphrase for epistemological stances in which anything goes. However, other authors argue that the real novelty and contribution of this tradition has to do with its view of action as the context in which all things human take place. Thus, it is action rather than, for example, discourses that should be our starting point in social theory. The introductory section of the book situates pragmatism (especially the ideas of G. H. Mead and John Dewey) within the field and tradition of social theory. This introductory also contextualizes the main core of the book which consists of four chapters. Two of these chapters have been published as articles in scientific journals and one in an edited book. All of them discuss the core problem of social theory: how is action related to social structures (and vice versa)? The argument is that habitual action is the explanation for the emergence of social structures from our action. Action produces structures and social reproduction takes place when action is habitualized; that is, when we develop social dispositions to act in a certain manner in familiar environments. This also means that even though the physical environment is the same for all of us, our habits structure it into different kinds of action possibilities. Each chapter highlights these general insights from different angles. Practice theory has gained momentum in recent years and it has many commonalities with pragmatism because both highlight the situated and corporeal character of human activity. One famous proponent of practice theory is Margaret Archer who has argued that the pragmatism of G. H. Mead leads to an oversocialized conception of selfhood. Mead does indeed present a socialized view of selfhood but this is a meta-sociological argument rather than a substantial sociological claim. Accordingly, one can argue that in this general sense intersubjectivity precedes subjectivity and not the other way around. Such a view does not indicate that our social relation would necessarily "colonize" individual action because there is a place for internal conversations (in Archer s terminology); it is especially in those phases of action where it meets obstacles due to the changes of the environment. The second issue discussed has the background assumption that social structures can fruitfully be conceptualized as institutions. A general classification of different institution theories is presented and it is argued that there is a need for a habitual theory of institutions due to the problems associated with these other theories. So-called habitual institutionalism accounts for institutions in terms of established and prevalent social dispositions that structure our social interactions. The germs of this institution theory can be found in the work of Thorstein Veblen. Since Veblen s times, these ideas have been discussed for example, by the economist Geoffrey M. Hodgson. His ideas on the evolution of institutions are presented but a critical stance is taken towards his tendency of defining institutions with the help of rules because rules are not always present in institutions. Accordingly, habitual action is the most basic but by no means the only aspect of institutional reproduction. The third chapter deals with theme of action and structures in the context of Pierre Bourdieu s thought. Bourdieu s term habitus refers to a system of dispositions which structure social fields. It is argued that habits come close to the concept of habitus in the sense that the latter consists of particular kinds of habits; those that are related to the reproduction of socioeconomic positions. Habits are thus constituents of a general theory of societal reproduction whereas habitus is a systematic combination of socioeconomic habits. The fourth theme relates to issues of social change and development. The capabilities approach has been associated with the name of Amartya Sen, for example, and it underscores problems inhering in economistic ways of evaluating social development. However, Sen s argument has some theoretical problems. For example, his theory cannot adequately confront the problem of relativism. In addition, Sen s discussion lacks also a theory of the role of the public. With the help of arguments derived from pragmatism, one gets an action-based, socially constituted view of freedom in which the role of the public is essential. In general, it is argued that a socially constituted view of agency does not necessarily to lead to pessimistic conclusions about the freedom of action.

Infrared spectroscopic study of the phase transitions in CsNO3, RbNO3 and NH4NO3

Phase transitions of CsNO3 (II-I), RbNO3 (IV-III-II) and NH4NO3 (V-IV-III-II-I) have been studied by i.r. spectroscopy. The study has provided useful information on the changes in the dispositions of the ions during the phase transitions.

Linguistic and perceptual processing of communicative cues in Asperger Syndrome

Asperger Syndrome (AS) belongs to autism spectrum disorders where both verbal and non-verbal communication difficulties are at the core of the impairment. Social communication requires a complex use of affective, linguistic-cognitive and perceptual processes. In the four studies included in the current thesis, some of the linguistic and perceptual factors that are important for face-to-face communication were studied using behavioural methods. In all four studies the results obtained from individuals with AS were compared with typically developed age, gender and IQ matched controls. First, the language skills of school-aged children were characterized in detail with standardized tests that measured different aspects of receptive and expressive language (Study I). The children with AS were found to be worse than the controls in following complex verbal instructions. Next, the visual perception of facial expressions of emotion with varying degrees of visual detail was examined (Study II). Adults with AS were found to have impaired recognition of facial expressions on the basis of very low spatial frequencies which are important for processing global information. Following that, multisensory perception was investigated by looking at audiovisual speech perception (Studies III and IV). Adults with AS were found to perceive audiovisual speech qualitatively differently from typically developed adults, although both groups were equally accurate in recognizing auditory and visual speech presented alone. Finally, the effect of attention on audiovisual speech perception was studied by registering eye gaze behaviour (Study III) and by studying the voluntary control of visual attention (Study IV). The groups did not differ in eye gaze behaviour or in the voluntary control of visual attention. The results of the study series demonstrate that many factors underpinning face-to-face social communication are atypical in AS. In contrast with previous assumptions about intact language abilities, the current results show that children with AS have difficulties in understanding complex verbal instructions. Furthermore, the study makes clear that deviations in the perception of global features in faces expressing emotions as well as in the multisensory perception of speech are likely to harm face-to-face social communication.

Professional non-neutrality: criticising the third party in psychotherapy

Using audio-recorded data from cognitive-constructivist psychotherapy, the article shows a particular institutional context in which successful professional action does not adhere to the pattern of affective neutrality which Parsons saw as an inherent component of medicine and psychotherapy. In our data, the professional’s non-neutrality functions as a tool for achieving institutional goals. The analysis focuses on the psychotherapist’s actions that convey a critical stance towards a third party with whom the patient has experienced problems. The data analysis revealed two practices of this kind of critique: (1) the therapist can confirm the critique that the patient has expressed or (2) return to the critique from which the patient has focused away. These actions are shown to build grounds for the therapist’s further actions that challenge the patient’s dysfunctional beliefs. The article suggests that in the case of psychotherapy, actions that as such might be seen as apparent lapses from the neutral professional role can in their specific context perform the task of the institution at hand.

Post-seizure EEG fractal dimension of first ECT predicts antidepressant response at two weeks

Background: Duration of seizure by itself is an insufficient criterion for a therapeutically adequate seizure in ECT. Therefore, measures of seizure EEG other than its duration need to be explored as indices of seizure adequacy and predictors of treatment response. We measured the EEG seizure using a geometrical method-fractal dimension (FD) and examined if this measure predicted remission. Methods: Data from an efficacy study on melancholic depressives (n = 40) is used for the present exploration. They received thrice or once weekly ECTs, each schedule at two energy levels - high or low energy level. FD was computed for early-, mid- and post-seizure phases of the ictal EEG. Average of the two channels was used for analysis. Results: Two-thirds of the patients (n = 25) were remitted at the end of 2 weeks. As expected, a significantly higher proportion of patients receiving thrice weekly ECT remitted than in patients receiving once weekly ECT. Smaller post-seizure FD at first ECT is the only variable which predicted remission status after six ECTs. within the once weekly ECT group too, smaller post-seizure FD was associated with remission status. Conclusions: Post-seizure FD is proposed as a novel measure of seizure adequacy and predictor of treatment response. Clinical implications: Seizure measures at first ECT may guide selection of ECT schedule to optimize ECT. Limitations: The study examined short term antidepressant effects only. The results may not be generalized to medication-resistant depressives. (C) 1999 Elsevier Science B.V. All rights reserved.

Study on ride comfort assessment of multiple occupants using lumped parameter analysis

Growing consumer expectations continue to fuel further advancements in vehicle ride comfort analysis including development of a comprehensive tool capable of aiding the understanding of ride comfort. To date, most of the work on biodynamic responses of human body in the context of ride comfort mainly concentrates on driver or a designated occupant and therefore leaves the scope for further work on ride comfort analysis covering a larger number of occupants with detailed modeling of their body segments. In the present study, governing equations of a 13-DOF (degrees-of-freedom) lumped parameter model (LPM) of a full car with seats (7-DOF without seats) and a 7-DOF occupant model, a linear version of an earlier non-linear occupant model, are presented. One or more occupant models can be coupled with the vehicle model resulting into a maximum of 48-DOF LPM for a car with five occupants. These multi-occupant models can be formulated in a modular manner and solved efficiently using MATLAB/SIMULINK for a given transient road input. The vehicle model and the occupant model are independently verified by favorably comparing computed dynamic responses with published data. A number of cases with different dispositions of occupants in a small car are analyzed using the current modular approach thereby underscoring its potential for efficient ride quality assessment and design of suspension systems.

Santa Gertrudis Magna : una mística teóloga

Resumen: Santa Gertrudis se ubica en el punto de inflexión en que la unidad tradicional entre teología y vida espiritual comienza a debilitarse. Contemporánea al desarrollo de la escolástica, pertenece sin embargo al mundo monástico, donde la integración entre la vida y la teología, se cultiva y se defiende. Su vida se nos presenta como la de aquélla en quien se cumple la finalidad teológica que subyace a toda vida cristiana: la comprensión vital del misterio por la experiencia de íntima comunión con lo divino. Su doctrina ilumina el núcleo de la fe a partir de las fuentes de la liturgia, la revelación y la tradición patrística, asimiladas a través de su experiencia espiritual. Esta se expresa en la originalidad y precisión teológica de sus visiones y oraciones, vertidas en un lenguaje afectivo y simbólico, en el equilibrio de su doctrina espiritual y en su hondo sentido de Iglesia. Su experiencia constituye una mística dogmática, eclesial y esponsal, cuya universalidad y actualidad la hacen apta y atractiva al público creyente y no creyente de hoy

La apariencia como trans-parencia : una situación existencial del homo poeticus

Resumen: Dostoevskij atribuye a la belleza una función salvífica (“la belleza salvará al mundo”), poniéndola así en relación con el campo afectivo, salvación significa en efecto vida plena; para Matisse “Todo arte digno de tal nombre es religioso”, es decir, posee una función de “mediación-unión” entre órdenes diversos. La noción de “visión interior”, es la que mejor fundamenta estas convicciones. Ella atraviesa el tiempo y el espacio: está presente en la antigua cultura china, así como en la Grecia clásica y en la Antigüedad Tardía y permanece implícita durante todo el Medioevo; se la vuelve a encontrar en alguno de los máximos pintores modernos (Kandinsky, Chagal). Todos los testimonios de los artistas concuerdan en indicar que para alcanzarla es necesario una especie de ascesis: ésta consiste en una revelación, experimentada como un don, del Sentido oculto en lo sensible; por el hecho de dar inicio al pasaje de un nivel ontológico a otro (valencia re-ligiosa o syn-bolica) y de consistir en una experiencia de plenitud de vida, le pertenece además un efecto transformante (valencia afectiva). Esta vía propiamente humana de la “visión interior”, por la cual la apariencia (lo sensible) se vuelve trans-parencia de lo invisible, se presenta como la más adecuada al arte cristiano para el culto.

La disciplina dell' adozione a Gortina

Abstract: The article presents Italian translation and commentary of Gortyn ‘code’ columns X.33-XII.23 about adoption’s legal dispositions. The epigraphic text is compared with literary sources of Athenian law in classical age, pointing out analogies and variances. The more substantial difference is that in Gortyn’s law the adoptive son had less prerogatives, in accordance with an archaic and aristocratic society

Educación integral de la sexualidad de mujeres y de varones : desafío de nuestra época

La autora expone en el presente artículo algunos conceptos sobre sexualidad y las consideraciones que se deben tener en cuenta a la hora de educar a varones y a mujeres en el tema, teniendo en cuenta sus diferencias y peculiaridades corporales, psicoafectivas, espirituales y sociales. El objetivo para con los jóvenes es brindarles una visión integradora de la sexualidad, integrándola con el amor.

Erasmus programako ikasleekin ikasiz

[Es] Una de las consecuencias del creciente paso de estudiantes por múltiples universidades europeas gracias al programa Erasmus (unos 700 anuales desde la UPV/EHU hacia más de trescientos centros) es el acercamiento de la propia universidad hacia otros modelos de enseñanza-aprendizaje. Así desde el convenciemiento de que la vivencia personal en Erasmus puede y debe convertirse en conocimiento significativo compartido entre discentes y docentes, hemos desarrollado una experiencia de investigación con un grupo de veinte estudiantes de nuestra universidad durante su curso en un centro extranjero. Para ello hemos utilizado la plataforma virtual moodle, la cual ha permitido poner en comunicación a este grupo, disperso por toda Europa, y a los responsables del proyecto. Asimismo hemos realizado un análisis cualitativo de los debates surgidos en la plataforma, utilizando el software NVivo7, que nos ha permitido extraer las conclusiones. Algunas de ellas ilustran diferentes modelos pedagógicos entre las universidades del norte y del sur europeos, así como la valoración que las y los estudiantes hacen de ellos. Otras van más allá de los objetivos inicialmente planteados y nos hablan de las necesidades de comunicación de estas y estos estudiantes durante el periplo (administrativas, afectivas, vivenciales o de construcción de sentido de lo que están viviendo), así como de la ideoneidad de instrumentos como moodle para hacerlas frente.

Estudio de la relación entre el compromiso organizativo y la intención de abandonar la organización: Modelo de dos componentes de compromiso de continuidad

[ES] El objetivo de este artículo es presentar evidencias empíricas sobre dos cuestiones aún abiertas en la investigación sobre el compromiso organizativo: la existencia de varios tipos de compromiso de continuidad, y la existencia de relaciones no lineales entre el compromiso, ciertos comportamientos organizativos y algunos indicadores clásicos de éstos como la intención de abandonar la organización. Para ello, se ha llevado a cabo un estudio empírico en el que participaron 241 informantes, que permitió testear las hipótesis mediante el uso de regresión lineal jerárquica.

Causas y consecuencias de la insatisfacción en consumidores con atribuciones externas

[ES] Este trabajo aborda el estudio de la formación de la insatisfacción, desde la perspectiva cognitiva y afectiva, y de sus consecuencias en forma de intenciones de comportamientos de queja. El objetivo es investigar la influencia directa e indirecta, a través de los afectos negativos, que ejerce la desconfirmación de expectativas sobre la insatisfacción, y analizar la contribución de estos juicios sobre las intenciones de respuestas de queja, a terceras partes y privadas. A partir de una muestra de clientes insatisfechos con restaurantes que manifiestan distintos niveles de atribución externa, se ha construido un modelo causal para estudiar las relaciones.