No description available.

No description available.

No description available.

Thesis (M. Med. Sc.)--University of Hong Kong, 2005.

No description available.

Dissertation (M.Mus. (Music Therapy))-University of Pretoria, 2008. / Abstract in English. Includes bibliographical references.

In 1960, the Home for the Aged, an institution of the Province of British Columbia, underwent an official name change to Valleyview Hospital. The change in name indicated a change in the philosophy toward the treatment of the aged mentally ill person. This change can be equated with new knowledge about the physical, psychological and social aspects of aging. Formerly the program and the goal were related to custodial care; now, the program and the goal are related to treatment which will result in the aged mentally ill patient returning to a living arrangement in the community that is most appropriate to his needs. This study, cites the problems of aged people in this province, with particular reference to problems of mental illness. The process of admission to hospital, treatment programs and discharge procedures, particularly as they relate to the work of the Social Service Department, are described. Against this background of procedures, the particular criteria for discharge and rehabilitation planning, as related to the hospital and to the resources available in the community are examined. Particular patient groups are noted in relationship to the particular resource required to receive them back into community. The study reveals that, although, using hospital criteria for discharge, a large number of patients could be appropriately rehabilitated, but sufficient community resources, including family care, boarding and nursing homes, are lacking for such patients. Furthermore, community attitudes towards the aged mentally ill person have not changed to meet the new philosophy about their treatment in Valleyview Hospital. Since correspondence revealed that Valleyview Hospital is unique amongst mental hospitals for the aged on this continent, the study was of necessity a pilot one, and is primarily descriptive. However, the questionnaire method was used to gather data about existing living accommodation available to discharged patients. Finally, the study offers some suggestions for improvement and expansion of community resources, and of legislation concerning them which, if carried out, would ensure, to a greater extent, that the philosophy of treatment and rehabilitation, rather than custodial care, could be translated into practice. / Arts, Faculty of / Social Work, School of / Moorhouse, Clayton Herbert Todd; Starak, Igor / Graduate

This dissertation reports on the evolution of an observation instrument designed to examine a series of dyadic interactions between service providers and elderly clients. The encounters took place in the physical context of the client's home and under the auspices of two different kinds of urban service agencies. Staff members and elderly clients of In-home Nursing and Interaction agencies participated in the study. The coding system (Service Provider/Client Dyadic Interaction Coding System or SP/CDICS), is comprised of 28 carefully defined and described behavioral categories. The categories were developed through literature reviews and a series of preliminary observations conducted in agencies similar to but not included among the sampled agencies. A majority of the defined behavioral categories require moderate levels of observer judgment. A Field Manual was developed to train the five observers who collected the data. This was supplemented with a videotape constructed to further assist observers in the learning and subsequent use of the code, particularly with non-verbal and paralinquistic aspects of the behaviors. Fifty-one service providers and 147 clients comprised the sample of observed dyads. The coded observational data were examined in the expectation that there would be recurrent patterns of behavior. Factor analysis resulted in the delineation of ten client and five service provider behavioral patterns that appear to be interpersonally meaningful. The derived service provider and client behavioral factors were correlated with other measurements available on the same population. These included several service provider personality and attitude measures as well as observer and client evaluations of the encounter. The comparisons, in general, tended to confirm the interpretations given to the described factors, further supporting an assumption that the SP/CDICS is a useful and valid instrument.

No description available.

O rápido envelhecimento populacional faz com que a saúde mental da população geriátrica venha tomando uma importância cada vez maior na saúde pública. Os objetivos deste estudo foram:(1) investigar a prevalência de transtornos mentais ao longo da vida, analisando possíveis fatores sócio-demográficos associados (2) pesquisar a possível relação entre prevalência de transtorno mental ao longo da vida e desempenho cognitivo. Foram estudados 82 sujeitos acima de 60 anos da área de captação do Hospital das Clínicas da cidade de São Paulo. O instrumento utilizado para investigação diagnóstica foi o Composite International Diagnostic Interview (CIDI), sendo a avaliação do desempenho cognitivo obtida através do Mini Exame do Estado Mental (MEEM) e do Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE). Os resultados mostraram que os transtornos mentais de maior prevalência ao longo da vida foram Depressão (16%), Transtorno de Humor Recorrente (10%) e Transtorno de Ansiedade Generalizada (8,5%). Os demais transtornos observados foram Distimia (6%), Transtorno Doloroso Persistente (5%), Uso Nocivo de Álcool (5%) e Transtorno Dissociativo (2,4%). Não foram identificados casos de Transtorno Afetivo Bipolar, Esquizofrenia e outras psicoses, assim como dependência de Álcool ou de psicotrópicos. Apesar de haver uma maior prevalência nas mulheres dos quadros de Depressão (18,5%), Transtorno de Humor Recorrente (12%), Distimia (6%), Transtorno Doloroso Persistente (7%) e Transtorno Dissociativo (3,5%), e por outro lado uma maior prevalência de Abuso de Álcool (9%) e Transtorno de Ansiedade Generalizada (9%) nos homens, não houve correlação estatisticamente significativa entre gênero e transtornos mentais. Na amostra, os sujeitos de maior escolaridade demonstraram maior associação com prevalência de distimia (p=0,01) e transtorno de ansiedade generalizada (p=0,03). Houve maior associação entre baixa escolaridade (p=0,000) e idade mais avançada (p=0,007) com pior desempenho cognitivo pelo MEEM. A presença de disfunção cognitiva pelo MEEM foi de 11% e pelo IQCODE 16%. Não foi identificada asssociação entre prevalência de transtornos mentais ao longo a vida e pior desempenho cognitivo. Os resultados da prevalência de transtornos mentais ao longo da vida desta amostra foi similar aos achados de outros estudos que utilizaram o CIDI, exceto pela maior prevalência de Transtorno do Humor Recorrente no presente estudo que nos demais. Maior atenção deve se dar a associação entre maior escolaridade e prevalência de distimia e transtornos de ansiedade generalizada ao longo da vida em populações idosas de regiões urbanas / With a rapidly aging society, geriatric mental health is emerging as important public health concern.The study objectives were: (1) investigate the lifetime prevalence of psychiatric illnesses and the association between sociodemografic characteristics (2) investigate the possible relationship between the prevalence of mental disorder throughout life and cognitive performance. We studied 82 subjects over 60 years older from the catchment area of Hospital das Clínicas de São Paulo. The instrument used for diagnostic investigation was the Composite International Diagnostic Interview (CIDI), and the assessment of cognitive performance achieved by the Mini Mental State Examination (MMSE) and Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE). The results showed that the most prevalent lifetime ICD-10/CIDI disorders were major depression (16%), followed by recurrent mood disorder (10%), and generalized anxiety disorder (8,5%). Other disorders were observed such as dysthymia (6%), persistent pain disorder (5%), alcohol abuse (5%) and dissociative disorders (2.4%). There were no identified cases of bipolar affective disorder, schizophrenia and other psychoses, as well as dependence on alcohol or psychotropic substances. Women had higher prevalence of depression (18.5%), recurrent mood disorders (12%), dysthymia (6%), persistent pain disorder (7%) and dissociative disorder (3.5%). On the other hand, men have higher prevalence alcohol (9%) and generalized anxiety disorder (9%). However, these differences were not statistically significant. In this sample, subjects with higher education showed an association with prevalence of dysthymia (p = 0.01) and generalized anxiety disorder (p = 0.03). There was a higher association between low education (p = 0.000) and older age (p = 0.007) with worse cognitive performance by the MMSE. The presence of cognitive impairment evaluated by the MMSE was 11% and the result based on the IQCODE was 16%. There was not a relationship between lifetime prevalence of mental disorders and impaired cognitive performance. The results of lifetime prevalence of mental disorders in this sample were similar to the findings of other studies using the CIDI, except for a higher prevalence of recurrent mood disorder in this study than the others. Close attention are required to address the relationships between higher educational level and dysthymia and generalized anxiety disorder in urban elderly population