Different Associations of Health Related Quality of Life with Pain,Psychological Distress and Coping Strategies in Patients with Irritable Bowel Syndrome and Inflammatory Bowel Disorder

The primary aim of this study was to measure psychological distress, pain severity, health related quality of life (QOL) and pain coping strategies in patients with irritable bowel syndrome (IBS) and ulcerative colitis (UC). A second aim was to determine the influence of somatic and psychological variables on health related QOL. Eighty-eight IBS and 66 UC patients completed the Irritable Bowel Syndrome Quality of Life Questionnaire (IBSQOL), Pain Severity Scale of West Haven Yale Multidimensional Pain Inventory (WHYMPY), Symptom Checklist-90-R (SCL-90-R) and Coping Strategies Questionnaire (CSQ). T-tests and GLM Analysis of Covariance were used for statistical analysis. IBS patients had significantly higher levels of psychological distress, pain severity and maladaptive pain coping strategies (catastrophization), and lower QOL than UC patients. Variance of QOL in IBS was explained for the most part by catastrophization (15%), then by psychological distress (8%), and for the less part by pain severity (5%). In UC, pain severity explained 21%, psychological distress 8%, and catastrophization 3% of the variance of QOL. These results suggest there are differences between IBS and UC patients in the role of physical and psychological factors in QOL and emphasize the importance of cognitive processes in IBS.     

Brazilian version of the Protocole Montréal d'Evaluation de la Communication (Protocole MEC): normative and reliability data

The lack of standardized instruments to evaluate communication disorders related to the right hemisphere was verified. A new evaluation tool was developed: Protocole Montréal d'Evaluation de la Communication--Protocole MEC, adapted to Brazilian Portuguese--Bateria Montreal de Avalia??o da Comunica??o--Bateria MAC (Montreal Evaluation of Communication Battery). The purpose was to present stratified normative data by age and educational level, and to verify the reliability parameters of the MEC Battery. 300 individuals, between the ages of 19 and 75 years, and levels of formal education between 2 and 35 years, participated in this study. They were divided equally into six normative groups, according to three age categories (young adults, intermediary age, and seniors) and two educational levels (low and high). Two procedures were used to check reliability: Cronbach alpha and reliability between evaluators, Results were established at the 10th percentile, and an alert point per task for each normative group. Cronbach's alpha was, in general, between .70 and .90 and the average rate of agreement between evaluators varied from .62 to .94. Standards of age and education were established. The reliability of this instrument was verified. The psychometric legitimization of the MEC Battery will contribute to the diagnostic process for communicative disorders.     

Are we losing our mind?

The individual mind of the patient, and how it works, are the central topics of this plenary address. In psychoanalysis we are always dealing with a mind--a mind with its own particular structure--and this is a fact of singular importance in how we listen to, understand, and communicate with patients. Techniques geared to this view are presented. The author reflects on and challenges some contrasting current views of psychoanalysis as primarily coconstructed or as a relational matrix. Technique according to this view highlights the analyst's subjectivity and actions as central to treatment.     

Intentional behaviour in dog-human communication: an experimental analysis of “showing” behaviour in the dog

Despite earlier scepticism there is now evidence for simple forms of intentional and functionally referential communication in many animal species. Here we investigate whether dogs engage in functional referential communication with their owners. “Showing” is defined as a communicative action consisting of both a directional component related to an external target and an attention-getting component that directs the attention of the perceiver to the informer or sender. In our experimental situation dogs witness the hiding of a piece of food (or a favourite toy) which they cannot get access to. We asked whether dogs would engage in “showing” in the presence of their owner. To control for the motivational effects of both the owner and the food on the dogs’ behaviour, control observations were also staged where only the food (or the toy) or the owner was present. Dogs’ gazing frequency at both the food (toy) and the owner was greater when only one of these was present. In other words, dogs looked more frequently at their owner when the food (toy) was present, and they looked more at the location of the food (toy) when the owner was present. When both the food (toy) and the owner were present a new behaviour, “gaze alternation”, emerged which was defined as changing the direction of the gaze from the location of the food (toy) to looking at the owner (or vice versa) within 2 s. Vocalisations that occurred in this phase were always associated with gazing at the owner or the location of the food. This behaviour, which was specific to this situation, has also been described in chimpanzees, a gorilla and humans, and has often been interpreted as a form of functionally referential communication. Based on our observations we argue that dogs might be able to engage in functionally referential communication with their owner, and their behaviour could be described as a form of “showing”. The contribution of domestication and individual learning to the well-developed communicative skills in dogs is discussed and will be the subject of further studies. Received: 3 April 2000 / Accepted after revision: 2 September 2000     

Lesbian Youth Support Information Service (LYSIS): Developing a Distance Support Agency for Young Lesbians

The Lesbian Youth Support Information Service (LYSIS) was established in 1991 as a result of research conducted into the needs and experiences of young lesbians. This research found that young lesbians are vulnerable to mental health problems, including depression, attempted suicide, self-harming behaviours and alcohol misuse, as well as isolation and social rejection. There were also strong indications that young lesbians are most vulnerable when they are coming to terms with their sexual orientation. LYSIS offers support to young lesbians in four main ways: correspondence counselling; telephone counselling; peer support; and information. LYSIS is part of an umbrella organization, the Lesbian Information Service (LIS), which provides indirect support for young lesbians including publishing, education and training, projects and campaigning.     

Feedback in Couple and Family Therapy: A Randomized Clinical Trial

Routine Outcome Monitoring (ROM) is recommended as a psychotherapy procedure to serve as clinical feedback in order to improve client treatment outcomes. ROM can work as a warning signal to the therapist if the client shows signs of no change or deterioration. This study has investigated whether any difference in outcome could be detected between those clients in couple and family therapy who used the Systemic Therapy Inventory of Change (STIC) feedback system (ROM condition) versus those who were offered treatment without the use of STIC (“treatment as usual” or TAU condition). A sample of 328 adults seeking couple and family therapy in Norway was randomly assigned to ROM versus TAU conditions. Outcome measures were The Outcome Questionnaire–45 and The Revised Dyadic Adjustment Scale. The results demonstrated no significant differences in outcomes between the ROM and TAU. Possible explanations of this result related to design and implementation issues are discussed.     

How the Process of the CSR Activities Works on Private Hospitals and Pharmaceutical Firms: Multiple Case Study from Strategic Perspective

Journal of Religion and Health - The phenomenon of corporate social responsibility “CSR” has stimulated lots of debates and disagreement among the business scholars. One of the most...