Depression Anxiety in Older Adults: Gaps in the Knowledge

Depression Anxiety in Older Adults: Gaps in the Knowledge Depression and Anxiety in Older Adults:Â  Are there gaps in current knowledge regarding diagnosis and treatment? Introduction Mental health problems in older adults can cause a massive social impact, often bringing about poor quality of life, isolation and exclusion. Depression is one of the most debilitating mental health disorders worldwide, affecting approximately 7% of the elderly population (Global Health Data Exchange, 2010). Despite this, it is also one of the most underdiagnosed and undertreated conditions in the primary care setting. Even with estimates of approximately 25% of over 65’s living in the community having depressive symptoms severe enough to warrant medical intervention, only one third discuss their symptoms with their GP. Of those that do, only 50% receive treatment as symptoms of depression within this population often coincide with other later life problems ( IAPT, 2009; World Health Organisation (WHO), 2004). Chapter 2: Literature Review 2.1: Depression and Anxiety in older adults Many misconceptions surround ageing including the fact that depression is a normal part of the ageing process. Actual evidence indicates that other physical health issues often supersede the presentation of depressive symptoms in older adults which may suggest that the development of depression is highly influenced by deteriorating physical health (Baldwin, 2008; Baldwin et al, 2002). Depression may present differently in older adults in comparison to adolescents or even working age adults. Although the same disorder may be present throughout different stages of the lifespan, in older adults certain symptoms of depression may be accentuated, such as somatic or psychotic symptoms and memory complaints, or suppressed, such as the feelings of sadness, in comparison to younger people with the same disorder (Baldwin, 2008; Chiu, Tam Chiu, 2008). O’Connor et al (2001) carried out a study into ‘the influence of age on the response of major depression to electroconvulsive thera py’ and found that when confounding variables are controlled (age at the beginning of a study), there is no difference in the remission rates for depression in both younger and older adults, however, relapse rates remain higher for older adults. Backing this up, Brodaty et al (1993) conducted a qualitative naturalistic study into the prognosis of depression in older adults in comparison to younger adults and again confirmed that the prognosis and remission for depression in older adults is not significantly worse than for younger adults. However, the rigor of a qualitative naturalistic study is argued by proponents as being value-laden in nature, while criticisms of this study approach highlight it as being subjective, anecdotal and subject to researcher bias (Koch, 2006). In addition to depression, anxiety disorders are also common among older adults, often presenting as a comorbid condition. In 2007, 2.28 million people were diagnosed as having an anxiety disorder, with 13% of those individuals aged 65 and over. By 2026, the projected number of people diagnosed with an anxiety disorder is expected to rise by 12.7% to 2.56 million with the greatest increase expected to be seen in the older adult population (King’s Fund, 2008). Despite the prevalence rate, anxiety is poorly researched in comparison to other psychiatric disorders in older people (Wetherell et al, 2005). Of the anxiety disorders, phobic disorders and generalised anxiety disorder (GAD) are the two most common in older people (Bryant et al, 2008). It wasn’t until 1980 that the American Psychiatric Association (APA) published the Diagnostic and Statistical Manual of Mental Disorders (DSM) 3rd Edition which introduced Generalised Anxiety Disorder (GAD) into the psychiatric nome nclature, distinguishing it from other anxiety disorders for the first time (APA, 1980). MCManus et al (2009) estimate that in England alone, as many as 4.4% of people in England suffer with GAD with prevalence rates between 1.2 and 2.5 times higher for women than men (Prajapati, 2012). Post-Traumatic Stress Disorder (PTSD) has received more clinical interest lately, correlating with individuals from the Second World War, Holocaust and Vietnam Veterans reaching or being well into old age and increasing recognition of PTSD. Despite this, data relating to prevalence rates still remains limited with research tending to focus on specific populations as opposed to community figures, for example, with regards to UK war veterans, approximately 30% will develop PTSD (pickingupthepieces.org.au, 2014). Unfortunately, stigma tends to misrepresent PTSD statistics as sufferers tend not to seek diagnosis or researcher bias is present. Britt (2000) found that many service personal within the military stated that admitting to a mental health problem was not only more stigmatising that admitting to a physical health problem but they also believed it would have a more detrimental impact on their career prospects. Furthermore, Mueller (2009) conducted a study into disclosure attitudes in which it was concluded that these attitudes can strongly predict symptom severity. With this in mind, it is important to stress the importance of practicing within the limits of NMC (2008) code of conduct in which unconditional positive regards must be show by all nursing staff whilst incorporating a non-bias attitude in practice. Anxiety and depression comorbidity is well established. A longitudinal study, noted for its beneficial adaptability in enabling the researcher to look at changes over time, conducted by Balkom et al (2000) found that in a random community sample of adults (55 and older), who were diagnosed as having an anxiety disorder, 13% also met the criteria of major depressive disorder (MDD). Adding weight to the evidence of anxiety and depression comorbidity in older adults, Schaub (2000) who also conducted a longitudinal study, found that 29.4% of a sample of older adults in a German community met the criteria for a depressive disorder. Longitudinal studies are thought to vary in their validity due to the attrition of randomly assigned participants during the course of the study, thus producing a final sample that is not a true representation of the population sampled (Rivet-Amico, 2009). King-Kallimanis, Gum and Kohn (2009) examined current and lifetime comorbidity of anxiety with depression. Within a 12 month period they found 51.8% of older adults with MDD in the United States also met the diagnostic criteria for an anxiety disorder. There is evidence to suggest that the first presentation of anxiety symptoms in older adults suggests an underlying depressive disorder (Chiu et al, 2008). Unfortunately, comorbid anxiety and depression in older adults is associated with much higher risks of suicidal symptoms (Bartels et al, 2002; Lenze et al, 2000) in addition to increased reports of more severe psychiatric and somatic symptoms and poorer social functioning when compared to depression alone (Lenze et al, 2000; Schoevers et al, 2003). 2.2 Diagnosis and Screening Tools APP TO PRACTICE Dementia, along with depression and other priority mental disorders are included in the WHO Mental Health Gap Action Programme (mhGAP). This programme aims to improve care for mental, neurological and substance use disorders through providing guidance and tools to develop health services in resource poor areas. Synthesis and utilization of empirical research is an important aspect of evidence-based care. Only within the context of the holistic assessment, can the highest quality of care be achieved. References: Baldwin, R., Chiu, E., Katona, C., and Graham, N. 2002. Guidelines on depression in older people: Practising the evidence. London: Martin Dunitz Ltd. Baldwin, R. 2008. Mood disorders: depressive disorders. In: Jacob R et al, Oxford Textbook of Older Age Psychiatry. Oxford: Oxford University Press. Balkom, V., Beekman , A., de Beurs, E., et al. Comorbidity of the anxiety disorders in a community-based older population in the Netherlands [Online]. Acta Psychiatrica Scandinavica 101(-). Pp 37–45. Available at: https://www-swetswise-com.abc.cardiff.ac.uk/FullTextProxy/swproxy?url=http://onlinelibrary.wiley.coc/resolve/doi/pdf?DOI=10.1034/j.1600-0447.2000.101001037.xts=1409279416128cs=1533436201userName=0000884.ipdireciemCondId=884articleID=25446758yevoID=1585273titleID=2498remoteAddr=131.251.137.64hostType=PRO [Accessed: 29th August 2014]. Bartels, S., Coakley, E., Oxman, T., et al. 2002. Suicidal and death ideation in older primary care patients with depression, anxiety, and at-risk alcohol use. American Journal of Psychiatry.159(10) pp.417–427. Brodaty, H., Harris, L., Peters, K., Wilhelm, K., Hickie, I., Boyce, P., Mitchell, P., Parker, G., and Eyers, K. 1993. Prognosis of depression in the elderly. A comparison with younger patients [Online]. The British Journal of Psychiatry 163(-) pp589-596. Available at: http://bjp.rcpsych.org/content/163/5/589#BIBL [Accessed 27th August 2014]. Chiu, H., Tam,W., and Chiu, E. 2008. WPA educational program on depressive disorders: Depressive disorders in older persons. World Psychiatric Association (WPA). King’s Fund. 2008. Paying the price: The cost of mental health care in England to 2026 [Online]. London: King’s Fund. Available at: http://www.kingsfund.org.uk/sites/files/kf/Paying-the-Price-the-cost-of-mental-health-care-England-2026-McCrone-Dhanasiri-Patel-Knapp-Lawton-Smith-Kings-Fund-May-2008_0.pdf [Accessed: 17th August 2014]. Koch, T. 2006. Establishing rigour in qualitative research: the decision trail. Journal of Advanced Nursing 53(1) pp. 91-100 Lenze, E., Mulsant, B., Shear M, et al. 2000. Comorbid anxiety disorders in depressed elderly patients [Online]. American Journal of Psychiatry. 157(-): pp.722–728. Available at: http://ajp.psychiatryonline.org.abc.cardiff.ac.uk/data/Journals/AJP/3712/722.pdf?resultClick=3 [Accessed: 29th August 2014]. O’Connor, M., Knapp, R., Husain, M., et al. 2001. The influence of age on the response of major depression to electroconvulsive therapy: a CORE report. American Journal of Geriatric Psychiatry. 9(-): pp. 382–390 Rivet-Amico, K. 2009. Percent Total Attrition: A Poor Metric for Study Rigor in Hosted Intervention Designs [Online]. American Journal of Public Health 99(9): pp 1567-1575. Available at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2724469/ [Accessed 22nd August 2014]. Schaub, R., Linden, M. 2000. Anxiety and anxiety disorders in the old and very old—results from the Berlin Aging Study (BASE) [Online]. Comprehensive Psychiatry. 41(-) pp 48–54. Available at: http://ac.els-cdn.com.abc.cardiff.ac.uk/S0010440X00800085/1-s2.0-S0010440X00800085-main.pdf?_tid=25fb884e-2f25-11e4-ae4a-00000aab0f6bacdnat=1409279912_0012d28347b6791e31a8b5199f3daaa1 [Accessed: 29th August 2014]. Schoevers, R., Beekman, A., Deeg, D., et al. 2003. The natural history of late-life depression: results from the Amsterdam Study of the Elderly (AMSTEL) [Online]. Journal of Affective Disorders.76(1): pp 5–14. Available at: http://ac.els-cdn.com.abc.cardiff.ac.uk/S0165032702000605/1-s2.0-S0165032702000605-main.pdf?_tid=1814aa80-2f34-11e4-a381-00000aab0f27acdnat=1409286331_4cb7efb58af9c004b37dc4825f8831d5 [Accessed 19th August 2014].

Hiroshima Essay -- essays research papers

The most significant theme in John Hersey’s book â€Å"Hiroshima† are the long- term effects of war, confusion about what happened, long term mental and physical scars, short term mental and physical scars, and people being killed. The confusing things after the A-bomb was dropped on Hiroshima where that the city had been wiped out, all means of communication where gone, all the roads and street signes where wiped out, destroyed or blocked by collapsed buildings â€Å"†¦saw through the darkness that all the houses in her neighbourhood had collapsed.†1 People not knowing what had happened as there had been no siting of a plane before the bomb was dropped, not being sure if a bomb or a fire had caused all the damage â€Å"The Americans are dropping gasoline. They’re going to set fire to us!†, and not knowing what the site effects of the bomb would be on the people and land such as acid rain â€Å"The drops grew abnormally large.†2 The long-term mental and physical scars left on the people of Hiroshima would have been not knowing what happened to family members, and friends who where missing and still are missing to this day, â€Å"You’ve go to find him†3, and â€Å"†¦.search for him.†4 The physical scars left on the people of Hiroshima after the bombing are, organ damage, disease, accelerated aging, eye brows burnt off and skin damaged on faces and hands. People forgetting what Americans did to Japanese civilians, by dropping that awful thing, â€Å"He was slowing a bit. His memory, like the world’s was gettin...

Smirnoff Nightlife Exchange Media Campaign

SMIRNOFF NIGHTLIFE EXCHANGE MEDIA CAMPAIGN CHAU Hong Duc Table of content I. Analysis 1. Overview 2. Significant figures 3. Why is it successful? II. Recommendation III. References I. Analysis 1. Overview Smirnoff Night Life Exchange project is an annual promotion campaign integrates series of nightlife parties, leading to the biggest party in the November each year, along with global dancing competition judged by Madonna.Initiated by Smirnoff – the 1st worldwide vodka brand from 2010, Night Life Exchange reached a huge success in 2011; marked with November 12th 2011 night, with (1)50 countries and 10 million people around the world involved and celebrate the best world’s nightlife. 2. Significant figures (2) 10 million participants 50 countries 3000 tracks of partygoers 5000 â€Å"liked† Smirnoff cocktails on Facebook 8000 photos uploaded on Facebook One of 11 best social media campaigns in 2011 selected by Econsultancy. com (3) 3. Why is it successful?In this p art, I’ll just discuss on the media’s aspect, which I believe is the major factor leading to its success. Firstly, Smirnoff heavily takes advantages of social media, specifically Facebook fan pages. It created 50 fan pages for each country involved, such as Smirnoff Vietnam, Smirnoff. These pages are altogether connected to the main fan page of Smirnoff with the special application called Around the world, which earns more than 386,000 likes. Fan pages significantly make a huge impact on earning participants for the project. Along the line, they also generate local ebsite in each country to promote the event, to attract people signing up for the event and receiving any ideas for the biggest night, varied from which drinks are suggested, which singers should be put in and so on. On both pages and sites, they put on valuable information about cocktails recipes as well as creating amazing and viral small contests with prizes good enough for calling attendants. The two mos t important elements in this media campaign are: First, Smirnoff had a great idea of hosting an enormous one-of-a-kind event locally, which means people from all over the world can enjoy a mutual experience.This obviously woke up either the feeling of national pride or the toward-global tendency. Second, Smirnoff created the two-way communication with their target customers. They can technically involve in organizing â€Å"their† own party through the possibility of sharing thousands ideas. It’s excellent that Smirnoff is having an open dialogue rather just informing information to audiences. In conclusion, Smirnoff successfully created the shared value for an event, which is social media all about.Besides, the logo is very well designed with the theme color is red, which is also the theme color of Smirnoff with the symbol of an eagle, represents a feeling of powerful and courtesy. II. Recommendation However, there is still room for improvement if Smirnoff want to get bigger achievements through this project. I went through some of Nightlife Exchange’s local website and realized that the design, as well as domain name of those websites is not consistent, for example in Vietnam, it’s bethere. n but in another country, it’s totally different. Therefore, I recommend that instead of having separate websites, they should link all of countries into one mother site and from there, direct to local page, such as bethere. com/Vietnam or bethere. com/brazil. This would help them organize better customer database, better statistics and easily keep track of their customer. I also highly suggest using mobile marketing, which is cheap and fast method to spread out the information to audiences as well as check-in function on Facebook.They should encourage their fans to do check-in whenever they go to the party. This will create an impressive appearance on fan pages. Last but not least, the slogan â€Å"Be There†, though it’s qu ite suitable for the beginning phase, should be change into some words more encourage the individual uniqueness like â€Å"Be Yourself There† or â€Å"Be Unique There†. I think it will encourage people to join party and prove themselves to all people in the world and create a vast diversity of styles, bringing more liveliness to an event. III. Refernces (1)Madonna Resurfaces in Smirnoff Social Media Promotion http://mashable. com/2011/08/17/madonna-smirnoff/ – Todd Wasserman, Mashable, Aug 2011 * (2)Smirnoff Nightlife Exchange Project Gathers Millions Globally for the World's Biggest Nightlife Experience http://www. marketwire. com/press-release/smirnoff-nightlife-exchange-project-gathers-millions-globally-worlds-biggest-nightlife-1586027. htm – Marketwire, 2011 * (3)11 of the best social media campaigns of 2011 (and what we can learn from them) * http://econsultancy. om/fr/blog/8452-the-best-social-media-campaigns-of-2011-and-what-we-can-learn-from-them – Steve Richards, Econsultancy. com, Dec 2011 * Superstar line-up for the Smirnoff Nightlife Exchange Projectâ„ ¢ with The Potbelleez, Fourplay DJ's And DJ Gordo http://www. irishtimes. com/events/smirnoff-nightlife-exchange/thailand-exchange. html – Iristimes. com * https://www. facebook. com/Smirnoff * http://nightlifeexchange. vice. com/en * The Smirnoff Nightlife Exchange Project 2011 video clip http://www. youtube. com/watch? v=k9lCf8VkMio

The Epidemic Of The Ebola Essay - 1497 Words

Since March 2014, in excess of 3,000 individuals have passed from the unstoppable spread of the Ebola infection all through the West African nations of Guinea, Sierra Leone, Liberia and Nigeria. Notwithstanding the colossal and miserable loss of human life, the Ebola broad sickness is having shocking and ruinous consequences for these West African economies in a mixed bag of greatly imperative parts/territories by ending exchange, harming cultivating and startling speculators. Capacity to move around confinements, exchange and transport: To end the spread of the infection, the nations most influenced by Ebola have put into utilization disconnects (or times of detachment) (to ensure from spreading illness) in territories where danger of disease is high while close-by nations, for example, Cote d ivoire and Senegal have constrained (by law) limitations on the development of individuals and merchandise, including fringe terminations. These measures, thusly, have lessened inner and (ide ntified with an expansive zone) exchange, transport and, obviously, tourism. In any case since authority exchange insights don t catch casual exchange -including cross-fringe exchange which could extend from 20 to 75 percent of the population for West African nations -the speculated a number effect proposed by the World Bank may ignore the extensive decrease in casual exchange because of capacity to move around confinements. While these activities intend to break the chain of transmission,Show MoreRelatedThe Epidemic Of Ebola Epidemic1476 Words   |  6 PagesLeone have obtained Ebola according to the World Health Organization, 3,000 people or more have died. The epidemic of Ebola spreading is a threat to Africa and other countries that’s healthcare isn’t strong enough to combat a disease alone (Burgess). 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