<b><i>Introduction:</i></b> Depression can be characterized by rumination that is featured by spontaneity and perseveration of internally oriented thoughts. At the same time, depressed subjects complain about abnormal slowness and lack of power/energy in their thoughts, suggesting abnormal “thought dynamics.” The relationship between rumination and thought dynamics in depression remains unclear, though. <b><i>Method:</i></b> We investigated thought dynamics and rumination in healthy control, major depressive disorder (MDD), and depressed bipolar disorder (BD) subjects. The dynamics in the spontaneous shift between internally and externally oriented thoughts were measured by a novel method of continuous experience sampling whose time series was subjected to power and frequency analyses. Subjects filled out the Beck Depression Inventory-II and Ruminative Response Scale questionnaires to evaluate current depressive symptoms and ruminative responses to negative affect. The methods used to analyze data included χ<sup>2</sup>, Pearson correlation, ANOVA, and partial correlation. <b><i>Results:</i></b> Our main findings are: (i) increased number and longer duration of internally oriented thought contents in MDD and BD; (ii) reduced thought dynamics with slower frequency (calculated in Hz) and decreased power (power spectral density) in shifting between internally and externally oriented thoughts, especially in MDD and, less strongly, in BD subjects; and (iii) power spectral density as a dimension of thought dynamics is related to brooding rumination with depression severity explaining high degrees of their variance. <b><i>Conclusion:</i></b> Our results show slow frequency and low power in the internal-external thought dynamic of acute MDD and depressed BD. Together with its close relation to depression severity and rumination, our findings highlight the key importance of abnormal dynamics on the cognitive level of depression.
Background: Access to medical care is one of the major issues affecting human health. This study aims to investigate inequality in access to medical care in the townships in Kermanshah, Iran. Methods: Methodology approach includes a descriptive-analytic study followed by determining the degree of development of the townships calculated in terms of access to medical care through the hierarchical cluster analysis and the combined model of human development index. Additionally, the mean center and standard distance tests are handled in a geographic information system software to identify the deployment pattern of the status of access to medical care indexes. Results: As for the ratio of physicians, nursing staff, paramedical staff, administrative staff of health care, dentists, pharmacists, hospitals, general and specialized clinics, radiology, rehabilitation centers and laboratories to a population of 10,000, the results of analyzing the findings were indicative of unequal distribution of facilities at the level of townships. This is based on The results of comparing the mean centers of population and health facilities showed that the centers of both data categories were located in Kermanshah. The two standard distances (i.e., population and health facilities) demonstrated that the health facilities witnessed more dispersion in the northwestern regions than the concentration of population in the central and southeastern regions of the province. Conclusions: The results indicated that the indexes of development of facilities and healthcare resources were not distributed equitably and with a balance between the townships of the Kermanshah Province. Keywords: healthcare; medical care inequality; human development index; spatial analysis, cluster analysis; Kermanshah, Iran
Background:Access to medical care is one of the major issues affecting human health. This study aims to investigate inequality in access to medical care in the townships in Kermanshah, Iran.MethodsMethodology approach includes a descriptive-analytic study followed by determining the degree of development of the townships calculated in terms of access to medical care through the hierarchical cluster analysis and the combined model of human development index. Additionally, the mean center and standard distance tests are handled in a geographic information system software to identify the deployment pattern of the status of access to medical care indexes.ResultsAs for the ratio of physicians, nursing staff, paramedical staff, administrative staff of health care, dentists, pharmacists, hospitals, general and specialized clinics, radiology, rehabilitation centers and laboratories to a population of 10,000, the results of analyzing the findings were indicative of unequal distribution of facilities at the level of townships. This is based on The results of comparing the mean centers of population and health facilities showed that the centers of both data categories were located in Kermanshah. The two standard distances (i.e., population and health facilities) demonstrated that the health facilities witnessed more dispersion in the northwestern regions than the concentration of population in the central and southeastern regions of the province.ConclusionsThe results indicated that the indexes of development of facilities and healthcare resources were not distributed equitably and with a balance between the townships of the Kermanshah Province.
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