WorldWideScience

Sample records for advanced illness focus

  1. Effectiveness of Advanced Illness Care Teams for Nursing Home Residents with Dementia

    Science.gov (United States)

    Chapman, Dennis G.; Toseland, Ronald W.

    2007-01-01

    This study evaluated the effectiveness of advanced illness care teams (AICTs) for nursing home residents with advanced dementia. The AICTs used a holistic approach that focused on four domains: (1) medical, (2) meaningful activities, (3) psychological, and (4) behavioral. The authors recruited 118 residents in two nursing homes for this study and…

  2. The impact of emotion regulation and illness-focused coping strategies on the relation of illness-related negative emotions to subjective health.

    Science.gov (United States)

    Karademas, Evangelos C; Tsalikou, Calliope; Tallarou, Maria-Christina

    2011-04-01

    In this study we examined whether emotion regulation and illness-focused coping strategies mediate and/ or moderate the relation of illness-related negative emotions to patients' subjective health. One hundred and thirty-five cardiac patients participated in the study. Illness-focused coping strategies were found to mediate the relation of emotions to physical functioning, whereas emotion regulation strategies mediated the relation to psychological well-being. Moreover, an emotion regulation strategy (i.e. emotion suppression) and two illness-focused coping strategies (instrumental coping and adherence) moderated the two relationships. These findings suggest that both emotion regulation and illness-focused coping strategies are integral parts of the illness-related negative emotions-health relationship.

  3. The nature of communication work during cancer: advancing the theory of illness trajectories.

    Science.gov (United States)

    Donovan-Kicken, Erin; Tollison, Andrew C; Goins, Elizabeth S

    2012-01-01

    More theory development about interpersonal communication during cancer is needed so that scholarship can be advanced and practical applications of findings can be best disseminated and applied. We proposed an evidence-based extension to the theory of illness trajectories based on findings from a qualitative study of cancer survivors' (n = 40) experiences with communication. Grounding our analysis in respondents' descriptions of the demands, obligations, and preparatory activities involved in discussing their cancer, we theorized the construct of communication work, which focuses on the labor and resources devoted to managing talk during cancer and living with illness. Findings are discussed in terms of how this conceptualization presents new opportunities for research and practice.

  4. How does uncertainty shape patient experience in advanced illness? A secondary analysis of qualitative data

    OpenAIRE

    Etkind, Simon Noah; Bristowe, Katherine Rachel; Bailey, Katharine; Selman, Lucy Ellen; Murtagh, Felicity Fliss

    2016-01-01

    BACKGROUND: Uncertainty is common in advanced illness but is infrequently studied in this context. If poorly addressed, uncertainty can lead to adverse patient outcomes.AIM: We aimed to understand patient experiences of uncertainty in advanced illness and develop a typology of patients' responses and preferences to inform practice.DESIGN: Secondary analysis of qualitative interview transcripts. Studies were assessed for inclusion and interviews were sampled using maximum-variation sampling. A...

  5. Advances in antibiotic therapy in the critically ill.

    Science.gov (United States)

    Vincent, Jean-Louis; Bassetti, Matteo; François, Bruno; Karam, George; Chastre, Jean; Torres, Antoni; Roberts, Jason A; Taccone, Fabio S; Rello, Jordi; Calandra, Thierry; De Backer, Daniel; Welte, Tobias; Antonelli, Massimo

    2016-05-17

    Infections occur frequently in critically ill patients and their management can be challenging for various reasons, including delayed diagnosis, difficulties identifying causative microorganisms, and the high prevalence of antibiotic-resistant strains. In this review, we briefly discuss the importance of early infection diagnosis, before considering in more detail some of the key issues related to antibiotic management in these patients, including controversies surrounding use of combination or monotherapy, duration of therapy, and de-escalation. Antibiotic pharmacodynamics and pharmacokinetics, notably volumes of distribution and clearance, can be altered by critical illness and can influence dosing regimens. Dosing decisions in different subgroups of patients, e.g., the obese, are also covered. We also briefly consider ventilator-associated pneumonia and the role of inhaled antibiotics. Finally, we mention antibiotics that are currently being developed and show promise for the future.

  6. Focus on Exercise: Client and Clinician Perspectives on Exercise in Individuals with Serious Mental Illness.

    Science.gov (United States)

    Browne, Julia; Mihas, Paul; Penn, David L

    2016-05-01

    The health benefits of exercise are well established, yet individuals with serious mental illness (SMI) have a shorter life expectancy due in large part to physical health complications associated with poor diet and lack of exercise. There is a paucity of research examining exercise in this population with the majority of studies having examined interventions with limited feasibility and sustainability. Before developing an intervention, a thorough exploration of client and clinician perspectives on exercise and its associated barriers is warranted. Twelve clients and fourteen clinicians participated in focus groups aimed at examining exercise, barriers, incentives, and attitudes about walking groups. Results indicated that clients and clinicians identified walking as the primary form of exercise, yet barriers impeded consistent participation. Distinct themes arose between groups; however, both clients and clinicians reported interest in a combination group/pedometer based walking program for individuals with SMI. Future research should consider examining walking programs for this population.

  7. Enhancing Work-Focused Supports for People with Severe Mental Illnesses in Australia

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    Natalia Contreras

    2012-01-01

    Full Text Available Persons with severe mental illness (SMI have reduced workforce participation, which leads to significant economic and social disadvantage. This theoretical review introduces the strategies that have been implemented to address this issue. These include Individual Placement and Support (IPS services, the most widely researched form of supported employment, to which cognitive remediation has more recently been recognised in the USA, as an intervention to improve employment outcomes by addressing the cognitive impairments often experienced by people with SMI. The authors review the international literature and discuss specifically the Australian context. They suggest that Australia is in a prime position to engage clients in such a dual intervention, having had recent success with increasing access to supported employment programs and workforce reentry, through implementation of the Health Optimisation Program for Employment (HOPE. Such programs assist with gaining and maintaining employment. However, they do not address the cognitive issues that often prevent persons with SMI from effectively participating in work. Thus, optimising current interventions, with work-focused cognitive skills development is critical to enhancing employment rates that remain low for persons with SMI.

  8. Illness-induced changes in thyroid hormone metabolism: focus on the tissue level

    NARCIS (Netherlands)

    J. Kwakkel; E. Fliers; A. Boelen

    2011-01-01

    During illness changes in thyroid hormone metabolism occur, collectively known as the non-thyroidal illness syndrome (NTIS). NTIS is characterised by low serum thyroid hormone levels without the expected rise in serum thyroid-stimulating hormone, indicating a major change in thyroid hormone feedback

  9. Reconciling employment with caring for a husband with an advanced illness

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    Gysels Marjolein

    2009-11-01

    Full Text Available Abstract Background Little is known about combining work with caring for a person with advanced illness. This is important given the increasing number of women in the workforce and current policy seeking to increase care in the community. The aim of this paper was to explore the meaning of work for women caring for a husband with an advanced illness and the consequences of combining these two roles. Methods A purposive sample of 15 carers was recruited from a hospital and from the community, via the patients they cared for. Their illnesses included chronic obstructive pulmonary disease, cancer, motor neurone disease, and heart failure. Data were collected through semi-structured, in-depth interviews that were tape-recorded and transcribed verbatim. A Grounded Theory approach was used and case studies were developed. NVivo software facilitated the management and analysis of the data. Results Caring presented challenges to carers' work life. It diminished productivity or the quality of work, and led to missed opportunities for promotion. Work had an effect on the quality of care and the relationship with the patient, which eventually led to work being given up for caring. Three carers resisted the pressures to give up work and used it as a coping strategy. Conclusion A positive choice to remain in employment does not necessarily signal reluctance to care. Caring arrangements need to be understood from the common and separate interests of carers and the people they support.

  10. Social factors, mental illness, and psychiatric care: recent advances from a sociological perspective.

    Science.gov (United States)

    Greenley, J R

    1984-08-01

    The author reviews advances in the sociological perspective on mental health over the past four years. He examines research on such topics as community acceptance of the mentally ill, arrest rates among former psychiatric inpatients, and the effect of social factors on the type of mental health treatment received. Other research areas surveyed include the influence of social factors on service utilization and on life stress and psychological distress, sex differences in psychological problems, and the relationship between organization of service delivery systems and patient outcome.

  11. The National Palliative Care Research Center and the Center to Advance Palliative Care: a partnership to improve care for persons with serious illness and their families.

    Science.gov (United States)

    Morrison, R Sean; Meier, Diane E

    2011-10-01

    The elimination of suffering and the cure of disease are the fundamental goals of medicine. While medical advances have transformed previously fatal conditions such as cancer and heart disease into illnesses that people can live with for many years, they have not been accompanied by corresponding improvements in the quality of life for these patients and their families. Living with a serious illness should not mean living in pain or experiencing symptoms like shortness of breath, nausea, or fatigue. Yet, multiple studies over the past decade suggest that medical care for patients with advanced illness is characterized by inadequately treated physical distress; fragmented care systems; poor communication between doctors, patients, and families; and enormous strains on family caregiver and support systems. Palliative care is interdisciplinary care focused on relief of pain and other symptoms and support for best possible quality of life for patients with serious illness, and their families. It is appropriate at the point of diagnosis of a serious illness. It goes beyond hospice care to offer patients and their families treatments focused on improving quality of life while they are receiving life-prolonging and curative treatments. Palliative care programs have been shown to reduce symptoms, improve doctor-patient-family communication and satisfaction with care, as well as enhance the efficiency and effectiveness of hospital services. In the last 5 years alone the number of palliative care programs has more than doubled. This growth is in response to the increasing numbers and needs of Americans living with serious, complex and chronic illnesses, and the realities of the care responsibilities faced by their families. In order to ensure that all persons with serious illness and their families receive the quality of care they deserve, palliative care must become an integral part of the U.S. healthcare landscape. Specifically, persons facing serious illness and their

  12. Developing narrative research in supportive and palliative care: the focus on illness narratives.

    Science.gov (United States)

    Bingley, A F; Thomas, C; Brown, J; Reeve, J; Payne, S

    2008-07-01

    The phenomenon of the 'illness narrative' is well-documented, in the last 25 years, of increasing interest to researchers in health and social sciences. Personal stories about the experience of facing the end of life also have an established history of particular relevance for palliative care clinicians. In this article, we review and describe a range of narrative analysis approaches that may be of use in palliative care. In particular, we distinguish between qualitative analysis applied to narratives and narrative analysis as a method. We discuss the potential benefits and challenges in the use of narrative research methods as a means to deepen our understanding of patient, carer and health professionals' experience, and to support improvements in end of life care policy and practice.

  13. [Focus on Siblings of Children with Chronic Illness or Disability - A Family Oriented Counselling Program].

    Science.gov (United States)

    Möller, Birgit; Schepper, Florian; Herrmann, Jessy; Gude, Marlies

    2016-01-01

    In the psychosocial support of families with a chronically ill or disabled child siblings are increasingly addressed as a target group for prevention and rehabilitation projects intending to reduce the risk for adverse health consequences. The following article presents a childfocused approach to family counselling as a short-term intervention. Ten flexibly applicable counselling core points covering commonly reported problems of affected siblings and their families are available - including the communication about the disease within the family or the expression of the sibling's feelings and needs. For this purpose an approach in specific counselling sessions has been determined which is used similarly by adept child and youth psychotherapists. The counselling approach is founded theoretically. Furthermore, the counselling approach provides guidance for the structured approach in the diagnosis of potential difficulties, the choice of core points and setting, the closure of counseling sessions as well as the recommendation of additional programs.

  14. EDITORIAL: Focus on Advances in Surface and Interface Science 2008 FOCUS ON ADVANCES IN SURFACE AND INTERFACE SCIENCE 2008

    Science.gov (United States)

    Scheffler, Matthias; Schneider, Wolf-Dieter

    2008-12-01

    Basic research in surface and interface science is highly interdisciplinary, covering the fields of physics, chemistry, biophysics, geo-, atmospheric and environmental sciences, material science, chemical engineering, and more. The various phenomena are interesting by themselves, and they are most important in nearly all modern technologies, as for example electronic, magnetic, and optical devices, sensors, catalysts, lubricants, hard and thermal-barrier coatings, protection against corrosion and crack formation under harsh environments. In fact, detailed understanding of the elementary processes at surfaces is necessary to support and to advance the high technology that very much founds the prosperity and lifestyle of our society. Current state-of-the-art experimental studies of elementary processes at surfaces, of surface properties and functions employ a variety of sophisticated tools. Some are capable of revealing the location and motion of individual atoms. Others measure excitations (electronic, magnetic and vibronic), employing, for example, special light sources such as synchrotrons, high magnetic fields, or free electron lasers. The surprising variety of intriguing physical phenomena at surfaces, interfaces, and nanostructures also pose a persistent challenge for the development of theoretical descriptions, methods, and even basic physical concepts. This second focus issue on the topic of 'Advances in Surface and Interface Science' in New Journal of Physics, following on from last year's successful collection, provides an exciting synoptic view on the latest pertinent developments in the field. Focus on Advances in Surface and Interface Science 2008 Contents Organic layers at metal/electrolyte interfaces: molecular structure and reactivity of viologen monolayers Stephan Breuer, Duc T Pham, Sascha Huemann, Knud Gentz, Caroline Zoerlein, Ralf Hunger, Klaus Wandelt and Peter Broekmann Spin polarized d surface resonance state of fcc Co/Cu(001) K Miyamoto, K

  15. Efficacy of illness perception focused intervention on quality of life, anxiety, and depression in patients with myocardial infarction

    Directory of Open Access Journals (Sweden)

    Reza Bagherian Sararoudi

    2016-01-01

    Full Text Available Background: Myocardial infarction (MI is one of the major causes of death and disability worldwide, which can reduces quality of life in patients. Some disabilities are depression and anxiety which delay returning to work. The aim of this study was to evaluate the effect of illness perception focused intervention on quality of life, anxiety, and depression in MI patients. Materials and Methods: A randomized controlled trial study of 48 recently hospitalized MI patients was conducted (24 in intervention group and 24 in control group. Intervention group was trained to understand the disease by a mental health counselor in three half-an-hour sessions for three consecutive days. Data were collected from three questionnaires: hospital anxiety and depression scale, the World Health Organization Quality of Life Questionnaire (short form, and Illness Perceptions Questionnaire Brief at admission, 1.5, and 3 months postdischarge. Data were analyzed with ANOVA repeated measure. Results: The mean duration of returning to work was 28.7 ± 8.1 days in intervention groups and 46 ± 7.6 days in control group which was statistically significant (P < 0.001. Moreover, anxiety, depression, and illness perceptions score were significantly decreased in intervention groups which were 8.3 ± 3.3, 6.8 ± 3.5, and 36.5 ± 5 in intervention groups and 15.8 ± 2.1(P < 0.001, 17.1 ± 2.3 (P < 0.001, and 41.9 ± 4 (P < 0.001 in control group, respectively. Mean of quality of life subscales scores just physical health subscale showed a significant reduction after 3 months in the control group. Conclusion: Training MI patients to understand the disease in three half-an-hour sessions for 3 consecutive days can decrease the duration of returning to work, anxiety and depression, and increase illness perceptions which can make a better outcome.

  16. Content and quality of websites supporting self-management of chronic breathlessness in advanced illness: a systematic review.

    Science.gov (United States)

    Luckett, Tim; Disler, Rebecca; Hosie, Annmarie; Johnson, Miriam; Davidson, Patricia; Currow, David; Sumah, Anthony; Phillips, Jane

    2016-05-26

    Chronic breathlessness is a common, burdensome and distressing symptom in many advanced chronic illnesses. Self-management strategies are essential to optimise treatment, daily functioning and emotional coping. People with chronic illness commonly search the internet for advice on self-management. A review was undertaken in June 2015 to describe the content and quality of online advice on breathlessness self-management, to highlight under-served areas and to identify any unsafe content. Google was searched from Sydney, Australia, using the five most common search terms for breathlessness identified by Google Trends. We also hand-searched the websites of national associations. Websites were included if they were freely available in English and provided practical advice on self-management. Website quality was assessed using the American Medical Association Benchmarks. Readability was assessed using the Flesch-Kincaid grades, with grade 8 considered the maximum acceptable for enabling access. Ninety-one web pages from 44 websites met the inclusion criteria, including 14 national association websites not returned by Google searches. Most websites were generated in the USA (n=28, 64%) and focused on breathing techniques (n=38, 86%) and chronic obstructive pulmonary disease (n=27, 61%). No websites were found to offer unsafe advice. Adherence to quality benchmarks ranged from 9% for disclosure to 77% for currency. Fifteen (54%) of 28 written websites required grade ⩾9 reading level. Future development should focus on advice and tools to support goal setting, problem solving and monitoring of breathlessness. National associations are encouraged to improve website visibility and comply with standards for quality and readability.

  17. Prevention of venous thromboembolism in hospitalized acutely ill medical patients: focus on the clinical utility of (low-dose fondaparinux

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    Di Nisio M

    2013-09-01

    hospitalized in intensive care units with no contraindications, LMWH or UFH are recommended, with frequent and careful assessment of the risk of bleeding. In this review, we discuss the evidence for use of thromboprophylaxis for VTE in acutely ill hospitalized medical patients, with a focus on (low-dose fondaparinux. Keywords: venous thromboembolism, medical patient, hospitalization, fondaparinux, heparin

  18. Developing Navigation Competencies to Care for Older Rural Adults with Advanced Illness.

    Science.gov (United States)

    Duggleby, Wendy; Robinson, Carole A; Kaasalainen, Sharon; Pesut, Barbara; Nekolaichuk, Cheryl; MacLeod, Roderick; Keating, Norah C; Santos Salas, Anna; Hallstrom, Lars K; Fraser, Kimberly D; Williams, Allison; Struthers-Montford, Kelly; Swindle, Jennifer

    2016-06-01

    Navigators help rural older adults with advanced illness and their families connect to needed resources, information, and people to improve their quality of life. This article describes the process used to engage experts - in rural aging, rural palliative care, and navigation - as well as rural community stakeholders to develop a conceptual definition of navigation and delineate navigation competencies for the care of this population. A discussion paper on the important considerations for navigation in this population was developed followed by a four-phased Delphi process with 30 expert panel members. Study results culminated in five general navigation competencies for health care providers caring for older rural persons and their families at end of life: provide patient/family screening; advocate for the patient/family; facilitate community connections; coordinate access to services and resources; and promote active engagement. Specific competencies were also developed. These competencies provide the foundation for research and curriculum development in navigation.

  19. Advancing Telephone Focus Groups Method Through the Use of Webinar

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    Eunice Chong

    2015-10-01

    Full Text Available Telephone focus groups have been increasingly popular in public health research and evaluation. One of the main concerns of telephone focus groups is the lack of nonverbal cues among participants, which could limit group interactions and dynamics during the focus group discussion. To overcome this limitation, we supplemented telephone focus groups with webinar technology in a recent evaluation of a provincial public health program in Ontario, Canada. In this article, we share the methods used and our experiences in conducting telephone focus groups supplemented with webinar technology, including advantages and challenges. Our experience will inform other researchers who may consider using telephone focus groups with webinars in future research and evaluation.

  20. Early-life experiences and the development of adult diseases with a focus on mental illness: The Human Birth Theory.

    Science.gov (United States)

    Maccari, Stefania; Polese, Daniela; Reynaert, Marie-Line; Amici, Tiziana; Morley-Fletcher, Sara; Fagioli, Francesca

    2017-02-07

    In mammals, early adverse experiences, including mother-pup interactions, shape the response of an individual to chronic stress or to stress-related diseases during adult life. This has led to the elaboration of the theory of the developmental origins of health and disease, in particular adult diseases such as cardiovascular and metabolic disorders. In addition, in humans, as stated by Massimo Fagioli's Human Birth Theory, birth is healthy and equal for all individuals, so that mental illness develop exclusively in the postnatal period because of the quality of the relationship in the first year of life. Thus, this review focuses on the importance of programming during the early developmental period on the manifestation of adult diseases in both animal models and humans. Considering the obvious differences between animals and humans we cannot systematically move from animal models to humans. Consequently, in the first part of this review, we will discuss how animal models can be used to dissect the influence of adverse events occurring during the prenatal and postnatal periods on the developmental trajectories of the offspring, and in the second part, we will discuss the role of postnatal critical periods on the development of mental diseases in humans. Epigenetic mechanisms that cause reversible modifications in gene expression, driving the development of a pathological phenotype in response to a negative early postnatal environment, may lie at the core of this programming, thereby providing potential new therapeutic targets. The concept of the Human Birth Theory leads to a comprehension of the mental illness as a pathology of the human relationship immediately after birth and during the first year of life.

  1. Recent advances in polarised {sup 3}He spin filters at the ILL

    Energy Technology Data Exchange (ETDEWEB)

    Petoukhov, A.K. [Institut Laue-Langevin, 6, rue Jules Horowitz, B.P. 156, 38042 Grenoble Cedex 9 (France)]. E-mail: petukhov@ill.fr; Andersen, K.H. [Institut Laue-Langevin, 6, rue Jules Horowitz, B.P. 156, 38042 Grenoble Cedex 9 (France); Jullien, D. [Institut Laue-Langevin, 6, rue Jules Horowitz, B.P. 156, 38042 Grenoble Cedex 9 (France); Babcock, E. [Institut Laue-Langevin, 6, rue Jules Horowitz, B.P. 156, 38042 Grenoble Cedex 9 (France); Chastagnier, J. [Institut Laue-Langevin, 6, rue Jules Horowitz, B.P. 156, 38042 Grenoble Cedex 9 (France); Chung, R. [Institut Laue-Langevin, 6, rue Jules Horowitz, B.P. 156, 38042 Grenoble Cedex 9 (France); Humblot, H. [Institut Laue-Langevin, 6, rue Jules Horowitz, B.P. 156, 38042 Grenoble Cedex 9 (France); Lelievre-Berna, E. [Institut Laue-Langevin, 6, rue Jules Horowitz, B.P. 156, 38042 Grenoble Cedex 9 (France); Tasset, F. [Institut Laue-Langevin, 6, rue Jules Horowitz, B.P. 156, 38042 Grenoble Cedex 9 (France); Radu, F. [Institut fuer Experimentalphysik/Festkoerperphysik, Ruhr-Universitaet Bochum, 44780 Bochum (Germany); Wolff, M. [Institut fuer Experimentalphysik/Festkoerperphysik, Ruhr-Universitaet Bochum, 44780 Bochum (Germany); Zabel, H. [Institut fuer Experimentalphysik/Festkoerperphysik, Ruhr-Universitaet Bochum, 44780 Bochum (Germany)

    2006-11-15

    We report the present status and recent advances made in polarised-{sup 3}He spin-filters at the ILL. The Tyrex filling station is working reliably and producing polarised {sup 3}He for neutron spin filters on a daily basis. The latest spin-filter cells have wall relaxation times between 200 and 400 h - the longest relaxation times yet achieved for valve-sealed cells. Recent results using {sup 3}He spin filters for reflectometry are presented and compared to the presently used supermirror-based polarisation analysers. By increasing the optical thickness of {sup 3}He gas, we move into a regime in which the neutron beam polarisation decays with a time constant of the order of a thousand hours and is thus negligible within the 24 h time scale of an experiment. We present the performance of a {sup 3}He spin flipper, which inverts the polarisation direction of the {sup 3}He nuclei by adiabatic fast passage with a polarisation loss of 10{sup -5} per flip. The development of in situ filling of the spin-filter cell via a capillary is described. This 'local filling' technique enables {sup 3}He spin filters to be used in inaccessible regions, such as inside large-detector vacuum tanks and in high-radiation environments.

  2. Advances of focused ion beam in micromachining technology

    Science.gov (United States)

    Zhang, S. J.; Fang, F. Z.; Hu, X. T.

    2007-12-01

    The applications of focused ion beam (FIB) technology in micromachining has advantages over other micromachining technologies, such as high feature resolution, capable markless process, rapid prototyping and adaptive for various materials and geometries. FIB direct-writing techniques are explored for their excellent abilities in micromachining. In addition to FIB technology and its principles for imaging, milling and deposition, a typical FIB system is presented. The key to FIB direct-writing technology is to operate a FIB with a proper beam size, shape, current and energy to remove or add a required amount of material from a pre-defined location in a controlled manner. In this way, high-precision and complicated three-dimensional structures with controlled profiles can be fabricated. Several examples of using milling technique for making high-quality microdevices or high-precision microcomponents for optical and other applications are given. The demonstration of milling a narrow readout gap at an oblique angle on a microaccelerometer shows a FIB's application on a small but accurate post-processing step on a micromechanical device. The diffractive optical element (DOE) with continuous relief and submicron feature size fabricated by FIB milling is also presented to prove high resolution and accurate relief control. Furthermore, FIB milling is used to shape a variety of cutting tools with extremely precise dimensions and complex tool face shapes.

  3. Targeted treatments in advanced renal cell carcinoma: focus on axitinib

    Directory of Open Access Journals (Sweden)

    Verzoni E

    2014-03-01

    Full Text Available Elena Verzoni, Paolo Grassi, Isabella Testa, Roberto Iacovelli, Pamela Biondani, Enrico Garanzini , Filippo De Braud, Giuseppe ProcopioDepartment of Medical Oncology 1, Fondazione IRCCS Istituto Nazionale Tumori, Milan, ItalyAbstract: Antiangiogenesis options have evolved rapidly in the last few years, with an increasing number of agents currently approved by the US Food and Drug Administration and European Medicines Agency. Angiogenesis inhibitors have been shown to be very effective for the treatment of metastatic renal cancer cell. Axitinib is a third-generation inhibitor of vascular endothelial growth factor receptor and is currently being developed for the treatment of various malignancies. The pharmacokinetic properties of axitinib may have a selective therapeutic effect, with minimal adverse reactions and enhanced safety. In a large Phase III study of previously treated patients with metastatic renal cell carcinoma, axitinib achieved a longer progression-free survival than sorafenib with an acceptable safety profile and good quality of life. This review focuses on the pharmacology, pharmacokinetics, and clinical activity of axitinib in the current treatment of renal cell carcinoma. The role of axitinib in the adjuvant and/or neoadjuvant setting needs to be evaluated in further clinical trials.Keywords: axitinib, renal cell carcinoma, vascular endothelial growth factor receptor, angiogenesis

  4. Factors that may facilitate or hinder a family-focus in the treatment of parents with a mental illness

    NARCIS (Netherlands)

    Lauritzen, C.; Reedtz, C.; Doesum, K.T.M. van; Martinussen, M.

    2015-01-01

    Children with mentally ill parents are at risk of developing mental health problems themselves. To enhance early support for these children may prevent mental health problems from being transmitted from one generation to the next. The sample (N = 219) included health professionals in a large univers

  5. Care for chronic illness in Australian general practice – focus groups of chronic disease self-help groups over 10 years: implications for chronic care systems reforms

    Directory of Open Access Journals (Sweden)

    Martin Carmel M

    2009-01-01

    Full Text Available Abstract Background Chronic disease is a major global challenge. However, chronic illness and its care, when intruding into everyday life, has received less attention in Asia Pacific countries, including Australia, who are in the process of transitioning to chronic disease orientated health systems. Aim The study aims to examine experiences of chronic illness before and after the introduction of Australian Medicare incentives for longer consultations and structured health assessments in general practice. Methods Self-help groups around the conditions of diabetes, epilepsy, asthma and cancer identified key informants to participate in 4 disease specific focus groups. Audio taped transcripts of the focus groups were coded using grounded theory methodology. Key themes and lesser themes identified using a process of saturation until the study questions on needs and experiences of care were addressed. Thematic comparisons were made across the 2002/3 and 1992/3 focus groups. Findings At times of chronic illness, there was need to find and then ensure access to 'the right GP'. The 'right GP or specialist' committed to an in-depth relationship of trust, personal rapport and understanding together with clinical and therapeutic competence. The 'right GP', the main specialist, the community nurse and the pharmacist were key providers, whose success depended on interprofessional communication. The need to trust and rely on care providers was balanced by the need for self-efficacy 'to be in control of disease and treatment' and 'to be your own case manager'. Changes in Medicare appeared to have little penetration into everyday perceptions of chronic illness burden or time and quality of GP care. Inequity of health system support for different disease groupings emerged. Diabetes, asthma and certain cancers, like breast cancer, had greater support, despite common experiences of disease burden, and a need for research and support programs. Conclusion Core

  6. Overview of the projects recently developed by the advanced neutron environment team at the ILL

    Energy Technology Data Exchange (ETDEWEB)

    Bourgeat-Lami, Eric [Institut Laue-Langevin, 6 rue Jules Horowitz, 38042 Grenoble Cedex 9 (France); Chapuis, Jean-Francois [Institut Laue-Langevin, 6 rue Jules Horowitz, 38042 Grenoble Cedex 9 (France); Chastagnier, Jeremie [Institut Laue-Langevin, 6 rue Jules Horowitz, 38042 Grenoble Cedex 9 (France); Demas, Steffen [Institut Laue-Langevin, 6 rue Jules Horowitz, 38042 Grenoble Cedex 9 (France); Gonzales, Jean-Paul [Institut Laue-Langevin, 6 rue Jules Horowitz, 38042 Grenoble Cedex 9 (France); Keay, Morley-Patrick [Institut Laue-Langevin, 6 rue Jules Horowitz, 38042 Grenoble Cedex 9 (France); Laborier, Jean-Luc [Institut Laue-Langevin, 6 rue Jules Horowitz, 38042 Grenoble Cedex 9 (France); Lelievre-Berna, Eddy [Institut Laue-Langevin, 6 rue Jules Horowitz, 38042 Grenoble Cedex 9 (France)]. E-mail: lelievre@ill.fr; Losserand, Olivier [Institut Laue-Langevin, 6 rue Jules Horowitz, 38042 Grenoble Cedex 9 (France); Martin, Paul [Institut Laue-Langevin, 6 rue Jules Horowitz, 38042 Grenoble Cedex 9 (France); Melesi, Louis [Institut Laue-Langevin, 6 rue Jules Horowitz, 38042 Grenoble Cedex 9 (France); Petoukhov, Alexander [Institut Laue-Langevin, 6 rue Jules Horowitz, 38042 Grenoble Cedex 9 (France); Pujol, Serge [Institut Laue-Langevin, 6 rue Jules Horowitz, 38042 Grenoble Cedex 9 (France); Ragazzoni, Jean-Louis [Institut Laue-Langevin, 6 rue Jules Horowitz, 38042 Grenoble Cedex 9 (France); Thomas, Frederic [Institut Laue-Langevin, 6 rue Jules Horowitz, 38042 Grenoble Cedex 9 (France); Tonon, Xavier [Institut Laue-Langevin, 6 rue Jules Horowitz, 38042 Grenoble Cedex 9 (France)

    2006-11-15

    Within the framework of the Millennium Programme, we have started the design and building of novel equipment with the aim at facilitating and diversifying the experimental conditions on Institut Laue-Langevin (ILL) and ILL-CRG instruments. We anticipate new devices for applying external parameters (pressure, temperature, magnetic or electric fields, etc.), handling the neutron beam polarisation (RF wide-band flipper, TOF-Cryopad, etc.) or carrying multi-task experiments. The facilities already in operation are briefly reviewed: 3 K cryogen-free cryostat hosting the Paris-Edinburgh pressure cell, 3 K pulse-tube top-loading cryostat with 700 K high-temperature insert, 2 K Joule-Thomson cryogen-free cryostat for Eulerian cradles, 20 mK dilution fridge for the recently acquired 15 T cryomagnet and a low-temperature gas-injection sample stick for Orange cryostats.

  7. Advanced oxidation protein products (AOPP) for monitoring oxidative stress in critically ill patients: a simple, fast and inexpensive automated technique.

    Science.gov (United States)

    Selmeci, László; Seres, Leila; Antal, Magda; Lukács, Júlia; Regöly-Mérei, Andrea; Acsády, György

    2005-01-01

    Oxidative stress is known to be involved in many human pathological processes. Although there are numerous methods available for the assessment of oxidative stress, most of them are still not easily applicable in a routine clinical laboratory due to the complex methodology and/or lack of automation. In research into human oxidative stress, the simplification and automation of techniques represent a key issue from a laboratory point of view at present. In 1996 a novel oxidative stress biomarker, referred to as advanced oxidation protein products (AOPP), was detected in the plasma of chronic uremic patients. Here we describe in detail an automated version of the originally published microplate-based technique that we adapted for a Cobas Mira Plus clinical chemistry analyzer. AOPP reference values were measured in plasma samples from 266 apparently healthy volunteers (university students; 81 male and 185 female subjects) with a mean age of 21.3 years (range 18-33). Over a period of 18 months we determined AOPP concentrations in more than 300 patients in our department. Our experiences appear to demonstrate that this technique is especially suitable for monitoring oxidative stress in critically ill patients (sepsis, reperfusion injury, heart failure) even at daily intervals, since AOPP exhibited rapid responses in both directions. We believe that the well-established relationship between AOPP response and induced damage makes this simple, fast and inexpensive automated technique applicable in daily routine laboratory practice for assessing and monitoring oxidative stress in critically ill or other patients.

  8. On the use of a toroidal mirror to focus neutrons at the ILL neutron spin echo spectrometer IN15

    Energy Technology Data Exchange (ETDEWEB)

    Hayes, C. [Institut Laue-Langevin, Grenoble (France); Alefeld, B. [Forschungszentrum Juelich GmbH, Juelich (Germany); Copley, J.R.D. [National Institute of Standards and Technology, Gaithersburg, MD (United States)] [and others

    1997-09-01

    The IN15 neutron spin echo spectrometer at the Institut Laue-Langevin (Grenoble) has been designed to accomodate a toroidal focusing mirror. This mirror will be used to increase the intensity at the sample position for measurements at long neutron wavelengths and to perform measurements in the low q-range (10{sup -3} {angstrom}{sup -1}). This paper summarizes the results of ray-tracing simulations for the toroidal mirror system. These calculations were performed in order to assess the effects of the neutron wavelength, gravitational fall, wavelength resolution and spherical aberrations on the quality of the focused beam. The gain in flux that can be expected from the focusing geometry is estimated. The recent installation and characterisation of the mirror is also briefly described.

  9. Testing an intervention to improve functional capability in advanced cardiopulmonary illness.

    Science.gov (United States)

    Dougherty, Cynthia M; Steele, Bonnie G; Hunziker, Jim

    2011-01-01

    The development of a conceptually driven exercise and self-management intervention for improving functional capability and reducing health care costs using social cognitive theory is described. The intervention has 2 components: a 1-month outpatient exercise intervention followed by a home component, lasting 5 months. The intervention is expected to have significant impact on daily function, quality of life, gait/balance, self-efficacy, and health care utilization in persons with advanced heart failure or chronic obstructive pulmonary disease. We report preliminary results related to process-related variables, including feasibility, safety, and intervention adherence. Intervention outcomes are currently under study and will be reported when available.

  10. The Efficacy of High-Intensity Focused Ultrasound (HIFU) in Advanced Pancreatic Cancer

    Institute of Scientific and Technical Information of China (English)

    Bo Xie; Jiajun Ling; Weiming Zhang; Xueqin Huang; Jihua Zhen; Yanzhe Huang

    2008-01-01

    OBJECTIVE To observe the efficacy of high-intensity focused ultrasound (HIFU)in the treatment of late-stage pancreatic cancer.METHODS Sixteen patients with advanced pancreatic cancer received HIFU therapy.Evaluation of efficacy was made on the basis of changes in clinical symptoms and variations in the tumor echo and size.RESULTS Clinical symptoms such as pain were significantly alleviated,echo of the tumor was enhanced with B-US and the quality of life such as eating,sleeping and mental status was markedly improved;no serious complications were observed.CONCLUSION The use of HIFU in the treatment of advanced pancreatic cancer is feasible and safe.It is effective in killing the carcinoma cells and alleviaring pain.This technique may offer non-invasive therapy for the treatment of patients with late-stage pancreatic cancer.

  11. Advances in research methods for information systems research data mining, data envelopment analysis, value focused thinking

    CERN Document Server

    Osei-Bryson, Kweku-Muata

    2013-01-01

    Advances in social science research methodologies and data analytic methods are changing the way research in information systems is conducted. New developments in statistical software technologies for data mining (DM) such as regression splines or decision tree induction can be used to assist researchers in systematic post-positivist theory testing and development. Established management science techniques like data envelopment analysis (DEA), and value focused thinking (VFT) can be used in combination with traditional statistical analysis and data mining techniques to more effectively explore

  12. Effectiveness and cost-effectiveness of home palliative care services for adults with advanced illness and their caregivers

    Directory of Open Access Journals (Sweden)

    Barbara Gomes

    Full Text Available BACKGROUND: Extensive evidence shows that well over 50% of people prefer to be cared for and to die at home provided circumstances allow choice. Despite best efforts and policies, one-third or less of all deaths take place at home in many countries of the world. OBJECTIVES: 1. to quantify the effect of home palliative care services for adult patients with advanced illness and their family caregivers on patients' odds of dying at home; 2. to examine the clinical effectiveness of home palliative care services on other outcomes for patients and their caregivers such as symptom control, quality of life, caregiver distress and satisfaction with care; 3. to compare the resource use and costs associated with these services; 4. to critically appraise and summarize the current evidence on cost-effectiveness. METHODS: Search methods: We searched 12 electronic databases up to November 2012. We checked the reference lists of all included studies, 49 relevant systematic reviews, four key textbooks and recent conference abstracts. We contacted 17 experts and researchers for unpublished data. Selection criteria: We included randomised controlled trials (RCTs, controlled clinical trials (CCTs, controlled before and after studies (CBAs and interrupted time series (ITSs evaluating the impact of home palliative care services on outcomes for adults with advanced illness or their family caregivers, or both. Data collection and analysis: One review author assessed the identified titles and abstracts. Two independent reviewers performed assessment of all potentially relevant studies, data extraction and assessment of methodological quality. We carried out meta-analysis where appropriate and calculated numbers needed to treat to benefit (NNTBs for the primary outcome (death at home. MAIN RESULTS: We identified 23 studies (16 RCTs, 6 of high quality, including 37,561 participants and 4042 family caregivers, largely with advanced cancer but also congestive heart failure

  13. Illness narratives of people who are homeless

    Directory of Open Access Journals (Sweden)

    Cecilia Håkanson

    2016-11-01

    Full Text Available Multiple illnesses are common in all homeless populations. While most previous studies have focused on experiences of mental illness, there is a scarcity of studies about experiences of bodily illness among people who are homeless. This study aimed to explore illness narratives of people who are homeless, and how homelessness as a social context shapes the experience of multiple and/or advancing somatic conditions. The design was a qualitative single-case study, using interpretive description. Data were generated through interviews, with nine participants who were homeless rough sleepers in Stockholm, Sweden, recruited while receiving care in a support home for homeless people with complex care needs. The findings revealed experiences of illness embedded in narratives about falling ill, being ill, and the future. The particularity of these illness narratives and the way that they are shaped by homelessness give rise to several observations: the necessity of a capable body for survival; chaos and profound solitude in illness and self-care management; ambiguous feelings about receiving care, transitioning from independence, and “freedom” in the streets to dependency and being institutionalized; and finally, the absence of hope and desire for recovery or a better future. The narratives are discussed from the perspective of Frank's four types of illness stories (restitution, chaos, quest, and testimony. The findings stress that to provide appropriate care and support to people who are homeless and have multiple and/or advancing somatic conditions, health care professionals need to be informed both about the individual's biography and about the circumstances under which illness and self-care takes place in the streets.

  14. Unconscious Bias - The Focus of the University of Arizona's NSF ADVANCE Award

    Science.gov (United States)

    Richardson, R. M.; Tolbert, L. P.; Vaillancourt, A. M.; Leahey, E. E.; Rodrigues, H. A.

    2011-12-01

    The University of Arizona ADVANCE program focuses on unconscious bias and ways to minimize its negative impact on the academy. Unconscious bias involves social stereotypes about certain groups of people that individuals form outside their own consciousness. Overwhelming scientific evidence supports that unconscious bias pervasively influences hiring, evaluation, selection of leaders, and even daily interactions. UA ADVANCE has a three-tiered strategy for improving the representation and advancement of women faculty in STEM departments that includes: 1) fostering the scientific and leadership careers of women; 2) promoting responsibility for gender equity among faculty and administrators; and 3) developing management software useful for promoting more equitable decision-making. This strategy has brought together a diverse array of faculty, staff, and faculty administrators working toward a common goal of promoting faculty diversity and the equitable treatment of faculty. Among the most effective aspects of our programming and products have been: 1) department head and search committee trainings; 2) monthly career discussion series events, and; 3) a salary modeling tool for department heads and deans. One key to the success of these efforts has been collaborations with campus partners, including the Office of the Associate Provost for Faculty Affairs, the Office of the Special Advisor to the President for Diversity and Inclusion, and the Division of Human Resources. A second key has been a commitment to the use of research-based material and tools, presented by respected colleagues, in small workshop-style settings that foster discussion. This has enabled us to extend our reach to more STEM departments and secure broader support in creating a more equitable environment for women faculty. Nearing the close of our grant period, our efforts are now concentrated on institutionalizing success. UA ADVANCE needs continued support from an increasingly tasked administration

  15. Using focus groups to identify characteristics of an ideal work environment for Advanced Practice Clinicians.

    Science.gov (United States)

    Motley, Robert J; Mazzaccaro, Richard J; Burmeister, David B; Land, Samuel D; Boulay, Richard M; Chung, Heiwon; Deitrick, Lynn; Sumner, Andrew D

    2016-09-01

    Advanced Practice Clinicians (APCs) in collaborative practice represent a diverse and valuable group of health care professionals, including nurse practitioners, physician assistants, nurse anesthetists, and nurse midwives. Because these healthcare professionals have been identified as part of the solution to physician shortages, it is critical for health networks to examine and address issues affecting collaborative relationships. We invited our network APCs to participate in focus group sessions to determine both attributes and barriers to an ideal work environment. Four major themes emerged: (1) compensation, (2) network representation, (3) employment structure, and (4) workplace culture. While issues relating to compensation and representation were prevalent, discussions also revealed the importance of relationships and communication. To ensure successful collaboration and, thereby, reduce clinician turnover, leaders must address gaps between the existing and ideal states in structural factors affecting job satisfaction (Themes 1-3) as well as the behavioral factors represented in workplace culture (Theme 4).

  16. Analgesic effect of high intensity focused ultrasound in patients with advanced pancreatic cancer

    Institute of Scientific and Technical Information of China (English)

    Xinjin Tan; Jian Chen; Li Ren; Ruilu Lin; Zailian Chen

    2013-01-01

    Objective:The aim of this study was to evaluate the analgesic ef ect of high intensity focused ultrasound (HIFU) in patients with advanced pancreatic cancer. Methods:A total of 106 patients with advanced pancreatic cancer accompanied by abdominal pain were treated by HIFU. Pain intensities and quantities of morphine consumption before and after treatment were observed and compared. Results:The average pain intensities before treatment, and at d3, d7 after treatment were 5.80 ± 2.14, 2.73 ± 2.68, 2.45 ± 2.43 respectively (P<0.01). Fifty-nine cases (55.7%) got to extremely ef ective, and 29 cases (27.4%) ef ective. Total ef icient rate was 83.0%. The average quantities of morphine consumption before and after treatment in the patients with grade III pain were 114.9 ± 132.5 mg, 16.8 ± 39.7 mg each person everyday respectively (P<0.01). Conclusion:HIFU can relieve pain suf ered by patients with pancreatic cancer ef ectively. It is a new adjuvant treatment for pancreatic cancer pain.

  17. Cost of illness of advanced ovarian carcinoma in Italy: results of an empirical, single-centre study

    Directory of Open Access Journals (Sweden)

    Carlo Lazzaro

    2015-09-01

    Full Text Available AIM: To perform an empirical, single-centre, retrospective and secondary cost of illness (COI study of advanced ovarian carcinoma (AOC in Italy. METHODS: Demographic, clinical, health care and non-health care resource consumption data concerning a convenience sample of subsequent patients in 1st line of treatment (100 patients, 2nd line of treatment A (surgery + chemotherapy; 30 patients and 2nd line of treatment B (chemotherapy only; 20 patients were obtained from a database created in 2011 by the Obstetrics and Ginecology Unit at Campus Biomedico teaching hospital, Rome. Patients were followed-up for 2 years. Resources were valued according to the above mentioned database and literature, following the societal viewpoint. Costs are expressed in Euro (€ 2014 and reported as mean and standard deviation (SD. RESULTS: One-year COI for 1st line of treatment reaches € 44,999.7 (SD: €28,757.3, € 55,410.8 (SD: € 32,454.6 and €46,895.6 (SD: € 28,407.4 for 2nd line of treatment A and B, respectively. Regardless the line of treatment, COI is mainly driven by cost borne by patient and her family. Due to the high costs of relapse the mean COI per patient after 2 years from the diagnosis of AOC equals € 81,869.4 (SD: € 30,660.9, or 182% of the COI for the 1st line of treatment. CONCLUSIONS: Despite some limitations, our results show that increasing progression-free survival could well reduce the COI for AOC in Italy.

  18. New pharmaceuticals reduce cost of illness.

    Science.gov (United States)

    Hansen, R W

    1986-06-01

    The cost of illness includes not only the funds required to treat illness, but also the effect on the patient's quality of life. Recent concern about rising health costs have focused on the direct expenditures without noting that the cost of illness in terms of mortality and morbidity has declined significantly. Pharmaceuticals have played a major role in reducing the total cost of illness. Several studies of the cost-effectiveness of past introductions of vaccines and pharmaceuticals reveal large cost savings. Although the focus of most studies has been on major advances, the continuing process of less dramatic therapeutic improvements has significantly trimmed the cost of illness. Cost-benefit studies of new drugs or changes in drug use, while more difficult to perform, make it possible to influence the selection of therapy. Since pharmaceuticals represent less than 10% of total treatment costs, reduction in the cost of pharmaceutical products can only have a minor impact on the total cost of illness. Pharmaceuticals can reduce the cost of illness by providing alternative therapies that reduce direct treatment cost or improve the public health.

  19. Assembling the evidence jigsaw: insights from a systematic review of UK studies of individual-focused return to work initiatives for disabled and long-term ill people

    Directory of Open Access Journals (Sweden)

    Povall Sue

    2011-03-01

    Full Text Available Abstract Background Employment rates of long-term ill and disabled people in the UK are low and 2.63 million are on disability-related state benefits. Since the mid-1990 s, UK governments have experimented with a range of active labour market policies aimed to move disabled people off benefits and into work to reduce the risk of poverty and social exclusion. This systematic review asks what employment impact have these interventions had and how might they work better? Methods A systematic review of observational and qualitative empirical studies and systematic reviews published between 2002 and mid-2008 reporting employment effects and/or process evaluations of national UK government interventions focused on helping long-term sick or disabled people (aged 16-64 into the open labour market. This built on our previous systematic review which covered the years 1970 to 2001. Results Searches identified 42 studies, 31 of which evaluated initiatives with an individual focus (improving an individual's employability or providing financial support in returning to work while 11 evaluated initiatives with an environmental focus (directed at the employment environment or changing the behaviour of employers. This paper synthesises evidence from the 31 studies with an individual focus. The use of personal advisors and individual case management in these schemes helped some participants back to work. Qualitative studies, however, revealed that time pressures and job outcome targets influenced advisors to select 'easier-to-place' claimants into programmes and also inhibited the development of mutual trust, which was needed for individual case management to work effectively. Financial incentives can help with lasting transitions into work, but the incentives were often set too low or were too short-term to have an effect. Many of the studies suffered from selection bias into these programmes of more work-ready claimants. Even though these were national

  20. Rural health professionals' experiences in implementing advance care planning: a focus group study.

    Science.gov (United States)

    Fletcher, Sophie; Sinclair, Craig; Rhee, Joel; Goh, Desiree; Auret, Kirsten

    2015-09-02

    Advance care planning (ACP) is described as an ongoing discussion between a patient, their family and healthcare professionals (HCPs) to understand a patient's wishes for future health care. Legislation supporting ACP in Western Australia is relatively new and HCPs are still learning about the process and implementation. This study aimed to provide a rich description of rural health professionals' perceptions and experiences with ACP within the context of their professional role and to identify systemic issues and training needs. Ten focus groups were conducted throughout 2014 with a total of 55 rural participants including general practitioners (n = 15), general practice registrars (n = 6), practice nurses (n = 18), community nurses (n = 4) and hospital nurses (n = 12) in the south-western regions of Western Australia. Thematic analysis has identified the following themes regarding ACP: benefits to patients and families; professional roles in ACP; barriers and enablers; and systems for communicating ACP. HCPs have self-determined their roles in the ACP process, which currently leaves some components of the process unaccounted for, suggesting that collaboration between HCPs working together in a rural health setting and a standardised system for distributing these documents may assist with the implementation of ACP.

  1. Maltreatment of people with serious mental illness in the early 20th century: a focus on Nazi Germany and eugenics in America.

    Science.gov (United States)

    Fischer, Bernard A

    2012-12-01

    Prejudice and stigma against people with mental illness can be seen throughout history. The worst instance of this prejudice was connected to the rise of the eugenics movement in the early 20th century. Although the Nazi German T-4 program of killing people with mental illness was the most egregious culmination of this philosophy, the United States has its own dark eugenics history-nearing a slippery slope all too similar to that of the Nazis. Mental health care clinicians need to examine this period to honor the memory of the victims of eugenics and to guarantee that nothing like this will ever happen again.

  2. HIGH-INTENSITY FOCUSED ULTRASOUND ABLATION OF PATIENTS WITH LOCALLY ADVANCED PROSTATE CANCER

    Directory of Open Access Journals (Sweden)

    L. V. Shaplygin

    2014-01-01

    Full Text Available In this study the results of retrospective analysis of treatment of 311 patients in Samara Oncology Center in 2008–2011 with locally advanced prostate cancer are presented. According to the received treatment patients were divided into 3 groups: 103 underwent HIFU, 101 patients had a course of EBRT, 107 patients received only hormone therapy (HT. Overall survival in patients with locally advanced prostate cancer after HIFU therapy was 86.2 %, after EBRT and HT – 66.3% and 18.1 %, respectively. These data indicate a high clinical efficacy of ultrasound ablation. 

  3. Advanced gastric cancer (GC) and cancer of the gastro-oesophageal junction (GEJ): focus on targeted therapies.

    Science.gov (United States)

    Cappetta, Alessandro; Lonardi, Sara; Pastorelli, Davide; Bergamo, Francesca; Lombardi, Giuseppe; Zagonel, Vittorina

    2012-01-01

    Despite recent improvements in surgical techniques and chemotherapy treatments, locally advanced/metastatic gastroesophageal junction (GEJ) and gastric cancer (GC) are still associated with poor clinical outcome. However, increased understanding of molecular mechanisms underlying carcinogenesis and its implementation in the treatment of breast, colon, lung, and other cancers in recent years have spurred focus on the development and incorporation of targeted agents in current therapeutic options for this difficult-to-treat disease. Such agents have the ability to target a variety of cancer relevant targets, including epidermal growth factor receptor (EGFR) and vascular endothelial growth factor (VEGF) and its receptor. In this review, we describe the current status of targeted therapies in the treatment of advanced GC and GEJ cancer, focusing on pre-clinical and clinical data available on monoclonal antibodies and tyrosine kinase inhibitors acting in these pathways, including completed and ongoing phase III studies.

  4. Borrmann Type 4 Advanced Gastric Cancer: Focus on the Development of Scirrhous Gastric Cancer

    OpenAIRE

    Jung, Kyoungwon; Park, Moo In; Kim, Sung Eun; Park, Seun Ja

    2016-01-01

    Early diagnosis of Borrmann type 4 advanced gastric cancer (AGC) is very important for improving the prognosis of AGC patients. Because there is no definite mass in most cases of Borrmann type 4 AGC, its accurate diagnosis via endoscopy requires an understanding of its pathogenesis and developmental process. Moreover, many people confuse linitis plastica (LP) type gastric cancer (GC), scirrhous GC, and Borrmann type 4 AGC. To distinguish each of these cancers, knowledge of their endoscopic an...

  5. Investigating Clinical Benefits of a Novel Sleep-Focused Mind-Body Program on Gulf War Illness (GWI) Symptoms: An Exploratory Randomized Controlled Trial

    Science.gov (United States)

    2014-07-01

    mindfulness, insomnia , sleep disturbance, Gulf War Illness 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF ABSTRACT 18. NUMBER OF PAGES 19a...MBB or SED). Each Veteran will receive a total of 6 hours of treatment , in 2-hour sessions once a week over 3 consecutive weeks. Each Veteran...will be evaluated again after treatment has ended. Three months after treatment ends, Veterans will complete follow-up questionnaires. These

  6. Part I: Advancing the Conversation. Just Scholarship! Publishing Academic Research with a Social Justice Focus

    Science.gov (United States)

    Salazar, Maria del Carmen; Rios, Francisco

    2016-01-01

    This article provides support to academics who are committed to engaging in scholarly activities in ways that promote an explicit social justice focus. Moreover, this article provides a broad overview of how to pursue social justice purposes in the field of education throughout the process of scholarly production and dissemination.

  7. Role conflict, uncertainty in illness, and illness-related communication avoidance: College students facing familial chronic illness

    OpenAIRE

    Suchak, Meghana

    2014-01-01

    The focus of the current study was on examining possible differences in college students' adjustment based on residency status (i.e., international Asian vs. domestic students) and illness status (i.e., having a family member with a chronic illness vs. not having a family member with a chronic illness). The study also examined the associations between overall college student adjustment and the family and illness-related factors of role conflict, uncertainty in illness, and illness-related com...

  8. Treating advanced non-small-cell lung cancer in Chinese patients: focus on icotinib

    Directory of Open Access Journals (Sweden)

    Liang JL

    2014-05-01

    Full Text Available Jun-Li Liang,1 Xiao-Cang Ren,2 Qiang Lin2 1Department of Radiation Oncology, Hebei Medical University Fourth Hospital, Shijiazhuang, People’s Republic of China; 2Department of Oncology, North China Petroleum Bureau General Hospital of Hebei Medical University, Renqiu, Hebei Province, People’s Republic of China Abstract: Icotinib hydrochloride is an orally administered small-molecule reversible tyrosine kinase inhibitor that has been independently researched and developed and has independent intellectual property rights in the People’s Republic of China. Clinical trials have demonstrated that the response to icotinib among advanced non-small-cell lung cancer (NSCLC patients who received at least one platinum-based chemotherapy regimen was not inferior to gefitinib. Since being launched August 2011 in the People’s Republic of China, icotinib has been widely used in clinics, and has become an important treatment option for Chinese patients with advanced NSCLC. The present study presents the Phase I, II, and III clinical trials of icotinib and discusses current clinical applications in the People’s Republic of China and future research directions. Keywords: targeted therapy, EGFR-TKI, NSCLC

  9. Impact localization for a composite plate using the spatial focusing properties of advanced signal processing techniques

    Energy Technology Data Exchange (ETDEWEB)

    Jeong, Hyunjo; Cho, Sungjong [Wonkwang Univ., Iksan (Korea, Republic of)

    2012-12-15

    A structural health monitoring technique for locating impact position in a composite plate is presented in this paper. The method employs a single sensor and spatial focusing properties of time reversal(TR) and inverse filtering(IF). We first examine the spatial focusing efficiency of both approaches at the impact position and its surroundings through impact experiments. The imaging results of impact localization show that the impact location can be accurately estimated in any position of the plate. Compared to existing techniques for locating impact or acoustic emission source, the proposed method has the benefits of using a single sensor and not requiring knowledge of anisotropic material properties and geometry of structures. Furthermore, it does not depend on a particular mode of dispersive Lamb waves that is frequently used in other ultrasonic testing of plate like structures.

  10. Development of tomographic reconstruction methods in materials science with focus on advanced scanning methods

    DEFF Research Database (Denmark)

    Lyckegaard, Allan

    Techniques for obtaining 3 dimensional information of individual crystals, socalled grains, in polycrystalline materials are important within the field of materials science for understanding and modeling the behavior of materials.In the last decade, a number of nondestructive X-ray diffraction...... techniques. Combining this with a novel 6-dimensional indexing routine it is possible to determine grain centers, radii and orientations of hundreds of individual grains in a sample. The grain centers are found with a precision which is better than the stepping size, and thus provides a road towards future......-stable beta titanium alloy comprising 1265 grains has been produced as part of a collaboration on spatial resolved strain measurements with Cornell University, USA, and the Advanced Photon Source, USA....

  11. Recent advances in biomarkers for Parkinson's disease focusing on biochemicals, omics and neuroimaging.

    Science.gov (United States)

    Ren, Rutong; Sun, Yi; Zhao, Xin; Pu, Xiaoping

    2015-09-01

    Parkinson's disease (PD) is one of the most common neurodegenerative disorders, involving progressive loss of the nigro-striatal dopaminergic neurons. Cardinal symptoms including tremors, muscle rigidity, drooping posture, drooping, walking difficulty, and autonomic symptoms appear when a significant number of nigrostriatal dopaminergic neurons have already been destroyed. Hence, reliable biomarkers are needed for early and accurate diagnosis to measure disease progression and response to therapy. We review the current status of protein and small molecule biomarkers involved in oxidative stress, protein aggregation and inflammation etc. which are present in cerebrospinal fluid, human blood, urine or saliva. In recent years, advances in genomics, proteomics, metabolomics, and functional brain imaging techniques have led to new insights into the pathoetiology of PD. Further studies in the novel discovery of PD biomarkers will provide avenues to treat PD patients more effectively with few or no side effects.

  12. Surgical imaging catheter for confocal microendoscopy with advanced contrast delivery and focus systems

    Science.gov (United States)

    Tanbakuchi, Anthony A.; Rouse, Andrew R.; Udovich, Josh A.; Gmitro, Arthur F.

    2006-02-01

    We present a laparoscope for fluorescence confocal microendoscopy specifically designed for microscopic imaging during diagnostic laparoscopic surgery. The catheter consists of a disposable rigid distal tip which houses a flexible microendoscope and dye channel. The laparoscopic tip is a small disposable polycarbonate sheath containing two inner lumens with a glass window on the distal end. The sheath outer diameter suitable for use in a 5mm trocar. The smaller inner lumen provides a channel for delivering fluorescent contrast agents to the tissue through a 200um hole in the glass window. On the proximal end, the smaller lumen is coupled to a computer controlled fluid delivery system that controls the amount of contrast agent dispensed onto the tissue down to a fraction of a micro liter. The main lumen houses the microendoscope. The microendoscope incorporates a computer-controlled focus mechanism that can quickly and accurately focus while correcting for hysteresis. This fluorescence confocal micro-laparoscope will be tested in a small-scale clinical trial on women undergoing oophorectomy in the near future.

  13. Nonsurgical treatment options for basal cell carcinoma - focus on advanced disease.

    Science.gov (United States)

    Goldenberg, Gary; Hamid, Omid

    2013-12-01

    Basal cell carcinoma (BCC) is the most common cancer in the world. It is typically slow growing and usually effectively managed with surgery. However, BCCs in some patients are unsuitable for surgery or the patient may prefer a nonsurgical treatment. Radiotherapy is a nonsurgical option for the primary treatment of either low- or high-risk BCCs. It is associated with high cure rates, albeit somewhat lower than those observed with Mohs micrographic surgery for high-risk BCCs. Not all patients with BCCs are suitable for radiotherapy. Superficial therapies for BCC include topical imiquimod or 5- fluorouracil and photodynamic therapy (PDT). These therapies are generally associated with somewhat lower clearance rates and/or higher recurrence rates than surgery or radiotherapy, although they may be suitable in patients with low-risk BCCs when surgery or radiotherapy are impractical or less appropriate. An appealing feature of PDT is excellent cosmesis, but PDT is not currently approved by the Food and Drug Administration (FDA), and regimens are not well standardized. Vismodegib is a first-in-class hedgehog pathway inhibitor and recent addition to the armamentarium for the treatment of advanced BCC.

  14. Heavy charged particle radiobiology: using enhanced biological effectiveness and improved beam focusing to advance cancer therapy.

    Science.gov (United States)

    Allen, Christopher; Borak, Thomas B; Tsujii, Hirohiko; Nickoloff, Jac A

    2011-06-03

    Ionizing radiation causes many types of DNA damage, including base damage and single- and double-strand breaks. Photons, including X-rays and γ-rays, are the most widely used type of ionizing radiation in radiobiology experiments, and in radiation cancer therapy. Charged particles, including protons and carbon ions, are seeing increased use as an alternative therapeutic modality. Although the facilities needed to produce high energy charged particle beams are more costly than photon facilities, particle therapy has shown improved cancer survival rates, reflecting more highly focused dose distributions and more severe DNA damage to tumor cells. Despite early successes of charged particle radiotherapy, there is room for further improvement, and much remains to be learned about normal and cancer cell responses to charged particle radiation.

  15. Experiment Setup for Focused Learning of Advanced Servo Control of DC-motors

    Directory of Open Access Journals (Sweden)

    Dag A. H. Samuelsen

    2012-02-01

    Full Text Available Remote laboratories are normally developed for giving students and others remote access to physical laboratory facilities. In contradiction to this, the main objective of the setup presented in this paper is to create a controlled environment where unwanted side activities like hardware setup, driver problems, troubleshooting faulty components, and struggles with special software for configuring DSP systems, are removed as much as possible, in order for the students to have their full focus on the tasks that is considered relevant for the module: modeling of non-linear systems, synthetisation of controllers, and stability and performance analysis. A secondary objective is to significantly reduce the setup and maintenance cost associated with complex laboratory setups involving DSPs and expensive hardware.

  16. Advanced receiver autonomous integrity monitoring using triple frequency data with a focus on treatment of biases

    Science.gov (United States)

    El-Mowafy, Ahmed

    2017-04-01

    Most current Advanced Receiver Autonomous Integrity Monitoring (ARAIM) methods are designed to use dual-frequency ionosphere-free observations. These methods assume that receiver bias is absorbed in the common receiver clock offset and bound satellite biases by nominal values. However, most multi-constellation Global Navigation Satellite Systems (GNSS) can offer triple frequency data that can be used for civilian applications in the future, which can improve observation redundancy, solution precision and detection of faults. In this contribution, we explore the use of this type of observations from GPS, Galileo and BeiDou in ARAIM. Nevertheless, the use of triple frequency data introduces receiver differential biases that have to be taken into consideration. To demonstrate the significance of these additional biases we first present a method to quantify them at stations of known coordinates and using available products from the International GNSS service (IGS). To deal with the additional receiver biases, we use a between-satellite single difference (BSSD) observation model that eliminates their effect. A pilot test was performed to evaluate ARAIM availability for Localizer Performance with Vertical guidance down to 200 feet (LPV-200) when using the triple-frequency observations. Real data were collected for one month at stations of known coordinates located in regions of different satellite coverage characteristics. The BSSD triple-frequency model was evaluated to give early indication about its feasibility, where the implementation phase still requires further comprehensive studies. The vertical position error was always found to be bounded by the protection level proven initial validity of the proposed integrity model.

  17. Advances in pediatrics in 2014: current practices and challenges in allergy, gastroenterology, infectious diseases, neonatology, nutrition, oncology and respiratory tract illnesses.

    Science.gov (United States)

    Caffarelli, Carlo; Santamaria, Francesca; Cesari, Silvia; Sciorio, Elisa; Povesi-Dascola, Carlotta; Bernasconi, Sergio

    2015-10-31

    Major advances in the conduct of pediatric practice have been reported in the Italian Journal of Pediatrics in 2014. This review highlights developments in allergy, gastroenterology, infectious diseases, neonatology, nutrition, oncology and respiratory tract illnesses. Investigations endorse a need to better educate guardians and improve nutritional management in food allergy. Management of hyperbilirubinemia in neonates and of bronchiolitis have been improved by position statements of scientific societies. Novel treatments for infant colic and inflammatory bowel diseases have emerged. Studies suggest the diagnostic utility of ultrasonography in diagnosing community-acquired pneumonia. Progress in infectious diseases should include the universal varicella vaccination of children. Recommendations on asphyxia and respiratory distress syndrome have been highlighted in neonatology. Studies have evidenced that malnutrition remains a common underestimated problem in developing countries, while exposure to cancer risk factors in children is not negligible in Western countries. Advances in our understanding of less common diseases such as cystic fibrosis, plastic bronchitis, idiopathic pulmonary hemosiderosis facilitate diagnosis and management. Researches have led to new therapeutic approaches in patent ductus arteriosus and pediatric malignancies.

  18. Recent advances in therapeutic strategies that focus on the regulation of ion channel expression.

    Science.gov (United States)

    Ohya, Susumu; Kito, Hiroaki; Hatano, Noriyuki; Muraki, Katsuhiko

    2016-04-01

    A number of different ion channel types are involved in cell signaling networks, and homeostatic regulatory mechanisms contribute to the control of ion channel expression. Profiling of global gene expression using microarray technology has recently provided novel insights into the molecular mechanisms underlying the homeostatic and pathological control of ion channel expression. It has demonstrated that the dysregulation of ion channel expression is associated with the pathogenesis of neural, cardiovascular, and immune diseases as well as cancers. In addition to the transcriptional, translational, and post-translational regulation of ion channels, potentially important evidence on the mechanisms controlling ion channel expression has recently been accumulated. The regulation of alternative pre-mRNA splicing is therefore a novel therapeutic strategy for the treatment of dominant-negative splicing disorders. Epigenetic modification plays a key role in various pathological conditions through the regulation of pluripotency genes. Inhibitors of pre-mRNA splicing and histone deacetyalase/methyltransferase have potential as potent therapeutic drugs for cancers and autoimmune and inflammatory diseases. Moreover, membrane-anchoring proteins, lysosomal and proteasomal degradation-related molecules, auxiliary subunits, and pharmacological agents alter the protein folding, membrane trafficking, and post-translational modifications of ion channels, and are linked to expression-defect channelopathies. In this review, we focused on recent insights into the transcriptional, spliceosomal, epigenetic, and proteasomal regulation of ion channel expression: Ca(2+) channels (TRPC/TRPV/TRPM/TRPA/Orai), K(+) channels (voltage-gated, KV/Ca(2+)-activated, KCa/two-pore domain, K2P/inward-rectifier, Kir), and Ca(2+)-activated Cl(-) channels (TMEM16A/TMEM16B). Furthermore, this review highlights expression of these ion channels in expression-defect channelopathies.

  19. Focused Ion Beam and Advanced Electron Microscopy for Minerals: Insights and Outlook from Bismuth Sulphosalts

    Directory of Open Access Journals (Sweden)

    Cristiana L. Ciobanu

    2016-10-01

    Full Text Available This paper comprises a review of the rapidly expanding application of nanoscale mineral characterization methodology to the study of ore deposits. Utilising bismuth sulphosalt minerals from a reaction front in a skarn assemblage as an example, we illustrate how a complex problem in ore petrology, can be approached at scales down to that of single atoms. We demonstrate the interpretive opportunities that can be realised by doing this for other minerals within their petrogenetic contexts. From an area defined as Au-rich within a sulphosalt-sulphide assemblage, and using samples prepared on a Focused Ion Beam–Scanning Electron Microscopy (SEM platform, we identify mineral species and trace the evolution of their intergrowths down to the atomic scale. Our approach progresses from a petrographic and trace element study of a larger polished block, to high-resolution Transmission Electron Microscopy (TEM and High Angle Annular Dark Field (HAADF Scanning-TEM (STEM studies. Lattice-scale heterogeneity imaged in HAADF STEM mode is expressed by changes in composition of unit cell slabs followed by nanoparticle formation and their growth into “veins”. We report a progressive transition from sulphosalt species which host lattice-bound Au (neyite, lillianite homologues; Pb-Bi-sulphosalts, to those that cannot accept Au (aikinite. This transition acts as a crystal structural barrier for Au. Fine particles of native gold track this progression over the scale of several hundred microns, leading to Au enrichment at the reaction front defined by an increase in the Cu gradient (several wt %, and abrupt changes in sulphosalt speciation from Pb-Bi-sulphosalts to aikinite. Atom-scale resolution imaging in HAADF STEM mode allows for the direct visualisation of the three component slabs in the neyite crystal structure, one of the largest and complex sulphosalts of boxwork-type. We show for the first time the presence of aikinite nanoparticles a few nanometres in

  20. On being Credibly Ill

    DEFF Research Database (Denmark)

    Mik-Meyer, Nanna

    2011-01-01

    problems. The paper shows that it is predominantly poorly educated women without a bio-medical diagnosis that welfare officers describe as suffering from psychological problems despite the fact that the women themselves focus on physical ailments in their illness stories. Men and better-educated women......unexplained symptoms. The study is conducted in Denmark using qualitative interviews with welfare officers and clients. The paper's focus is on how issues of gender and class intersect in the negotiation of illness among welfare officers and clients. The particular client group in question consists...... are described by the welfare officers as tired and exhausted or truly stressed after a long working life....

  1. Cost-of-illness analysis of patients with chronic hand eczema in routine care in Germany: focus on the impact of occupational disease.

    Science.gov (United States)

    Diepgen, Thomas L; Purwins, Sandra; Posthumus, Jan; Kuessner, Daniel; John, Swen M; Augustin, Matthias

    2013-09-04

    Chronic hand eczema places a heavy burden on patients, often affecting their ability to work. This paper compares the cost-of-illness and treatment approaches for patients with refractory chronic hand eczema, in relation to whether the disease was occupational or unrelated to work factors. Data from 2 surveys, comprising 310 patients with chronic hand eczema insured by German statutory health insurance (SHI) (including work-impaired patients, work-unaffected patients and non-working patients) and known work-related chronic hand eczema insured by occupational health insurance (OHI). Annual healthcare costs of managing work-impaired patients (SHI) and patients with work-related chronic hand eczema (OHI) were €3,164 and €3,309, respectively, approximately double the costs of managing non-working and work-unaffected (SHI) patients. This analysis shows that the costs associated with chronic hand eczema are affected by the correlation of chronic hand eczema with work, with costs being higher for occupational patients with chronic hand eczema.

  2. Improving Communication About Serious Illness

    Science.gov (United States)

    2017-01-07

    Critical Illness; Chronic Disease; Terminal Care; Palliative Care; Communication; Advance Care Planning; Neoplasm Metastasis; Lung Neoplasms; Pulmonary Disease, Chronic Obstructive; Heart Failure; End Stage Liver Disease; Kidney Failure, Chronic

  3. Counsellors' Focus on Competitive Employment for People with Severe Mental Illness: An Application of the Theory of Planned Behaviour in Vocational Rehabilitation Programmes

    Science.gov (United States)

    Knaeps, Jeroen; Neyens, Inge; van Weeghel, Jaap; Van Audenhove, Chantal

    2016-01-01

    Although the evidence-based Individual Placement and Support programme highlights the importance of the vocational rehabilitation (VR) counsellors' focus on competitive employment during career counselling, studies have shown that counsellors do not always target such jobs. This study examines which determinants affect the counsellors' intentions…

  4. Foodborne Illnesses

    Science.gov (United States)

    ... jejuni (C. jejuni), found in raw or undercooked chicken and unpasteurized milk. Shigella, a bacterium spread from ... health care provider may prescribe medications, such as antibiotics, to treat the illness. Hospitalization may be required ...

  5. Motivational aftercare planning to better care: Applying the principles of advanced directives and motivational interviewing to discharge planning for people with mental illness.

    Science.gov (United States)

    Kisely, Steve; Wyder, Marianne; Dietrich, Josie; Robinson, Gail; Siskind, Dan; Crompton, David

    2017-02-01

    Improving the input of people with mental illness into their recovery plans can potentially lead to better outcomes. In the present study, we evaluated the introduction of motivational aftercare planning (MAP) into the discharge planning of psychiatric inpatients. MAP is a manualized intervention combining motivational interviewing with advance directives. We measured changes in the level of patient input into discharge planning following training staff in the use of MAP. This included the following: (i) documentation of early relapse signs along with successful past responses; (ii) evidence of aftercare planning; and (iii) the use of the patients' own words in the plan. We used a ward-level controlled before-and-after design comparing one intervention ward with two control wards. We used anonymized recovery plans, with a goal of 50 plans per ward before and after the intervention, to look for evidence of patient input into care planning with a standardized checklist. There were also qualitative interviews with individuals discharged from the unit. We reviewed 100 intervention ward plans and 197 control ones (total n = 297). There were no significant differences in recovery plans from intervention and control wards at baseline. Following MAP training, the intervention ward improved significantly (e.g. identification of triggers increased from 52 to 94%, χ(2)  = 23.3, d.f. =1, P planning. MAP increased inpatient input into discharge planning and was valued by participants. The effect on subsequent health service use needs evaluation.

  6. A systematic review of prognostic/end-of-life communication with adults in the advanced stages of a life-limiting illness: patient/caregiver preferences for the content, style, and timing of information.

    Science.gov (United States)

    Parker, Sharon M; Clayton, Josephine M; Hancock, Karen; Walder, Sharon; Butow, Phyllis N; Carrick, Sue; Currow, David; Ghersi, Davina; Glare, Paul; Hagerty, Rebecca; Tattersall, Martin H N

    2007-07-01

    Evidence-based recommendations concerning how to discuss dying, life expectancy, and likely future symptoms with patients with a limited life expectancy and their families are lacking. The aim of this systematic review was to review studies regarding prognostic/end-of-life communication with adult patients in the advanced stages of a life-limiting illness and their caregivers. Relevant studies meeting the inclusion criteria were identified by searching computerized databases up to November 2004. One hundred twenty-three studies met the criteria for the full review, and 46 articles reported on patient/caregiver preferences for content, style, and timing of information. The majority of the research was descriptive. Although there were individual differences, patients/caregivers in general had high levels of information need at all stages of the disease process regarding the illness itself, likely future symptoms and their management, and life expectancy and information about clinical treatment options. Patient and caregiver information needs showed a tendency to diverge as the illness progressed, with caregivers needing more and patients wanting less information. Patients and caregivers preferred a trusted health professional who showed empathy and honesty, encouraged questions, and clarified each individual's information needs and level of understanding. In general, most patients/caregivers wanted at least some discussion of these topics at the time of diagnosis of an advanced, progressive, life-limiting illness, or shortly after. However, they wanted to negotiate the content and extent of this information.

  7. Diarrheal Illness

    Centers for Disease Control (CDC) Podcasts

    2011-08-30

    Dr. Steve Monroe, director of CDC’s Division of High-Consequence Pathogens and Pathology, discusses diarrheal illness, its causes, and prevention.  Created: 8/30/2011 by National Center for Emerging Zoonotic and Infectious Diseases (NCEZID).   Date Released: 8/31/2011.

  8. Adjuvant hormone therapy in patients undergoing high-intensity focused ultrasound therapy for locally advanced prostate cancer

    Directory of Open Access Journals (Sweden)

    A. I. Neimark

    2014-01-01

    Full Text Available Objective: to evaluate the efficiency and safety of using the luteinizing hormone releasing hormone leuprorelin with the Atrigel delivery system in doses of 7.5, 22.5, and 45 mg as an adjuvant regimen in high- and moderate-risk cancer patients who have received high-intensity focused ultrasound (HIFU therapy.Subjects and methods. Moderate- and high-risk locally advanced prostate cancer (PC patients treated with HIFU (n = 28 and HIFU in combination with hormone therapy during 6 months (n = 31 were examined.Results. The investigation has shown that leuprorelin acetate monotherapy used within 6 months after HIFU therapy can achieve the highest reduction in prostate-specific antigen levels and positively affect the symptoms of the disease. HIFU in combination with androgen deprivation substantially diminishes the clinical manifestations of the disease and improves quality of life in HIFU-treated patients with PC, by reducing the degree of infravesical obstruction (according to uroflowmetric findings and IPSS scores, and causes a decrease in prostate volume as compared to those who have undergone HIFU only. Treatment with leuprorelin having the Atrigel delivery system has demonstrated the low incidence of adverse reactions and good tolerability.

  9. Evolving definitions of mental illness and wellness.

    Science.gov (United States)

    Manderscheid, Ronald W; Ryff, Carol D; Freeman, Elsie J; McKnight-Eily, Lela R; Dhingra, Satvinder; Strine, Tara W

    2010-01-01

    Understanding of the definitions of wellness and illness has changed from the mid-20th century to modern times, moving from a diagnosis-focused to a person-focused definition of mental illnesses, and from an "absence of disease" model to one that stresses positive psychological function for mental health. Currently, wellness refers to the degree to which one feels positive and enthusiastic about oneself and life, whereas illness refers to the presence of disease. These definitions apply to physical as well as mental illness and wellness. In this article, we build on the essential concepts of wellness and illness, discuss how these definitions have changed over time, and discuss their importance in the context of health reform and health care reform. Health reform refers to efforts focused on health, such as health promotion and the development of positive well-being. Health care reform refers to efforts focused on illness, such as treatment of disease and related rehabilitation efforts.

  10. Evolving Definitions of Mental Illness and Wellness

    OpenAIRE

    Tara W. Strine, MPH; Satvinder Dhingra, MPH; Lela R. McKnight-Eily, PhD; Carol D. Ryff, PhD; Elsie J. Freeman, MD, MPH; Ronald W. Manderscheid, PhD

    2010-01-01

    Understanding of the definitions of wellness and illness has changed from the mid-20th century to modern times, moving from a diagnosis-focused to a person-focused definition of mental illnesses, and from an "absence of disease" model to one that stresses positive psychological function for mental health. Currently, wellness refers to the degree to which one feels positive and enthusiastic about oneself and life, whereas illness refers to the presence of disease. These definitions apply to ph...

  11. Advances in nutrition screening and nutritional assessment among critically ill children%危重症儿童营养筛查及营养评定的研究进展

    Institute of Scientific and Technical Information of China (English)

    李菁菁; 王莹

    2014-01-01

    Malnutrition is common in critically ill children.Nutrition prescription is hampered by various factors,and the nutritional status of these children often deteriorates during hospitalization.Nutrition therapy for critically ill children must be based on proper nutrition screening and nutritional assessment.Adopting dynamic nutritional assessment is an effective method to monitor patients under nutrition therapy and inform the prescription and administration of nutrition therapy.This article reviews the recent advances in nutrition screening and nutritional assessment in critically ill children.%危重症儿童营养不良发生率高,住院期间因多种因素导致营养处方难以完成,增加营养不良发生.合理的营养筛查及营养评定是危重症儿童营养治疗的基石.实施动态营养评定可有效评价营养治疗疗效,并提供改善营养状况的建议.现就危重症儿童营养筛查及营养评定的研究进展进行综述.

  12. Review of hormone-based treatments in postmenopausal patients with advanced breast cancer focusing on aromatase inhibitors and fulvestrant

    DEFF Research Database (Denmark)

    Kümler, Iben; Knoop, Ann S; Jessing, Christina A R;

    2016-01-01

    . However, overall survival was not significantly increased. CONCLUSION: Conventional treatment with an aromatase inhibitor or fulvestrant may be an adequate treatment option for most patients with hormone receptor-positive advanced breast cancer. Mammalian target of rapamycin (mTOR) inhibition and cyclin...

  13. History, Advances, Challenges and Guidelines for the Next 10 Years——Focus on Tropical Crop Proteomics

    Institute of Scientific and Technical Information of China (English)

    Xuchu Wang

    2012-01-01

    .For tropical crop proteomics,these challenges are of significant notability due to the lack of available genome-sequence information for the main tropical crops such as rubber tree Hevea brasiliensis,cassava Manihot esculenta,and banana Musa paradisiaca.In the past few years,we have optimized the some conditions to produce high-resolution 2-DE gels and finally obtained well proteomic results in several tropical crops.To perform proteomic analysis of laticifer latex in Hevea brasiliensis,we have developed an efficient method for protein preparation from different latex subcellular fractions and constructed high-resolution reference 2-DE maps (Xuchu Wang et al.,2010,Proteome Science,8,35),which is expected to be used in future comparative proteomic analysis for natural rubber latex.We also observed that thermal denaturation would not only changed the protein profiles and produced more polydisperse protein bands/spots,but also heavily interfered with the subsequent MS analysis (Xuchu Wang et al.,2011,Electrophoresis,32,348-356).At the same time,we have systematically evaluated the effects of different staining parameters on CBB methods by 1-DE and 2-DE,and demonstrated G-250 was more suitable for visualizing low abundant proteins as well as generating more spots than R-250,whereas R-250 had a superior capability for fast staining of high abundant proteins.Based on these findings,a new protocol using CBB G-250,ammonium sulfate and phosphoric acid (GAP) was developed by incorporating the fixation,sensitization and staining procedures together.This method was not only compatible with MS but also obviously reduced in vitro protein-modification,and thus could be a preferable protocol in future proteomic analysis (Xuchu Wang et al.,2012,Electrophoresis,33,296-306).Based on these aforementioned technical advances,we obtained good proteomic results by using both DIGE and ITRAQ for rubber latex,cassava roots,and banana leaves.In the next 10 years,plant proteomics including both the model

  14. Integrating Palliative Care into the Care of Neurocritically Ill Patients: A Report from The IPAL-ICU (Improving Palliative Care in the Intensive Care Unit) Project Advisory Board and the Center to Advance Palliative Care

    Science.gov (United States)

    Frontera, Jennifer A.; Curtis, J. Randall; Nelson, Judith E.; Campbell, Margaret; Gabriel, Michelle; Hays, Ross M.; Mosenthal, Anne C.; Mulkerin, Colleen; Puntillo, Kathleen A.; Ray, Daniel E.; Bassett, Rick; Boss, Renee D.; Lustbader, Dana R.; Brasel, Karen J.; Weiss, Stefanie P.; Weissman, David E.

    2015-01-01

    Objectives To describe unique features of neurocritical illness that are relevant to provision of high-quality palliative care; To discuss key prognostic aids and their limitations for neurocritical illnesses; To review challenges and strategies for establishing realistic goals of care for patients in the neuro-ICU; To describe elements of best practice concerning symptom management, limitation of life support, and organ donation for the neurocritically ill. Data Sources A search of Pubmed and MEDLINE was conducted from inception through January 2015 for all English-language articles using the term “palliative care,” “supportive care,” “end-of-life care,” “withdrawal of life-sustaining therapy,” “limitation of life support,” “prognosis,” or “goals of care” together with “neurocritical care,” “neurointensive care,” “neurological,” “stroke,” “subarachnoid hemorrhage,” “intracerebral hemorrhage,” or “brain injury.” Data Extraction and Synthesis We reviewed the existing literature on delivery of palliative care in the neurointensive care unit setting, focusing on challenges and strategies for establishing realistic and appropriate goals of care, symptom management, organ donation, and other considerations related to use and limitation of life-sustaining therapies for neurocritically ill patients. Based on review of these articles and the experiences of our interdisciplinary/interprofessional expert Advisory Board, this report was prepared to guide critical care staff, palliative care specialists, and others who practice in this setting. Conclusions Most neurocritically ill patients and their families face the sudden onset of devastating cognitive and functional changes that challenge clinicians to provide patient-centered palliative care within a complex and often uncertain prognostic environment. Application of palliative care principles concerning symptom relief, goal setting, and family emotional support, will

  15. Childhood adversity, mental ill-health and aggressive behavior in an African orphanage: Changes in response to trauma-focused therapy and the implementation of a new instructional system

    Directory of Open Access Journals (Sweden)

    Schauer Elisabeth

    2011-09-01

    Full Text Available Abstract Background The number of orphans in Sub-Saharan Africa is constantly rising. While it is known that family or community care is preferable over institutional care of African orphans, little is known about the quality of care in orphanages and possibilities of improvement. Study 1 Methods Exposure to traumatic stress, experiences of violence in the home, school and orphanage, as well as mental ill-health and aggression of 38 children (mean age of M = 8.64 years living in an orphanage in rural Tanzania were assessed at two time points. The severity of post-traumatic stress disorder symptoms (PTSD, depressive symptoms, and internalizing and externalizing problems were used as indicators of mental ill-health. Results Violence experienced in the orphanage correlated more strongly with all indicators of mental ill-health than violence in the former home, school or neighborhood at time point 1. Additionally, violence experienced in the orphanage had a positive relationship with the aggressive behavior of the children at time point 2. Study 2 Methods With the help of the pre-post assessment of Study 1, the implementation of a new instructional system and psychotherapeutic treatment (KIDNET for trauma-related illness were evaluated. Results In response to both, a change in the instructional system and psychotherapeutic treatment of PTSD, a massive decline in experienced violence and in the severity of PTSD-symptoms was found, whereas depressive symptoms and internalizing and externalizing problems exhibited little change. Conclusions These studies show that violence, especially in the orphanage, can severely contribute to mental ill-health in orphans and that mental health can be improved by implementing a new instructional system and psychotherapeutic treatment in an orphanage. Moreover, the results indicate that the experience of violence in an orphanage also plays a crucial role in aggressive behavior of the orphans.

  16. Focusing, collimation and flux throughput at the IMCA-CAT bending-magnet beamline at the Advanced Photon Source

    Energy Technology Data Exchange (ETDEWEB)

    Koshelev, Irina; Huang, Rong; Graber, Timothy; Meron, Mati; Muir, J. Lewis; Lavender, William; Battaile, Kevin; Mulichak, Anne M.; Keefe, Lisa J.; (IIT); (UC)

    2009-09-02

    The IMCA-CAT bending-magnet beamline was upgraded with a collimating mirror in order to achieve the energy resolution required to conduct high-quality multi- and single-wavelength anomalous diffraction (MAD/SAD) experiments without sacrificing beamline flux throughput. Following the upgrade, the bending-magnet beamline achieves a flux of 8 x 10{sup 11} photons s{sup -1} at 1 {angstrom} wavelength, at a beamline aperture of 1.5 mrad (horizontal) x 86 {mu}rad (vertical), with energy resolution (limited mostly by the intrinsic resolution of the monochromator optics) {delta}E/E = 1.5 x 10{sup -4} (at 10 kV). The beamline operates in a dynamic range of 7.5-17.5 keV and delivers to the sample focused beam of size (FWHM) 240 {micro}m (horizontally) x 160 {micro}m (vertically). The performance of the 17-BM beamline optics and its deviation from ideally shaped optics is evaluated in the context of the requirements imposed by the needs of protein crystallography experiments. An assessment of flux losses is given in relation to the (geometric) properties of major beamline components.

  17. Focusing, collimation and flux throughput at the IMCA-CAT bending-magnet beamline at the Advanced Photon Source.

    Science.gov (United States)

    Koshelev, Irina; Huang, Rong; Graber, Timothy; Meron, Mati; Muir, J Lewis; Lavender, William; Battaile, Kevin; Mulichak, Anne M; Keefe, Lisa J

    2009-09-01

    The IMCA-CAT bending-magnet beamline was upgraded with a collimating mirror in order to achieve the energy resolution required to conduct high-quality multi- and single-wavelength anomalous diffraction (MAD/SAD) experiments without sacrificing beamline flux throughput. Following the upgrade, the bending-magnet beamline achieves a flux of 8 x 10(11) photons s(-1) at 1 A wavelength, at a beamline aperture of 1.5 mrad (horizontal) x 86 microrad (vertical), with energy resolution (limited mostly by the intrinsic resolution of the monochromator optics) deltaE/E = 1.5 x 10(-4) (at 10 kV). The beamline operates in a dynamic range of 7.5-17.5 keV and delivers to the sample focused beam of size (FWHM) 240 microm (horizontally) x 160 microm (vertically). The performance of the 17-BM beamline optics and its deviation from ideally shaped optics is evaluated in the context of the requirements imposed by the needs of protein crystallography experiments. An assessment of flux losses is given in relation to the (geometric) properties of major beamline components.

  18. 危重病应激性代谢反应的研究进展%Advances in metabolic response to stress during critical illness

    Institute of Scientific and Technical Information of China (English)

    张清荣; 薄禄龙; 邓小明

    2016-01-01

    The metabolic response to stress plays a key role in the adaptive response during critical illness.Multiple mechanisms including the stimulation of the sympathetic nervous system,inflammation,and immune responses were involved.Insulin resistance is one of the main features in metabolic response to stress.Metabolic response to stress was manifested by disorders of energy consumption,such as glucose,lactic acid,lipids,and proteins.The decrease in fat-free body mass and cell mass,relative excess of adipose tissues,and increased extracellular fluid volumes were also involved.Therapeutic interventions,including hormone supplementation,enhanced protein intake,and early mobilization,are considered for prevention and therapy of metabolic response to stress.The review aims to summarize the pathophysiological mechanisms,clinical consequences,and therapeutic implications of metabolic response to stress in critical illness.%机体应激性代谢反应在危重病发生发展中具有重要作用.神经-内分泌反应、炎症及免疫系统参与了应激性代谢,而胰岛素抵抗是危重病时应激性代谢反应的主要特征之一.临床上应激性代谢反应的特点主要包括能量消耗,葡萄糖、乳酸、脂质、蛋白质等能量底物失调,以及无脂体质量减轻、脂肪组织相对过多、体细胞质量减轻、细胞外液量增加等机体改变.补充外源性激素以增强蛋白质摄取及早期下床活动有助于改善危重病患者应激性代谢反应.通过对危重病应激性代谢反应的病理生理机制、临床特点及治疗进展的系统综述,以期为临床及基础研究提供参考.

  19. Advances in Remote Sensing for Assessing High Altitude Glacio-Hydrology - with a Focus on High Mountain Asia

    Science.gov (United States)

    Bolch, T.

    2014-12-01

    Meltwater released by glaciers can be of high importance for the overall run-off and thus affect society and development of mountainous regions and their forelands. However, glaciers are mostly located in harsh and remote environment and detailed in-situ measurements are impossible or limited to few glaciers. This lack of measurements of glacier characteristics (e.g. area, debris cover, flow) and mass budgets hampers a correct glacio-hydrologic modelling and representation of processes in advanced simulation models. Remote sensing has been proven a powerful tool in providing essential data to fill this gap. The most basic information in this respect is the location and area of the glaciers. A global and some regional inventories exist, but the uncertainties and differences among them are high, especially with respect to the upper accumulation area and debris cover. I here present a multi-method approach to map glaciers more precisely based on remote sensing data and combining image ratioing (using visible, infrared and thermal bands), micro-wave coherence images, terrain analysis, differencing of digital elevation models (DEMs) and, if available, high resolution images. DEM differencing is used to provide region-wide mass balance assessments, but volume to mass conversion and data voids introduce uncertainties. For High Mountain Asia (HMA), a crucial region in terms of water resources and glacier changes, most studies concentrate on the period after the year 2000 with the SRTM-DEM as baseline data set. However, declassified satellite data from the 1960s and 1970s also exist and allowed to extend the data record back in time for several regions in HMA. Using an example from an ice-covered area of ~5000 km² in the Aksu-Tarim catchment in Central Tien Shan the importance of remote sensing for glacio-hydrological modelling is shown. This is especially true for debris-covered and surge-type glaciers whose reaction to climate is still not fully understood. Therefore

  20. Development of Collaborative Research Initiatives to Advance the Aerospace Sciences-via the Communications, Electronics, Information Systems Focus Group

    Science.gov (United States)

    Knasel, T. Michael

    1996-01-01

    The primary goal of the Adaptive Vision Laboratory Research project was to develop advanced computer vision systems for automatic target recognition. The approach used in this effort combined several machine learning paradigms including evolutionary learning algorithms, neural networks, and adaptive clustering techniques to develop the E-MOR.PH system. This system is capable of generating pattern recognition systems to solve a wide variety of complex recognition tasks. A series of simulation experiments were conducted using E-MORPH to solve problems in OCR, military target recognition, industrial inspection, and medical image analysis. The bulk of the funds provided through this grant were used to purchase computer hardware and software to support these computationally intensive simulations. The payoff from this effort is the reduced need for human involvement in the design and implementation of recognition systems. We have shown that the techniques used in E-MORPH are generic and readily transition to other problem domains. Specifically, E-MORPH is multi-phase evolutionary leaming system that evolves cooperative sets of features detectors and combines their response using an adaptive classifier to form a complete pattern recognition system. The system can operate on binary or grayscale images. In our most recent experiments, we used multi-resolution images that are formed by applying a Gabor wavelet transform to a set of grayscale input images. To begin the leaming process, candidate chips are extracted from the multi-resolution images to form a training set and a test set. A population of detector sets is randomly initialized to start the evolutionary process. Using a combination of evolutionary programming and genetic algorithms, the feature detectors are enhanced to solve a recognition problem. The design of E-MORPH and recognition results for a complex problem in medical image analysis are described at the end of this report. The specific task involves the

  1. First line treatment of advanced non-small-cell lung cancer – specific focus on albumin bound paclitaxel

    Directory of Open Access Journals (Sweden)

    Gupta N

    2013-12-01

    Full Text Available Neha Gupta, Hassan Hatoum, Grace K DyDepartment of Medicine, Roswell Park Cancer Institute, Buffalo, NY, USAAbstract: Lung cancer is the leading cause of cancer mortality worldwide in both men and women. Non-small-cell lung cancer (NSCLC is the most common type of lung cancer, accounting for more than 80% of cases. Paclitaxel has a broad spectrum of activity against various malignancies, including NSCLC. Paclitaxel is poorly soluble in water and thus, until recently, its commercially available preparations contained a non-ionic solvent Cremophor EL®. Cremophor EL® improves the solubility of paclitaxel and allows its intravenous administration. However, certain side-effects associated with paclitaxel, such as hypersensitivity reactions, myelosuppression, and peripheral neuropathy, are known to be worsened by Cremophor®. Nanoparticle albumin-bound paclitaxel ([nab-paclitaxel] ABRAXANE® ABI-007 is a new generation formulation of paclitaxel that obviates the need for Cremophor®, resulting in a safer and faster infusion without requiring the use of premedications to avoid hypersensitivity. Albumin-binding receptor-mediated delivery and lack of sequestering Cremophor® micelles allow higher intratumoral concentration of pharmacologically active paclitaxel. Multiple clinical trials have demonstrated a superior tolerability profile of nab-paclitaxel in comparison to solvent-bound paclitaxel (sb-paclitaxel. A recent Phase III trial compared the effects of weekly nab-paclitaxel in combination with carboplatin versus sb-paclitaxel in combination with carboplatin given every 3 weeks for first line treatment of NSCLC. This trial highlights the weekly nab-paclitaxel combination as an alternate treatment option for NSCLC, with higher response rate in squamous cell NSCLC and longer survival in elderly patients. This review will focus on the properties of nab-paclitaxel and its use in the first line treatment of NSCLC.Keywords: ABI-007, Abraxane, nab

  2. Focused Ion Beam (FIB) combined with SEM (FIB/SEM) and TEM: Advanced tools for nano-analysis in Geosciences

    Science.gov (United States)

    Wirth, R.; Morales, L. G.

    2011-12-01

    Focused ion beam (FIB) techniques have been successfully applied to the preparation of site-specific electron transparent membranes for transmission electron microscopy (TEM) investigations in Geosciences since several years. For example, systematic TEM studies of nano-inclusions in diamond foils prepared with FIB have improved our knowledge on diamond formation. However, FIB is not exclusively used for sample preparation for TEM application because it has been proved that one and the same TEM foil can also be used for Synchrotron IR, Synchrotron X-Ray fluorescence (XRF), scanning transmission X-Ray microscopy (STXM) and NanoSIMS analysis. In addition, FIB milling turned out to be very useful for sample preparation of Brillouin scattering experiments and has a strong potential for preparation of highly-polished, micrometer-scale samples. However, a real break through in FIB application was achieved combining a Ga-ion source of the FIB with an electron source of a scanning electron microscope (SEM) in one single instrument. The combination of FIB/SEM renders access to the third dimension of the sample possible. A cavity normal to the sample surface is sputtered with Ga-ions and this newly created inner surface is imaged with the electron beam. Alternating slicing and viewing along these cavities allow the acquisition of a sequence of images that allows the observation in 3 dimensions. Recently, this technique has been successfully applied to image the structure of grain or phase boundaries in metamorphic rocks as well as micro- and nanoporosity in shales, but its applicability goes far beyond these few examples. Combining slicing and viewing with X-Ray and electron backscatter diffraction (EBSD) analysis can provide 3D elemental mapping and 3D crystallographic orientation mapping of crystalline materials. Combined FIB/SEM devices also facilitate the preparation of substantially thinner and cleaner TEM foils (approximately 30 nm) because electron beam imaging

  3. Coping with Chronic Illness

    Science.gov (United States)

    Having a long-term, or chronic, illness can disrupt your life in many ways. You may often be tired and in pain. Your illness might affect your ... able to work, causing financial problems. For children, chronic illnesses can be frightening, because they may not ...

  4. The feasibility and safety of high-intensity focused ultrasound combined with low-dose external beam radiotherapy as supplemental therapy for advanced prostate cancer following hormonal therapy

    Institute of Scientific and Technical Information of China (English)

    Rui-Yi Wu; Guo-Min Wang; Lei Xu; Bo-Heng Zhang; Ye-Qing Xu; Zhao-Chong Zeng; Bing Chen

    2011-01-01

    The aim of this study was to investigate the feasibility and safety of high-intensity focused ultrasound (HIFU) combined with (+) low-dose external beam radiotherapy (LRT) as supplemental therapy for advanced prostate cancer (PCa) following hormonal therapy (HT). Our definition of HIFU+LRT refers to treating primary tumour lesions with HIFU in place of reduced field boost irradiation to the prostate, while retaining four-field box irradiation to the pelvis in conventional-dose external beam radiotherapy (CRT). We performed a prospective, controlled and non-randomized study on 120 patients with advanced PCa after HT who received HIFU, CRT, HIFU+LRT and HT alone, respectively. CT/MR imaging showed the primary tumours and pelvic lymph node metastases visibly shrank or even disappeared after HIFU+LRT treatment. There were significant differences among four groups with regard to overall survival (OS) and disease-specific survival (DSS) curves (P=0.018 and 0.015). Further comparison between each pair of groups suggested that the long-term DSS of the HIFU+LRT group was higher than those of the other three groups, but there was no significant difference between the HIFU+LRT group and the CRT group. Multivariable Cox's proportional hazard model showed that both HIFU+LRT and CRT were independently associated with DSS (P=0.001 and 0.035) and had protective effects with regard to the risk of death. Compared with CRT, HIFU+LRT significantly decreased incidences of radiation-related late gastrointestinal (GI) and genitourinary (GU) toxicity grade ≥II. In conclusion, long-term survival of patients with advanced PCa benefited from strengthening local control of primary tumour and regional lymph node metastases after HT. As an alternative to CRT, HIFU+LRT showed good efficacy and better safety.

  5. Recent advances in managing chronic HCV infection: focus on therapy in patients with severe liver disease [version 1; referees: 3 approved

    Directory of Open Access Journals (Sweden)

    Raoel Maan

    2016-03-01

    Full Text Available Chronic hepatitis C virus (HCV infection still represents a major public health problem, as it is thought to be responsible for more than 350,000 deaths around the globe on a yearly basis. Fortunately, successful eradication of the virus has been associated with improved clinical outcome and reduced mortality rates. In the past few years, treatment has improved considerably by the implementation of direct-acting antivirals (DAAs. From 2014 onwards, sofosbuvir, simeprevir, daclatasvir, ledipasvir, paritaprevir, ombitasvir, and dasabuvir have been approved by the US Food and Drug Administration (FDA and European Medicines Agency (EMA. Regimens with various combinations of these new drugs, without the use of interferon (IFN, proved to be very effective and well tolerated, even among patients with advanced liver disease. Moreover, treatment duration could be shortened to 12 weeks in the majority of patients. The high costs of these DAAs, however, limit the availability of IFN-free therapy worldwide. Even in wealthy countries, it is deemed necessary to prioritize DAA treatment in order to limit the immediate impact on the health budget. As patients with advanced liver disease are in most need of HCV clearance, many countries decided to treat those patients first. In the current review, we focus on the currently available IFN-free treatment options for patients with cirrhosis. We discuss the virological efficacy as well as the clinical relevance of these regimens among this specific patient population.

  6. The role and structure of the multidisciplinary team in the management of advanced Parkinson's disease with a focus on the use of levodopa-carbidopa intestinal gel.

    Science.gov (United States)

    Pedersen, Stephen W; Suedmeyer, Martin; Liu, Louis W C; Domagk, Dirk; Forbes, Alison; Bergmann, Lars; Onuk, Koray; Yegin, Ashley; van Laar, Teus

    2017-01-01

    A multidisciplinary team (MDT) approach is increasingly recommended in Parkinson's disease (PD) treatment guidelines, but no standard of care exists for such an approach, and the guidelines do not provide clarification on how it should be implemented. This paper reviews evidence of MDT interventions in people with PD and provides expert clinical perspectives for an MDT approach, with a focus on advanced PD and levodopa-carbidopa intestinal gel (carbidopa-levodopa enteral suspension in the USA). The key recommendations are to enable the best possible treatment of people with PD locally by facilitating a close structured collaboration of different health care professionals working in a fixed network structure; to refer people with PD to established MDT centers in a timely manner; to establish regular meetings for the MDT enabling interdisciplinary exchange and learning; to optimize individual treatment and carefully evaluate available treatment options; to ensure treatment decisions are agreed jointly between people with PD, their caregivers, family, and health care professional; and to include specialists outside of neurology from adjuvant medical departments as necessary when implementing advanced therapies.

  7. Assessing illness- and non-illness-based motivations for violence in persons with major mental illness.

    Science.gov (United States)

    Penney, Stephanie R; Morgan, Andrew; Simpson, Alexander I F

    2016-02-01

    Research on violence perpetrated by individuals with major mental illness (MMI) typically focuses on the presence of specific psychotic symptoms near the time of the violent act. This approach does not distinguish whether symptoms actually motivate the violence or were merely present at the material time. It also does not consider the possibility that non-illness-related factors (e.g., anger, substance use), or multiple motivations, may have been operative in driving violence. The failure to make these distinctions clouds our ability to understand the origins of violence in people with MMI, to accurately assess risk and criminal responsibility, and to appropriately target interventions to reduce and manage risk. This study describes the development of a new coding instrument designed to assess motivations for violence and offending among individuals with MMI, and reports on the scheme's interrater reliability. Using 72 psychiatric reports which had been submitted to the court to assist in determining criminal responsibility, we found that independent raters were able to assess different motivational influences for violence with a satisfactory degree of consistency. More than three-quarters (79.2%) of the sample were judged to have committed an act of violence as a primary result of illness, whereas 20.8% were deemed to have offended as a result of illness in conjunction with other non-illness-based motivating influences. Current findings have relevance for clarifying the rate of illness-driven violence among psychiatric patients, as well as legal and clinical issues related to violence risk and criminal responsibility more broadly.

  8. Evolving Definitions of Mental Illness and Wellness

    Directory of Open Access Journals (Sweden)

    Tara W. Strine, MPH

    2010-01-01

    Full Text Available Understanding of the definitions of wellness and illness has changed from the mid-20th century to modern times, moving from a diagnosis-focused to a person-focused definition of mental illnesses, and from an “absence of disease” model to one that stresses positive psychological function for mental health. Currently, wellness refers to the degree to which one feels positive and enthusiastic about oneself and life, whereas illness refers to the presence of disease. These definitions apply to physical as well as mental illness and wellness. In this article, we build on the essential concepts of wellness and illness, discuss how these definitions have changed over time, and discuss their importance in the context of health reform and health care reform. Health reform refers to efforts focused on health, such as health promotion and the development of positive well-being. Health care reform refers to efforts focused on illness, such as treatment of disease and related rehabilitation efforts.

  9. Foodborne Germs and Illnesses

    Science.gov (United States)

    ... 2020 and Food Safety Food Safety Modernization Act Foodborne Germs and Illnesses Recommend on Facebook Tweet Share Compartir Foodborne Germs Botulism Campylobacter Clostridium perfringens Cyclospora E. coli ...

  10. Mental illness in the nursing workplace: a collective autoethnography.

    Science.gov (United States)

    Kidd, Jacquie Dianne; Finlayson, Mary P

    2010-01-01

    Many nurses are burned out, exhausted and have a high intent to leave their jobs. These factors, when experienced over a period of time, are consistent with the development of mental illness. This study takes a collective autoethnographical approach to mental illness in the nursing workplace by focusing on the stories of nurses who have experienced mental illness in clinical practice. It highlights three ways in which nursing and mental illness are connected; the nurse who is vulnerable to mental illness prior to entering the profession, the nurse who develops mental illness that is independent of her work but is nevertheless impacted by it, and the nurse who develops mental illness as a result of her work and/or role. This paper explores the hyphenated lives and bullying these nurses experience, and recommends strategies that the profession, employing organisations, and individuals can adopt to reduce nurses' progression from stress to distress and mental illness.

  11. Heat Related Illnesses

    Institute of Scientific and Technical Information of China (English)

    Robert Carter III; Samuel N. Cheuvront; Michael N. Sawka

    2007-01-01

    @@ KEY POINTS · Heat illnesses range in severity from mild (heat rash, heat syncope, cramps) to serious (heat exhaustion, heat injury, heat stroke). · Although heat illness can occur in anyone, an increased risk is associated with a variety of environmental factors, personal characteristics,health conditions, and medications.

  12. Fathers with mental illness: implications for clinicians and health services.

    Science.gov (United States)

    Fletcher, Richard J; Maharaj, O'Neil N; Fletcher Watson, Chloe H; May, Chris; Skeates, Nigel; Gruenert, Stefan

    2013-08-05

    A significant proportion of fathers living with their natural, adopted, step or foster children experience mental illness. Psychiatric illness among fathers can have a devastating impact on children's wellbeing, and even milder forms of paternal mental illness can have serious developmental effects on children. While several pathways linking paternal mental illness with poor child outcomes have been identified, fathers' impaired parenting is an important, potentially malleable factor. Clinicians can assist fathers with mental illness and their families by proactively inquiring about children and by exploring fathering-focused psychological support.

  13. Advanced Illness: Feeding Tubes and Ventilators

    Science.gov (United States)

    ... the feedings may be difficult. There is some debate, for example, about whether feeding tubes actually extend ... pneumonia cannot, but people can now get a vaccination to prevent many kinds of viral pneumonia. Aspiration ...

  14. Advanced Illness: Holding on and Letting Go

    Science.gov (United States)

    ... the caregiver, so that there is an official spokesperson when one is too sick or too confused ... to accept the responsibility of being someone's official spokesperson? If that person has relatives who would be ...

  15. Ethics and mental illness research.

    Science.gov (United States)

    Roberts, Laura Weiss

    2002-09-01

    There are many tasks ahead in the area of ethics and mental illness research. We face unknown challenges in psychiatric genetics projects, studies of psychopharmacological interventions in children, controversial scientific designs (e.g., symptom challenge, medication-free interval), and cross-disciplinary research incorporating goals and methods of health services, epidemiology, and social and behavioral science endeavors. Boundaries between innovative clinical practices and research-related experimentation will become increasingly difficult to distinguish, as will the roles between clinicians, clinical researchers, and basic scientists. Moreover, the institutions and systems in which research occurs are being rapidly and radically revised, raising new questions about oversight responsibilities and standards. Our ability to identify and respond to the ethical questions arising in this uncharted territory will depend on our willingness to self-reflect, to integrate the observations and insights of the past century, to think with great clarity, and to anticipate novel ethical problems that keep company with scientific advancements. It will also depend on data. Empirical study of ethical dimensions of human research is essential to anchor and attune the intuitions and theoretical constructs that we develop. Science and ethics have changed over the past 100 years, as they will over the next century. It is ironic that the ethical acceptability of psychiatric research is so much in question at this time, when it holds so much promise for advancing our understanding of mental illness and its treatment. The tension between the duty to protect vulnerable individuals and the duty to perform human science will continue to grow, as long as ethics and science are seen as separable, opposing forces with different aims championed by different heroes. The profession of psychiatry is poised to move toward a new, more coherent research ethics paradigm in which scientific and

  16. Which is the best advanced MR imaging protocol for predicting recurrent metastatic brain tumor following gamma-knife radiosurgery: focused on perfusion method

    Energy Technology Data Exchange (ETDEWEB)

    Koh, Myeong Ju; Kim, Ho Sung; Choi, Choong Gon; Kim, Sang Joon [University of Ulsan College of Medicine, Asan Medical Center, Department of Radiology and Research Institute of Radiology, Songpa-Gu, Seoul (Korea, Republic of)

    2015-04-01

    High spatial resolution of dynamic contrast-enhanced (DCE) MR imaging allows characterization of heterogenous tumor microenvironment. Our purpose was to determine which is the best advanced MR imaging protocol, focused on additional MR perfusion method, for predicting recurrent metastatic brain tumor following gamma-knife radiosurgery (GKRS). Seventy-two consecutive patients with post-GKRS metastatic brain tumor were enrolled. Two readers independently calculated the percentile histogram cutoffs for normalized cerebral blood volume (nCBV) from dynamic susceptibility contrast (DSC) imaging and initial area under the time signal-intensity curve (IAUC) from DCE imaging, respectively. Area under the receiver operating characteristic curve (AUC) and interreader agreement were assessed. For differentiating tumor recurrence from therapy effect, adding DCE imaging to diffusion-weighted imaging (DWI) significantly improved AUC from 0.79 to 0.95 for reader 1 and from 0.80 to 0.96 for reader 2, respectively. There was no significant difference of AUC between the combination of DWI with DSC imaging and the combination of DWI with DCE imaging for both readers. With the combination of DWI and DCE imaging, the sensitivity and specificity were 86.7 and 88.1 % for reader 1 and 90.0 and 85.7 % for reader 2, respectively. The intraclass correlation coefficient (ICC) between readers was highest for calculation of the 90th percentile histogram cutoffs for IAUC (ICC, 0.87). Adding perfusion MR imaging to DWI significantly improves the prediction of recurrent metastatic tumor; however, the diagnostic performance is not affected by selection of either DSC or DCE MR perfusion method. (orig.)

  17. Vaccines Stop Illness

    Science.gov (United States)

    Skip Navigation Bar Home Current Issue Past Issues Vaccines Stop Illness Past Issues / Spring 2008 Table of ... meningitis won't infect, cripple, or kill children. Vaccine Safety In light of recent questions about vaccine ...

  18. Chronic Critical Illness

    Science.gov (United States)

    ... the patient’s situation and on the hospital and city. Do Chronically Critically Ill Patients Regain the Ability ... as the patient. You may feel stress, worry, sadness, or fatigue. Some families worry about financial burdens. ...

  19. Heat-Related Illnesses

    Medline Plus

    Full Text Available ... exhaustion symptoms include cool, moist, pale or flushed skin; headache; dizziness; weakness; feeling exhausted; heavy sweating; nausea; ... stage of heat illness) include flushed, hot, dry skin; fainting; a rapid, weak pulse; rapid, shallow breathing; ...

  20. Chronic Illness & Mental Health

    Science.gov (United States)

    ... is present. For More Information Share Chronic Illness & Mental Health Download PDF Download ePub Order a free hardcopy ... For more information, see the National Institute of Mental Health (NIMH) booklet on Depression at http://www.nimh. ...

  1. Heat-Related Illnesses

    Medline Plus

    Full Text Available ... for signs of heat stroke or exhaustion. Heat Stroke and Exhaustion Symptoms of early heat exhaustion symptoms ... heavy sweating; nausea; and giddiness. Symptoms of heat stroke (late stage of heat illness) include flushed, hot, ...

  2. Violence and Mental Illness

    OpenAIRE

    2008-01-01

    Violence attracts attention in the news media, in the entertainment business, in world politics, and in countless other settings. Violence in the context of mental illness can be especially sensationalized, which only deepens the stigma that already permeates our patients’ lives. Are violence and mental illness synonymous, connected, or just coincidental phenomena? This article reviews the literature available to address this fundamental question and to investigate other vital topics, includi...

  3. Nonthyroidal Illness (NTIs)

    OpenAIRE

    Nanny Natalia Mulyani Soetedjo

    2009-01-01

    Nonthyroidal illness (NTIs) can be described as abnormal findings on thyroid function tests that occur in the setting of a nonthyroidal illness (NTI) without preexisting hypothalamic-pituitary and thyroid gland dysfunction. After recovery from an NTI, these thyroid function test result abnormalities should be completely reversible. Multiple alterations in serum thyroid function test findings have been recognized in patients with a wide variety of NTI without evidence of preexisting thyroid or...

  4. Needs of people with severe mental illness

    NARCIS (Netherlands)

    Wiersma, D

    2006-01-01

    Objective: This study reviews conceptual and methodological issues of needs for care among people with severe mental illness (SMI) and presents data on their prevalence, correlates and consequences for mental health care. Method: Focus is on the definition of the concept of need as what people can b

  5. Myopathies in critical illness: characterization and nutritional aspects.

    Science.gov (United States)

    Burnham, Ellen L; Moss, Marc; Ziegler, Thomas R

    2005-07-01

    Myopathies related to critical illness have received increasing recognition over the past decade and are common in patients even after a brief period in the intensive care unit. Recent studies have revealed that myopathies in the critically ill may in fact be more prevalent than neuropathies and that morbidity and mortality may be greater. Protein catabolism, an increase in urinary nitrogen loss, and muscle wasting are observed in critical illness myopathy. Muscle biopsies in critically ill patients demonstrate low glutamine levels, low protein/DNA levels, and high concentrations of extracellular water. The increased flux of glutamine in muscle in these patients is thought to be insufficient to meet the body's requirement for glutamine, and thus in critical illness this amino acid may be classified as "conditionally essential." Three subtypes of critical illness myopathy have been described that are often grouped together as acute quadriplegic myopathy: thick-filament myopathy, critical illness myopathy, and necrotizing myopathy. These can be differentiated based on clinical features and muscle biopsy. Treatments for critical illness myopathies range from primary prevention, i.e., avoiding myopathy-inducing drugs, to novel nutritional therapies, such as glutamine and glutathione supplementation. One should be particularly vigilant for the development of myopathies in critically ill alcoholic patients, who may have a chronic alcoholic myopathy at baseline. In the past decade, advances have been made in characterizing and identifying patients with myopathies due to critical illness. However, additional studies must be performed in order to develop appropriate therapies for this potentially devastating disorder.

  6. [Creativity and mental illness].

    Science.gov (United States)

    Rihmer, Zoltán; Gonda, Xénia; Rihmer, Annamária

    2006-01-01

    It has been known for a long time that people with salient social and artistic creativity suffer more frequently from psychiatric illnesses than the average population. In their review paper, the authors assess the Hungarian and international scientific literature regarding the association of creativity and psychopathology. They conclude that contrary to the concept prevailing in the first part of the 20th century about the strong association between schizophrenia and creativity, the results of empirical research now unambiguously suggest that prominent social and artistic creativity is associated primarily with affective, and more specifically with bipolar affective illnesses. In addition, we already know that as regards the development of creativity, it is not the given affective (depressive, manic, hypomanic) episode which is important, but the hyperthymic or cyclothymic temperament structure which also predisposes for affective illness.

  7. Evaluating the systematic implementation of the 'Let Me Decide' advance care planning programme in long term care through focus groups: staff perspectives.

    LENUS (Irish Health Repository)

    Cornally, Nicola

    2015-11-01

    The \\'Let Me Decide\\' Advance Care Planning (LMD-ACP) programme offers a structured approach to End-of-Life (EoL) care planning in long-term care for residents with and without capacity to complete an advance care directive\\/plan. The programme was implemented in three homes in the South of Ireland, with a view to improving quality of care at end of life. This paper will present an evaluation of the systematic implementation of the LMD-ACP programme in the homes.

  8. Impact of childhood chronic illnesses on siblings: a literature review.

    LENUS (Irish Health Repository)

    O' Brien, Irene

    2012-02-01

    BACKGROUND: Childhood illness can have a significant impact on families, particularly on the ill child\\'s siblings. There is a dearth of published literature focusing on the needs of siblings of ill children. AIM: This literature review aims to provide an overview of the current healthcare literature in relation to the impact of childhood chronic illness or disability on siblings. METHOD: A literature review was undertaken by searching the databases CINAHL, PsycINFO, ProQuest and Cochrane Library for relevant articles in English using the search terms: \\'siblings\\

  9. Long-term survival after gemcitabine and cisplatin in patients with locally advanced transitional cell carcinoma of the bladder: focus on supplementary treatment strategies

    DEFF Research Database (Denmark)

    Als, Anne Birgitte; Sengelov, Lisa; von der Maase, Hans

    2007-01-01

    OBJECTIVE: The objective was to evaluate response and survival, as well as efficacy of subsequent supplementary treatment and follow-up strategy in patients with locally advanced transitional cell carcinoma of the bladder following combination chemotherapy with gemcitabine and cisplatin (GC...

  10. Scaffolding Online Discourse in Collaborative Ill-Structured Problem-Solving for Innovation

    Directory of Open Access Journals (Sweden)

    Deller James FERREIRA

    2009-09-01

    Full Text Available This work highlights the importance of verbal creativity, providing a productive online discourse definition, in which students intertwine convergent and divergent thinking by means of a transactional and controversial dialog. Developing the formulated productive online discourse definition, it is also presented and evaluated, an original scaffolding process designed here to further collaborative knowledge building, during ill-structured problem-solving, focusing on creativity and innovation. Evidence from qualitative online discourse analysis indicated an improvement in the knowledge building processes, and knowledge advancement and deepening after teacher's scaffolding.

  11. Mental Illness And Brain Disease.

    Science.gov (United States)

    Bedrick, Jeffrey D

    2014-01-01

    It has become common to say psychiatric illnesses are brain diseases. This reflects a conception of the mental as being biologically based, though it is also thought that thinking of psychiatric illness this way will reduce the stigma attached to psychiatric illness. If psychiatric illnesses are brain diseases, however, it is not clear why psychiatry should not collapse into neurology, and some argue for this course. Others try to maintain a distinction by saying that neurology deals with abnormalities of neural structure while psychiatry deals with specific abnormalities of neural functioning. It is not clear that neurologists would accept this division, nor that they should. I argue that if we take seriously the notion that psychiatric illnesses are mental illnesses we can draw a more defensible boundary between psychiatry and neurology. As mental illnesses, psychiatric illnesses must have symptoms that affect our mental capacities and that the sufferer is capable of being aware of, even if they are not always self-consciously aware of them. Neurological illnesses, such as stroke or multiple sclerosis, may be diagnosed even if they are silent, just as the person may not be aware of having high blood pressure or may suffer a silent myocardial infarction. It does not make sense to speak of panic disorder if the person has never had a panic attack, however, or of bipolar disorder in the absence of mood swings. This does not mean psychiatric illnesses are not biologically based. Mental illnesses are illnesses of persons, whereas other illnesses are illnesses of biological individuals.

  12. Foodborne Illness Retrospective

    Centers for Disease Control (CDC) Podcasts

    2015-05-07

    Dr. Paul Mead and Dr. Peter Drotman discuss the historic October 1999 article, Food-related Illness and Death in the United States.  Created: 5/7/2015 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 5/7/2015.

  13. The nonthyroidal illness syndrome.

    Science.gov (United States)

    Adler, Suzanne Myers; Wartofsky, Leonard

    2007-09-01

    This article briefly summarizes thyroid function alterations generally seen in the euthyroid sick syndrome, provides an overview of specific thyroidal adaptations during several clinical conditions and secondary to specific pharmacologic agents, and discusses the current controversy in thyroid hormone treatment of nonthyroidal illness.

  14. High-Altitude Illness

    Science.gov (United States)

    ... also called HAPE), which affects the lungsHigh-altitude cerebral edema (also called HACE), which affects the brainThese illnesses ... HAPE, high altitude, high altitude sickness, high-altitude cerebral edema, high-altitude pulmonary edema, hypobaropathy, mountain sickness, nifedipine, ...

  15. Illness anxiety disorder

    Science.gov (United States)

    ... a serious disease is unreasonable or unfounded. Illness anxiety disorder is different from somatic symptom disorder. With somatic symptom disorder, the person has physical pain or other symptoms, but the medical cause is not found. Exams and Tests The doctor or nurse will examine you and ...

  16. Critical-Illness Polyneuropathy

    OpenAIRE

    J Gordon Millichap

    1993-01-01

    A review of the neurological complications of sepsis from the University of Western Ontario, London, and Queen’s University, Kingston, Ontario, Canada, draws attention to “critical-illness polyneuropathy” as a cause of difficulty in weaning from the ventilator.

  17. Diagnostic Categories in Autobiographical Accounts of Illness.

    Science.gov (United States)

    Kelly, Michael P

    2015-01-01

    Working within frameworks drawn from the writings of Immanuel Kant, Alfred Schutz, and Kenneth Burke, this article examines the role that diagnostic categories play in autobiographical accounts of illness, with a special focus on chronic disease. Four lay diagnostic categories, each with different connections to formal medical diagnostic categories, serve as typifications to make sense of the way the lifeworld changes over the course of chronic illness. These diagnostic categories are used in conjunction with another set of typifications: lay epidemiologies, lay etiologies, lay prognostics, and lay therapeutics. Together these serve to construct and reconstruct the self at the center of the lifeworld. Embedded within the lay diagnostic categories are narratives of progression, regression, or stability, forms of typification derived from literary and storytelling genres. These narratives are developed by the self in autobiographical accounts of illness.

  18. Brainstorm: occupational choice, bipolar illness and creativity.

    Science.gov (United States)

    Tremblay, Carol Horton; Grosskopf, Shawna; Yang, Ke

    2010-07-01

    Although economists have analyzed earnings, unemployment, and labor force participation for those with bipolar illness, occupational choice has yet to be explored. Psychological and medical studies often suggest an association between bipolar illness and creative achievement, but they tend to focus on eminent figures, case studies, or small samples. We seek to examine occupational creativity of non-eminent individuals with bipolar disorder. We use Epidemiologic Catchment Area data to estimate a multinomial logit model matched to an index of occupational creativity. Those with bipolar illness appear to be disproportionately concentrated in the most creative occupational category. Nonparametric kernel density estimates reveal that the densities of the occupational creativity variable for the bipolar and non-bipolar individuals significantly differ in the ECA data, and suggest that the probability of engaging in creative activities on the job is higher for bipolar than non-bipolar workers.

  19. Narrow zone heating by a new radiation focusing technique - Toroidal ellipsoid furnace. [for zone leveling and crystal growth in advanced multicomponent semiconductors

    Science.gov (United States)

    Davidson, M. C.; Holland, L. R.

    1978-01-01

    The paper describes the design of a toroidal ellipsoid furnace for narrow zone heating of materials in sealed transparent ampoules. The heater is a toroid flattened to an elliptical cross section like a partially inflated inner tube resting on a horizontal surface. The foci of the ellipsoid are two concentric rings. The outer focus is occupied by a heater wire, and the inner focus is arranged to fall on the surface of the cylindrical ingot within its transparent capsule. One advantage of the new furnace is that the wire heater closely approximates the ideal shape, lying along an extended line focus, as opposed to the elusive point source of the Costello furnace. Also, the ingot is heated uniformly around its circumference.

  20. Disparities in oral cancer survival among mentally ill patients.

    Directory of Open Access Journals (Sweden)

    Ting-Shou Chang

    Full Text Available BACKGROUND: Many studies have reported excess cancer mortality in patients with mental illness. However, scant studies evaluated the differences in cancer treatment and its impact on survival rates among mentally ill patients. Oral cancer is one of the ten most common cancers in the world. We investigated differences in treatment type and survival rates between oral cancer patients with mental illness and without mental illness. METHODS: Using the National Health Insurance (NHI database, we compared the type of treatment and survival rates in 16687 oral cancer patients from 2002 to 2006. The utilization rate of surgery for oral cancer was compared between patients with mental illness and without mental illness using logistic regression. The Cox proportional hazards model was used for survival analysis. RESULTS: Oral cancer patients with mental disorder conferred a grave prognosis, compared with patients without mental illness (hazard ratios [HR] = 1.58; 95% confidence interval [CI] = 1.30-1.93; P<0.001. After adjusting for patients' characteristics and hospital characteristics, patients with mental illness were less likely to receive surgery with or without adjuvant therapy (odds ratio [OR] = 0.47; 95% CI = 0.34-0.65; P<0.001. In multivariate analysis, oral cancer patients with mental illness carried a 1.58-times risk of death (95% CI = 1.30-1.93; P<0.001. CONCLUSIONS: Oral cancer patients with mental illness were less likely to undergo surgery with or without adjuvant therapy than those without mental illness. Patients with mental illness have a poor prognosis compared to those without mental illness. To reduce disparities in physical health, public health strategies and welfare policies must continue to focus on this vulnerable group.

  1. HIGH-ALTITUDE ILLNESS

    Directory of Open Access Journals (Sweden)

    Dwitya Elvira

    2015-05-01

    Full Text Available AbstrakHigh-altitude illness (HAI merupakan sekumpulan gejala paru dan otak yang terjadi pada orang yang baru pertama kali mendaki ke ketinggian. HAI terdiri dari acute mountain sickness (AMS, high-altitude cerebral edema (HACE dan high-altitude pulmonary edema (HAPE. Tujuan tinjauan pustaka ini adalah agar dokter dan wisatawan memahami risiko, tanda, gejala, dan pengobatan high-altitude illness. Perhatian banyak diberikan terhadap penyakit ini seiring dengan meningkatnya popularitas olahraga ekstrim (mendaki gunung tinggi, ski dan snowboarding dan adanya kemudahan serta ketersediaan perjalanan sehingga jutaan orang dapat terpapar bahaya HAI. Di Pherice, Nepal (ketinggian 4343 m, 43% pendaki mengalami gejala AMS. Pada studi yang dilakukan pada tempat wisata di resort ski Colorado, Honigman menggambarkan kejadian AMS 22% pada ketinggian 1850 m sampai 2750 m, sementara Dean menunjukkan 42% memiliki gejala pada ketinggian 3000 m. Aklimatisasi merupakan salah satu tindakan pencegahan yang dapat dilakukan sebelum pendakian, selain beberapa pengobatan seperti asetazolamid, dexamethasone, phosopodiestrase inhibitor, dan ginko biloba.Kata kunci: high-altitude illness, acute mountain sickness, edema cerebral, pulmonary edema AbstractHigh-altitude illness (HAI is symptoms of lung and brain that occurs in people who first climb to altitude. HAI includes acute mountain sickness (AMS, high-altitude cerebral edema (HACE and high altitude pulmonary edema (HAPE. The objective of this review was to understand the risks, signs, symptoms, and treatment of high-altitude illness. The attention was given to this disease due to the rising popularity of extreme sports (high mountain climbing, skiing and snowboarding and the ease and availability of the current travelling, almost each year, millions of people could be exposed to the danger of HAI. In Pherice, Nepal (altitude 4343 m, 43% of climbers have symptoms of AMS. Furthermore, in a study conducted at sites in

  2. Critical illness neuropathy

    Directory of Open Access Journals (Sweden)

    Vijayan J

    2005-01-01

    Full Text Available The neuromuscular syndrome of acute limb and respiratory weakness that commonly accompanies patients with multi-organ failure and sepsis constitutes critical illness polyneuropathy. It is a major cause of difficulty in weaning off the patient from the ventilator after respiratory and cardiac causes have been excluded. It is usually an axonal motor-sensory polyneuropathy, and is usually associated with or accompanied with a coma producing septic encephalopathy. The neuropathy is usually not apparent until the patient′s encephalopathy has peaked, and may be noted only when the brain dysfunction is resolving. Patients usually have a protracted hospital course complicated by multi-organ failure and the systemic inflammatory response syndrome. Elevated serum glucose levels and reduced albumin are risk factors for nerve dysfunction, as is prolonged intensive care unit stay. Polyneuropathy may develop after only one week of the systemic inflammatory response syndrome, but the frequency tends to correlate with the duration of the severe illness.

  3. Nonthyroidal Illness (NTIs

    Directory of Open Access Journals (Sweden)

    Nanny Natalia Mulyani Soetedjo

    2009-09-01

    Full Text Available Nonthyroidal illness (NTIs can be described as abnormal findings on thyroid function tests that occur in the setting of a nonthyroidal illness (NTI without preexisting hypothalamic-pituitary and thyroid gland dysfunction. After recovery from an NTI, these thyroid function test result abnormalities should be completely reversible. Multiple alterations in serum thyroid function test findings have been recognized in patients with a wide variety of NTI without evidence of preexisting thyroid or hypothalamic-pituitary disease. The most prominent alterations are low serum triiodothyronine (T3 and elevated reverse T3 (rT3, leading to the general term low T3 syndrome. Thyroid-stimulating hormone (TSH, thyroxine (T4, and free T4 also are affected in variable degrees based on the severity and duration of the NTI. It cannot diagnosed NTIs only by measure one thyroid hormone. As the severity of the NTI increases, both serum T3 and T4 levels drop and gradually normalize as the patient recovers. It's still be an argument for administration of replacement T3 and T4 hormone in patients with NTIS. However, it is impossible to be certain at this time that it is beneficial to replace hormone, or whether this could be harmful. Only a prospective study will be adequate to prove this point, and probably this would need to involve hundreds of patients. Ongoing studies document the beneficial effects of replacement of other hormones in these acutely and severely ill patients.

  4. Exercise Prevents Mental Illness

    Science.gov (United States)

    Purnomo, K. I.; Doewes, M.; Giri, M. K. W.; Setiawan, K. H.; Wibowo, I. P. A.

    2017-03-01

    Multiple current studies show that neuroinflammation may contribute to mental illness such as depression, anxiety, and mood disorder. Chronic inflammation in peripheral tissues is indicated by the increase of inflammatory marker like cytokine IL-6, TNF-α, and IL-1β. Pro-inflammatory cytokine in peripheral tissues can reach brain tissues and activate microglia and it causes neuroinflammation. Psychological stress may led peripheral and central inflammation. Activated microglia will produce pro-inflammatory cytokine, ROS, RNS, and tryptophan catabolizes. This neuroinflammation can promote metabolism changes of any neurotransmitter, such as serotonin, dopamine, and glutamate that will influence neurocircuit in the brain including basal ganglia and anterior cingulated cortex. It leads to mental illness. Exercise give contribution to reduce tissue inflammation. When muscle is contracting in an exercise, muscle will produce the secretion of cytokine like IL-6, IL-1ra, and IL-10. It will react as anti-inflammation and influence macrophage, T cell, monosit, protein Toll-Like Receptor (TLR), and then reduce neuroinflammation, characterised by the decrease of pro-inflammatory cytokine and prevent the activation of microglia in the brain. The objective of the present study is to review scientific articles in the literature related to the contribution of exercise to prevent and ease mental illness.

  5. The Stigma of Mental Illness

    Science.gov (United States)

    Overton, Stacy L.; Medina, Sondra L.

    2008-01-01

    Stigma surrounding major mental illness creates many barriers. People who experience mental illness face discrimination and prejudice when renting homes, applying for jobs, and accessing mental health services. The authors review the current literature regarding stigma and mental illness. They define stigma and review theories that explain its…

  6. A NARRATIVE: MEDITATION IN THE LIVES OF CHILDREN WITH CHRONIC ILLNESS

    Directory of Open Access Journals (Sweden)

    Taunya WIDEMAN-JOHNSTON

    2012-01-01

    Full Text Available The presence of chronic illness in one’s life often entails endless appointments, tests, medications, treatments, and procedures. In the instances of children with chronic illness, they do not know what life consists of without their illness, and consequently, have lived with many restrictions. Children with chronic illness and their families are not only in need of traditional methods and strategies from the medical model but are often in need of additional strategies to support and cope with the nature and effects of the chronic illness. This paper focuses on how mediation, mindfulness, and visualization strategies aid individuals with chronic illness.

  7. 聚焦专业技能,培养应用型高级秘书人才%Focus on Professinal Skills and Train Pragmatic Advanced Secretarial Talents

    Institute of Scientific and Technical Information of China (English)

    张媛媛

    2013-01-01

    在秘书教育与培训中,要走内涵式发展道路,培养应用型高级秘书人才所需要重视培养五方面秘书在实际工作中的业务能力,即书面表达能力、口头表达能力、信息处理能力、协调和社交能力和独立办事能力。%There are five aspects of professional ability in secretarial work need to be more cultivated and more practised .T he five aspects are w ritten and spoken ability 、information processing ability 、good so-ciability and communication skill ,ability to work independently .The sevretavial training program should develop its connotation course and train more people with pragmatic advanced secretarial skills .

  8. Psychotherapy for depression among patients with advanced cancer.

    Science.gov (United States)

    Akechi, Tatsuo

    2012-12-01

    Cancer causes profound suffering for patients, and previous reports have demonstrated that psychological distress, particularly depression, is frequently observed in advanced and/or terminally ill cancer patients. Such depression can lead to serious and far-reaching negative consequences in patients with advanced cancer: reducing their quality of life and causing severe suffering, a desire for early death, and suicide, as well as psychological distress in family members. For the management of their distress, cancer patients are more likely to prefer psychotherapeutic interventions to pharmacotherapy, and psychotherapy is known to be effective for the management of depression among advanced cancer patients. Hence, psychotherapy is an important treatment strategy for alleviating their depression. Furthermore, patients with advanced and/or terminal cancer suffer from various physical symptoms and are forced to face a continuous decline in physical function. In addition, psychological defense mechanisms such as denial are frequently observed in these patients. Hence, an individually tailored and careful psychotherapeutic approach should be followed, which considers the specific nature of the advanced and/or terminal cancer. This review focuses on psychological interventions that can be utilized in the clinical oncology practice to ameliorate depression among advanced and/or terminally ill cancer patients, rather than focusing on the level of evidence for each intervention. In addition, the current review introduces some novel therapeutic strategies that have not yet been proved to be effective but show promise for future studies.

  9. Ion focusing

    Energy Technology Data Exchange (ETDEWEB)

    Cooks, Robert Graham; Baird, Zane; Peng, Wen-Ping

    2017-01-17

    The invention generally relates to apparatuses for focusing ions at or above ambient pressure and methods of use thereof. In certain embodiments, the invention provides an apparatus for focusing ions that includes an electrode having a cavity, at least one inlet within the electrode configured to operatively couple with an ionization source, such that discharge generated by the ionization source is injected into the cavity of the electrode, and an outlet. The cavity in the electrode is shaped such that upon application of voltage to the electrode, ions within the cavity are focused and directed to the outlet, which is positioned such that a proximal end of the outlet receives the focused ions and a distal end of the outlet is open to ambient pressure.

  10. ILL Annual report 97

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-12-31

    In 1997 the reactor operated for the planned 225 days and more than 750 experiments were carried out. Among the experimental highlights are 2 contrasting examples of the new types of experiments now possible using the new high-intensity diffractometer D2O: stroboscopic measurements of kinetic processes and rapid texture measurements of structural materials. Some early results from the new high-resolution gamma spectrometer in the study of nuclear structure are also presented. Another new facility is just coming into service: the 2{pi} image-plate detector LADI, optimised for Laue measurements on biological crystals. The contrast between biological experiments and for example those on superconductivity or neutron {beta}-decay, illustrates very well the range of scientific questions addressed through the use of ILL`s neutron beams. 30 brief accounts of research work achieved during this year are given, they are classified under 9 topics: polymers and colloids, chemistry and structure, biology, materials science, liquids and glasses, magnetism, strongly correlated electron systems, quantum systems, nuclear and fundamental physics. The scheduled new developments are described and a list of the publications is also given

  11. The stigma of mental illness

    OpenAIRE

    Kordosi A; Saridi M; Souliotis K

    2015-01-01

    Introduction:The stigma of mental illness is not a modern phenomenon, but it can now be approached scientifically. The stigma, because of the mental illness which characterizes a person, can be explained by the natural propensity of man to deliver biased and stereotyped estimates to phenomena he cannot explain, accept or face. Methodology:This study is an attempt to describe the concept of stigma and the impact of the stigma of mental illness in the personal and social life of the...

  12. Subjective Illness theory and coping

    Directory of Open Access Journals (Sweden)

    Gessmann H.-W.

    2015-03-01

    Full Text Available The article presents a view of a problem of subjective illness theory in context of coping behavior. The article compiles the results of the latest studies of coping; discloses the way subjective illness theory affects the illness coping and patient's health; presents the study of differences in coping behaviour of patients at risk of heart attack and oncology. The article is recommended for specialists, concerned with psychological reasons of pathogenic processes and coping strategies of patients.

  13. Without 'Focus'

    Directory of Open Access Journals (Sweden)

    Aldo Sevi

    2010-12-01

    Full Text Available It is widely accepted that a notion of 'focus', more or less as conceived of in Jackendoff (1972, must be incorporated into our theory of grammar, as a means of accounting for certain observed correlations between prosodic facts and semantic/pragmatic facts. In this paper, we put forth the somewhat radical idea that the time has come to give up this customary view, and eliminate 'focus' from our theory of grammar. We argue that such a move is both economical and fruitful.Research over the years has revealed that the correlations between prosody, 'focus', and the alleged semantic/pragmatic effects of focus are much less clear and systematic than we may have initially hoped. First we argue that this state of affairs detracts significantly from the utility of our notion of 'focus', to the point of calling into question the very motivation for including it in the grammar. Then we look at some of the central data, and show how they might be analyzed without recourse to a notion of 'focus'. We concentrate on (i the effect of pitch accent placement on discourse congruence, and (ii the choice of 'associate' for the so-called 'focus sensitive' adverb only. We argue that our focus-free approach to the data improves empirical coverage, and begins to reveal patterns that have previously been obscured by preconceptions about 'focus'.ReferencesBeaver, D. & Clark, B. 2008. Sense and Sensitivity: How Focus Determines Meaning. Blackwell.Beaver, D., Clark, B., Flemming, E., Jaeger, T. F. & Wolters, M. 2007. ‘When semantics meets phonetics: Acoustical studies of second occurrence focus’. Language 83.2: 245–76.http://dx.doi.org/10.1353/lan.2007.0053Beckman, M. & Hirschberg, J. 1994. ‘The ToBI Annotation Conventions’. Ms.,http://www.cs.columbia.edu/~julia/files/conv.pdf.Bolinger, D. 1972. ‘Accent is predictable (if you are a mind-reader’. Language 48.3: 633–44.http://dx.doi.org/10.2307/412039Büring, D. 2006. ‘Focus projection and default

  14. Siblings of the Child with a Life-Threatening Illness.

    Science.gov (United States)

    Sourkes, Barbara M.

    1987-01-01

    The experience of siblings of a child with a life-threatening illness may be seen at the juncture of the following perspectives: (1) the family system; (2) a focus on living rather than on dying; and (3) a view toward positive adaptation rather than toward psychopathology. The most critical focus is on the sibling-patient relationship itself. (BJV)

  15. Protein requirement in critical illness.

    Science.gov (United States)

    Hoffer, Leonard John

    2016-05-01

    How much protein do critically ill patients require? For the many decades that nutritional support has been used there was a broad consensus that critically ill patients need much more protein than required for normal health. Now, however, some clinical investigators recommend limiting all macronutrient provision during the early phase of critical illness. How did these conflicting recommendations emerge? Which of them is correct? This review explains the longstanding recommendation for generous protein provision in critical illness, analyzes the clinical trials now being claimed to refute it, and concludes with suggestions for clinical investigation and practice.

  16. Barriers to involvement in physical activities of persons with mental illness.

    Science.gov (United States)

    Shor, Ron; Shalev, Anat

    2016-03-01

    Participating in physical activities could be essential for reducing the multiple risk factors for health problems that persons with severe mental illness (SMI) may suffer. However, people with SMI are significantly less active than the general population. To develop knowledge about factors related to the perceived barriers hindering this population's participation in physical activities and the benefits this participation would have, a study was conducted in Israel with 86 people with mental illness living in community mental health facilities prior to their participation in a health promotion program. A mixed method was implemented and included: a scale designed to measure participants' perceptions of the barriers to and benefits of involvement in physical activities; instruments focusing on bio-psycho-social factors that may affect the level of barriers experienced; and personal interviews. The findings revealed high ranking for accessibility barriers hindering the participation in physical activities. Bio-psycho-social factors stemming from the participants' mental health, such as level of depression, were correlated with higher ranking of accessibility barriers. Bio-psycho-social factors reflecting positive mental health and health, such as positive appraisal of body weight, were correlated with lower ranking of accessibility barriers. Other barriers may include organizational and broader systemic barriers in the mental health facilities where the participants reside. These findings illuminate the need to consider the unique challenges that persons with mental illness may face in any attempt to advance their involvement in physical activity.

  17. [Nutrition in critical illness].

    Science.gov (United States)

    Ökrös, Ilona

    2014-12-21

    Critically ill patients are often unable to eat by themselves over a long period of time, sometimes for weeks. In the acute phase, serious protein-energy malnutrition may develop with progressive muscle weakness, which may result in assisted respiration of longer duration as well as longer stay in intensive care unit and hospital. In view of the metabolic processes, energy and protein intake targets should be defined and the performance of metabolism should be monitored. Enteral nutrition is primarily recommended. However, parenteral supplementation is often necessary because of the disrupted tolerance levels of the gastrointestinal system. Apparently, an early parenteral supplementation started within a week would be of no benefit. Some experts believe that muscle loss can be reduced by increased target levels of protein. Further studies are needed on the effect of immune system feeding, fatty acids and micronutrients.

  18. Attributing illness to food

    DEFF Research Database (Denmark)

    Batz, M. B.; Doyle, M. P.; Morris, J. G.

    2005-01-01

    Identification and prioritization of effective food safety interventions require an understanding of the relationship between food and pathogen from farm to consumption. Critical to this cause is food attribution, the capacity to attribute cases of foodborne disease to the food vehicle or other...... source responsible for illness. A wide variety of food attribution approaches and data are used around the world including the analysis of outbreak data, case-control studies, microbial subtyping and source tracking methods, and expert judgment, among others. The Food Safety Research Consortium sponsored...... the Food Attribution Data Workshop in October 2003 to discuss the virtues and limitations of these approaches and to identify future options for collecting food attribution data in the United States. We summarize workshop discussions and identify challenges that affect progress in this critical component...

  19. Heat Illness in Football: Current Concepts.

    Science.gov (United States)

    Krohn, Austin R; Sikka, Robby; Olson, David E

    2015-01-01

    Despite growing health and safety concerns, American football remains a vastly popular sport in the United States. Unfortunately, even with increased efforts in promoting education and hydration, the incidence of death from exertional heat stroke continues to rise. General risk factors such as hydration status, obesity, fitness level, and football-specific risk factors such as timing of training camp and equipment all contribute to the development of heat illness. At the professional level, changes have been made to effectively reduce mortality from heat stroke with no deaths since August 2001. However, there have been at least 33 total deaths at the high school and collegiate levels since this time. More efforts need to be focused at these levels to mandate exertional heat illness prevention guidelines in order to reverse this trend of mortality in our younger athletes.

  20. Focused ultrasound in ophthalmology

    Directory of Open Access Journals (Sweden)

    Silverman RH

    2016-09-01

    Full Text Available Ronald H Silverman1,2 1Department of Ophthalmology, Columbia University Medical Center, 2F.L. Lizzi Center for Biomedical Engineering, Riverside Research, New York, NY, USA Abstract: The use of focused ultrasound to obtain diagnostically significant information about the eye goes back to the 1950s. This review describes the historical and technological development of ophthalmic ultrasound and its clinical application and impact. Ultrasound, like light, can be focused, which is crucial for formation of high-resolution, diagnostically useful images. Focused, single-element, mechanically scanned transducers are most common in ophthalmology. Specially designed transducers have been used to generate focused, high-intensity ultrasound that through thermal effects has been used to treat glaucoma (via cilio-destruction, tumors, and other pathologies. Linear and annular transducer arrays offer synthetic focusing in which precise timing of the excitation of independently addressable array elements allows formation of a converging wavefront to create a focus at one or more programmable depths. Most recently, linear array-based plane-wave ultrasound, in which the array emits an unfocused wavefront and focusing is performed solely on received data, has been demonstrated for imaging ocular anatomy and blood flow. While the history of ophthalmic ultrasound extends back over half-a-century, new and powerful technologic advances continue to be made, offering the prospect of novel diagnostic capabilities. Keywords: ophthalmic ultrasound, ultrasound biomicroscopy (UBM, high-intensity focused ultrasound (HIFU, ultrafast imaging, Doppler imaging 

  1. Aspects of spirituality concerning illness

    NARCIS (Netherlands)

    van Leeuwen, Rene; Tiesinga, Lucas J.; Jochemasen, Henk; Post, Doeke

    2007-01-01

    The spiritual dimension of illness, health and care may be seen as a unique aspect in addition to the physical, mental and social dimension. This contribution describes experiences of patients, nurses and hospital chaplains in relation to the spiritual aspects of being ill. Qualitative research was

  2. Water Recreation and Illness Severity

    Science.gov (United States)

    Abstract Background: The health endpoint of prior studies of water recreation has been the occurrence gastrointestinal (GI) of illness. The use of this dichotomous health outcome fails to take into account the range of symptom severity among those with GI illness, as well as thos...

  3. Staging of unipolar affective illness

    Directory of Open Access Journals (Sweden)

    Ewa Ferensztajn

    2014-12-01

    Full Text Available In this article, a concept of staging of unipolar affective illness (recurrent depression is presented. In respective subchapters, three most important aspects of this issue have been discussed: 1 staging of unipolar affective illness; 2 staging of treatment-resistant depression; and 3 conversion of unipolar into bipolar affective illness. The evidence for so called neuroprogression of the illness, accumulated in recent years, has allowed for a classification of staging based on a concept of allostasis and allostatic load. In the course of illness, changes in neuroendocrine system (mainly hypothalamic pituitary-adrenal (HPA axis, immunological system, mechanisms of oxidative stress, neurotransmitters, neurotrophic factors as well as structural and functional changes of the brain occur. In their paper of 2007, Fava and Tossani elaborated a concept of staging of unipolar affective illness presenting a continuum model of five consecutive stages with specific clinical features. In the present paper, a concept of treatment-resistant depression and staging of treatment resistance is presented in the context of several models. An important determinant of treatment-resistant depression is so called subthreshold bipolarity which is connected with worse efficacy of antidepressant drugs. In the course of illness, there is a possibility of changing diagnosis from recurrent depression into bipolar affective illness. The studies on this issue show that frequency of such diagnostic conversion is 1,5% of depressed patients per year.

  4. Focus: Digital

    DEFF Research Database (Denmark)

    Technology has been an all-important and defining element within the arts throughout the 20th century, and it has fundamentally changed the ways in which we produce and consume music. With this Focus we investigate the latest developments in the digital domain – and their pervasiveness and rapid...... production and reception of contemporary music and sound art. With ‘Digital’ we present four composers' very different answers to how technology impact their work. To Juliana Hodkinson it has become an integral part of her sonic writing. Rudiger Meyer analyses the relationships between art and design and how...

  5. The Future of Psychotherapy for Mentally Ill Children and Adolescents

    Science.gov (United States)

    March, John S.

    2009-01-01

    Objective: Given striking advances in translational developmental neuroscience and its convergence with developmental psychopathology and developmental epidemiology, it is now clear that mental illnesses are best thought of as neurodevelopmental disorders. This simple fact has enormous implications for the nature and organization of psychotherapy…

  6. 巷道聚焦电流法超前探测的三维有限元数值模拟%3D finite element numerical simulation of advanced detection in roadway for DC focus method

    Institute of Scientific and Technical Information of China (English)

    邓小康; 柳建新; 刘海飞; 童孝忠; 柳卓

    2013-01-01

    Within the roadway advanced detection methods, DC resistivity method has an extensive application because of its simple principle and operation. Numerical simulation of the effect of focusing current on advanced detection was carried out using a three-dimensional finite element method (FEM), meanwhile the electric-field distribution of the point source and nine-point power source were calculated and analyzed with the same electric charges. The results show that the nine-point power source array has a very good ability to focus, and the DC focus method can be used to predict the aquifer abnormality body precisely. By comparing the FEM modelling results with physical simulation results from soil sink, it is shown that the accuracy of forward simulation meets the requirement and the artificial disturbance from roadway has no impact on the DC focus method.%  在巷道超前探测的方法中,电阻率法由于原理简单、操作方便,有着很好的应用前景。运用三维有限元法对聚焦电流法的超前预报效果进行数值模拟,计算和分析点电源和九点式电源在供相同电流的情况下电场的分布情况。结果表明:九点式布极方式有很好的聚焦能力,聚焦电流法能准确地发现掘进面前方含水异常体。将数值模拟和物理土槽试验进行对比,正演模拟精度符合要求,巷道中的人为干扰对聚焦电流法超前探测没有影响。

  7. Youth blogging and serious illness.

    Science.gov (United States)

    Nesby, Linda; Salamonsen, Anita

    2016-03-01

    In recent years, a growing number of young people who experience illness tend to blog about it. In this paper, we question whether and how illness blogs illustrate the intercommunicative aspect of blogging by bringing forth both the literary concept of the implied reader and the sociological concepts of empowerment and agency in the analysis. We argue that young people blogging about serious illness demonstrate the inherent intercommunicative potential of blogging. We also argue that youth blogging about serious illness may represent a fruitful strategy for ill young people to create meaning, stay front-stage in youth communities and build self-esteem and confidence out of chaos. Furthermore, we argue that these blogs may contribute rather unique experience-based knowledge and reflections about existential issues to other young blog readers, who may otherwise not get access to this aspect of life. Youth blogging about serious illness thereby reflects a patient group so far not very visible and through the genre youth stand out as more competent when it comes to illness and healthcare issues than what is often presumed.

  8. Psychology and theology meet: illness appraisal and spiritual coping.

    Science.gov (United States)

    Baldacchino, Donia R; Borg, Josette; Muscat, Charlene; Sturgeon, Cassandra

    2012-10-01

    This descriptive exploratory study explored illness appraisal and spiritual coping of three groups of individuals with life-threatening illness. These were hospice clients with cancer (Ca; n = 10), clients with first myocardial infarction (MI; n = 6), and parents of children with cystic fibrosis (CF; n = 16). Qualitative data were collected by audiotaped face-to-face interviews (parents) and focus groups (MI and Ca). Similarities in illness appraisal and spiritual coping were found across the three groups except appreciation of crafts, which was found only in clients with Ca and causal meaning of parents (CF). Overall, illness was appraised negatively and positively, whereas spiritual coping incorporated existential and religious coping. These findings confirm the psychological theory (Lazarus & Folkman, 1984) and theological theory (Otto, 1950), which guided this study. Recommendations were proposed to integrate spirituality and religiosity in the curricula, clinical practice and to conduct cross-cultural comparative longitudinal research.

  9. [Non thyroidal illnesses (NTIS)].

    Science.gov (United States)

    Luca, F; Goichot, B; Brue, T

    2010-09-01

    Abnormalities in the circulating levels of thyroid hormones, without evidence of coexisting thyroid or pituitary gland disease can be observed in all general diseases. These nonthyroidal illnesses (NTIS) are the result of complex mechanisms that combine the effect of some drugs, cytokines, nutritional and endocrine factors at all levels of the thyrotropic axis, from the hypothalamus to the cellular transporters and nuclear receptors of thyroid hormones. The patterns of NTIS depend on the underlying disease and its severity. Thirtyfive years after the initial description, the pathophysiological significance of these anomalies remains controversial. One of the dilemma of NTIS is whether the hormone responses represent an adaptive and normal, physiologic response to conserve energy and protect against hypercatabolism in case of aggression, or whether it is a maladaptive response contributing to a worsening of the disease. This debate is not just a theoretical question, because in the first case the process must be respected, in the other case a vigorous treatment to restore circulating thyroid hormone levels is justified. There have been very few clinical studies designed to address whether the substitution with thyroid hormone is advantageous, and there is at current time no permissive evidence for the use of thyroid hormone replacement in patients with NTIS. But the clinical context, the choice of the molecule or of the dose and the way of administration were not necessarily the most relevant. Theoretically, stimulation of thyreotrope axis used a continuous infusion of TRH seems to provide clinical benefit. With the expectation that randomized clinical trials will provide demonstration of NTIS treatment efficiency, the question might remain unanswered for several more years.

  10. Advanced nanoelectronics

    CERN Document Server

    Ismail, Razali

    2012-01-01

    While theories based on classical physics have been very successful in helping experimentalists design microelectronic devices, new approaches based on quantum mechanics are required to accurately model nanoscale transistors and to predict their characteristics even before they are fabricated. Advanced Nanoelectronics provides research information on advanced nanoelectronics concepts, with a focus on modeling and simulation. Featuring contributions by researchers actively engaged in nanoelectronics research, it develops and applies analytical formulations to investigate nanoscale devices. The

  11. Student Attitudes Toward Mental Illness

    Science.gov (United States)

    Hare-Mustin, Rachel T.; Garvine, Richard

    1974-01-01

    Inquiry into the initial attitudes toward mental illness of students taking an abnormal psychology class indicates students' concerns and preconceptions and provides a basis for shaping the course to respond to student needs. (JH)

  12. Transfusion in critically ill children

    DEFF Research Database (Denmark)

    Secher, E L; Stensballe, J; Afshari, A

    2013-01-01

    Transfusion of blood products is a cornerstone in managing many critically ill children. Major improvements in blood product safety have not diminished the need for caution in transfusion practice. In this review, we aim to discuss the interplay between benefits and potential adverse effects...... of transfusion in critically ill children by including 65 papers, which were evaluated based on previously agreed selection criteria. Current practice on transfusing critically ill children is mainly founded on the basis of adult studies, common practices with cut-off values, and expert opinions, rather than...... evidence-based medicine. Paediatric patients have explicit physiological challenges and requirements to be addressed. Critically ill children often suffer from anaemia, have substantial iatrogenic blood loss with subsequent transfusions, and are at a higher risk of complications, often due to human errors...

  13. The Ubiquity of Chronic Illness.

    Science.gov (United States)

    Fonseca, Claudia; Fleischer, Soraya; Rui, Taniele

    2016-01-01

    This is a review of five different books dealing with some aspect of what might be termed a "chronic illness" - Alzheimer's disease, lupus, addiction, erectile dysfunction, and leprosy. The array of different subjects examined in these books points to the negotiable limits of this hugely open category. What exactly constitutes an "illness"? Why not use a less biomedical term instead: "disturbance", "problem", or simply "condition"? And how are we to understand "chronic" - simply as the flipside of "acute" or "curable"?

  14. Staging of bipolar affective illness [Etapy przebiegu choroby afektywnej dwubiegunowej

    Directory of Open Access Journals (Sweden)

    Ferensztajn, Ewa

    2012-08-01

    Full Text Available The concept of staging as a description of clinical advancement of illness is prevalent and commonly used in medicine. Regarding bipolar mood disorder (BD a staging model assumes a progression from prodromal (at-risk to more severe and treatment-refractory conditions. Four different staging models of BD have been proposed. The concept of Robert Post’s is based on the phenomenon of kindling and neurosensitization, assuming a role of stressors in triggering the first episode of illness, with subsequent persistent changes in the activity of neurones, greater vulnerability to relapse and worse response to treatment. The concept of Anne Duffy’s is based on the research of high risk bipolar offspring and describes the early development of the illness as successive stages, i.e. non-mood disorders, minor mood disorders and acute episodes of illness, starting in childhood, with an attempt to distinguish subtypes of the disease depending on the parent’s response to prophylactic lithium treatment. The model of Michael Berk’s has been constructed in parallel to the therapeutic algorithms and classifies the stages of illness based on clinical features, prognosis, and response to treatment. It also identifies high risk individuals, highlights need of early intervention and is proposed as a course specifier for BD. The model of Flavio Kapczinski’s is based on a phenomenon of allostatic load and evaluation of the changes of biomarkers and cognitive functions during the episode and between episodes. A significant consequence of introducing the staging model is employing treatment which is adequate to a stage of the illness. The model underlines a necessity of early intervention and defines the first episode of the illness as a critical target of it, in a hope to a possibility of prevention against neuroanatomical, neuropsychological, clinical and functional consequence of the illness.

  15. Dependency in Critically Ill Patients

    Directory of Open Access Journals (Sweden)

    Rumei Yang

    2016-03-01

    Full Text Available By necessity, critically ill patients admitted to intensive care units (ICUs have a high level of dependency, which is linked to a variety of negative feelings, such as powerlessness. However, the term dependency is not well defined in the critically ill patients. The concept of “dependency” in critically ill patients was analyzed using a meta-synthesis approach. An inductive process described by Deborah Finfgeld-Connett was used to analyze the data. Overarching themes emerged that reflected critically ill patients’ experience and meaning of being in dependency were (a antecedents: dependency in critically ill patients was a powerless and vulnerable state, triggered by a life-threatening crisis; (b attributes: the characteristic of losing “self” was featured by dehumanization and disembodiment, which can be alleviated by a “self”-restoring process; and (c outcomes: living with dependency and coping with dependency. The conceptual model explicated here may provide a framework for understanding dependency in critically ill patients.

  16. Effect of a vocationally-focused brief cognitive behavioural intervention on employment-related outcomes for individuals with mood and anxiety disorders.

    Science.gov (United States)

    Kidd, Sean A; Boyd, Geoffrey M; Bieling, Peter; Pike, Shannon; Kazarian-Keith, Dawnna

    2008-01-01

    Despite an increasing emphasis on the importance of vocational success to the quality of life of individuals with mental illness (Bond, Drake, & Becker, 2008), minimal work has examined the impact of cognitive behavioural interventions that focus on vocational stressors. Vocational stressors commonly faced by persons with mental illness include difficulties with work task completion, obtaining employment, and coping with interpersonal stressors (Becker et al., 1998). The purpose of this pilot study was to examine the effectiveness of a brief cognitive behavioural therapy group intervention that targets vocational stressors for individuals whose vocational functioning had been significantly impacted by mental illness. Participants included 16 individuals with mood and anxiety disorder diagnoses. After this intervention, it was found that employed persons reported an improved sense of mastery in the completion of work tasks, improved satisfaction with work supervision, and decreased satisfaction with advancement and job security. Unemployed participants reported improved expectancy for employment success.

  17. [Gustave Flaubert's illness].

    Science.gov (United States)

    Gastaut, H; Gastaut, Y

    1982-01-01

    All those interested in Gustave Flaubert's illness, during his lifetime as well as after his death, have agreed that he had epilepsy. The one important exception is Jean-Paul Sartre, who, in the 2800 pages of his "Idiot de la famille" claimed that Flaubert was a hysteric with very moderate intelligence who somatized his neurosis in the form of seizures. These, in Sartre's views, were moreover probably hysterical, but possibly epileptic resulting from the existence of a psychogenic epilepsy bred from the neurosis. The basis for this neurosis could have originated at the time of Gustave's birth, as this occurred between those of two brothers who both died young, and as his mother had wished for a daughter. Further development of the neurosis might have taken place during a temporary phase of learning difficulties, exaggerated and exploited by his father to make his youngest son the idiot of a family in which the eldest son was the dauphin. Destroyed in this way, Gustave would have sought refuge in passivity and could have developed a hatred for his father and for his elder brother, who he would have liked to kill before killing himself. But, unable to carry out his wishes and desiring both to die and to survive, Gustave, adolescent, might have chosen the pathway of "false deaths", as exemplified by the seizures. Modern epileptology data enables not only to confirm the epileptic etiology and to discount the hysterical nature of the fits, but also: 1. to establish precise details of the site and nature of the cerebral lesions responsible for the attacks: neonatal atrophy or vascular malformation of the occipitotemporal cortex of the left hemisphere, the only lesion capable of provoking: a) the phosphenes marking the onset of the seizures; b) the intellectual manifestations (forced thoughts or flight of ideas), affective features (panic terror), and psychosensory (ecmnesic hallucinations) or psychomotor (confusional automatism) symptoms accompanying some attacks; c) the

  18. The stigma of mental illness

    Directory of Open Access Journals (Sweden)

    Kordosi A

    2015-10-01

    Full Text Available Introduction:The stigma of mental illness is not a modern phenomenon, but it can now be approached scientifically. The stigma, because of the mental illness which characterizes a person, can be explained by the natural propensity of man to deliver biased and stereotyped estimates to phenomena he cannot explain, accept or face. Methodology:This study is an attempt to describe the concept of stigma and the impact of the stigma of mental illness in the personal and social life of the individual. The search for sources of this review was made through books on the topic and articles of the last twenty years, from online internet sources (pubmed, scopus, google scholar. Literature Review:Stigma brought about by illness from mental illness, is a complex process and concept, located in social interaction and the dynamics of social relations. The social stigma borne by mental illness in general, as well as the lack of information, ignorance, stereotypes, myths and prejudices, are the main reasons that characterize, even today, depression as a taboo subject. The stigma of mental illness is indeliblyimprinted in the identity of human suffering. In any case, the impact of stigma is critical for people who are sick. The psychological stress and difficult conditions that shape their daily lives aggravate their already compromised mental health, having a significant impact on the course and outcome of the disease itself. Key strategies to address stigma are protest, education and contact. Conclusions:A significant step in combating the stigma is to raise public awareness on the issues of mental health and their inclusion in society.

  19. Understanding the impact of chronic childhood illness on families.

    Science.gov (United States)

    Sabbeth, B

    1984-02-01

    A great deal has been written about mothers and their relationships with their ill children. Fathers, however, have been relatively excluded from the research, as they have been from many pediatrician-mother-child interactions. Although it has been noted that some fathers tend to withdraw from the family, in fact very little is known about the impact of childhood illness on their lives. In general, studies of mothers, fathers, siblings, marriage, and families emphasize psychopathology and other psychosocial problems. Yet, there is a growing awareness in the social sciences that we have much to learn from the capacity to adjust. How is it that some families of chronically ill children survive so well? This question has not been addressed. Most studies focus on individual constituents of the family. Minuchin and others have taught us about aberrant family systems that sometimes develop around chronically ill children. Such systems are characterized by high cohesion and conformity, and the absence of apparent friction. How frequently do such systems develop? How can they be prevented? Finally, understanding the impact of chronic childhood illness on families is a difficult task. Parents have reasons for obscuring the impact, and particularly their distress, from the view of their pediatrician. Physicians are often uncertain how much understanding they ought to offer. Careful attention to the parent-pediatrician relationship is essential to a thorough understanding of the impact of childhood illness on the family.

  20. Antioxidant Vitamins and Trace Elements in Critical Illness.

    Science.gov (United States)

    Koekkoek, W A C Kristine; van Zanten, Arthur R H

    2016-08-01

    This comprehensive narrative review summarizes relevant antioxidant mechanisms, the antioxidant status, and effects of supplementation in critically ill patients for the most studied antioxidant vitamins A, C, and E and the enzyme cofactor trace elements selenium and zinc. Over the past 15 years, oxidative stress-mediated cell damage has been recognized to be fundamental to the pathophysiology of various critical illnesses such as acute respiratory distress syndrome, ischemia-reperfusion injury, and multiorgan dysfunction in sepsis. Related to these conditions, low plasma levels of antioxidant enzymes, vitamins, and trace elements have been frequently reported, and thus supplementation seems logical. However, low antioxidant plasma levels per se may not indicate low total body stores as critical illness may induce redistribution of antioxidants. Furthermore, low antioxidant levels may even be beneficial as pro-oxidants are essential in bacterial killing. The reviewed studies in critically ill patients show conflicting results. This may be due to different patient populations, study designs, timing, dosing regimens, and duration of the intervention and outcome measures evaluated. Therefore, at present, it remains unclear whether supplementation of antioxidant micronutrients has any clinical benefit in critically ill patients as some studies show clear benefits, whereas others demonstrate neutral outcomes and even harm. Combination therapy of antioxidants seems logical as they work in synergy and function as elements of the human antioxidant network. Further research should focus on defining the normal antioxidant status for critically ill patients and to study optimal supplement combinations either by nutrition enrichment or by enteral or parenteral pharmacological interventions.

  1. Theory of Primary Rights for Persons with Mental Illness.

    Science.gov (United States)

    Dreuth, Laura

    2002-01-01

    Argues for an organized scheme that considers the human rights of people with mental illness in a way that focuses attention on primary rights. The theory of primary rights emphasizes: life, liberty, and security of persons; the right to an adequate standard of living; all human beings being free and equal in dignity and rights; and conditional…

  2. Teaching Students with Emotional Disorders and/or Mental Illnesses.

    Science.gov (United States)

    Alberta Learning, Edmonton.

    This resource manual is designed to assist Alberta teachers in the identification and education of students with emotional disorders and/or mental illnesses. It takes a comprehensive look at six emotional disorders. The first section focuses on eating disorders. It describes the characteristics and symptoms of anorexia nervosa, bulimia nervosa,…

  3. Consent for Dental Therapy in Severely Ill Patients.

    Science.gov (United States)

    Litch, C. Scott; Liggett, Martha L.

    1992-01-01

    Legal standards for informed consent are discussed in the context of dental care for the elderly and severely ill. Variations in state common law and legislation are analyzed, focusing on differences between practitioner-oriented and patient-oriented approaches to informed consent. Implications for educators and practitioners are examined.…

  4. Psychodynamics in medically ill patients.

    Science.gov (United States)

    Nash, Sara Siris; Kent, Laura K; Muskin, Philip R

    2009-01-01

    This article explores the role of psychodynamics as it applies to the understanding and treatment of medically ill patients in the consultation-liaison psychiatry setting. It provides historical background that spans the eras from Antiquity (Hippocrates and Galen) to nineteenth-century studies of hysteria (Charcot, Janet, and Freud) and into the twentieth century (Flanders Dunbar, Alexander, Engle, and the DSM). The article then discusses the effects of personality on medical illness, treatment, and patients' ability to cope by reviewing the works of Bibring, Kahana, and others. The important contribution of attachment theory is reviewed as it pertains the patient-physician relationship and the health behavior of physically ill patients. A discussion of conversion disorder is offered as an example of psychodynamics in action. This article highlights the important impact of countertransference, especially in terms of how it relates to patients who are extremely difficult and "hateful," and explores the dynamics surrounding the topic of physician-assisted suicide, as it pertains to the understanding of a patient's request to die. Some attention is also given to the challenges surrounding the unique experience of residents learning how to treat medically ill patients on the consultation-liaison service. Ultimately, this article concludes that the use and understanding of psychodynamics and psychodynamic theory allows consultation-liaison psychiatrists the opportunity to interpret the life narratives of medically ill patients in a meaningful way that contributes importantly to treatment.

  5. Enhancement Approach in Well&Illness Tourism

    Directory of Open Access Journals (Sweden)

    Ruhet Genç

    2015-04-01

    Full Text Available The component of tourism preparatory parties is to make tourists, whether they are medical or companion, feel more comfortable and bring back home good health attached to good memories. In order to lead a satisfactory discussion primarily wellness and illness tourism concepts are properly described. After explaining their dynamics, factors which are constitutive in these kind of touristic activities, mainly tourists‟ motivations are mentioned. As being a new era of medical tourism, it is shown that facilitators are of great significance. They offer medical value tourism by eliminating too many unknowns for the tourist. Not only empathy but queries also enable highlighting the tourists‟ expectations, experiences and showing the ways of understanding their situation better. New medical hubs and the future ones have to take into account, promote consumer researches that they can advance themselves in the light of new information. The best way to develop well&illness tourism is to make tourist, patient and their companion satisfied with their activities and/or treatment.

  6. Somali Refugees' Perceptions of Mental Illness.

    Science.gov (United States)

    Bettmann, Joanna E; Penney, Deb; Clarkson Freeman, Pamela; Lecy, Natalie

    2015-01-01

    Nearly 13% of the U.S. population is comprised of foreign-born individuals, with Somalis constituting one of the largest resettled groups. Research suggests that, among Somali refugees, rates of mental illness are high. Yet research shows Somalis underutilize mental health services. Understanding their perceptions of mental illness and its cures may help practitioners to design more effective treatments for this population. Thus, this pilot study investigated Somali refugees' perceptions of mental illness and its treatments. Using purposive sampling, this qualitative study interviewed 20 Somali refugees using a semi-structured interview guide. Qualitative analysis yielded participants' perceptions of mental illness through their descriptions of physical symptoms accompanying mental illness, the stigma of mental illness, causes of mental illness, medical and non-medical treatments for mental illness, spirit possession causing mental illness, and the Qur'an as treatment for mental illness. Such information may help practitioners in the United States approach Somali clients in the most culturally coherent manner.

  7. Mental Illness and Mental Health: The Two Continua Model Across the Lifespan

    NARCIS (Netherlands)

    Westerhof, Gerben J.; Keyes, Cory L.M.

    2010-01-01

    Mental health has long been defined as the absence of psychopathologies, such as depression and anxiety. The absence of mental illness, however, is a minimal outcome from a psychological perspective on lifespan development. This article therefore focuses on mental illness as well as on three core co

  8. Advance Care Planning.

    Science.gov (United States)

    Stallworthy, Elizabeth J

    2013-04-16

    Advance care planning should be available to all patients with chronic kidney disease, including end-stage kidney disease on renal replacement therapy. Advance care planning is a process of patient-centred discussion, ideally involving family/significant others, to assist the patient to understand how their illness might affect them, identify their goals and establish how medical treatment might help them to achieve these. An Advance Care Plan is only one useful outcome from the Advance Care Planning process, the education of patient and family around prognosis and treatment options is likely to be beneficial whether or not a plan is written or the individual loses decision making capacity at the end of life. Facilitating Advance Care Planning discussions requires an understanding of their purpose and communication skills which need to be taught. Advance Care Planning needs to be supported by effective systems to enable the discussions and any resulting Plans to be used to aid subsequent decision making.

  9. Nursing the critically ill surgical patient in Zambia.

    Science.gov (United States)

    Carter, Chris; Snell, David

    2016-11-10

    Critical illness in the developing world is a substantial burden for individuals, families, communities and healthcare services. The management of these patients will depend on the resources available. Simple conditions such as a fractured leg or a strangulated hernia can have devastating effects on individuals, families and communities. The recent Lancet Commission on Global Surgery and the World Health Organization promise to strengthen emergency and essential care will increase the focus on surgical services within the developing world. This article provides an overview of nursing the critically ill surgical patient in Zambia, a lower middle income country (LMIC) in sub-Saharan Africa.

  10. A patient-centered research agenda for the care of the acutely ill older patient.

    Science.gov (United States)

    Wald, Heidi L; Leykum, Luci K; Mattison, Melissa L P; Vasilevskis, Eduard E; Meltzer, David O

    2015-05-01

    Hospitalists and others acute-care providers are limited by gaps in evidence addressing the needs of the acutely ill older adult population. The Society of Hospital Medicine sponsored the Acute Care of Older Patients Priority Setting Partnership to develop a research agenda focused on bridging this gap. Informed by the Patient-Centered Outcomes Research Institute framework for identification and prioritization of research areas, we adapted a methodology developed by the James Lind Alliance to engage diverse stakeholders in the research agenda setting process. The work of the Partnership proceeded through 4 steps: convening, consulting, collating, and prioritizing. First, the steering committee convened a partnership of 18 stakeholder organizations in May 2013. Next, stakeholder organizations surveyed members to identify important unanswered questions in the acute care of older persons, receiving 1299 responses from 580 individuals. Finally, an extensive and structured process of collation and prioritization resulted in a final list of 10 research questions in the following areas: advanced-care planning, care transitions, delirium, dementia, depression, medications, models of care, physical function, surgery, and training. With the changing demographics of the hospitalized population, a workforce with limited geriatrics training, and gaps in evidence to inform clinical decision making for acutely ill older patients, the identified research questions deserve the highest priority in directing future research efforts to improve care for the older hospitalized patient and enrich training.

  11. Perspectives of Treatment Providers and Clients with Serious Mental Illness Regarding Effective Therapeutic Relationships.

    Science.gov (United States)

    Easter, Alison; Pollock, Michele; Pope, Leah Gogel; Wisdom, Jennifer P; Smith, Thomas E

    2016-07-01

    This study explores the nature of clinical therapeutic relationships between mental health treatment providers and high-need clients with serious mental illness who had recently discontinued treatment. Semi-structured qualitative interviews of 56 clients with serious mental illness who had recently discontinued care and 25 mental health treatment providers were completed. Both clients with serious mental illness and treatment providers emphasized the importance of client-focused goal setting, time and availability of treatment providers, a caring approach, and trust and honesty in the relationship. However, clients with serious mental illness placed greater emphasis on goals involving tangible services, a notable area of discord between the two groups. Individuals with serious mental illness and treatment providers agreed regarding several key elements to a positive clinical relationship. Further attention to client goals related to tangible services may serve to improve relationships between treatment providers and high-need clients with serious mental illness.

  12. Gulf War Illness Research Program

    Science.gov (United States)

    2010-01-01

    neurofibromato- sis; autism ; and other areas with military health interests including psychological health, traumatic brain injury, and Gulf War Illness (GWI...the national news headlines, it has not dimmed our hope that treatments and cures for GWI are waiting to be discovered and brought to bear against

  13. Nonthyroidal illness syndrome in children.

    Science.gov (United States)

    Marks, Seth D

    2009-12-01

    Neuroendocrine changes in the hypothalamic-pituitary-thyroid axis during critical illness result in nonthyroidal illness syndrome (NTIS) characterized by abnormal thyrotropin (TSH) and thyroid hormone levels. Studies looking at the natural history of neuroendocrine changes during critical illness have revealed the presence of NTIS. NTIS has been described in a variety of patient settings. Many studies have tried to uncover the pathophysiology behind NTIS and several theories are proposed. Whether NTIS requires treatment or intervention is still controversial and the results of the treatment studies are arguably mixed. Whether implicitly stated or not, the underlying purpose of all the natural history, pathophysiology, or treatment studies is to determine whether NTIS is adaptive or maladaptive. Some studies have illustrated a correlation between illness severity and the degree of NTIS but a cause and effect relationship is still elusive. The human studies can be divided between those with either adult or pediatric subjects, with much less data available in the latter. This review examines the available literature on NTIS with an emphasis on the pediatric literature.

  14. New chopper control at ILL

    Energy Technology Data Exchange (ETDEWEB)

    Descamps, F. [Institut Max von Laue - Paul Langevin (ILL), 38 - Grenoble (France)

    1997-04-01

    Proper phasing is an essential characteristic of the chopper systems used at ILL. A wide variety of choppers and selectors differing in weight, speed and bearing types are controlled by a unique electronic card performing digital adaptative filtering. The chopper regulation system is described. (author).

  15. Estimates of Foodborne Illness in the United States -- Burden of Foodborne Illness: Findings

    Science.gov (United States)

    ... Illness Trends Foodborne Outbreaks Foodsafety.gov Burden of Foodborne Illness: Findings Recommend on Facebook Tweet Share Compartir ... CDC provides estimates for two major groups of foodborne illnesses Known foodborne pathogens — 31 pathogens known ...

  16. 高强度超声聚焦治疗晚期胰腺癌20例的疗效分析%a Study about Curative Effect of High Intensity Focused Ultrasound on 20 Patients with advanced Pancreatic Cancer

    Institute of Scientific and Technical Information of China (English)

    张涛; 刘在照

    2013-01-01

    Objective To investigate the efficacy and security of High Intensity Focused Ultrasound (HIFU) in treating patients with advanced pancreatic carcinoma. Methods 20 newly received cases of advanced pancreatic carcinoma with HIFU was treated. The curative effect of HIFU was observed by testing the function of major organs, examining the tumor volume changes with CT and ultrasound, and observing the serum level of CA19-9, CA242 and other indicators. Results After treatment, the pain symptoms were relieved significantly in nearly 85% of the patients. Results of 7-21d imaging examination showed that compared with patients before treatment, tumor volume in 9 cases (45%) was decreased, in 8 cases (40%) was almost changeless and in 3 cases (15%) was increased among patients after treatment. Results of CT enhanced scan showed that tumors in 6 cases did not have significant enhancement and in 14 cases had regional enhancement. The latter indicated the existence of blood flow and suggested that tumors had not been destroyed by heat and more treatment were needed. The concentration of biochemical markers such as CA19-9、CA242 was decreased and no significant complications were appeared in patients after treatment in the near future. Conclusion As a safe treatment method, HIFU treatment can significantly relieve sufferings, improve life quality and extend life span of patients with advanced pancreatic carcinoma.%  目的探讨高强度超声聚焦(HIFU)对晚期胰腺癌患者治疗的效果和安全性。方法对近期收治的20例晚期胰腺癌患者应用高能超声聚焦刀治疗。通过主要脏器功能测定,超声及CT检查肿瘤体积变化,通过血清标志物CA19-9、CA242等指标的测定观察HIFU的疗效。结果治疗后85%的患者癌性疼痛症状得到了较大缓解;7-21 d影像学检查显示:与治疗前相比,治疗后肿瘤体积缩小的有9例,占45.00%;无明显变化的有8例,占40.00%;增大的有3例,占15.00%

  17. Communication About Chronic Critical Illness

    Science.gov (United States)

    Nelson, Judith E.; Mercado, Alice F.; Camhi, Sharon L.; Tandon, Nidhi; Wallenstein, Sylvan; August, Gary I.; Morrison, R. Sean

    2008-01-01

    Background Despite poor outcomes, life-sustaining treatments including mechanical ventilation are continued for a large and growing population of patients with chronic critical illness. This may be owing in part to a lack of understanding resulting from inadequate communication between clinicians and patients and families. Our objective was to investigate the informational needs of patients with chronic critical illness and their families and the extent to which these needs are met. Methods In this prospective observational study conducted at 5 adult intensive care units in a large, university-affiliated hospital in New York, New York, 100 patients with chronic critical illness (within 3–7 days of elective tracheotomy for prolonged mechanical ventilation) or surrogates for incapacitated patients were surveyed using an 18-item questionnaire addressing communication about chronic critical illness. Main outcome measures included ratings of importance and reports of whether information was received about questionnaire items. Results Among 125 consecutive, eligible patients, 100 (80%) were enrolled; questionnaire respondents included 2 patients and 98 surrogates. For all items, more than 78% of respondents rated the information as important for decision making (>98% for 16 of 18 items). Respondents reported receiving no information for a mean (SD) of 9.0 (3.3) of 18 items, with 95% of respondents reporting not receiving information for approximately one-quarter of the items. Of the subjects rating the item as important, 77 of 96 (80%) and 69 of 74 (93%) reported receiving no information about expected functional status at hospital discharge and prognosis for 1-year survival, respectively. Conclusions Many patients and their families may lack important information for decision making about continuation of treatment in the chronic phase of critical illness. Strategies for effective communication in this clinical context should be investigated and implemented. PMID

  18. Relatives to Critically Ill Patients Have No Sense of Coherence

    DEFF Research Database (Denmark)

    Laursen, Jannie; Andresen, Kristoffer; Rosenberg, Jacob

    2016-01-01

    Aims and Objective. To investigate the relatives' satisfaction and involvement on a general surgery ward regarding the critically ill patient. Introduction. Relatives to critically ill patients are affected both physically and mentally during the hospitalization of a family member. Research has...... be guidance and support. Thereby, relatives can gain a sense of coherence during the hospitalization of a critically ill patient, which can lead to a greater satisfaction and thereby better support for the patient....... shown that relatives do not always receive the attention they need from health professionals. There is a lack of studies that focus on relatives' satisfaction and involvement during their family members' hospitalization. Design. A mixed methods design was chosen. Methods. A quantitative study...

  19. Headache in the presentation of noncephalic acute illness

    Directory of Open Access Journals (Sweden)

    Tomer Tzadok

    2015-01-01

    Full Text Available Background: Headache is a frequent symptom of many systemic diseases that do not involve cranial structures. In this observational study, we assessed factors associated with headache in the acute presentation of systemic conditions in a nonsurgical emergency department (ED. Methods: Consecutive patients, admitted to Soroka University Medical Center ED due to noncephalic illness, were prospectively surveyed using a structured questionnaire focused on the prevalence and characteristics of headache symptoms. Medical data were extracted from the patient's charts. Results: Between 1 and 6/2012, 194 patients aged 64.69 ± 19.52 years, were evaluated. Headache was reported by 83 (42.7% patients and was more common among patients with febrile illness (77.5% vs. 22.5%, P < 0.001. Respiratory illness and level of O2saturation were not associated with headache. Headache in the presentation of a noncephalic illness was associated with younger age (58 vs. 69, P < 0.001 and with suffering from a primary headache disorder (48.2% vs. 10.8%, P < 0.001. Headache was also associated with higher body temperature and lower platelets count. Conclusions: Headache is a common symptom in acute noncephalic conditions and was found to be associated with younger age and febrile disease on presentation. Patients who present with primary headache disorders are more prone to have headache during acute illness. Acute obstructive respiratory disease, hypercarbia or hypoxemia were not associated with headache.

  20. Sarcopenia and critical illness: a deadly combination in the elderly.

    Science.gov (United States)

    Hanna, Joseph S

    2015-03-01

    Sarcopenia is the age-associated loss of lean skeletal muscle mass. It is the result of multiple physiologic derangements, ultimately resulting in an insidious functional decline. Frailty, the clinical manifestation of sarcopenia and physical infirmity, is associated with significant morbidity and mortality in the elderly population. The underlying pathology results in a disruption of the individual's ability to tolerate internal and external stressors such as injury or illness. This infirmity results in a markedly increased risk of falls and subsequent morbidity and mortality from the resulting traumatic injury, as well as an inability to recover from medical insults, resulting in critical illness. The increasing prevalence of sarcopenia and critical illness in the elderly has resulted in a deadly intersection of disease processes. The lethality of this combination appears to be the result of altered muscle metabolism, decreased mitochondrial energetics needed to survive critical illness, and a chronically activated catabolic state likely mediated by tumor necrosis factor-α. Furthermore, these underlying derangements are independently associated with an increased incidence of critical illness, resulting in a progressive downward spiral. Considerable evidence has been gathered supporting the role of aggressive nutrition support and physical therapy in improving outcomes. Critical care practitioners must consider sarcopenia and the resulting frailty phenotype a comorbid condition so that the targeted interventions can be instituted and research efforts focused.

  1. Problematizing health coaching for chronic illness self-management.

    Science.gov (United States)

    Howard, Lisa M; Ceci, Christine

    2013-09-01

    To address the growing costs associated with chronic illness care, many countries, both developed and developing, identify increased patient self-management or self-care as a focus of healthcare reform. Health coaching, an implementation strategy to support the shift to self-management, encourages patients to make lifestyle changes to improve the management of chronic illness. This practice differs from traditional models of health education because of the interactional dynamics between nurse and patient, and an orientation to care that ostensibly centres and empowers patients. The theoretical underpinnings of coaching reflect these differences, however in its application, the practices arranged around health coaching for chronic illness self-management reveal the social regulation and professional management of everyday life. This becomes especially problematic in contexts defined by economic constraint and government withdrawal from activities related to the 'care' of citizens. In this paper, we trace the development of health coaching as part of nursing practice and consider the implications of this practice as an emerging element of chronic illness self-management. Our purpose is to highlight health coaching as an approach intended to support patients with chronic illness and at the same time, problematize the tensions contained in (and by) this practice.

  2. How to Report a Foodborne Illness

    Science.gov (United States)

    ... Inspection Service Food Safety How to Report a Foodborne Illness - General Public Recommend on Facebook Tweet Share ... of foodborne disease outbreaks. Contact CDC about a Foodborne Illness: Please call CDC INFO at 1-800- ...

  3. Helping a Child Manage a Chronic Illness

    Science.gov (United States)

    ... https://medlineplus.gov/news/fullstory_160011.html Helping a Child Manage a Chronic Illness Feeling they have control over their ... News) -- Children and teens who feel confident handling a chronic illness on their own appear better able ...

  4. Correlates of Illness Severity in Infectious Mononucleosis

    Directory of Open Access Journals (Sweden)

    John Odame

    2014-01-01

    Full Text Available INTRODUCTION: Understanding the spectrum and frequencies of Epstein-Barr virus (EBV complications and markers of illness severity in immunocompetent patients with primary EBV infection will inform management of patients with EBV-related illnesses.

  5. How to Improve Interactions between Police and the Mentally Ill.

    Science.gov (United States)

    Krameddine, Yasmeen I; Silverstone, Peter H

    2014-01-01

    There have been repeated instances of police forces having violent, sometimes fatal, interactions with individuals with mental illness. Police forces are frequently first responders to those with mental illness. Despite this, training police in how to best interact with individuals who have a mental illness has been poorly studied. The present article reviews the literature examining mental illness training programs delivered to law-enforcement officers. Some of the key findings are the benefits of training utilizing realistic "hands-on" scenarios, which focus primarily on verbal and non-verbal communication, increasing empathy, and de-escalation strategies. Current issues in training police officers are firstly the tendency for organizations to provide training without proper outcome measures of effectiveness, secondly the focus of training is on changing attitudes although there is little evidence to demonstrate this relates to behavioral change, and thirdly the belief that a mental health training program given on a single occasion is sufficient to improve interactions over the longer-term. Future police training needs to address these issues.

  6. How to improve interactions between police and the mentally ill

    Directory of Open Access Journals (Sweden)

    Yasmeen eKrameddine

    2015-01-01

    Full Text Available There have been repeated instances of police forces having violent, sometimes fatal, interactions with individuals with mental illness. Police forces are frequently first responders to those with mental illness. Despite this, training police in how to best interact with individuals who have a mental illness has been poorly studied. The present article reviews the literature examining mental illness training programs delivered to law enforcement officers. Some of the key findings are the benefits of training utilizing realistic hands-on scenarios, which focus primarily on verbal and non-verbal communication, increasing empathy, and de-escalation strategies. Current issues in training police officers are firstly the tendency for organizations to provide training without proper outcome measures of effectiveness, secondly the focus of training is on changing attitudes although there is little evidence to demonstrate this relates to behavioural change, and thirdly the belief that a mental health training program given on a single occasion is sufficient to improve interactions over the longer-term. Future police training needs to address these issues.

  7. Bipolar illness, creativity, and treatment.

    Science.gov (United States)

    Rothenberg, A

    2001-01-01

    There have been in recent years increasing claims in both popular and professional literature for a connection between bipolar illness and creativity. A review of studies supporting this claim reveals serious flaws in sampling, methodology, presentation of results, and conclusions. Although there is therefore no evidence for etiological or genetic linkages, it is still necessary to explain interrelationships in those creative persons suffering from the illness. Examples of the work in progress of artists with bipolar disorder, Jackson Pollock and Edvard Munch, illustrate the use of healthy and adaptive creative cognition--janusian and homospatial processes--in the former's breakthrough conception during an improvement phase in treatment leading to the development of the Abstract Expressionist Movement and in the latter's transformation of an hallucination into his famous artwork "The Scream." Treatment options that do not produce cognitive effects are important for creative persons with bipolar disorder.

  8. Hinduism, marriage and mental illness.

    Science.gov (United States)

    Sharma, Indira; Pandit, Balram; Pathak, Abhishek; Sharma, Reet

    2013-01-01

    For Hindus, marriage is a sacrosanct union. It is also an important social institution. Marriages in India are between two families, rather two individuals, arranged marriages and dowry are customary. The society as well as the Indian legislation attempt to protect marriage. Indian society is predominantly patriarchal. There are stringent gender roles, with women having a passive role and husband an active dominating role. Marriage and motherhood are the primary status roles for women. When afflicted mental illness married women are discriminated against married men. In the setting of mental illness many of the social values take their ugly forms in the form of domestic violence, dowry harassment, abuse of dowry law, dowry death, separation, and divorce. Societal norms are powerful and often override the legislative provisions in real life situations.

  9. Illness causal beliefs in Turkish immigrants

    OpenAIRE

    Klimidis Steven; Minas Harry; Tuncer Can

    2007-01-01

    Abstract Background People hold a wide variety of beliefs concerning the causes of illness. Such beliefs vary across cultures and, among immigrants, may be influenced by many factors, including level of acculturation, gender, level of education, and experience of illness and treatment. This study examines illness causal beliefs in Turkish-immigrants in Australia. Methods Causal beliefs about somatic and mental illness were examined in a sample of 444 members of the Turkish population of Melbo...

  10. Cell signaling and receptors in toxicity of advanced glycation end products (AGEs): α-dicarbonyls, radicals, oxidative stress and antioxidants.

    Science.gov (United States)

    Kovacic, Peter; Somanathan, Ratnasamy

    2011-10-01

    Considerable attention has been paid to the toxicity of advanced glycation end products (AGEs), including relation to various illnesses. AGEs, generated nonenzymatically from carbohydrates and proteins, comprises large numbers of simple and more complicated compounds. Many reports deal with a role for receptors (RAGE) and cell signaling, including illnesses and aging. Reactive oxygen species appear to participate in signaling. RAGE include angiotensin II type 1 receptors. Many signaling pathways are involved, such as kinases, p38, p21, TGF-β, NF-κβ, TNF-α, JNK and STAT. A recent review puts focus on α-dicarbonyl metabolites, formed by carbohydrate oxidation, and imine derivatives from protein condensation, as a source via electron transfer (ET) of ROS and oxidative stress (OS). The toxic species have been related to illnesses and aging. Antioxidants alleviate the adverse effects.

  11. [DGSMP - Interdisciplinarity to Advance Social Medicine and Prevention of Illness].

    Science.gov (United States)

    Gaertner, T; Mittelstaedt, G v

    2016-02-01

    The German Society for Social Medicine and Prevention (DGSMP) refers back to a tradition of over more than 100 years, nevertheless having a critical look at it. As a scientific medical society the DGSMP promotes cross-sectoral configuration of contemporary social medicine to the benefit of both, general welfare and individual health in form of prevention, rehabilitation, re-integration, palliation and long-term care. Human medicine is the lead discipline in the interdisciplinary approach by the DGSMP in order to create - facing the dynamics in the health care system - professional prerequisites to maintain and update solidarity and equity in medical services on a scientific basis.

  12. Meditation's impact on chronic illness.

    Science.gov (United States)

    Bonadonna, Ramita

    2003-01-01

    Meditation is becoming widely popular as an adjunct to conventional medical therapies. This article reviews the literature regarding the experience of chronic illness, theories about meditation, and clinical effects of this self-care practice. Eastern theories of meditation include Buddhist psychology. The word Buddha means the awakened one, and Buddhist meditators have been called the first scientists, alluding to more than 2500 years of precise, detailed observation of inner experience. The knowledge that comprises Buddhist psychology was derived inductively from the historical figure's (Prince Siddhartha Gautama) diligent self-inquiry. Western theories of meditation include Jungian, Benson's relaxation response, and transpersonal psychology. Clinical effects of meditation impact a broad spectrum of physical and psychological symptoms and syndromes, including reduced anxiety, pain, and depression, enhanced mood and self-esteem, and decreased stress. Meditation has been studied in populations with fibromyalgia, cancer, hypertension, and psoriasis. While earlier studies were small and lacked experimental controls, the quality and quantity of valid research is growing. Meditation practice can positively influence the experience of chronic illness and can serve as a primary, secondary, and/or tertiary prevention strategy. Health professionals demonstrate commitment to holistic practice by asking patients about use of meditation, and can encourage this self-care activity. Simple techniques for mindfulness can be taught in the clinical setting. Living mindfully with chronic illness is a fruitful area for research, and it can be predicted that evidence will grow to support the role of consciousness in the human experience of disease.

  13. Using research evidence to reframe the policy debate around mental illness and guns: process and recommendations.

    Science.gov (United States)

    McGinty, Emma E; Frattaroli, Shannon; Appelbaum, Paul S; Bonnie, Richard J; Grilley, Anna; Horwitz, Joshua; Swanson, Jeffrey W; Webster, Daniel W

    2014-11-01

    Recent mass shootings have prompted a national dialogue around mental illness and gun policy. To advance an evidence-informed policy agenda on this controversial issue, we formed a consortium of national gun violence prevention and mental health experts. The consortium agreed on a guiding principle for future policy recommendations: restricting firearm access on the basis of certain dangerous behaviors is supported by the evidence; restricting access on the basis of mental illness diagnoses is not. We describe the group's process and recommendations.

  14. A focus on intra-abdominal infections

    Directory of Open Access Journals (Sweden)

    Sartelli Massimo

    2010-03-01

    Full Text Available Abstract Complicated intra-abdominal infections are an important cause of morbidity and are frequently associated with poor prognosis, particularly in higher risk patients. Well defined evidence-based recommendations for intra-abdominal infections treatment are partially lacking because of the limited number of randomized-controlled trials. Factors consistently associated with poor outcomes in patients with intra-abdominal infections include increased illness severity, failed source control, inadequate empiric antimicrobial therapy and healthcare-acquired infection. Early prognostic evaluation of complicated intra-abdominal infections is important to select high-risk patients for more aggressive therapeutic procedures. The cornerstones in the management of complicated intra-abdominal infections are both source control and antibiotic therapy. The timing and the adequacy of source control are the most important issues in the management of intra-abdominal infections, because inadequate and late control of septic source may have a negative effect on the outcomes. Recent advances in interventional and more aggressive techniques could significantly decrease the morbidity and mortality of physiologically severe complicated intra-abdominal infections, even if these are still being debated and are yet not validated by limited prospective trials. Empiric antimicrobial therapy is nevertheless important in the overall management of intra-abdominal infections. Inappropriate antibiotic therapy may result in poor patient outcomes and in the appearance of bacterial resistance. Antimicrobial management is generally standardised and many regimens, either with monotherapy or combination therapy, have proven their efficacy. Routine coverage especially against Enterococci and candida spp is not always recommended, but can be useful in particular clinical conditions. A de escalation approach may be recommended in patients with specific risk factors for multidrug

  15. The role of illness perceptions in the attachment-related process of affect regulation.

    Science.gov (United States)

    Vilchinsky, Noa; Dekel, Rachel; Asher, Zvia; Leibowitz, Morton; Mosseri, Morris

    2013-01-01

    Based on the predictions of the attachment theory and the Common Sense Model of illness perceptions, the current study focused on the role played by illness perceptions in explaining the path linking attachment orientations to negative affect during recovery from cardiac illness. We predicted two putative mechanisms: (1) illness perceptions would mediate the direct association between attachment-related insecurity (especially attachment anxiety) and levels of distress at follow-up and (2) illness perceptions would interact with attachment orientations (attachment avoidance in particular) in explaining patients' distress. The sample consisted of 111 male patients admitted to the Cardiac Care Unit of the Meir Medical Center, located in the central region of Israel. Patients completed a measure of attachment orientations during hospitalization (baseline). One month later, patients' illness perceptions were measured. Patients' depression and anxiety symptoms were measured at baseline and at the six-month follow-up. The associations between attachment-related anxiety and anxiety symptoms at follow-up were fully mediated by illness perceptions. Attachment-related avoidance was found to interact with illness perceptions in the prediction of depressive symptoms at follow-up. The findings shed light on the possible dynamics among personality, cognitive appraisals, and affect regulation efforts when coping with illness.

  16. Breastfeeding during maternal or infant illness.

    Science.gov (United States)

    Coates, M M; Riordan, J

    1992-01-01

    The continuation of breastfeeding during a hospital stay is not only possible, it can be beneficial for both the mother and the infant. The ill mother avoids breast engorgement and possible mastitis; the infant of an ill mother continues to receive, in breast milk, antibodies to the mother's illness. Through breast milk, an ill infant receives antibodies to his illness, liquids, and an easily digested, nourishing food. In addition, the physical and emotional comfort the mother and infant give each other eases the job of the nurse who cares for them. Hospital policies that take a woman's lactational status into account and encourage breastfeeding should be the accepted standard.

  17. Disparities in appendicitis rupture rate among mentally ill patients

    Directory of Open Access Journals (Sweden)

    Bai Ya-Mei

    2007-11-01

    Full Text Available Abstract Background Many studies have been carried out that focus on mental patients' access to care for their mental illness, but very few pay attention on these same patients' access to care for their physical diseases. Acute appendicitis is a common surgical emergency. Our population-based study was to test for any possible association between mental illness and perforated appendicitis. We hypothesized that there are significant disparities in access to timely surgical care between appendicitis patients with and without mental illness, and more specifically, between patients with schizophrenia and those with another major mental illness. Methods Using the National Health Insurance (NHI hospital-discharge data, we compared the likelihood of perforated appendix among 97,589 adults aged 15 and over who were hospitalized for acute appendicitis in Taiwan between the years 1997 to 2001. Among all the patients admitted for appendicitis, the outcome measure was the odds of appendiceal rupture vs. appendicitis that did not result in a ruptured appendix. Results After adjusting for age, gender, ethnicity, socioeconomic status (SES and hospital characteristics, the presence of schizophrenia was associated with a 2.83 times higher risk of having a ruptured appendix (odds ratio [OR], 2.83; 95% confidence interval [CI], 2.20–3.64. However, the presence of affective psychoses (OR, 1.15; 95% CI: 0.77–1.73 or other mental disorders (OR, 1.58; 95% CI: 0.89–2.81 was not a significant predictor for a ruptured appendix. Conclusion These findings suggest that given the fact that the NHI program reduces financial barriers to care for mentally ill patients, they are still at a disadvantage for obtaining timely treatment for their physical diseases. Of patients with a major mental illness, schizophrenic patients may be the most vulnerable ones for obtaining timely surgical care.

  18. Integration of Biosensors and Drug Delivery Technologies for Early Detection and Chronic Management of Illness

    Directory of Open Access Journals (Sweden)

    Viness Pillay

    2013-06-01

    Full Text Available Recent advances in biosensor design and sensing efficacy need to be amalgamated with research in responsive drug delivery systems for building superior health or illness regimes and ensuring good patient compliance. A variety of illnesses require continuous monitoring in order to have efficient illness intervention. Physicochemical changes in the body can signify the occurrence of an illness before it manifests. Even with the usage of sensors that allow diagnosis and prognosis of the illness, medical intervention still has its downfalls. Late detection of illness can reduce the efficacy of therapeutics. Furthermore, the conventional modes of treatment can cause side-effects such as tissue damage (chemotherapy and rhabdomyolysis and induce other forms of illness (hepatotoxicity. The use of drug delivery systems enables the lowering of side-effects with subsequent improvement in patient compliance. Chronic illnesses require continuous monitoring and medical intervention for efficient treatment to be achieved. Therefore, designing a responsive system that will reciprocate to the physicochemical changes may offer superior therapeutic activity. In this respect, integration of biosensors and drug delivery is a proficient approach and requires designing an implantable system that has a closed loop system. This offers regulation of the changes by means of releasing a therapeutic agent whenever illness biomarkers prevail. Proper selection of biomarkers is vital as this is key for diagnosis and a stimulation factor for responsive drug delivery. By detecting an illness before it manifests by means of biomarkers levels, therapeutic dosing would relate to the severity of such changes. In this review various biosensors and drug delivery systems are discussed in order to assess the challenges and future perspectives of integrating biosensors and drug delivery systems for detection and management of chronic illness.

  19. Mesenteric Lymph: The Bridge to Future Management of Critical Illness

    OpenAIRE

    2007-01-01

    Toxic factors released from the intestine have been implicated in the pathophysiology of severe acute illness, including acute pancreatitis, trauma and hemorrhagic shock, and burns. Toxic factors in mesenteric lymph may induce an inflammatory systemic response while bypassing the portal circulation and liver. This paper reviews current knowledge of the anatomy, physiology and pathophysiology of mesenteric lymph and focuses on factors influencing its composition and flow, and potential therape...

  20. End-of-Life Decisions and Palliative Care in Advanced Heart Failure.

    Science.gov (United States)

    Meyers, Deborah E; Goodlin, Sarah J

    2016-09-01

    Advanced heart failure (HF) therapies are focused on extending life and improving function. In contrast, palliative care is a holistic approach that focuses on symptom alleviation and patients' physical, psychosocial, and spiritual needs. HF clinicians can integrate palliative care strategies by incorporating several important components of planning and decision-making for HF patients. Future care planning (FCP) for HF patients should incorporate the basic tenets of shared decision-making (SDM). These include understanding the patient's perspective and care preferences, articulating what is medically feasible, and integrating these considerations into the overall care plan. Use of defined triggers for FCP can stimulate important patient-caregiver conversations. Guidelines advocate an annual review of HF status and future care preferences. Advance directives are important for any individual with a chronic, life-limiting illness and should be integrated into FCP. Nevertheless, use of advance directives by HF patients is extremely low. Consideration of illness trajectories and risk-scoring tools might facilitate prognostication and delivery of appropriate HF care. Decisions about heart transplantation or left ventricular assist device implantation should include planning for potential complications associated with these therapies. Such decisions also should include a discussion of palliative management, as an alternative to intervention and also as an option for managing symptoms or adverse events after intervention. Palliative care, including FCP and SDM, should be integrated into the course of all patients with advanced HF. Clinicians who provide HF care should acquire the skills necessary for conducting FCP and SDM discussions.

  1. Focus on Organic Conductors

    Directory of Open Access Journals (Sweden)

    Shinya Uji, Takehiko Mori and Toshihiro Takahashi

    2009-01-01

    Full Text Available Organic materials are usually thought of as electrical insulators. Progress in chemical synthesis, however, has brought us a rich variety of conducting organic materials, which can be classified into conducting polymers and molecular crystals. Researchers can realize highly conducting molecular crystals in charge-transfer complexes, where suitable combinations of organic electron donor or acceptor molecules with counter ions or other organic molecules provide charge carriers. By means of a kind of chemical doping, the charge-transfer complexes exhibit high electrical conductivity and, thanks to their highly crystalline nature, even superconductivity has been observed. This focus issue of Science and Technology of Advanced Materials is devoted to the research into such 'organic conductors'The first organic metal was (TTF(TCNQ, which was found in 1973 to have high conductivity at room temperature and a metal–insulator transition at low temperatures. The first organic superconductor was (TMTSF2PF6, whose superconductivity under high pressures was reported by J´erome in 1980. After these findings, the research on organic conductors exploded. Hundreds of organic conductors have been reported, among which more than one hundred exhibit superconductivity. Recently, a single-component organic conductor has been found with metallic conductivity down to low temperatures.In these organic conductors, in spite of their simple electronic structures, much new physics has arisen from the low dimensionality. Examples are charge and spin density waves, characteristic metal–insulator transitions, charge order, unconventional superconductivity, superconductor–insulator transitions, and zero-gap conductors with Dirac cones. The discovery of this new physics is undoubtedly derived from the development of many intriguing novel organic conductors. High quality single crystals are indispensable to the precise measurement of electronic states.This focus issue

  2. Post orgasmic illness syndrome (POIS)

    Science.gov (United States)

    2016-01-01

    Men with post orgasmic illness syndrome (POIS) become ill rather immediately after ejaculation, whether spontaneously at night, during sexual intercourse or masturbation. Two subtypes are distinguished: primary and secondary POIS. It also occurs before or after a man has been sterilized. POIS is an invalidating most probably auto-immune disease leading to much distress in males and their partners. It is characterized by five criteria. Its symptoms are described by seven clusters. However, the manifestation of these symptoms varies from one male to the other but is relatively constant in the person himself. Among men the symptoms vary in intensity, durations and sort of symptoms. POIS is a chronic disorder that manifests itself in POIS “attacks” that occur within a few minutes to a few hours after ejaculation, and disappear spontaneously after 3 to 7 days. POIS is not associated with increased total serum IgE concentrations. On the contrary, there are indications that POIS is triggered by specific cytokines that are released by an auto-immune reaction to the man’s seminal fluid. Indirect clinical evidence suggests that the antigen (Ag) triggering the POIS systemic reaction is not bound to spermatozoa but to seminal fluid produced by prostatic tissue. In addition, POIS may also occur—although rarely—in females. In those cases, it is hypothesized that the Ag is associated with female prostatic tissue around the vagina. PMID:27652231

  3. Post orgasmic illness syndrome (POIS).

    Science.gov (United States)

    Waldinger, Marcel D

    2016-08-01

    Men with post orgasmic illness syndrome (POIS) become ill rather immediately after ejaculation, whether spontaneously at night, during sexual intercourse or masturbation. Two subtypes are distinguished: primary and secondary POIS. It also occurs before or after a man has been sterilized. POIS is an invalidating most probably auto-immune disease leading to much distress in males and their partners. It is characterized by five criteria. Its symptoms are described by seven clusters. However, the manifestation of these symptoms varies from one male to the other but is relatively constant in the person himself. Among men the symptoms vary in intensity, durations and sort of symptoms. POIS is a chronic disorder that manifests itself in POIS "attacks" that occur within a few minutes to a few hours after ejaculation, and disappear spontaneously after 3 to 7 days. POIS is not associated with increased total serum IgE concentrations. On the contrary, there are indications that POIS is triggered by specific cytokines that are released by an auto-immune reaction to the man's seminal fluid. Indirect clinical evidence suggests that the antigen (Ag) triggering the POIS systemic reaction is not bound to spermatozoa but to seminal fluid produced by prostatic tissue. In addition, POIS may also occur-although rarely-in females. In those cases, it is hypothesized that the Ag is associated with female prostatic tissue around the vagina.

  4. Nutrition in chronic critical illness.

    Science.gov (United States)

    Pingleton, S K

    2001-03-01

    Nutritional management of patients with respiratory failure can be a model of nutritional management in chronically critically ill patients. This model requires recognition of the differing metabolic states of starvation and hypermetabolism. Starvation can result in malnutrition, with adverse effect on respiratory muscle strength, ventilatory drive, and immune defense mechanisms. General nutritional goals include preservation of lean body mass by providing adequate energy and positive nitrogen balance. General nutritional prescriptions for both states include a substrate mix of 20% protein, 60% to 70% carbohydrates, and 20% to 30% fat. Positive nitrogen balance is difficult to attain in hypermetabolic patients and energy requirements are increased compared with starved patients. Enteral nutrition should be the mode of initial nutrient delivery unless the gastrointestinal tract is nonfunctional. Monitoring of nutritional support is essential. Complications of nutritional support are multiple. Nutritional hypercapnia is an important complication in a chronically critically ill patient. Outcomes of selected long-term acute patients are poor, with only 8% of patients fully functional 1 year after discharge. Appropriate nutritional therapy is one aspect of management of these patients that has the possibility of optimizing function and survival.

  5. Seizures in the critically ill.

    Science.gov (United States)

    Ch'ang, J; Claassen, J

    2017-01-01

    Critically ill patients with seizures are either admitted to the intensive care unit because of uncontrolled seizures requiring aggressive treatment or are admitted for other reasons and develop seizures secondarily. These patients may have multiorgan failure and severe metabolic and electrolyte disarrangements, and may require complex medication regimens and interventions. Seizures can be seen as a result of an acute systemic illness, a primary neurologic pathology, or a medication side-effect and can present in a wide array of symptoms from convulsive activity, subtle twitching, to lethargy. In this population, untreated isolated seizures can quickly escalate to generalized convulsive status epilepticus or, more frequently, nonconvulsive status epileptics, which is associated with a high morbidity and mortality. Status epilepticus (SE) arises from a failure of inhibitory mechanisms and an enhancement of excitatory pathways causing permanent neuronal injury and other systemic sequelae. Carrying a high 30-day mortality rate, SE can be very difficult to treat in this complex setting, and a portion of these patients will become refractory, requiring narcotics and anesthetic medications. The most significant factor in successfully treating status epilepticus is initiating antiepileptic drugs as soon as possible, thus attentiveness and recognition of this disease are critical.

  6. Underdevelopment and the political economy of malnutrition and ill health.

    Science.gov (United States)

    Chossudovsky, M

    1983-01-01

    This article applies Marx's abstract subdivision of social consumption to the prevailing patterns of capital accumulation in the Third World. Built-in scarcities in the availability of necessary consumer goods, alongside patterns of overconsumption and social waste by the upper-income groups, are conducive to conditions of mass poverty, malnutrition, and disease that coexist with small pockets of social privilege and affluence. Malnutrition and ill health must be understood and analyzed in relation to the dual and divided structure of social consumption: necessities of life as opposed to luxury and semi-luxury goods. The relationship between capital accumulation, the distribution of money income, and patterns of malnutrition and ill health is analyzed. It is shown that patterns of malnutrition and ill health are socially differentiated, and the core disease pattern in Third World social formations is discussed in relation to the material and social conditions of life which generate ill health and which underlie particular patterns of peripheral capital accumulation. The study focuses on empirical procedures for analyzing the relationship between levels of money income and levels of calorie and protein intake. An appendix outlines a methodology for estimating undernourishment in urban areas from household budget surveys.

  7. EDITORIAL: Focus on Plasmonics FOCUS ON PLASMONICS

    Science.gov (United States)

    Bozhevolnyi, Sergey; García-Vidal, Francisco

    2008-10-01

    Plasmonics is an emerging field in optics dealing with the so-called surface plasmons whose extraordinary properties are being both analyzed from a fundamental point of view and exploited for numerous technological applications. Surface plasmons associated with surface electron density oscillations decorating metal-dielectric interfaces were discovered by Rufus Ritchie in the 1950s. Since the seventies, the subwavelength confinement of electromagnetic fields as well as their enhancement inherent to the surface plasmon excitation has been widely used for spectroscopic purposes. Recent advances in nano-fabrication, characterization and modelling techniques have allowed unique properties of these surface electromagnetic modes to be explored with respect to subwavelength field localization and waveguiding, opening the path to truly nanoscale plasmonic optical devices. This area of investigation also has interesting links with research on photonic band gap materials and the field of optical metamaterials. Nowadays, plasmonics can be seen as a mature interdisciplinary area of research in which scientists coming from different backgrounds (chemistry, physics, optics and engineering) strive to discover and exploit new and exciting phenomena associated with surface plasmons. The already made and forthcoming discoveries will have impacts in many fields of science and technology, including not only photonics and materials science but also computation, biology and medicine, among others. This focus issue of New Journal of Physics is intended to cover all the aforementioned capabilities of surface plasmons by presenting a current overview of state-of-the-art advances achieved by the leading groups in this field of research. The below list of articles represents the first contributions to the collection and further additions will appear soon. Focus on Plasmonics Contents Nanoantenna array-induced fluorescence enhancement and reduced lifetimes Reuben M Bakker, Vladimir P Drachev

  8. Neuropsychological assessment of patients with dementing illness.

    Science.gov (United States)

    Fields, Julie A; Ferman, Tanis J; Boeve, Bradley F; Smith, Glenn E

    2011-11-01

    Neuropsychological assessment has a distinct role in the detection and monitoring of cognitive and functional changes associated with dementing illness. Molecular, structural and functional neuroimaging studies have advanced our understanding of the anatomy and physiology underlying neurodegenerative disease; however, the overlap in pathological features of different dementia-associated diseases limits the information that can be obtained by these methods. Incorporation of information obtained from multiple sources can help to increase diagnostic and prognostic accuracy. Neuropsychological test findings provide unique value as biomarkers of dementia, as differentiators of disease topography and in the estimation of disease risk and trajectory. However, psychometric test properties--such as construct validity, stability and the use of appropriate norms--must be understood, because they influence both the application of neuropsychological tests and the interpretation of their results. Finally, measurement of cognitive strengths and weaknesses in patients at risk of dementia can be helpful to predict changes in functional abilities, design appropriate and effective interventions, and assist family and health-care providers in the planning of the patient's future care needs. This Review describes the key characteristics of neuropsychological testing in the assessment of patients at risk of dementia.

  9. Using simulation to educate police about mental illness: A collaborative initiative

    Directory of Open Access Journals (Sweden)

    Wendy Stanyon

    2014-06-01

    Full Text Available Mental illness is a major public health concern in Canada and also globally. According to the World Health Organization, five of the top ten disabilities worldwide are mental health disorders. Within Canada, one in five individuals is living with mental illness each year. Currently, there are 6.7 million Canadians living with mental illness and over 1 million Canadian youth living with mental illness. Police are frequently the first responders to situations in the community involving people with mental illness, and police services are increasingly aware of the need to provide officers with additional training and strategies for effectively interacting with these citizens. This study examined the effectiveness of four online, interactive video-based simulations designed to educate police officers about mental illness and strategies for interacting with people with mental illness. The simulations were created through the efforts of a unique partnership involving a police service, a mental health facility and two postsecondary institutions. Frontline police officers from Ontario were divided into one of three groups (simulation, face to face, control. Using a pre- and post-test questionnaire, the groups were compared on their level of knowledge and understanding of mental illness. In addition, focus groups explored the impact of the simulations on officers’ level of confidence in engaging with individuals with mental illness and officers’ perceptions of the simulations’ ease of use and level of realism. The study’s findings determined that the simulations were just as effective as face-to-face learning, and the officers reported the simulations were easy to use and reflected real-life scenarios they had encountered on the job. As mental health continues to be a major public concern, not only in Canada but also globally, interactive simulations may provide an effective and affordable education resource not only for police officers but for

  10. Selfies of Ill Health: Online Autopathographic Photography and the Dramaturgy of the Everyday

    Directory of Open Access Journals (Sweden)

    Tamar Tembeck

    2016-03-01

    Full Text Available This article offers a preliminary investigation into what I term “selfies of ill health” and traces the expansion of the autopathographic genre in visual media from professional art photography to the vernacular selfie in recent years. In this context, the word autopathography is used to describe self-representational practices that offer a first-person perspective on experiences of illness or hospitalization. I first situate the genre by identifying several typologies of selfies of ill health, including diagnostic selfies, cautionary selfies, and treatment impact selfies. I then focus on the forms of identity performance that selfies, and selfies of ill health in particular, deploy. I argue that the performative qualities of certain selfies of ill health overlap with salient characteristics of autopathographic practice in the arts. Using Karolyn Gehrig’s #HospitalGlam series as a case study, I examine how autopathographic selfies can also construct a politicized dramaturgy of the lived body, notably by enabling individuals like Gehrig to “come out” as being invisibly ill. I conclude that the dramaturgical thrust of such autopathographic imagery is to convey both the centrality of medical experiences in subjects’ lives and their specific desire to be publicly identified as persons living with illness. In light of this, although selfies of ill health may have opened up new avenues for autopathographic practice thanks to the affordances of social media, their communicative intents remain consistent with those of earlier forms of autopathographic photography.

  11. Seasonal Patterns of Gastrointestinal Illness and Streamflow along the Ohio River

    Directory of Open Access Journals (Sweden)

    Elena N. Naumova

    2012-05-01

    Full Text Available Waterborne gastrointestinal (GI illnesses demonstrate seasonal increases associated with water quality and meteorological characteristics. However, few studies have been conducted on the association of hydrological parameters, such as streamflow, and seasonality of GI illnesses. Streamflow is correlated with biological contamination and can be used as proxy for drinking water contamination. We compare seasonal patterns of GI illnesses in the elderly (65 years and older along the Ohio River for a 14-year period (1991–2004 to seasonal patterns of streamflow. Focusing on six counties in close proximity to the river, we compiled weekly time series of hospitalizations for GI illnesses and streamflow data. Seasonal patterns were explored using Poisson annual harmonic regression with and without adjustment for streamflow. GI illnesses demonstrated significant seasonal patterns with peak timing preceding peak timing of streamflow for all six counties. Seasonal patterns of illness remain consistent after adjusting for streamflow. This study found that the time of peak GI illness precedes the peak of streamflow, suggesting either an indirect relationship or a more direct path whereby pathogens enter water supplies prior to the peak in streamflow. Such findings call for interdisciplinary research to better understand associations among streamflow, pathogen loading, and rates of gastrointestinal illnesses.

  12. Attitude about mental illness of health care providers and community leaders in rural Haryana, North India

    Directory of Open Access Journals (Sweden)

    Harshal Ramesh Salve

    2014-12-01

    Full Text Available Background: Attitude about mental illness determines health seeking of the people. Success of National Mental Health Programme (NMHP is dependent on attitude about mental illness of various stakeholders in the programme. Material & Methods: A community based cross-sectional study was carried out in Ballabgarh block of Faridabad district in Haryana. We aimed to study attitude about mental illness of various stakeholders of health care providers (HCP, community leaders in rural area of Haryana, north India. Study area consisting of five Primary Health Centers (PHCs serving 2,12,000 rural population. All HCP working at PHCs, Accredited Social Health Activist (ASHA and community leaders in study area were approached for participation. Hindi version of Opinion about Mental illness Scale for Chinese Community (OMICC was used to study attitude. Results: In total, 467 participants were participated in the study. Of which, HCP, ASHAs and community leaders were 81 (17.4%, 145 (31.0% and 241 (51.6% respectively. Community members reported socially restrictive, pessimistic and stereotyping attitude towards mentally ill person. ASHA and HCP reported stereotyping attitude about person with mental illness. None of the stakeholders reported stigmatizing attitude. Conclusion: Training programme focusing on spectrum of mental illness for HCP and ASHA working in rural area under NMHP programme is needed. Awareness generation of community leaders about bio-medical concept of mental illness is cornerstone of NMHP success in India.

  13. Reporting of foodborne illness by U.S. consumers and healthcare professionals.

    Science.gov (United States)

    Arendt, Susan; Rajagopal, Lakshman; Strohbehn, Catherine; Stokes, Nathan; Meyer, Janell; Mandernach, Steven

    2013-08-19

    During 2009-2010, a total of 1,527 foodborne disease outbreaks were reported by the Centers for Disease Control and Prevention (CDC) (2013). However, in a 2011 CDC report, Scallan et al. estimated about 48 million people contract a foodborne illness annually in the United States. Public health officials are concerned with this under-reporting; thus, the purpose of this study was to identify why consumers and healthcare professionals don't report foodborne illness. Focus groups were conducted with 35 consumers who reported a previous experience with foodborne illness and with 16 healthcare professionals. Also, interviews with other healthcare professionals with responsibility of diagnosing foodborne illness were conducted. Not knowing who to contact, being too ill, being unsure of the cause, and believing reporting would not be beneficial were all identified by consumers as reasons for not reporting foodborne illness. Healthcare professionals that participated in the focus groups indicated the amount of time between patients' consumption of food and seeking treatment and lack of knowledge were barriers to diagnosing foodborne illness. Issues related to stool samples such as knowledge, access and cost were noted by both groups. Results suggest that barriers identified could be overcome with targeted education and improved access and information about the reporting process.

  14. Reporting of Foodborne Illness by U.S. Consumers and Healthcare Professionals

    Directory of Open Access Journals (Sweden)

    Steven Mandernach

    2013-08-01

    Full Text Available During 2009–2010, a total of 1,527 foodborne disease outbreaks were reported by the Centers for Disease Control and Prevention (CDC (2013. However, in a 2011 CDC report, Scallan et al. estimated about 48 million people contract a foodborne illness annually in the United States. Public health officials are concerned with this under-reporting; thus, the purpose of this study was to identify why consumers and healthcare professionals don’t report foodborne illness. Focus groups were conducted with 35 consumers who reported a previous experience with foodborne illness and with 16 healthcare professionals. Also, interviews with other healthcare professionals with responsibility of diagnosing foodborne illness were conducted. Not knowing who to contact, being too ill, being unsure of the cause, and believing reporting would not be beneficial were all identified by consumers as reasons for not reporting foodborne illness. Healthcare professionals that participated in the focus groups indicated the amount of time between patients’ consumption of food and seeking treatment and lack of knowledge were barriers to diagnosing foodborne illness. Issues related to stool samples such as knowledge, access and cost were noted by both groups. Results suggest that barriers identified could be overcome with targeted education and improved access and information about the reporting process.

  15. Illness perceptions in relation to experiences of contemporary cancer care settings among colorectal cancer survivors and their partners.

    Science.gov (United States)

    Johansson, Ann-Caroline; Axelsson, Malin; Berndtsson, Ina; Brink, Eva

    2014-01-01

    Illness is constituted by subjective experiences of symptoms and their psychosocial consequences. Illness perceptions concern people's lay beliefs about understandings and interpretation of a disease and expectations as to disease outcome. Our knowledge about illness perceptions and coping in relation to the cancer care context among persons with colorectal cancer (CRC) and their partners is incomplete. The aim of the present study was to explore illness perceptions in relation to contemporary cancer care settings among CRC survivors and partners. The present research focused on illness rather than disease, implying that personal experiences are central to the methodology. The grounded theory method used is that presented by Kathy Charmaz. The present results explore illness perceptions in the early recovery phase after being diagnosed and treated for cancer in a contemporary cancer care setting. The core category outlook on the cancer diagnosis when quickly informed, treated, and discharged illustrates the illness perceptions of survivors and partners as well as the environment in which they were found. The cancer care environment is presented in the conceptual category experiencing contemporary cancer care settings. Receiving treatment quickly and without waiting was a positive experience for both partners and survivors; however partners experienced the information as massive and as causing concern. The period after discharge was being marked by uncertainty and loneliness, and partners tended to experience non-continuity in care as more problematic than the survivor did. The results showed different illness perceptions and a mismatch between illness perceptions among survivors and partners, presented in the conceptual category outlook on the cancer diagnosis. One illness perception, here presented among partners, focused on seeing the cancer diagnosis as a permanent life-changing event. The other illness perception, here presented among survivors, concentrated on

  16. Finding Identity and Meaning as a Nurse with a Mental Illness.

    Science.gov (United States)

    Peterson, Ashley L

    2016-10-01

    Through professional acculturation, nurses establish their identities as nurses. They also develop of an understanding what mental illness and associated phenomena mean. When nurses themselves develop mental illness, they must learn to establish a new identity as a patient and more specifically as a nurse-patient, and come to a new understanding of what mental illness means to them. This autoethnographic paper focuses on the author's own experience of finding an identity as nurse-patient and discovering what that really meant, at the same time incorporating analysis to connect the personal and the cultural.

  17. Violence and mental illness: an overview

    OpenAIRE

    Stuart, Heather

    2003-01-01

    This paper evaluates the relationship of mental illness and violence by asking three questions: Are the mentally ill violent? Are the mentally ill at increased risk of violence? Are the public at risk? Mental disorders are neither necessary nor sufficient causes of violence. Major determinants of violence continue to be socio-demographic and economic factors. Substance abuse is a major determinant of violence and this is true whether it occurs in the context of a concurrent ...

  18. Glycemic control in critically ill patients

    OpenAIRE

    2012-01-01

    Hyperglycemia is common in critically ill patients and can be caused by various mechanisms, including nutrition, medications, and insufficient insulin. In the past, hyperglycemia was thought to be an adaptive response to stress, but hyperglycemia is no longer considered a benign condition in patients with critical illnesses. Indeed, hyperglycemia can increase morbidity and mortality in critically ill patients. Correction of hyperglycemia may improve clinical outcomes. To date, a definite answ...

  19. Inequality in the social consequences of illness

    DEFF Research Database (Denmark)

    Burström, B; Whitehead, M; Lindholm, C

    2000-01-01

    those people with chronic illness. The study tests two opposing hypotheses: (1) the increasingly flexible, deregulated labor market in Britain would result in an increased number of new jobs, and thus better employment opportunities for unskilled workers, including those with chronic illness; (2......) the more regulated labor market in Sweden, with the associated health and social policies, would provide greater opportunities for jobs and job security for workers with chronic illness. Analysis of data on men from the British General Household Survey and the Swedish Survey of Living Conditions, 1979...... that active labor market policies and employment protection may increase the opportunities for people with chronic illness to remain in work....

  20. HYPOPHOSPHATAEMIA IN CRITICALLY ILL CHILDREN

    Directory of Open Access Journals (Sweden)

    Poornima Shankar

    2016-07-01

    Full Text Available BACKGROUND To estimate the prevalence of hypophosphataemia and outcome associated with this disturbance in children admitted to PICU. METHOD In this prospective cohort study, 102 children admitted consecutively to a paediatric intensive care unit (PICU were monitored regarding their phosphorus serum levels during the first 7 days of admission. Age, gender, diagnosis at admission, malnutrition, starvation period, length of stay, and outcome were analysed as independent variables for hypophosphataemia. RESULTS Most of our patients (56% developed hypophosphataemia during their PICU stay. The number of starvation days, days on mechanical ventilation, and survival to discharge were significantly associated with hypophosphataemia. The worst outcomes correlated well with this abnormality. CONCLUSION Hypophosphataemia was commonly observed in our PICU and was associated with the presence of respiratory diseases, infections, and increased starvation days and ventilation days. These factors might be considered as risk factors for hypophosphataemia in critically ill children

  1. Looking after chronically ill dogs

    DEFF Research Database (Denmark)

    Christiansen, Stine B.; Kristensen, Annemarie Thuri; Sandøe, Peter

    2013-01-01

    thus face similar challenges when caring for their animals. This qualitative study uncovers impacts on an owner's life, when attending to the care of an aged or chronically ill dog and reflects on the differing roles of caregivers with animal and human patients. Twelve dog owners were selected for in......-depth interviews based on the dogs' diagnoses, and the choice of treatments and care expected to affect the owner's life. Interviews were recorded, transcribed, and analyzed qualitatively. The dog owners reported several changes in their lives due to their dog's condition: practicalities like extra care, changes...... in use of the home, and restrictions relating to work, social life, and finances. These were time-consuming, tough, and annoying, but could often be dealt with through planning and prioritizing. Changes in the human–dog relationship and activities caused sadness and frustration, which in turn led...

  2. Beyond descriptive research: advancing the study of spirituality and health.

    Science.gov (United States)

    Rosmarin, David H; Wachholtz, Amy; Ai, Amy

    2011-12-01

    The past three decades have witnessed a surge in research on spirituality and health. This growing body of literature has linked many aspects of spirituality as well as religion to both positive and negative indices of human functioning. However, studies have primarily been descriptive, focusing on identifying associations between spirituality and health, rather than explanatory, focusing on identifying mechanisms underlying observed relationships. Earlier research is also limited by failure to control for salient covariates, apply prospective design, and use sophisticated measurements with well defined and empirically-validated factors. Recent research, however, is advancing the study of spirituality and health by examining not only whether religious factors are relevant to human health, but also how spirituality may functionally impact medical and psychological wellbeing and illness. This article introduces a special issue on Spirituality and Health containing 12 full-length research reports to further this welcomed, emerging trend.

  3. Hyponatremia in critically ill patients

    Directory of Open Access Journals (Sweden)

    Rajesh Padhi

    2014-01-01

    Full Text Available Context: Hyponatremia is a common electrolyte disturbance in critically ill hence understanding its implications is important. Aims: This study was carried out to ascertain frequency, predisposing conditions and outcome in critically ill patients with hyponatremia on intensive care unit (ICU admission. Settings and Design: This was an observational, prospective study of a series of ICU patients during a 12-month period. Materials and Methods: The patients were divided into two groups: Hyponatremic (serum sodium < 135 mmol/L and Eunatremic groups (135-145 mmol/L. Clinical examination included volume status and drug history, biochemistries, clinical diagnosis and cause of hyponatremia. Statistical Analysis Used: Fisher′s exact test, unpaired t-tests Wilcoxon ranksum tests, profile-likelihood method, log-rank test and Kaplan-Meier curves were used. P < 0.05 were considered to be statistically significant. Results: In the hyponatremic group, the frequency of hyponatremia on ICU admission was 34.3%, most were euvolumic, 58.96%. Females comprised of 36.5%. The mean age was 60.4 ± 17.2. The Syndrome of inappropriate Antidiuretic Hormone (SIADH criteria was met in ninety-one patients (36.25%, peumonia being the leading cause of SIADH. Patients with severe sepsis, elective surgery patients, renal failure and heart failure, cirrhosis of liver and subarachnoid hemorrhage were other more likely etiologic causes (P < 0.05. The hyponatremic group spent a longer time in the ICU (P = 0.02, had longer mechanical ventilator days (P < 0.05 and had an increased mortality rate (P = 0.01. Conclusions: Hyponatremia present on admission to the ICU is independent risk factors for poor prognosis.

  4. Positive psychology: an approach to supporting recovery in mental illness.

    Science.gov (United States)

    Schrank, B; Brownell, T; Tylee, A; Slade, M

    2014-09-01

    This paper reviews the literature on positive psychology with a special focus on people with mental illness. It describes the characteristics, critiques, and roots of positive psychology and positive psychotherapy, and summarises the existing evidence on positive psychotherapy. Positive psychology aims to refocus psychological research and practice on the positive aspects of experience, strengths, and resources. Despite a number of conceptual and applied research challenges, the field has rapidly developed since its introduction at the turn of the century. Today positive psychology serves as an umbrella term to accommodate research investigating positive emotions and other positive aspects such as creativity, optimism, resilience, empathy, compassion, humour, and life satisfaction. Positive psychotherapy is a therapeutic intervention that evolved from this research. It shows promising results for reducing depression and increasing well-being in healthy people and those with depression. Positive psychology and positive psychotherapy are increasingly being applied in mental health settings, but research evidence involving people with severe mental illness is still scarce. The focus on strengths and resources in positive psychology and positive psychotherapy may be a promising way to support recovery in people with mental illness, such as depression, substance abuse disorders, and psychosis. More research is needed to adapt and establish these approaches and provide an evidence base for their application.

  5. Creative writing in recovery from severe mental illness.

    Science.gov (United States)

    King, Robert; Neilsen, Philip; White, Emma

    2013-10-01

    There is evidence that creative writing forms an important part of the recovery experience of people affected by severe mental illness. In this paper, we consider theoretical models that explain how creative writing might contribute to recovery, and we discuss the potential for creative writing in psychosocial rehabilitation. We argue that the rehabilitation benefits of creative writing might be optimized through focus on process and technique in writing, rather than content, and that consequently, the involvement of professional writers might be important. We describe a pilot workshop that deployed these principles and was well-received by participants. Finally, we make recommendations regarding the role of creative writing in psychosocial rehabilitation for people recovering from severe mental illness and suggest that the development of an evidence base regarding the effectiveness of creative writing is a priority.

  6. Dogs as a diagnostic tool for ill health in humans.

    Science.gov (United States)

    Wells, Deborah L

    2012-01-01

    Researchers have long reported that dogs and cats improve the physical and psychological health of their human caregivers, and while it is still inconclusive, a substantial amount of research now lends support for the commonly held view that pets are good for us. Recently, studies have directed attention toward exploring the use of animals, most notably dogs, in the detection of disease and other types of health problems in people. This article reviews the evidence for dogs' ability to detect ill health in humans, focusing specifically on the detection of cancer, epileptic seizures, and hypoglycemia. The author describes the research carried out in this area and evaluates it in an effort to determine whether dogs have a role to play in modern health care as an alert tool or screening system for ill health. Where necessary, the author has highlighted weaknesses in the work and proposed directions for future studies.

  7. Random Assignment to Illness: Teaching Illness and Disease in the Introductory Health Communication Course

    Science.gov (United States)

    Gray, Jennifer B.; Riley, Sarah

    2011-01-01

    A key concept in health communication is the difference between disease and illness: disease refers to the physical manifestations of a condition, while illness encompasses the physical, emotional, social, communicative, and psychological experience of living with a condition. The individual illness experience takes into account the full story of…

  8. Illness Insight and Recovery: How Important is Illness Insight in Peoples’ Recovery Process?

    DEFF Research Database (Denmark)

    Korsbek, Lisa

    2013-01-01

    Topic: This account reflects on the topic of illness insight and recovery. Purpose: The purpose of the account is to clarify our understanding about the importance of illness insight in peoples’ recovery process, especially when relating the question of illness insight to the question of identity...

  9. Illness perceptions of cancer patients: relationships with illness characteristics and coping.

    NARCIS (Netherlands)

    Hopman, P.; Rijken, M.

    2015-01-01

    Objective: Illness perceptions have proven to be predictive of coping and adjustment in many chronically ill patients. However, insights into illness perceptions of cancer patients are scarce. The purpose of the present study was to explore how a heterogeneous sample of cancer patients perceive thei

  10. A meta-ethnographic synthesis on phenomenographic studies of patients’ experiences of chronic illness

    Directory of Open Access Journals (Sweden)

    Marta Röing

    2015-02-01

    Full Text Available Phenomenography is a qualitative research approach developed within an educational framework, focusing on the qualitative experience of learning. It is also being used, to a lesser degree, in healthcare research. In the present study, we conducted a meta-ethnographic synthesis of phenomenographic studies on chronic illness, in order to give a broader perspective of how chronic illness can be experienced. Our aim was not to describe patients’ various individual experiences of illness, but instead to identify the different ways chronic illness can be experienced by patients. Our synthesis and phenomenographic interpretation of 12 selected articles found that patients’ experiences of chronic illness can be described in terms of a different lived body, a struggle with threat to identity and self-esteem, a diminished lifeworld, and a challenging reality. These experiences relate to each other in a process of recurring loops, where the different ways of experiencing continue to influence each other over time. According to these findings, the use of phenomenography as a research approach has the potential to add to the understanding of how chronic illness can be experienced. Patients may benefit from seeing that their illness can be experienced in many different ways and that it has many aspects, which then can lead to a better understanding and coping with their illness. We suggest that it may be worthwhile to expand the scope of phenomenography outside pedagogics. This presupposes a revision of the application to include a wider and more comprehensive description, for instance, of the different ways illness and healthcare phenomena can be experienced, and how these different ways are related to each other, with less focus on hierarchical relations.

  11. Attitudes of psychiatry residents toward mental illness

    Directory of Open Access Journals (Sweden)

    Pejović-Milovančević Milica

    2007-01-01

    Full Text Available Introduction. Attitudes of lay people and physicians towards mentally ill patients are frequently highly biased. The aim of this study was to investigate differences in attitudes of psychiatry and internal medicine residents toward mental illness and to establish the relationship between their attitudes and their personal characteristics. Material and methods. The sample consisted of 45 psychiatry and 36 internal medicine residents. The attitudes toward mental illness were assessed using Opinions about Mental Illness Questionnaire (OMI and personality traits were examined using the Eysenck Personality Questionnaire (EPQ. Results. Our findings showed that in regard to internal medicine residents, psychiatry residents do not consider mentally ill patients to be inferior and dangerous. Psychiatry residents have a benevolent attitude toward the mentally ill. Personality traits of psychiatry residents were not related to their opinions about mental illness. Discussion. The results suggest that there is a need to develop strategies that would bring about changes in the curriculum of training programs for medical residents, including proper training in mental health issues. Such strategies should help in destigmatization of persons with mental disorders and increase the competence of physicians to deal with mentally ill. .

  12. Illness in Children and Parental Response

    NARCIS (Netherlands)

    M.A. Bruijnzeels (Marc)

    1997-01-01

    textabstractMost children suffer from illnesses from time to time. In only a small part of these ill children parents decide to seek professional help. So, most child health care is carried out by parents. In general, this phenomenon is called the iceberg of symptoms. The part of the iceberg under t

  13. Illness representations in patients with hand injury.

    LENUS (Irish Health Repository)

    Chan, Jeffrey C Y

    2009-07-01

    Differences in illness perception about hand injury may partly explain the variation in health behaviours such as adherence to post-operative therapy, coping strategy, emotional response and eventual clinical outcome. This study examined the illness perception of patients with hand injuries in the acute trauma setting.

  14. Illness perceptions in patients with fibromyalgia

    NARCIS (Netherlands)

    van Ittersum, M.W.; van Wilgen, C.P.; Hilberdink, W.K.; Groothoff, J.W.; van der Schans, C.P.

    2009-01-01

    OBJECTIVE: Former studies in chronic diseases showed the importance of patients' beliefs and perceptions. The Revised Illness Perception Questionnaire was developed to assess these illness perceptions. Our goal was to investigate psychometric properties of the IPQ-R for Fibromyalgia Dutch language v

  15. Illness perceptions in patients with fibromyalgia

    NARCIS (Netherlands)

    Van Ittersum, M. W.; van Wilgen, C. P.; Hilberdink, W. K. H. A.; Groothoff, J. W.; van der Schans, C. P.

    2009-01-01

    Objective: Former studies in chronic diseases showed the importance of patients' beliefs and perceptions. The Revised Illness Perception Questionnaire was developed to assess these illness perceptions. Our goal was to investigate psychometric properties of the IPQ-R for Fibromyalgia Dutch language v

  16. Mental Illness in the Peripartum Period

    Science.gov (United States)

    Ostler, Teresa

    2009-01-01

    Women are particularly vulnerable in the peripartum period for either developing a mental illness or suffering symptom exacerbation. These illnesses are often experienced covertly, however, and women may not seek out professional help, even though their symptoms may be seriously affecting their well-being and parenting. This article provides an…

  17. Molecular genetics in affective illness

    Energy Technology Data Exchange (ETDEWEB)

    Mendlewicz, J.; Sevy, S.; Mendelbaum, K. (Erasme Univ. Hospital, Brussels (Belgium))

    1993-01-01

    Genetic transmission in manic depressive illness (MDI) has been explored in twins, adoption, association, and linkage studies. The X-linked transmission hypothesis has been tested by using several markers on chromosome X: Xg blood group, color blindness, glucose-6-phosphate dehydrogenase (G6PD), factor IX (hemophilia B), and DNA probes such as DXS15, DXS52, F8C, ST14. The hypothesis of autosomal transmission has been tested by association studies with the O blood group located on chromosome 9, as well as linkage studies on chromosome 6 with the Human Leucocyte Antigens (HLA) haplotypes and on Chromosome 11 with DNA markers for the following genes: D2 dopamine receptor, tyrosinase, C-Harvey-Ras-A (HRAS) oncogene, insuline (ins), and tyrosine hydroxylase (TH). Although linkage studies support the hypothesis of a major locus for the transmission of MDI in the Xq27-28 region, several factors are limiting the results, and are discussed in the present review. 105 refs., 1 fig., 2 tabs.

  18. Critically ill Guillain Barre' syndrome.

    Science.gov (United States)

    Taly, A B; Gupta, S K; Vasanth, A; Suresh, T G; Rao, U; Nagaraja, D; Swamy, H S; Rao, S; Subbakrishna, D K

    1994-11-01

    Among the 153 patients fulfilling NINDS criteria for Guillain Barre' Syndrome (GBS) seen over 5.5 yrs, there were 47 (M:F 38.9) critically ill patients (age range 4 to 60 years). Antecedent event was recorded in 25 patients and the peak deficit was attained over a mean period of 9.5 days. Besides severe motor paralysis other salient features were: bulbar paralysis--42, sensory symptoms or signs--21, dysautonomia 31 and requirement for ventilatory assistance 45. CSF protein was raised in 63% cases. All the 17 patients who underwent electromyography had abnormalities of nerve conduction paramentes. Mean stay on the ventilator was 29.6 days and was not influenced by corticosteroid. Complications were frequent: pulmonary and urinary tract infection, dysautonomia, electrolyte disturbances, haemetmesis, bleeding from tracheostomy site and hepatic and renal failure. Mortality in steroids treated group (13/27) and the conservatively managed group (5/20) did not differ significantly. No discriminant factor emerged between survivors and non-survivors. Age and sex of the patients, presence of antecedent event, onset to peak interval and CSF protein level did not predict the need for ventilatory assistance, although these patients at admission had more frequent weakness of facial, bulbar, trunk, neck and proximal muscles of upper limbs and autonomic disturbances. Course of GBS remains unpredictable at the onset of the disease, warrants close supervision and meticulous supportive care and remains a therapeutic challenge.

  19. The Impact of Illness Identity on Recovery from Severe Mental Illness.

    Science.gov (United States)

    Yanos, Philip T; Roe, David; Lysaker, Paul H

    2010-04-01

    The impact of the experience and diagnosis of mental illness on one's identity has long been recognized; however, little is known about the impact of illness identity, which we define as the set of roles and attitudes that a person has developed in relation to his or her understanding of having a mental illness. The present article proposes a theoretically driven model of the impact of illness identity on the course and recovery from severe mental illness and reviews relevant research. We propose that accepting a definition of oneself as mentally ill and assuming that mental illness means incompetence and inadequacy impact hope and self-esteem, which further impact suicide risk, coping, social interaction, vocational functioning, and symptom severity. Evidence supports most of the predictions made by the model. Implications for psychiatric rehabilitation services are discussed.

  20. Illness perception in Polish patients with chronic diseases: Psychometric properties of the Brief Illness Perception Questionnaire.

    Science.gov (United States)

    Nowicka-Sauer, Katarzyna; Banaszkiewicz, Dorota; Staśkiewicz, Izabela; Kopczyński, Piotr; Hajduk, Adam; Czuszyńska, Zenobia; Ejdys, Mariola; Szostakiewicz, Małgorzata; Sablińska, Agnieszka; Kałużna, Anna; Tomaszewska, Magda; Siebert, Janusz

    2016-08-01

    The study evaluates the psychometric properties of a Polish translation of the Brief Illness Perception Questionnaire. A total of 276 patients with chronic conditions (58.7% women) completed the Brief Illness Perception Questionnaire and the Hospital Anxiety and Depression Scale. The internal consistency of the Polish Brief Illness Perception Questionnaire measured with Cronbach's alpha was satisfactory (α = 0.74). Structural validity was demonstrated by significant inter-correlations between the Brief Illness Perception Questionnaire components. Discriminant validity was supported by the fact that the Brief Illness Perception Questionnaire enables patients with various conditions to be differentiated. Significant correlations were found between Brief Illness Perception Questionnaire and depression and anxiety levels. The Polish Brief Illness Perception Questionnaire thus evaluated is a reliable and valid tool.

  1. For better or worse? Long-term outcome of critical illness in childhood : Long-term outcome of critical illness in childhood

    NARCIS (Netherlands)

    L. van Zellem (Lennart)

    2015-01-01

    markdownabstract__Abstract__ The aim of this thesis was to investigate the long-term outcome of critically ill children admitted to the pediatric intensive care unit (PICU) of the Erasmus MC – Sophia Children’s’ Hospital in Rotterdam, the Netherlands. Our main focus was to investigate the long-term

  2. 聚焦超声热疗技术在中晚期腹盆腔实体癌瘤治疗中的应用%Application of ultrasound focused heat therapy to advanced solid carcinoma of pelvic cavity

    Institute of Scientific and Technical Information of China (English)

    何申戌

    2003-01-01

    @@ 由体外发射大功率超声经水介质偶合进入人体并在腹盆腔实体癌瘤聚焦,焦点处声能大部被吸收转化为热能导致组织温度迅速升高(约70~100℃),从而起到杀灭癌细胞的治疗作用,这种技术被称为聚焦超声(FUS,focused ultrasound)热疗,它也称FEP(focused extracorporeal pyrotherapy)技术或HIFu (high intensive focused ultrasound) 技术.此技术在20世纪40年代兴起,国外较早地研制成功治疗设备并进行了临床试用,我国在90年代正式进入临床推广应用,迄今治疗病例总数逾万例,治疗病种迅速扩大,其有效性和安全性已被公认.

  3. Trends In News Media Coverage Of Mental Illness In The United States: 1995-2014.

    Science.gov (United States)

    McGinty, Emma E; Kennedy-Hendricks, Alene; Choksy, Seema; Barry, Colleen L

    2016-06-01

    The United States is engaged in ongoing dialogue around mental illness. To assess trends in this national discourse, we studied the volume and content of a random sample of 400 news stories about mental illness from the period 1995-2014. Compared to news stories in the first decade of the study period, those in the second decade were more likely to mention mass shootings by people with mental illnesses. The most frequently mentioned topic across the study period was violence (55 percent overall) divided into categories of interpersonal violence or self-directed (suicide) violence, followed by stories about any type of treatment for mental illness (47 percent). Fewer news stories, only 14 percent, described successful treatment for or recovery from mental illness. The news media's continued emphasis on interpersonal violence is highly disproportionate to actual rates of violence among those with mental illnesses. Research suggests that this focus may exacerbate social stigma and decrease support for public policies that benefit people with mental illnesses.

  4. Biographical value: towards a conceptualisation of the commodification of illness narratives in contemporary healthcare.

    Science.gov (United States)

    Mazanderani, Fadhila; Locock, Louise; Powell, John

    2013-07-01

    Illness narratives play a central role in social studies of health and illness, serving as both a key theoretical focus and a popular research method. Despite this, relatively little work has gone into conceptualising how and why illness narratives - be they in books, websites, television or other media - are commodified in contemporary healthcare and its social environment; namely, how distinctive forms of value are generated in the production, circulation, use and exchange of illness narratives. In this article we propose the notion of biographical value as a first step towards conceptualising the values attributed to illness narratives in this context. Based on a secondary analysis of 37 interviews with people affected by 15 different health conditions in the UK (all of whom have shared their illness experiences across various media) and drawing on understandings of value in research on the bioeconomy and the concept of biovalue in particular, we sketch out how epistemic, ethical and economic forms of value converge and co-constitute each other in the notion of biographical value and in broader economies of illness experiences.

  5. Nutritional Needs of the Child with a Handicap or Chronic Illness. Manual II: Clinical Nutrition. Presentations from a National Interdisciplinary Symposium.

    Science.gov (United States)

    Ekvall, Shirley M.; Wheby, Elizabeth A.

    The following papers were presented at a symposium on clinical nutrition for the child who is chronically ill or handicapped: (1) "Food Allergy"; (2) "Anemia and the Chronically Ill or Handicapped Child"; (3) "Nutrition and Neurotransmitters--Clinical Implications"; (4) "The Importance of Lipid Type in the Diet after Burn Injury"; (5) "Advances of…

  6. Focus On Photoshop Elements Focus on the Fundamentals

    CERN Document Server

    Asch, David

    2011-01-01

    Are you bewildered by the advanced editing options available in Photoshop Elements? Do you want to get the most out of your image without going bleary-eyed in front of a computer screen? This handy guide will explain the ins and outs of using Photoshop Elements, without having to spend hours staring at the screen. Using a fabulous combination of easy-to-follow advice and step-by-step instructions, Focus On Photoshop Elements gives great advice on setting up, storing and sharing your image library and teaches you the basics of RAW image processing and color correction, plus shows you how to edi

  7. Integrated management of childhood illness with the focus on caregivers: an integrative literature review La atención integrada de las enfermedades prevalentes en la infancia y el enfoque en los cuidadores: revisión integradora de la literatura Atenção integrada às doenças prevalentes na infância e o enfoque nos cuidadores: revisão integrativa da literatura

    Directory of Open Access Journals (Sweden)

    Vania Daniele Paranhos

    2011-02-01

    Full Text Available The Integrated Management of Childhood Illness (IMCI strategy addresses the diseases most prevalent in infancy, the reception of the child and family, and the comprehension the problem and effective procedures. The aim was to identify, between 1998 and 2008, publications relating to the IMCI strategy focusing on the caregiver. This study is an Integrative literature review in the Pubmed, Lilacs and Scielo databases. The caregivers knew one or more warning signs for acute respiratory infection, but not for diarrhea. Pneumonia was perceived as a serious childhood disease. Communication skills among health professionals trained in the IMCI strategy were different to those in untrained professionals. The follow-up of the health of the child is higher according to the education level of the caregiver, and according to the medications supplied in the consultation and in the follow-up. Regarding the health of the child it is relevant to focus on the IMCI strategy, favoring experiences that include the family in the care.La estrategia Atención Integrada a las Enfermedades Prevalentes en la Infancia (AIEPI aborda las enfermedades de mayor prevalencia en la infancia, el acogimiento del niño y de la familia, la comprensión del problema y los procedimientos eficaces. El objetivo fue identificar, entre 1998 y 2008, publicaciones relacionadas a la estrategia AIEPI con enfoque en el cuidador. Revisión integradora con evidencias en la literatura, en las bases de datos Pubmed, Lilacs y Scielo. Los cuidadores conocen una o más señales de alarma para infección respiratoria aguda, pero no para diarrea. La neumonía es percibida como una grave enfermedad infantil. Las habilidades comunicativas entre los profesionales de la salud capacitados en la estrategia AIEPI y los no capacitados son diferentes. El seguimiento de la salud del niño es mayor de acuerdo con la escolaridad del cuidador, los medicamentos ofrecidos en la consulta y el retorno. En la salud del

  8. Mental illness, violence risk, and race in juvenile detention: implications for disproportionate minority contact.

    Science.gov (United States)

    Desai, Rani A; Falzer, Paul R; Chapman, John; Borum, Randy

    2012-01-01

    Disproportionate minority contact (DMC) is a pervasive problem throughout the juvenile justice system. This article explored whether mental illness may be an explanatory factor in DMC. Data such as measures of violence risk and symptoms of mental illness were taken from intake interviews with 482 detained youth in Connecticut. Results indicated that racial minorities in detention have significantly lower violence risk than Caucasians but are disproportionately represented among detention populations relative to their proportions in the general population. In addition, DMC in these data was not explained by mental illness, seriousness of charges, violence risk, age, or gender. We suggest that mandated efforts to reduce DMC will need to address more than improving behavior or reducing symptoms of mental illness among detained minority youth. Instead, efforts should be focused on reducing the racial disparity evident in decisions made within the juvenile justice system.

  9. Management of critically ill patients with type 2 diabetes:The need for personalised therapy

    Institute of Scientific and Technical Information of China (English)

    2015-01-01

    Critical illness in patients with pre-existing diabetesfrequently causes deterioration in glycaemic control.Despite the prevalence of diabetes in patients admittedto hospital and intensive care units, the idealmanagement of hyperglycaemia in these groups isuncertain. There are data that suggest that acutehyperglycaemiain critically ill patients without diabetesis associated with increased mortality and morbidity.Exogenous insulin to keep blood glucose concentrations〈 10 mmol/L is accepted as standard of care in thisgroup. However, preliminary data have recently beenreported that suggest that chronic hyperglycaemia mayresult in conditioning, which protects these patientsagainst damage mediated by acute hyperglycaemia.Furthermore, acute glucose-lowering to 〈 10 mmol/Lin patients with diabetes with inadequate glycaemiccontrol prior to their critical illness appears to havethe capacity to cause harm. This review focuses onglycaemic control in critically ill patients with type 2diabetes, the potential for harm from glucose-loweringand the rationale for personalised therapy.

  10. Hypophosphatemia in critically ill children.

    Directory of Open Access Journals (Sweden)

    Kavous Shahsavari Nia

    2016-08-01

    Full Text Available Introduction: Hypophosphatemia is a common disorder in critically ill patients, and is associated with myasthenia, especially in respiratory muscles, and respiratory infections. This study was conducted to describe the prevalence of hypophosphatemia in children hospitalized in the pediatric intensive care unit (PICU of Children’s Hospital in Tabriz, Iran, in 2014-2015. Methods: In this descriptive study, medical records of all children admitted to the PICU of the children’s university hospital affiliated to Tabriz University of Medical Sciences were collected from archives of the hospital from 2014-2015 upon adopting permission. The medical records were examined in terms of demographic information, clinical diagnosis of the disease, serum phosphate level, nutritional status, therapeutic interventions, and other underlying specifications. The data were analyzed using SPSS software and descriptive tests. Results: Of the 83 eligible medical records, 45 records belonged to boys, and 38 records belonged to girls. The most prevalent and the least prevalent diseases in these children were acute pulmonary disease (57.8% and septic shock (1.2% respectively. Regarding the nutritional status, 38.6% of the children suffered malnutrition. Phosphorus deficiency was prevalent in the first day in 10.8% of the children, and abnormal levels of phosphorus were observed from the fourth to the sixth day in 26.5% of the children, which increased to 34.9% from the seventh to the tenth day. Conclusion: This study showed no statistically significant correlation between sex and prevalence of hypophosphatemia. Type of disease was not significantly associated with the level of phosphorus. Moreover, the patients’ nutritional status was not significantly associated with the prevalence of hypophosphatemia.

  11. The meaning of social support for the critically ill patient.

    Science.gov (United States)

    Hupcey, J E

    2001-08-01

    Social support has been shown to be important for the critically ill patient. However, what constitutes adequate support for these patients has not been investigated. Thus, the purpose of this qualitative study was to investigate patients' perceptions of their need for and adequacy of the social support received while they were critically ill. Thirty adult patients who were critical during some point of their stay in the intensive care unit (ICU) stay were interviewed, once stable. Interviews were tape-recorded and began with an open-ended question regarding the ICU experience. This was followed by open-ended focused questions regarding social support, such as 'Who were your greatest sources of social support while you were critically ill?' 'What did they do that was supportive or unsupportive?' Data were analyzed according to Miles and Huberman (1994). The categories that emerged were need for social support based on patient perceptions (not number of visitors), quality of support (based on perceptions of positive and negative behaviors of supporters) and lack of support. This study found that quality of support was more important than the actual number of visitors. Patients with few visitors may have felt supported, while those with numerous visitors felt unsupported. Patients who felt unsupported also were more critical of the staff and the care they received. Nurses need to individually assess patients regarding their need for support, and assist family/friends to meet these needs.

  12. [The mentally ill artist--a historical retrospect].

    Science.gov (United States)

    Bergdolt, K

    1995-07-01

    The painting of the mentally ill has fascinated artists and their public throughout the 20th century. Yet the psychologically as well as art-historically interesting topic can be traced back over a long period in the history of Western culture. Aristotle emphasizes that all men who create great works, such as artists, philosophers, poets and politicians, are prone to melancholy, that excess of black gall which is characteristic of artists and depressive. Although Plato distinguished between creative and clinical mania, the topos of "genius and madness" prevails up to our century. The cult of melancholy is taken up bei Marsilio Ficino and becomes fashionable among the artists of the 16th and 17th centuries. During the Romantic period of the early 19th century the psychologically unstable or even sick intellectual and artist becomes the focus of attention. Artistic madness is glorified in an almost mystical fashion. However, disillusionment was soon to follow. Schopenhauer, Lombroso and many physicians stress the close relationship between genius and madness. However, they judge madness to be merely morbid and negative. During the 20th century the artists of the avantgarde show much interest in psychoanalysis and in the art of the mentally ill. The rise of National Socialism brought about a drastic break in the appraisal of the art of the mentally ill, which today is an acknowledged factor in contemporary art.

  13. 高强度聚焦超声治疗中空化效应的研究进展%Advancement in Cavitational Effects of High Intensity Focused Ultrasound During Thareputics

    Institute of Scientific and Technical Information of China (English)

    李全义; 李付长

    2011-01-01

    High intensity focused ultrasound (HIFU) as a new technology has been used in clinical practices. The mechanism is one of the hot points in research. Cavitation was reviewed in this paper.%高强度聚焦超声(high intensity focusedu ultrasound,HIFU)作为一种新技术已经成功的应用于临床治疗,其治疗机制一直是研究热点.本文就HIFU治疗中空化效应进行综述.

  14. Chronic illness in adolescents: a sociological perspective.

    Science.gov (United States)

    Silber, T J

    1983-01-01

    This article relates chronic illness in adolescents to a sociological model of deviance. This is an area of controversy: the views of Freidson, Lorber and Robinson are presented as being representative of the dispute. Four situations are discussed in which the issues of prognosis, responsibility and stigma elicit societal response. The usefulness of a sociological model consists in making vague societal perception and rules explicit. The concept of the chronically ill adolescent as deviant is descriptive and devoid of value judgment. Only through such rigorous assessment is it possible to gain a realistic understanding of the societal role in the life of the chronically ill adolescent.

  15. Electrotherapy and mental illness: then and now.

    Science.gov (United States)

    Gilman, Sander L

    2008-09-01

    Today electrotherapy has reappeared as a therapy of choice for the treatment of depression and other forms of mental illness. It had de facto vanished from allopathic medicine from the 1920s to the end of the century. The debates about electrotherapy mirror the question of whether mental illness was somatic and to be treated by somatic means or psychological to be treated with psychotherapy. Sigmund Freud's move from an advocate to an opponent of electrotherapy is exemplary for a shift in attitude and the decline of electrotherapy. With the re-somaticization of mental illness over the past decades has come the reappearance of somatic therapies such as electrotherapy.

  16. Physics of Fission and Fusion for the Diagnostics and Monitoring of the Deadliest Illness of Mankind

    Science.gov (United States)

    Saxena, Arjun

    2015-03-01

    The physics of fission and fusion has been well known for the past several decades. It has been used primarily for destructive purposes (e. g., nuclear armaments) with both processes. However for peaceful purposes, e. g., generation of energy, only fission has been used, but not yet fusion. It is also well known that the deadliest illness of mankind is the group of illnesses called mental illnesses. A large segment of the world population is afflicted by them causing more loss of human lives, destruction of families, businesses and overall economy than all the other illnesses combined. Despite outstanding advancements in medical research and huge investments, unfortunately no diagnostic techniques have yet been found which can characterize the patient's mental illness. Consequently, no quantitative monitoring techniques are available to evaluate the efficacy of the various medicines used to treat the patients, and to develop them in the pharmaceutical labs. The purpose of this paper is to apply the constructive aspects of fission and fusion to identify the missing links in the diagnosis and treatment of mental illnesses. Each patient is a unique human being, not a disease or a group of symptoms. This makes it even more difficult to treat the patients suffering from mental illnes

  17. Household out-of-pocket payments for illness: Evidence from Vietnam

    Directory of Open Access Journals (Sweden)

    Janlert Urban

    2006-11-01

    Full Text Available Abstract Background In Vietnam, illnesses create high out-of-pocket health care expenditures for households. In this study, the burden of illness in the Bavi district, Vietnam is measured based upon individual household health expenditures for communicable and non-communicable illnesses. The focus of the paper is on the relative effect of different illnesses on the total economic burden of health care on households in general and on households that have catastrophic health care spending in particular. Methods The study was performed by twelve monthly follow-up interviews of 621 randomly selected households. The households are part of the FilaBavi project sample – Health System Research Project. The heads of household were interviewed at monthly intervals from July 2001 to June 2002. Results For the population in the Bavi district, communicable illnesses predominate among the episodes of illness and are the reason for most household health care expenditure. This is the case for almost all groups within the study and for the study population as a whole. However, communicable illnesses are more dominant in the poor population compared to the rich population, and are more dominant in households that have very large, or catastrophic, health care expenditure, compared to those without such expenditures. Conclusion The main findings indicate that catastrophic health care spending for a household is not usually the result of one single disastrous event, but rather a series of events and is related more to "every-day illnesses" in a developing country context than to more spectacular events such as injuries or heart illnesses.

  18. Concept Analysis of Illness Engulfment in Schizophrenia.

    Science.gov (United States)

    Vining, Danny; Robinson, Jennifer C

    2016-06-01

    Schizophrenia has a significant risk of damaging an individual's self-concept. Through the process of illness engulfment an individual's self-concept becomes reorganized entirely around the experience of having schizophrenia. The purpose of this manuscript is to clarify the structure and function of the concept of illness engulfment in schizophrenia using Walker and Avant's (2011) method of concept analysis. Data came from a review of scholarly literature, as well as contemporary and historical art, literature, music, and other media forms. The analysis discussed two defining attributes of experience of illness and impact on self-concept with a total of seven indicators. The article listed antecedents, consequences, and discussed the Modified Engulfment Scale as empirical referents. Fictional cases were developed to illustrate the concept. Finally, the concept of illness engulfment was discussed within the framework of the Roy Adaptation Model.

  19. Why critically ill patients are protein deprived.

    Science.gov (United States)

    Hoffer, L John; Bistrian, Bruce R

    2013-01-01

    Critical illness dramatically increases muscle proteolysis and more than doubles the dietary protein requirement. Yet surprisingly, most critically ill patients receive less than half the recommended amount of protein during their stay in a modern intensive care unit. What could explain the wide gap between the recommendations in clinical care guidelines and actual clinical practice? We suggest that an important aspect of the problem is the failure of guidelines to explain the pathophysiology of protein-energy malnutrition and the ways critical illness modifies protein metabolism. The difficulty created by the lack of a framework for reasoning about appropriate protein provision in critical illness is compounded by the many ambiguous and often contradictory ways the word malnutrition is used in the critical care literature. Failing to elucidate these matters, the recommendations for protein provision in the guidelines are incoherent, unconvincing, and easy to ignore.

  20. Outbreak of Mysterious Illness Among Hospital Staff

    DEFF Research Database (Denmark)

    Jacobsen, Peter; Ebbehøj, Niels Erik

    2016-01-01

    department became acutely ill with nonspecific symptoms. After uneventful observation they were discharged, but symptoms worsened at reassembly for debriefing. Poisoning with hydrogen sulfide was suspected, and the victims were transferred by helicopter for hyperbaric oxygen (HBO) treatment. During...

  1. Gulf War Illness Inflammation Reduction Trial

    Science.gov (United States)

    2015-10-01

    1 AWARD NUMBER: W81XWH-14-1-0477 TITLE: Gulf War Illness Inflammation Reduction Trial PRINCIPAL INVESTIGATOR: Ronald R. Bach, Ph.D...5a. CONTRACT NUMBER Gulf War Illness Inflammation Reduction Trial 5b. GRANT NUMBER W81XWH-14-1-0477 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d...GWI). Elevated biomarkers of inflammation were observed in our pilot observational study of GWI. Thus, chronic inflammation appears to be part of

  2. Probiotic (VSL#3) for Gulf War Illness

    Science.gov (United States)

    2012-10-01

    are relevant to GW Veterans. Altered gut flora may be the etiological factor for IBS and GW Illness. Probiotics are living organisms that improve... health by re-establishing a normal gut flora. The overall objective of the study was to determine whether Bifidobacterium infantis 35624 (Align...W81XWH-10-1-0593 TITLE: Probiotic (VSL#3) for Gulf War Illness. PRINCIPAL INVESTIGATOR: Ashok Tuteja, M.D. M.P.H

  3. Electrotherapy and mental illness: then and now

    OpenAIRE

    Sander L. Gilman

    2008-01-01

    Abstract Today electrotherapy has reappeared as a therapy of choice for the treatment of depression and other forms of mental illness. It had de facto vanished from allopathic medicine from the 1920s to the end of the century. The debates about electrotherapy mirror the question of whether mental illness was somatic and to be treated by somatic means or psychological to be treated with psychotherapy. Sigmund Freud's move from an advocate to an opponent of electrothera...

  4. Focus groups in organizational research

    Directory of Open Access Journals (Sweden)

    L. Kamfer

    1989-05-01

    Full Text Available Focus groups are commonly used in marketing research. In this article an application of the focus group technique within an organizational context is described. Nine focus groups were conducted during the planning stage of a survey intended to establish employee perceptions of advancement policies and practices in a major South African manufacturing company. Fourteen themes emerged from a content analysis of the discussions. Two of these reflected aspects requiring commitment decisions from management toward the survey. The others indicated areas of concern which should be included in the survey. In this way, the focus groups contributed useful information for the subsequent sample survey. Opsomming Fokusgroepe word algemeen in bemarkingsnavorsing aangewend. In hierdie studie word 'n toepassingvan die fokusgroeptegniek in die konteks van 'n opname binne 'n organisasie beskryf. Nege fokusgroepbesprekings is gevoer tydens die beplanningstadium van 'n opname wat binne 'n Suid-Afrikaanse vervaardigingsonderneming gedoen is. Die doel van die opname was om die persepsies van werknemers teenoor die bestaande personeel- en bestuursontwikkelingsbeleid en -praktyke van die maatskappy te bepaal. Veertien temas is deur middel van 'n inhoudontleding gei'dentifiseer. Twee hiervan het aspekte aangedui waaroor bestuur beginselbesluite t.o.v. die opname sou moes neem. Die ander het probleemareas aangedui wat by die ondersoek selfingesluit behoort te word. Sodoende het die fokusgroepe inligting verskafwat vir die latere vraelysopname belangrik was.

  5. Media and mental illness: Relevance to India

    Directory of Open Access Journals (Sweden)

    S K Padhy

    2014-01-01

    Full Text Available Media has a complex interrelationship with mental illnesses. This narrative review takes a look at the various ways in which media and mental illnesses interact. Relevant scientific literature and electronic databases were searched, including Pubmed and GoogleScholar, to identify studies, viewpoints and recommendations using keywords related to media and mental illnesses. This review discusses both the positive and the negative portrayals of mental illnesses through the media. The portrayal of mental health professionals and psychiatric treatment is also discussed. The theories explaining the relationship of how media influences the attitudes and behavior are discussed. Media has also been suggested to be a risk factor for the genesis or exacerbation of mental illnesses like eating disorders and substance use disorders. The potential use of media to understand the psychopathology and plight of those with psychiatric disorders is referred to. The manner in which media can be used as a tool for change to reduce the stigma surrounding mental illnesses is explored.

  6. [The debate on the development of advanced competences].

    Science.gov (United States)

    Dimonte, Valerio; Palese, Alvisa; Chiari, Paolo; Laquintana, Dario; Tognoni, Gianni; Di Giulio, Paola

    2016-01-01

    . The debate on the development of advanced nursing competences. The dossier aims to describe and disentagle the present Italian and international debate on the development and recognition of advanced nursing competences. Following a general brief description of the legislative national background, the attention is first of all focused on the lack of clarity on the definition of advanced competence, which is further complicated by the issue of their formal, contractual and economic recognition. To explore these issues a list of contributions is presented and some proposals are formulated to favor a better oriented development of the debate: a. A convenience sample of 139 nurses were interviewed asking to describe problems occurred in the last month that could prompt the intervention of an expert nurse and to list the clinical, managerial and educational competences of a specialized nurse in their ward. The results document the quality and the dispersion of the definitions which are perceived and applied in the general settings of care. b. The issue the post basic courses (master, specialization) offered to nurses in 2015-2016 by Italian universities were described and their aims. While the contribution of the courses in increasing the theoretical knowledge is well defined, the aims and the description of the clinical training are badly developed and an acquisition of advanced competences would seem unlikely. c. The definition of advanced competences was explored in the international literature: while evidences are available on the impact of advanced nursing on patients' outcomes, what is advanced nursing is far from being clear, and an impressive list of roles, activities and functions are considered advanced. d. Although at national level there is no formal recognition for nurses with advanced competences (with the exception of the head nurse that holds mostly an organizational rather than clinical role), the opportunities for promoting the role of specialistic/advanced

  7. Integrated Development of Embedded Systems with AutoFocus

    OpenAIRE

    Franz Huber; Bernhard Schaetz

    2016-01-01

    This article presents AutoFocus, a tool prototype for formally based development of distributed, embedded systems. AutoFocus supports system development offering integrated, comprehensive and mainly graphical description techniques to specify different views as well as different levels of abstraction of a system. To avoid ill-defined specifications, consistency conditions on these system descriptions can be formulated and checked. Prototypes can be generated from consistent and executable spe...

  8. 高强度聚焦超声治疗胰腺癌的研究进展%Advances of High-intensity Focused Ultrasound on the Treatment of Pancreatic Cancer

    Institute of Scientific and Technical Information of China (English)

    陈依静(综述); 许青(审校)

    2015-01-01

    High-intensity focused ultrasound( HIFU) is a non-invasive technique used for thermal abla-tion in multiple benign and malignant solid tumors. Pancreatic cancer has a dismal prognosis, and most patients are diagnosed at an inoperable stage. Chemotherapy and radiation therapy is not satisfactory enough. So,there is an urge need for new treatments to improve the situation. Clinical trials suggest that HIFU,as part of the comprehensive treatment for patients with pancreatic cancer,may increase the effective rate,median survival time,1-year survival rate and improve the quality of life.%高强度聚焦超声(HIFU)是一种无创局部热消融技术,适用于多种良恶性实体肿瘤的治疗。胰腺癌起病隐匿,恶性程度高,多数患者确诊时已失去手术机会,且化疗、放疗效果欠佳,故需要新的治疗手段改善现状。临床研究显示,HIFU作为综合治疗手段可能提高胰腺癌患者的治疗有效率、中位生存期及1年生存率,改善患者的生活质量。

  9. Perceived illness intrusion among patients on hemodialysis

    Directory of Open Access Journals (Sweden)

    Bapat Usha

    2009-01-01

    Full Text Available Dialysis therapy is extremely stressful as it interferes with all spheres of daily acti-vities of the patients. This study is aimed at understanding the perceived illness intrusion among pa-tients on hemodialysis (HD and to find the association between illness intrusion and patient demo-graphics as well as duration of dialysis. A cross sectional study involving 90 patients with chronic kidney disease (CKD stage V, on HD was performed during the period from 2005 to 2006. The subjects included were above 18 years of age, willing, stable and on dialysis for at least two months. Patients with psychiatric co-morbidity were excluded. A semi-structured interview schedule covering socio-demographics and a 13 item illness intrusion checklist covering the various aspects of life was ca-rried out. The study patients were asked to rate the illness intrusion and the extent. The data were ana-lyzed statistically. The mean age of the subjects was 50.28 ± 13.69 years, males were predominant (85%, 73% were married, 50% belonged to Hindu religion, 25% had pre-degree education, 25% were employed and 22% were housewives. About 40% and 38% of the study patients belonged to middle and upper socio-economic strata respectively; 86% had urban background and lived in nuclear fami-lies. The mean duration on dialysis was 24 ± 29.6 months. All the subjects reported illness intrusion to a lesser or greater extent in various areas including: health (44%, work (70% finance (55%, diet (50% sexual life (38% and psychological status (25%. Illness had not intruded in areas of rela-tionship with spouse (67%, friends (76%, family (79%, social (40% and religious functions (72%. Statistically significant association was noted between illness intrusion and occupation (P= 0.02.

  10. Beliefs regarding diet during childhood illness

    Directory of Open Access Journals (Sweden)

    Asha D Benakappa

    2012-01-01

    Full Text Available Background: Fifty percent to 70% of the burden of childhood diarrhea and respiratory infections is attributable to undernutrition. It is compounded by food restriction during illness due to false beliefs, leading to a vicious cycle of malnutrition and infection. In the long run, it decreases the child′s productivity, which is an obstacle to sustainable socioeconomic development. Objectives: To assess the dietary practices during different illnesses, to study the role of education, culture and religion in feeding an ill child and to create awareness against detrimental practices. Materials and Methods: A cross-sectional study was undertaken among 126 caregivers of ill children using an open-ended pretested questionnaire. Statistical package for social sciences software was used for data analysis. Simple proportions, percentages and Chi-square were used. Results: Caregivers believed that a child must be fed less during illness. Educational status did not play a role in maintaining beliefs, but elders and religion did. Doctors too were responsible for unwanted dietary restrictions. Media did not have an impact in spreading nutrition messages. Decreased breast feeds, initiating bottle feeds, feeding diluted milk and reducing complementary feeds during illness was widely practiced. Calorie intake during illness was very less and statistically significant. Firmly rooted beliefs about "hot" and "cold" foods lead to restriction of food available at home. Conclusions: Healthy feeding practices were few, and inappropriate ones predominant. Dietary education was overlooked. While planning community-based nutrition programs, firmly rooted beliefs should be kept in mind. Involving the elderly caregivers and mothers actively along with the health workers is the need of the hour.

  11. The transfigured body and the ethical turn in Australian illness memoir.

    Science.gov (United States)

    Nettelbeck, Amanda

    2008-09-01

    Within the fields of social medicine and the medical humanities, chronic illness is acknowledged not just as an individually but as a socially transformative experience. The proliferation of published 'illness narratives' in recent years attests to the socially compelling nature of this particular story of transformation. Indeed, illness narratives have, in the past decade or so, become a rich source of interest in sociological and medical anthropological work for their capacity to map the material transformation of person to patient, of an assumed to a newly fluid model of subjectivity. Their significance is particularly visible in the cultural context of the west, where more people live both to be diagnosed with chronic illnesses (such as cancer) and to survive them. With a focus on two recently published Australian works, Eating the Underworld: A Memoir in Three Voices (2001), by the psychologist Doris Brett, and Tiger's Eye: A Memoir (2001), by the historian Inga Clendinnen, this paper will consider how the illness experience marks a transformation of embodied subjectivity that, in turn, triggers transformations of other kinds. These works have quite different intents, but they provide models for exploring how physical and individual transformation through illness becomes the occasion for reconsidering the body of history, and of the resonances of history in social memory.

  12. Heart-related anxieties in relation to general anxiety and severity of illness in cardiology patients.

    Science.gov (United States)

    Muschalla, Beate; Glatz, Johannes; Linden, Michael

    2014-01-01

    Absence of an adequate reason for anxiety is a criterion for pathological anxiety. However, the presence of danger or fear-provoking stimuli may even be a risk factor for anxiety and does not exclude that there is additionally pathological anxiety too. The question is, to what degree can heart-related anxiety be explained by the severity of illness or trait anxiety? Two hundred and nine patients (37.8% women) from a cardiology inpatient unit completed the Heart-Anxiety-Questionnaire, Progression-Anxiety-Questionnaire, Job-Anxiety-Scale and the State-Trait-Anxiety-Inventory. The severity of cardiac illness was rated by the treating cardiologists using the Multidimensional Severity of Morbidity Rating. Time absent from work due to sickness was assessed as an indicator for illness-related impairment. Heart anxiety was significantly related to progression anxiety and, to a lesser extent, trait anxiety and indicators of subjective symptoms of somatic illness. No association was found with medical ratings for prognosis, multimorbidity, or reduction in life expectancy. Heart-related anxiety is a symptom of an anxiety disorder. Although partially dependent on subjective suffering, it cannot be explained by the severity of medical illness. Treatment of health-related anxieties should focus on how to cope with subjective symptoms of illness.

  13. Preventive family service coordination for parents with a mental illness in the Netherlands

    NARCIS (Netherlands)

    Wansink, H.J.; Hosman, C.M.H.; Janssens, J.M.A.M.; Hoencamp, E.; Willems, W.J.H.

    2014-01-01

    TOPIC: The Preventive Basic Care Management (PBCM) program is a Dutch service coordination program for parents with mental illnesses, which focuses on organizing tailored support from various services for parents and their children from a preventive perspective. PURPOSE: The article discusses our ef

  14. Coping with the Stigma of Mental Illness: Empirically-Grounded Hypotheses from Computer Simulations

    Science.gov (United States)

    Kroska, Amy; Har, Sarah K.

    2011-01-01

    This research demonstrates how affect control theory and its computer program, "Interact", can be used to develop empirically-grounded hypotheses regarding the connection between cultural labels and behaviors. Our demonstration focuses on propositions in the modified labeling theory of mental illness. According to the MLT, negative societal…

  15. Conceptualizing Social Integration among Formerly Homeless Adults with Severe Mental Illness

    Science.gov (United States)

    Tsai, Jack; Rosenheck, Robert A.

    2012-01-01

    The multiple dimensions of social integration among formerly homeless adults with severe mental illness have not been well-studied. Previous studies have focused on clinical measures or narrow components of social integration. We used a multisite study of chronically homeless adults who were provided housing to (a) identify the main factors…

  16. Disease severity is a major determinant for the pharmacodynamics of propofol in critically ill patients

    NARCIS (Netherlands)

    Peeters, M. M. M.; Bras, L. J.; DeJongh, J.; Aarts, L. P. H. J.; Danhof, M.; Knibbe, C. A. J.

    2008-01-01

    As oversedation is still common and significant variability between and within critically ill patients makes empiric dosing difficult, the population pharmacokinetics and pharmacodynamics of propofol upon long-term use are characterized, particularly focused on the varying disease state as determina

  17. Hope as a Strategy in Supervising Social Workers of Terminally Ill Patients

    Science.gov (United States)

    Itzhaky, Haya; Lipschitz-Elhawi, Rachel

    2004-01-01

    This article focuses on supervision of social workers who feel despair and hopelessness in treating terminally ill patients. The emotional difficulties that may lead to these feelings are discussed. A special model of supervision that relates to hope as a strategy to help social workers cope with such difficulties is presented. The model suggests…

  18. New insights towards the acute nonthyroidal illness syndrome

    Directory of Open Access Journals (Sweden)

    ANA LUIZA eMAIA

    2012-01-01

    Full Text Available The non-thyroidal illness syndrome (NTIS refers to changes in serum thyroid hormone levels observed in critically-ill patients in the absence of hypothalamic-pituitary-thyroid primary dysfunction. Affected individuals have low T3, elevated rT3 and inappropriately normal TSH levels. The pathophysiological mechanisms are poorly understood but the acute and chronic changes in pituitary–thyroid function are probably the consequence of the action of multiple factors. The early phase seems to reflect changes occurring primarily in the peripheral thyroid hormone metabolism, best seen in humans since 80-90% of the circulating T3 are derived from the pro-hormone T4. The conversion of T4-to-T3 is catalyzed by type 1 (D1 and type 2 (D2 deiodinases via outer-ring deiodination. In contrast, type 3 deiodinase (D3 catalyzes the inactivation of both T4 and T3. Over the last decades, several studies have attempted to elucidate the mechanisms underlying the changes on circulating thyroid hormones in NTIS. Increased inflammatory cytokines, which occurs in response to virtually any illness, has long been speculated to play a role in derangements of deiodinase expression. On the other hand, oxidative stress due to augmented reactive oxygen species (ROS generation is characteristic of many diseases that are associated with NTIS. Changes in the intracellular redox state may disrupt deiodinase function by independent mechanisms, which might include depletion of the as yet unidentified endogenous thiol cofactor. Here we aim to present an updated picture of the advances in understanding the mechanisms that result in the fall of thyroid hormone levels in the acute phase of NTIS.

  19. How the Media Cover Mental Illnesses: A Review

    Science.gov (United States)

    Ma, Zexin

    2017-01-01

    Purpose: Mental illness has become an important public health issue in society, and media are the most common sources of information about mental illnesses. Thus, it is important to review research on mental illnesses and media. The purpose of this paper is to provide a narrative review of studies on mental illnesses in the media and identifies…

  20. Life satisfaction post stroke : The role of illness cognitions

    NARCIS (Netherlands)

    van Mierlo, M. L.; van Heugten, C. M.; Post, M. W. M.; de Kort, P. L. M.; Visser-Meily, J. M. A.

    2015-01-01

    Objective: To describe illness cognitions two months and two years post stroke and to investigate changes in illness cognitions over time. We also examined the associations between illness cognitions and life satisfaction at two months and two years post stroke and investigated if changes in illness

  1. Life satisfaction post stroke : The role of illness cognitions

    NARCIS (Netherlands)

    van Mierlo, M. L.; van Heugten, C. M.; Post, M. W M; de Kort, P. L M; Visser-Meily, J.M.A.

    2015-01-01

    OBJECTIVE: To describe illness cognitions two months and two years post stroke and to investigate changes in illness cognitions over time. We also examined the associations between illness cognitions and life satisfaction at two months and two years post stroke and investigated if changes in illness

  2. Non-communicable diseases, mental ill-health: Is it a failure of the food system?

    Science.gov (United States)

    Crawford, Michel A

    2013-01-01

    The rise in brain disorders and mental ill-health is the most serious crisis facing the survival of humanity. Starting from an understanding of the origins of the nervous system and the brain, together with its nutritional requirements, the present direction of the food system since World War II (WWII) can be seen as departing from the biological essence of brain chemistry and its nutritional needs. Such advances in the food system would lead to epigenetic changes. Improper maternal/foetal nutrition is considered in this manner to lead to heart disease, stroke and diabetes in later life. Is there any reason why the brain would not be similarly susceptible to a nutritional background departing from its specific needs? The changing food system likely bears responsibility for the rise in mental ill health that has now overtaken all other burdens of ill health. Its globalisation is threatening civil society.

  3. What Proportion of Terminally Ill and Dying People Require Specialist Palliative Care Services?

    Directory of Open Access Journals (Sweden)

    Donna M. Wilson

    2014-01-01

    Full Text Available Currently, around 55 million people die each year worldwide. That number is expected to increase rapidly with accelerating population aging. Despite growth in the number of palliative care specialists and specialist services in most countries, the prospect of an increasing number of terminally ill and dying persons is daunting. This paper attempts to answer the question: what proportion of terminally ill and dying persons require specialist palliative care services? To address this question and highlight which persons require specialist palliative care, the current state of access to specialist palliative care services and specialists in Canada and other countries is highlighted, along with available evidence-based information on specialist services utilization and the care needs of terminally ill and dying persons. Current evidence and information gaps reveal that this question cannot be answered now, but it should be answered in advance of a crisis of unmet end-of-life care needs with the rising death toll.

  4. FOCUS: Sustainable Mathematics Successes

    Science.gov (United States)

    Mireles, Selina V.; Acee, Taylor W.; Gerber, Lindsey N.

    2014-01-01

    The FOCUS (Fundamentals of Conceptual Understanding and Success) Co-Requisite Model Intervention (FOCUS Intervention) for College Algebra was developed as part of the Developmental Education Demonstration Projects (DEDP) in Texas. The program was designed to use multiple services, courses, and best practices to support student completion of a…

  5. Joining of advanced materials

    CERN Document Server

    Messler, Robert W

    1993-01-01

    Provides an unusually complete and readable compilation of the primary and secondary options for joining conventional materials in non-conventional ways. Provides unique coverage of adhesive bonding using both organic and inorganic adhesives, cements and mortars. Focuses on materials issues without ignoring issues related to joint design, production processing, quality assurance, process economics, and joining performance in service.Joining of advanced materials is a unique treatment of joining of both conventional and advanced metals andalloys, intermetallics, ceramics, glasses, polymers, a

  6. [Neuropsychological aspects of the manic syndrome in the course of bipolar affective illness].

    Science.gov (United States)

    Lewandowska, Anna; Rybakowski, Janusz

    2009-01-01

    Neuropsychological deficits in schizophrenia and affective illnesses have been a topic of increasing research interest for more than two decades. Currently, the cognitive dysfunctions are regarded as an essential element of these illnesses, occurring already in their prodromal phase, with an increment during the course of illness and with some deficits persisting also during the remission period. In schizophrenia, deficits in working memory and executive functions are most frequently demonstrated. In patients with affective illnesses, the initial research focused mainly on depression, where psychomotor slowness, deficits of attention, verbal and working memory and executive functions have been observed. It has been shown that during depression in the course of bipolar affective illness, the cognitive dysfunctions have been more marked as compared with recurrent depression. In this paper, the neuropsychological changes occurring during the period of mania and hypomania have been presented. The disturbances that have been shown most frequently include selective cognitive dysfunctions such as disturbances of attention and learning process, working memory and executive functions. During periods of mania/hypomania, the specific distortions of thinking occur ("anastrophic" thinking), as well as disturbances in the decision making process, connected with increased impulsivity. Another characteristic of the episode of elevated mood has been a change of information processing of affective type, mostly a lower ability for perception and recognition of negative emotions. Among persons with bipolar affective illness, especially during the hypomanic period, an increased level of creativity than in control persons has been observed, what may facilitate higher artistic activity. Recently, the evidence has been accumulated pointing to more severe cognitive dysfunctions in bipolar affective illness, type I (with manic states) compared with bipolar affective illness, type II (with

  7. The role and experiences of family members during the rehabilitation of mentally ill offenders.

    Science.gov (United States)

    Rowaert, Sara; Vandevelde, Stijn; Lemmens, Gilbert; Vanderplasschen, Wouter; Vander Beken, Tom; Vander Laenen, Freya; Audenaert, Kurt

    2016-03-01

    Taking care of a family member with a mental illness imposes a burden on various aspects of family life. This burden may be enhanced if the mentally ill individual has a criminal history. This paper aims to summarize the scientific literature dealing with the experiences, needs and burdens of families of mentally ill offenders. We aim to explore the roles that family members play in the rehabilitation of their relative and review the families' needs and burdens. Finally, we aim to investigate whether or not the family strengths are considered in the literature. A literature search in line with the PRISMA statement for systematic reviews and with the recommendations for an integrative review was performed in the ISI Web of Science, PubMed, Elsevier Science Direct and ProQuest databases. Limited research has been carried out into the experiences, needs and burdens of families of mentally ill offenders, with only eight studies fulfilling the inclusion criteria. Families of mentally ill offenders experience more stress than those of mentally ill individuals with no judicial involvement. This is because of the fact that these family members have to deal with both mental health services and judicial systems. The eight retrieved studies focus on needs and burdens, with little reference to strengths or capabilities. The review has highlighted the need for further research into the needs and burdens of families with mentally ill offenders, with a focus on strengths rather than an exclusively problem-oriented perspective. It is important that families become more involved in the health and social care of their relatives to avoid being considered 'second patients'.

  8. Regional distribution of fatiguing illnesses in the United States: a pilot study

    Science.gov (United States)

    Bierl, Cynthia; Nisenbaum, Rosane; Hoaglin, David C; Randall, Bonnie; Jones, Ann-Britt; Unger, Elizabeth R; Reeves, William C

    2004-01-01

    Background Chronic fatigue syndrome (CFS) is a debilitating illness with no known cause or effective therapy. Population-based epidemiologic data on CFS prevalence are critical to put CFS in a realistic context for public health officials and others responsible for allocating resources. Methods We conducted a pilot random-digit-dialing survey to estimate the prevalence of fatiguing illnesses in different geographic regions and in urban and rural populations of the United States. This report focuses on 884 of 7,317 respondents 18 to 69 years old. Fatigued (440) and randomly selected non-fatigued (444) respondents completed telephone questionnaires concerning fatigue, other symptoms, and medical history. Results We estimated 12,186 per 100,000 persons 18 to 69 years of age suffered from fatigue lasting for at least 6 months (chronic fatigue), and 1,197 per 100,000 described an illness that, though lacking clinical evaluation, met criteria for CFS (CFS-like). Chronic fatigue and CFS-like illness were more common in rural than in urban populations, although the differences were not significant. The prevalence of these fatiguing illnesses did not differ meaningfully among the four regions surveyed, and no significant geographic trends were observed. Conclusions This investigation estimated that nearly 2.2 million American adults suffer from CFS-like illness. The study also suggested the need to focus future investigations of fatigue on populations with lower incomes and less education. There was no evidence for regional differences in the occurrence of fatiguing illnesses. PMID:14761250

  9. Regional distribution of fatiguing illnesses in the United States: a pilot study

    Directory of Open Access Journals (Sweden)

    Unger Elizabeth R

    2004-02-01

    Full Text Available Abstract Background Chronic fatigue syndrome (CFS is a debilitating illness with no known cause or effective therapy. Population-based epidemiologic data on CFS prevalence are critical to put CFS in a realistic context for public health officials and others responsible for allocating resources. Methods We conducted a pilot random-digit-dialing survey to estimate the prevalence of fatiguing illnesses in different geographic regions and in urban and rural populations of the United States. This report focuses on 884 of 7,317 respondents 18 to 69 years old. Fatigued (440 and randomly selected non-fatigued (444 respondents completed telephone questionnaires concerning fatigue, other symptoms, and medical history. Results We estimated 12,186 per 100,000 persons 18 to 69 years of age suffered from fatigue lasting for at least 6 months (chronic fatigue, and 1,197 per 100,000 described an illness that, though lacking clinical evaluation, met criteria for CFS (CFS-like. Chronic fatigue and CFS-like illness were more common in rural than in urban populations, although the differences were not significant. The prevalence of these fatiguing illnesses did not differ meaningfully among the four regions surveyed, and no significant geographic trends were observed. Conclusions This investigation estimated that nearly 2.2 million American adults suffer from CFS-like illness. The study also suggested the need to focus future investigations of fatigue on populations with lower incomes and less education. There was no evidence for regional differences in the occurrence of fatiguing illnesses.

  10. Physicians should increase focus on poor medicine adherence among chronically ill patients

    DEFF Research Database (Denmark)

    Tøttenborg, Sandra Søgaard; Topp, Marie; Ingebrigtsen, Truls Sylvan;

    2014-01-01

    Non-adherence to medicine is common in patients with chronic diseases, contributing to significant worsening of disease, increased mortality and health expenditure. Methods of measuring adherence include self report, prescription refill rates, biomarkers, electronic monitoring and therapeutic out...... treatments to the patient's lifestyle and preferences....

  11. Planar-Focusing Cathodes

    CERN Document Server

    Lewellen, J W

    2005-01-01

    Conventional pi-mode rf photoinjectors typically use magnetic solenoids for emittance compensation. This provides independent focusing strength, but can complicate rf power feed placement, introduce asymmetries (due to coil crossovers), and greatly increase the cost of the photoinjector. Cathode-region focusing can also provide for a form of emittance compensation. Typically this method strongly couples focusing strength to the field gradient on the cathode, however, and also requires altering the longitudinal position of the cathode to change the focusing. We propose a new method for achieving cathode-region variable-strength focusing for emittance compensation. The new method reduces the coupling to the gradient on the cathode, and does not require a change in the longitudinal position of the cathode. Expected performance for an S-band system is similar to conventional solenoid-based designs. This paper presents the results of rf cavity and beam dynamics simulations of the new design.

  12. Life threatening illness and hospice care.

    Science.gov (United States)

    Stein, A; Forrest, G C; Woolley, H; Baum, J D

    1989-01-01

    A retrospective study was undertaken of 25 families and their 26 ill children attending the first children's hospice in the United Kingdom. The study examined the family's perceptions of the care offered and the impact of chronic and life threatening illness. Eighteen (72%) of the families felt they had been well supported by the hospice and valued the family like atmosphere, perceiving the staff to be friendly, approachable, and helpful. The actual nature of hospice care, in an environment with other terminally ill children, was, however, considered a drawback for a few families. A number of families still had unmet needs, notably appropriate child minding when away from the hospice. The impact of chronic life threatening illness on the families was substantial. The parents (particularly the mothers), the index children, and their siblings all experienced much higher levels of psychological symptomatology than would have been expected from normal samples. While families felt greatly helped over symptom control, a proportion remained very worried about certain symptoms, particularly breathlessness, seizures, and pain. A high proportion of families were experiencing financial and employment difficulties as a result of their children's illnesses. PMID:2730123

  13. Making sense of different illness realities: restructuring of illness meaning among Swedish-born women.

    Science.gov (United States)

    Bäärnhielm, Sofie

    2005-01-01

    This study explores restructuring of illness meaning among eight Swedish-born female patients, assessed as somatizing, encountering caregivers imposing a "psychological language" of distress. Data were collected 1997-2001 from 32 interviews and analysed with a Grounded Theory approach. Two major trends were identified in the participants' process of restructuring illness meaning: first, a trend of accepting a "psychological language" of understanding distress and then of paying attention to stress and demanding work conditions. The term "burnout" was introduced. For participants, giving meaning to illness had been a continuous and interactive process in which new meanings had been integrated within a framework of both constancy and change. Restructuring illness meaning had not been uncomplicated. Participants tried to bridge illness perspectives and treatment strategies within their daily life situations of handling distress. The social context had been important for bridging gaps in illness perspectives and in creating coherence between frames of meanings. The results support the view that Antonovsky's concept of Sense of Coherence (SOC) may have relevance when considering the process of restructuring illness meaning, and that constructing coherence between experience, expression, past and new meanings given to illness, may be significant for patients' recovery. The results stress the importance of research exploring the interaction between individuals and social and cultural groups in multicultural milieus in order to obtain insights as to how people make sense of their clinical encounter.

  14. The Chronic Illness Initiative: Supporting College Students with Chronic Illness Needs at DePaul University

    Science.gov (United States)

    Royster, Lynn; Marshall, Olena

    2008-01-01

    College students with chronic illness find it difficult to succeed in traditional degree programs due to disruptions caused by relapses and unpredictable waxing and waning symptoms. College disability offices are often unable to help, both because their standard supports are not appropriate and because students with chronic illness frequently do…

  15. Perceived Mental Illness Stigma, Intimate Relationships, and Sexual Risk Behavior in Youth with Mental Illness

    Science.gov (United States)

    Elkington, Katherine S.; Hackler, Dusty; Walsh, Tracy A.; Latack, Jessica A.; McKinnon, Karen; Borges, Cristiane; Wright, Eric R.; Wainberg, Milton L.

    2013-01-01

    The current study examines the role of mental illness-related stigma on romantic or sexual relationships and sexual behavior among youth with mental illness (MI), including youths' experiences of stigma, the internalization of these experiences, and the behavior associated with managing stigma within romantic and sexual relationships. We conducted…

  16. Mental Illness among Us: A New Curriculum to Reduce Mental Illness Stigma among Medical Students

    Science.gov (United States)

    Aggarwal, Anuj K.; Thompson, Maxwell; Falik, Rebecca; Shaw, Amy; O'Sullivan, Patricia; Lowenstein, Daniel H.

    2013-01-01

    Objectives: Medical students have been shown to have high levels of psychological distress, including self-stigmatization and unwillingness to seek care. The authors hypothesized that a student-led curriculum involving personal mental illness experience, given during the first-year neuroscience course, and titled "Mental Illness Among Us…

  17. Illness as a condition of our existence in the world: on illness and pathic existence.

    Science.gov (United States)

    Martinsen, Elin Håkonsen; Solbakk, Jan Helge

    2012-06-01

    This paper seeks to find different ways of addressing illness as an experience essential to the understanding of being a human being. As a conceptual point of departure, we suggest the notion of 'pathic existence' as developed by the German physician and philosopher Viktor von Weizsäcker (1886-1957). Through an analysis of his conceptualisation of the pathic and of pathic categories, we demonstrate how this auxiliary typology may be of help in unveiling different modes of ill-being, or Kranksein. Furthermore, we show how illness plays a paradigmatic role in this type of existence. We discuss how von Weizsäcker's claim of illness as "a way of being human" indicates how such a view of the illness existence both differs from and touches upon other streams of thought within the philosophy of medicine and medical ethics. Finally, we highlight some of the normative implications emerging from this perspective of relevance in today's medicine.

  18. The detection and treatment of depression in the physically ill

    OpenAIRE

    2010-01-01

    Depression and chronic physical illness are in reciprocal relationship with one another: not only do many chronic illnesses cause higher rates of depression, but depression has been shown to antedate some chronic physical illnesses. Depression associated with physical illness is less well detected than depression occurring on its own, and various ways of improving both the detection and treatment of depression accompanying physical illness are described. This paper is in fou...

  19. [Health education: knowledge, social representation, and illness].

    Science.gov (United States)

    Gazzinelli, Maria Flávia; Gazzinelli, Andréa; Reis, Dener Carlos dos; Penna, Cláudia Maria de Mattos

    2005-01-01

    This article discusses the theory and practice of health and education, beginning with the notion of the hegemony (in health education practice) of strategies linked to the notion that to grasp established knowledge always leads to the acquisition of new behaviors and practices. Five different axioms have oriented education and health practices, either juxtaposed or at different moments: (1) the notion of overcoming the determination of knowledge over practices; (2) the determination of representations over practices; (3) the analysis of representations within the traditional framework of right and wrong; (4) reciprocity between representations and practices; and (5) the importance of considering practices amenable to re-elaboration through representations, thus situating experience in understanding subjects' illness processes, as well as the way subjects culturally construct illness. The article highlights the need for a link between social representations and illness-as-experience in health education practices.

  20. Protein and energy provision in critical illness.

    Science.gov (United States)

    Hoffer, L John

    2003-11-01

    It has recently been recommended that parenterally fed, critically ill patients should receive considerably less energy than the 36 kcal.kg(-1).d(-1) customarily received in earlier years and that mixed amino acid infusions not exceed 1.5 g.kg(-1).d(-1). The implications of these recommendations should be considered carefully, especially for patients with low body weight. Any sizeable reduction in energy provision will lead to negative energy balance in at least some patients, and negative energy balance is known to increase protein requirements. The optimal rate of amino acid delivery for underfed, critically ill patients is not well defined and could well exceed 1.5 g.kg(-1).d(-1). In addition, there are good reasons to suspect that the safe protein requirement of severely underweight, critically ill patients is >1.5 g.kg(-1).d(-1), even when adequate energy is provided.

  1. Nutrition, illness, and injury in aquatic sports.

    Science.gov (United States)

    Pyne, David B; Verhagen, Evert A; Mountjoy, Margo

    2014-08-01

    In this review, we outline key principles for prevention of injury and illness in aquatic sports, detail the epidemiology of injury and illness in aquatic athletes at major international competitions and in training, and examine the relevant scientific evidence on nutrients for reducing the risk of illness and injury. Aquatic athletes are encouraged to consume a well-planned diet with sufficient calories, macronutrients (particularly carbohydrate and protein), and micronutrients (particularly iron, zinc, and vitamins A, D, E, B6, and B12) to maintain health and performance. Ingesting carbohydrate via sports drinks, gels, or sports foods during prolonged training sessions is beneficial in maintaining energy availability. Studies of foods or supplements containing plant polyphenols and selected strains of probiotic species are promising, but further research is required. In terms of injury, intake of vitamin D, protein, and total caloric intake, in combination with treatment and resistance training, promotes recovery back to full health and training.

  2. Telehomecare for patients with multiple chronic illnesses

    Science.gov (United States)

    Liddy, Clare; Dusseault, Joanne J.; Dahrouge, Simone; Hogg, William; Lemelin, Jacques; Humber, Jennie

    2008-01-01

    OBJECTIVE To examine the feasibility and efficacy of integrating home health monitoring into a primary care setting. DESIGN A mixed method was used for this pilot study. It included in-depth interviews, focus groups, and surveys. SETTING A semirural family health network in eastern Ontario comprising 8 physicians and 5 nurses caring for approximately 10 000 patients. PARTICIPANTS Purposeful sample of 22 patients chosen from the experimental group of 120 patients 50 years old or older in a larger randomized controlled trial (N = 240). These patients had chronic illnesses and were identified as being at risk based on objective criteria and physician assessment. INTERVENTIONS Between November 2004 and March 2006, 3 nurse practitioners and a pharmacist installed telehomecare units with 1 or more peripheral devices (eg, blood-pressure monitor, weight scale, glucometer) in patients’ homes. The nurse practitioners incorporated individualized instructions for using the unit into each patient’s care plan. Patients used the units every morning for collecting data, entering values into the system either manually or directly through supplied peripherals. The information was transferred to a secure server and was then uploaded to a secure Web-based application that allowed care providers to access and review it from any location with Internet access. The devices were monitored in the office on weekdays by the nurse practitioners. MAIN OUTCOME MEASURES Acceptance and use of the units, patients’ and care providers’ satisfaction with the system, and patients’ demographic and health characteristics. RESULTS All 22 patients, 12 men and 10 women with an average age of 73 years (range 60 to 88 years), agreed to participate. Most were retired, and a few were receiving community services. Common diagnoses included hypertension, diabetes, cardiovascular disease, and chronic obstructive pulmonary disease. All patients had blood pressure monitors installed, 11 had wired weight

  3. New focused crawling algorithm

    Institute of Scientific and Technical Information of China (English)

    Su Guiyang; Li Jianhua; Ma Yinghua; Li Shenghong; Song Juping

    2005-01-01

    Focused carawling is a new research approach of search engine. It restricts information retrieval and provides search service in specific topic area. Focused crawling search algorithm is a key technique of focused crawler which directly affects the search quality. This paper first introduces several traditional topic-specific crawling algorithms, then an inverse link based topic-specific crawling algorithm is put forward. Comparison experiment proves that this algorithm has a good performance in recall, obviously better than traditional Breadth-First and Shark-Search algorithms. The experiment also proves that this algorithm has a good precision.

  4. Challenging claims that mental illness has been increasing and mental well-being declining.

    Science.gov (United States)

    Busfield, Joan

    2012-08-01

    There has been a tendency by some social scientists and the media to claim that in advanced western societies like Britain and the US mental illness has been increasing and mental well-being declining over the period since the Second World War. In this paper I consider the evidence that is invoked in making such claims, along with the counter-evidence. In order to assess the evidence it is essential to take account of the different ways mental illness and mental well-being are measured and the definitions the measures embed. I argue that when the findings from studies using similar measures at different points in time are compared, there is little evidence of consistent secular increases in mental illness or declines in mental well-being. I suggest that such claims are encouraged by two main factors: first and most importantly, the major changes that have occurred in the official boundaries of mental disorder over the post-war period, which have also changed the ideas and perceptions of professionals and the public about mental health and illness; and second, the ready way in which data on mental health and illness can be used to support criticism of certain features of present-day society.

  5. Probiotic (VSL 3) for Gulf War Illness

    Science.gov (United States)

    2015-10-01

    AD_________________ Award Number: W81XWH-10-1-0593 TITLE: Probiotic (VSL#3) for Gulf War Illness PRINCIPAL INVESTIGATOR: Ashok Tuteja, M.D...2015 5a. CONTRACT NUMBER Probiotic (VSL#3) for Gulf War Illness 5b. GRANT NUMBER W81XWH-10-1-0593 5c. PROGRAM ELEMENT NUMBER 6 . AUTHOR(S) 5d...ABSTRACT The overall objective of the study is to determine whether probiotic VSL#3® will improve 1) intestinal symptoms of Irritable Bowel Syndrome

  6. Probiotic (VSL#3) for Gulf War Illness

    Science.gov (United States)

    2014-10-01

    AD_________________ Award Number: W81XWH-10-1-0593 TITLE: Probiotic (VSL#3) for Gulf War Illness. PRINCIPAL INVESTIGATOR: Ashok Tuteja, M.D...5a. CONTRACT NUMBER Probiotic (VSL#3) for Gulf War Illness 5b. GRANT NUMBER W81XWH-10-1-0593 5c. PROGRAM ELEMENT NUMBER 6 . AUTHOR(S) 5d. PROJECT...ABSTRACT The overall objective of the study is to determine whether probiotic VSL#3® will improve 1) intestinal symptoms of Irritable Bowel Syndrome and 2

  7. New U.S. Foodborne Illness Estimate

    Centers for Disease Control (CDC) Podcasts

    2010-12-13

    This podcast discusses CDC's report on new estimates of illnesses due to eating contaminated food in the United States. Dr. Elaine Scallan, assistant professor at the University of Colorado and former lead of the CDCs FoodNet surveillance system, shares the details from the first new comprehensive estimates of foodborne illness in the U.S. since 1999.  Created: 12/13/2010 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID); National Center for Immunization and Respiratory Diseases (NCIRD).   Date Released: 12/15/2010.

  8. Final focus test beam

    Energy Technology Data Exchange (ETDEWEB)

    1991-03-01

    This report discusses the following: the Final Focus Test Beam Project; optical design; magnets; instrumentation; magnetic measurement and BPM calibration; mechanical alignment and stabilization; vacuum system; power supplies; control system; radiation shielding and personnel protection; infrastructure; and administration.

  9. Final focus nomenclature

    Energy Technology Data Exchange (ETDEWEB)

    Erickson, R.

    1986-08-08

    The formal names and common names for all devices in the final focus system of the SLC are listed. The formal names consist of a device type designator, microprocessor designator, and a four-digit unit number. (LEW)

  10. Focus group discussions

    CERN Document Server

    Hennink, Monique M

    2014-01-01

    The Understanding Research series focuses on the process of writing up social research. The series is broken down into three categories: Understanding Statistics, Understanding Measurement, and Understanding Qualitative Research. The books provide researchers with guides to understanding, writing, and evaluating social research. Each volume demonstrates how research should be represented, including how to write up the methodology as well as the research findings. Each volume also reviews how to appropriately evaluate published research. Focus Group Discussions addresses the challenges associated with conducting and writing focus group research. It provides detailed guidance on the practical and theoretical considerations in conducting focus group discussions including: designing the discussion guide, recruiting participants, training a field team, moderating techniques and ethical considerations. Monique Hennink describes how a methodology section is read and evaluated by others, such as journal reviewers or ...

  11. EDITORIAL: Focus on Attosecond Physics

    Science.gov (United States)

    Bandrauk, André D.; Krausz, Ferenc; Starace, Anthony F.

    2008-02-01

    future involve using overdense plasmas. Electronic processes on sub-atomic spatio-temporal scales are the basis of chemical physics, atomic, molecular, and optical physics, materials science, and even some life science processes. Research in these areas using the new attosecond tools will advance together with the ability to control electrons themselves. Indeed, we expect that developments will advance in a way that is similar to advances that have occurred on the femtosecond time scale, in which much previous experimental and theoretical work on the interaction of coherent light sources has led to the development of means for 'coherent control' of nuclear motion in molecules. This focus issue of New Journal of Physics is centered on experimental and theoretical advances in the development of new methodologies and tools for electron control on the attosecond time scale. Topics such as the efficient generation of harmonics; the generation of attosecond pulses, including those having only a few cycles and those produced from overdense plasmas; the description of various nonlinear, nonperturbative laser-matter interactions, including many-electron effects and few-cycle pulse effects; the analysis of ultrashort propagation effects in atomic and molecular media; and the development of inversion methods for electron tomography, as well as many other topics, are addressed in the current focus issue dedicated to the new field of 'Attosecond Physics'. Focus on Attosecond Physics Contents Observing the attosecond dynamics of nuclear wavepackets in molecules by using high harmonic generation in mixed gases Tsuneto Kanai, Eiji J Takahashi, Yasuo Nabekawa and Katsumi Midorikawa Core-polarization effects in molecular high harmonic generation G Jordan and A Scrinzi Interferometric autocorrelation of an attosecond pulse train calculated using feasible formulae Y Nabekawa and K Midorikawa Attosecond pulse generation from aligned molecules—dynamics and propagation in H2+ E Lorin, S

  12. High harmonics focusing undulator

    Energy Technology Data Exchange (ETDEWEB)

    Varfolomeev, A.A.; Hairetdinov, A.H.; Smirnov, A.V.; Khlebnikov, A.S. [Kurchatov Institute, Moscow (Russian Federation)

    1995-12-31

    It was shown in our previous work that there exist a possibility to enhance significantly the {open_quote}natural{close_quote} focusing properties of the hybrid undulator. Here we analyze the actual undulator configurations which could provide such field structure. Numerical simulations using 2D code PANDIRA were carried out and the enhanced focusing properties of the undulator were demonstrated. The obtained results provide the solution for the beam transport in a very long (short wavelength) undulator schemes.

  13. CLIC Final Focus Studies

    CERN Document Server

    Tomás, R; Schulte, Daniel; Zimmermann, Frank

    2006-01-01

    The CLIC final focus system has been designed based on the local compensation scheme proposed by P. Raimondi and A. Seryi. However, there exist important chromatic aberrations that deteriorate the performance of the system. This paper studies the optimization of the final focus based on the computation of the higher orders of the map using MAD-X and PTC. The use of octupole tail folding to reduce the size of the halo in the locations with aperture limitations is also discussed.

  14. Electron beam focusing system

    Energy Technology Data Exchange (ETDEWEB)

    Dikansky, N.; Nagaitsev, S.; Parkhomchuk, V.

    1997-09-01

    The high energy electron cooling requires a very cold electron beam. Thus, the electron beam focusing system is very important for the performance of electron cooling. A system with and without longitudinal magnetic field is presented for discussion. Interaction of electron beam with the vacuum chamber as well as with the background ions and stored antiprotons can cause the coherent electron beam instabilities. Focusing system requirements needed to suppress these instabilities are presented.

  15. Plutonium focus area

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-08-01

    To ensure research and development programs focus on the most pressing environmental restoration and waste management problems at the U.S. Department of Energy (DOE), the Assistant Secretary for the Office of Environmental Management (EM) established a working group in August 1993 to implement a new approach to research and technology development. As part of this new approach, EM developed a management structure and principles that led to the creation of specific Focus Areas. These organizations were designed to focus the scientific and technical talent throughout DOE and the national scientific community on the major environmental restoration and waste management problems facing DOE. The Focus Area approach provides the framework for intersite cooperation and leveraging of resources on common problems. After the original establishment of five major Focus Areas within the Office of Technology Development (EM-50, now called the Office of Science and Technology), the Nuclear Materials Stabilization Task Group (EM-66) followed the structure already in place in EM-50 and chartered the Plutonium Focus Area (PFA). The following information outlines the scope and mission of the EM, EM-60, and EM-66 organizations as related to the PFA organizational structure.

  16. Research on the Positioning, Focus and Strategy of Tianjin Advanced Manufacturing Industry from the Perspective of Synergy Development of Beijing, Tianjin and Hebei%天津先进制造业发展“短板”分析及应对策略--基于京津冀协同的视角

    Institute of Scientific and Technical Information of China (English)

    余桂玲

    2016-01-01

    Tianjin development process of advanced manufacturing industry exposed many shortcomings:Information technology does not close with industry, weak industrial technology innovation, low degree of industrial integration, and low proportion of high-tech industry has seriously affected the development of the industry.In the perspective of the Industrial Synergy development of Beijing, Tianjin and Hebei, Tianjin has to accelerate the implementation of the national advanced manufacturing R&D base construction, promote development of advanced manufacturing, accelerating the international strategy of advanced manufacturing industry for positioning, clear the work focus of filling the shorts, through institutional innovation to promote the depth of integration of the industries in three provinces, accelerating independent innovation to stimulate industrial driving force, constantly optimize the industrial structure, accelerate the formation of industrial clusters, vigorously develop the productive service industry, improve the industrial development environment measures to enhance the competitiveness of Tianjin advanced manufacturing industry.%天津先进制造业发展过程中暴露出诸多短板:信息技术与产业结合不紧密、产业技术创新水平弱化、产业融合程度低、高新技术产业比例低等问题已经严重影响产业的发展。在京津冀产业协同发展视角下,天津先进制造业要以加速落实全国先进制造研发基地建设、推动先进制造业加速发展、加速先进制造业“走出去”为战略定位,明确“补短板”中的工作重点,通过制度创新推进三地产业的深度融合;通过企业自主创新,激发产业内驱力;不断优化产业结构,加速产业集群的形成;大力发展生产性服务业,优化产业发展环境等措施,提升推进天津先进制造业的竞争力。

  17. The stigma of mental illness in the labor market.

    Science.gov (United States)

    Hipes, Crosby; Lucas, Jeffrey; Phelan, Jo C; White, Richard C

    2016-03-01

    Mental illness labels are accompanied by devaluation and discrimination. We extend research on reactions to mental illness by utilizing a field experiment (N = 635) to test effects of mental illness labels on labor market discrimination. This study involved sending fictitious applications to job listings, some applications indicating a history of mental illness and some indicating a history of physical injury. In line with research indicating that mental illness leads to stigma, we predicted fewer callbacks to candidates with mental illness. We also predicted relatively fewer callbacks for applicants with mental illness when the jobs involved a greater likelihood for interpersonal contact with the employer. Results showed significant discrimination against applicants with mental illness, but did not indicate an effect of potential proximity to the employer. This contributes a valuable finding in a natural setting to research on labor market discrimination towards people with mental illness.

  18. Resisting the Stigma of Mental Illness

    Science.gov (United States)

    Thoits, Peggy A.

    2011-01-01

    The relationship between stigmatization and the self-regard of patients/consumers with mental disorder is negative but only moderate in strength, probably because a subset of persons with mental illness resists devaluation and discrimination by others. Resistance has seldom been discussed in the stigma and labeling literatures, and thus conditions…

  19. Doing gender, doing away with illness

    DEFF Research Database (Denmark)

    Kolling, Marie

    2012-01-01

    fieldwork conducted among men and women who are living with type 2 diabetes in conditions of urban poverty in Northeast Brazil, this article examines how the men’s illness experiences are interwoven with the changes they concomitantly experienced in their sexuality. By examining the disruptiveness...

  20. Cardiac troponin elevations among critically ill patients.

    NARCIS (Netherlands)

    Klein Gunnewiek, J.M.T.; Hoeven, J.G. van der

    2004-01-01

    PURPOSE OF THE REVIEW: Elevated levels of cardiac troponins, indicative of the presence of cardiac injury, have been reported in critically ill patients. In this review, the incidence, significance, and clinical relevance of elevated troponin levels among this group of patients will be discussed. RE

  1. Smoking, Mental Illness, and Public Health.

    Science.gov (United States)

    Prochaska, Judith J; Das, Smita; Young-Wolff, Kelly C

    2016-12-16

    Tobacco remains the leading preventable cause of death worldwide. In particular, people with mental illness are disproportionately affected with high smoking prevalence; they account for more than 200,000 of the 520,000 tobacco-attributable deaths in the United States annually and die on average 25 years prematurely. Our review aims to provide an update on smoking in the mentally ill. We review the determinants of tobacco use among smokers with mental illness, presented with regard to the public health HAVE framework of "the host" (e.g., tobacco user characteristics), the "agent" (e.g., nicotine product characteristics), the "vector" (e.g., tobacco industry), and the "environment" (e.g., smoking policies). Furthermore, we identify the significant health harms incurred and opportunities for prevention and intervention within a health care systems and larger health policy perspective. A comprehensive effort is warranted to achieve equity toward the 2025 Healthy People goal of reducing US adult tobacco use to 12%, with attention to all subgroups, including smokers with mental illness. Expected final online publication date for the Annual Review of Public Health Volume 38 is March 20, 2017. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

  2. Burden of Illness in Hereditary Angioedema

    DEFF Research Database (Denmark)

    Bygum, Anette; Aygören-Pürsün, Emel; Beusterien, Kathleen

    2015-01-01

    The objective of the Hereditary Angioedema Burden of Illness Study in Europe was to assess the real-world experience of HAE from the patient perspective. Based on open-ended qualitative interviews with 30 patients from Spain, Germany and Denmark, 5 key themes emerged characterizing the impact...

  3. Wellness within illness: happiness in schizophrenia.

    Science.gov (United States)

    Palmer, Barton W; Martin, Averria Sirkin; Depp, Colin A; Glorioso, Danielle K; Jeste, Dilip V

    2014-10-01

    Schizophrenia is typically a chronic disorder and among the most severe forms of serious mental illnesses in terms of adverse impact on quality of life. Yet, there have been suggestions that some people with schizophrenia can experience an overall sense of happiness in their lives. We investigated happiness among 72 outpatients with non-remitted chronic schizophrenia with a mean duration of illness of 24.4 years, and 64 healthy comparison subjects (HCs). Despite continued treatment with antipsychotic medications, the individuals with schizophrenia manifested a mild to moderate level of psychopathology. People with schizophrenia reported lower mean levels of happiness than HCs, but there was substantial heterogeneity within the schizophrenia group. Level of happiness in persons with schizophrenia was significantly correlated with higher mental health-related quality of life, and several positive psychosocial factors (lower perceived stress, and higher levels of resilience, optimism, and personal mastery). However, level of happiness was not related to sociodemographic characteristics, duration of illness, severity of positive or negative symptoms, physical function, medical comorbidity, or cognitive functioning. Except for an absence of an association with resilience, the pattern of correlations of happiness with other variables seen among HCs was similar to that in individuals with schizophrenia. Although happiness may be harder to achieve in the context of a serious mental illness, it nonetheless appears to be a viable treatment goal in schizophrenia. Psychotherapies targeting positive coping factors such as resilience, optimism, and personal mastery warrant further investigation.

  4. Acute Stress Response in Critically Ill Children

    NARCIS (Netherlands)

    M. den Brinker (Marieke)

    2006-01-01

    textabstractThe understanding of the endocrine changes in critically ill children is important, as it provides insights in the pathophysiology of the acute stress in children and its differences compared with adults. Furthermore, it delineates prognostic factors for survival and supports the rati

  5. New European policy toward chronically ill employees

    NARCIS (Netherlands)

    Kopnina, H.; Haafkens, J.; Elling, L.R.

    2009-01-01

    This article provides an overview of current policies related to the chronically ill employees in the Netherlands. Different levels of policy are discussed: those formulated at the European, Dutch and organizational levels. A significantg percentage of Dutch employees suffer from longstanding diseas

  6. Development of neutron optical components at ILL

    CERN Document Server

    Courtois, P; Humblot, H; Alianelli, L; Pfeiffer, F O

    2002-01-01

    The neutron optics laboratory at ILL carries out an innovative research program in various fields of neutron optics with the aim of developing new and improved tools for neutron instrumentation. An overview of some recent highlights is presented, indicating the breadth of the potential applications. (orig.)

  7. Acronyms Gone Wild! ILL Flirts with NCIP

    Science.gov (United States)

    Carlson, Al

    2008-01-01

    While the traditional uses of InterLibrary Loan (ILL) can be cumbersome, much of the work is now done electronically. Google and WorldCat can tell patrons which libraries in their areas owns the the titles they want, but they cannot always tell patrons whether there is a copy on the shelf available for loan. Several ILS vendors and OCLC are…

  8. Blood-Injury-Illness Phobia: A Review.

    Science.gov (United States)

    Thyer, Bruce A.; And Others

    1985-01-01

    Surveys empirical literature pertaining to phobias of blood, injury, or illness (BII); defines BII phobia as selectively associated with vasovagal fainting response upon exposure to phobic stimuli. Presents clinical, demographic, and etiological information from 15 BII phobics and suggests that BII phobia warrants diagnostic category separate from…

  9. Attitudes toward patient expertise in chronic illness.

    Science.gov (United States)

    Thorne, S E; Ternulf Nyhlin, K; Paterson, B L

    2000-08-01

    Although it has become an accepted standard to acknowledge the patient as a full partner in health care decisions, replacing traditional authoritative relationships with those based on an emancipatory model, the experiences of persons living with chronic illness confirm that this paradigm shift is not yet apparent in many health care relationships. In this paper, the authors present a qualitative secondary analysis of combined data sets from their research into chronic illness experience with two quite different chronic diseases - Type I Diabetes (a socially legitimized chronic disease) and Environmental Sensitivities (a disease which is currently treated with considerable scepticism). Comparing the experiences of individuals with diseases that are quite differently socially constructed, it becomes possible to detect common underlying health professional values and attitudes that powerfully influence the experience of living with and negotiating health care for a chronic illness. In the discussion of findings from this study, the authors examine the implications of the spiral of behaviors that fuels mutual alienation in chronic illness care relationships if professionals are unable to value patient expertise.

  10. Diagnosing Febrile Illness in a Returned Traveler

    Centers for Disease Control (CDC) Podcasts

    2012-03-01

    This podcast will assist health care providers in diagnosing febrile illness in patients returning from a tropical or developing country.  Created: 3/1/2012 by National Center for Enteric, Zoonotic, and Infectious Diseases (NCEZID).   Date Released: 3/1/2012.

  11. Pancreatic Involvement in Critically ill Patients

    Directory of Open Access Journals (Sweden)

    Abhinav Agrawal

    2015-07-01

    Full Text Available Elevation of pancreatic enzymes is often observed in patients admitted to intensive care units in the United States. Elevated pancreatic enzymes can occur due to acute pancreatitis or numerous non-specific reasons. Non-specific enzyme elevation can be seen in patients with head injury, acute renal failure, diabetic ketoacidosis or patients on hemodialysis. Patients with severe acute pancreatitis can be admitted to the intensive care units for intensive care or patients admitted to the intensive care units for other critical illness can develop acute pancreatitis due to a variety of reasons like ischemia, hypoperfusion, drugs or hypercalcemia. It can be a challenging task to distinguish between acute pancreatitis and non-specific enzyme elevation, especially in critically ill patients with multiple co-morbidities admitted to the intensive care units in whom historical information may not be always available. In addition, the clinical consequences of pancreatic enzyme elevation in the critically ill patients are also not very clear. This review attempts to describe the complex interplay of various factors that can lead to either pancreatic inflammation and/or pancreatic enzyme elevation in the critically ill patients along with the clinical consequences and approach to patient with pancreatic enzyme elevation in the intensive care units.

  12. Communication with older, seriously ill patients.

    NARCIS (Netherlands)

    Vliet, L.M. van; Lindenberger, E.; Weert, J.C.M. van

    2015-01-01

    This article aims to provide more insight into effective communication with older people with serious illness and their surrogates/caregivers. To do so, if focusses on specific skills in three core functions of communication (i) empathic behavior, (ii) information provision and (iii) enabling decisi

  13. The Stigma of Families with Mental Illness

    Science.gov (United States)

    Larson, Jon E.; Corrigan, Patrick

    2008-01-01

    Objective: This article describes family stigma, which is defined as the prejudice and discrimination experienced by individuals through associations with their relatives. Methods: The authors describe family stigma and present current research related to mental illness stigma experienced by family members. Research indicates this type of stigma…

  14. Gendering psychosis: the illness of Zelda Fitzgerald.

    Science.gov (United States)

    Seeman, Mary V

    2016-03-01

    Psychiatric textbooks tend to describe psychosis as it is experienced by men. The well-documented illness of Zelda Fitzgerald illustrates the feminine side of psychosis. The distinctive features of Zelda's illness--its specific precipitants, the timing of its onset, the discontinuities in its course, the pronounced mood swings, the preservation of intellect and of agency, the maintenance of human ties, the association of flare-ups with immune and hormonal changes, the responsiveness to treatment, the lifelong creativity and productivity--show the female side of psychotic illness, one that is rarely described in diagnostic manuals. This paper relies on Nancy Milford's biography of Zelda, as well as on several other biographical sources and, using Zelda's own words and the words of her husband and friends, allows entry into a feminine world of psychosis, not encountered in textbooks. The expression of psychotic illness varies from person to person, its exact shape depending on many factors, most of them still undetermined, but gender is a critically important core component of variance.

  15. Mental Illness in Children: Know the Signs

    Science.gov (United States)

    ... Autism spectrum disorder: Signs and symptoms. Centers for Disease Control and Prevention. http://www.cdc.gov/ncbddd/autism/signs.html. Accessed Dec. 8, 2014. Feb. 11, 2015 Original article: http://www.mayoclinic.org/healthy-lifestyle/childrens-health/in-depth/mental-illness-in-children/ ...

  16. On a Monotone Ill-posed Problem

    Institute of Scientific and Technical Information of China (English)

    Nguyen BUONG

    2005-01-01

    A class of a posteriori parameter choice strategies for the operator version of Tikhonovregularization (including variants of Morozov's and Arcangeli's methods) is proposed and used in investigating the rate of convergence of the regularized solution for ill-posed nonlinear equation involving a monotone operator in Banach space.

  17. Ministry to the Chronically Ill Child.

    Science.gov (United States)

    Spinetta, Pat Deasy; Collins, Denis E.

    1993-01-01

    Reports growth in the number of chronically ill children attending Catholic schools. Describes the separate roles of home, school, and hospital in children's long-term care. Urges educators to obtain necessary information on children's attendance, peer interaction, education, and medical compliance. Reviews issues specific to chronically ill…

  18. Assistance Focus: Africa

    Energy Technology Data Exchange (ETDEWEB)

    2017-03-29

    The Clean Energy Solutions Center, an initiative of the Clean Energy Ministerial, helps countries throughout the world create policies and programs that advance the deployment of clean energy technologies. Through the Solutions Center's no-cost 'Ask an Expert' service, a team of international experts has delivered assistance to countries in all regions of the world. High-impact examples from Africa are featured here.

  19. Difficulties in diagnosing and treating depression in the terminally ill cancer patient

    OpenAIRE

    Lloyd-Williams, M.

    2000-01-01

    It is estimated that for a quarter of all patients with advanced metastatic cancer, depression will be significant symptom. However up to 80% of the psychological and psychiatric morbidity which develops in cancer patients goes unrecognised and untreated. One of the main difficulties in establishing a diagnosis of an illness where there are no biological markers, physical signs, or diagnostics tests is deciding what can be called "appropriate sadness" as patients approach the end of life and ...

  20. Theorizing health and illness: functionalism, subjectivity and reflexivity.

    Science.gov (United States)

    Stam, H J

    2000-05-01

    Health and illness in contemporary psychology are remarkably undertheorized, with the consequence that implicit definitions of these topics are unquestionably imported into health psychology. Largely inspired and oriented to the medical system, health psychology is often subservient to biomedically inspired theory or directed to solving the problems of the health care system, not those of its patients or those who might ultimately benefit from health knowledge. Qualitative approaches have attempted to reintroduce the voice of the patient/sufferer/individual back into health psychology but without adequate theoretical integration this work has been marginalized and ignored by mainstream health psychology in the service of medical modelling. The point is not to develop a health psychology as an exclusive disciplinary enclave but rather to open up the possibilities of a responsible knowing. Using Kathryn Addelson's work on professional knowing I argue that the collective activity that constitutes health psychology can be made more explicit not only by devising reflexive theories and practices but by focusing on what the outcomes of that activity might be. Functional theories of health and illness, on the other hand, obscure our epistemological and moral commitments.

  1. Decontamination & decommissioning focus area

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-08-01

    In January 1994, the US Department of Energy Office of Environmental Management (DOE EM) formally introduced its new approach to managing DOE`s environmental research and technology development activities. The goal of the new approach is to conduct research and development in critical areas of interest to DOE, utilizing the best talent in the Department and in the national science community. To facilitate this solutions-oriented approach, the Office of Science and Technology (EM-50, formerly the Office of Technology Development) formed five Focus AReas to stimulate the required basic research, development, and demonstration efforts to seek new, innovative cleanup methods. In February 1995, EM-50 selected the DOE Morgantown Energy Technology Center (METC) to lead implementation of one of these Focus Areas: the Decontamination and Decommissioning (D & D) Focus Area.

  2. Doing focus group research

    DEFF Research Database (Denmark)

    Lindegaard, Laura Bang

    2014-01-01

    , not as something that pre-exists or goes beyond the situated interaction. This article, however, challenges not only the first, but also the second position and suggests that it is, after all, possible to do committedly ethnomethodological studies of focus group data that demonstrate how members of a focus group......Scholars of ethnomethodologically informed discourse studies are often sceptical of the use of interview data such as focus group data. Some scholars quite simply reject interview data with reference to a general preference for so-called naturally occurring data. Other scholars acknowledge...... of interview interaction, but inadequate as data for studying phenomena that go beyond the phenomenon of interview interaction. Neither of these more and less sceptical positions are, on the face of it, surprising due to the ethnomethodological commitment to study social order as accomplished in situ...

  3. Focusing Vacuum Fluctuations, 2

    CERN Document Server

    Ford, L H

    2002-01-01

    The quantization of the scalar and electromagnetic fields in the presence of a parabolic mirror is further developed in the context of a geometric optics approximation. We calculate the mean squared scalar and electric fields near the focal line of a parabolic cylindrical mirror. These quantities are found to grow as inverse powers of the distance from the focus. We give a combination of analytic and numerical results for the mean squared fields. In particular, we find that the mean squared electric field can be either negative or positive, depending upon the choice of parameters. The case of a negative mean squared electric field corresponds to a repulsive Van der Waals force on an atom near the focus, and to a region of negative energy density. Similarly, a positive value corresponds to an attractive force and a possibility of atom trapping in the vicinity of the focus.

  4. Decreasing the Stigma of Mental Illness Through a Student-Nurse Mentoring Program: A Qualitative Study.

    Science.gov (United States)

    Fokuo, J Konadu; Goldrick, Virginia; Rossetti, Jeanette; Wahlstrom, Carol; Kocurek, Carla; Larson, Jonathon; Corrigan, Patrick

    2017-04-01

    Stigma is defined as endorsing prejudicial attitudes about mental illness leading to discriminatory behaviors. It undermines the quality of medical care received by people with mental illness. Research suggests contact based interventions are effective in reducing stigma and increasing positive attitudes towards people with mental illness. This paper describes the development of a consumer led student-nurse mentoring program as part of nursing student education. People with lived mental health experience would mentor student nurses regarding the harmful effects of stigma and the beneficial outcomes of affirming attitudes. Seventy members of stakeholder groups (people with lived mental health experience and student nurses) participated in focus groups. Qualitative analyses revealed themes across stakeholder groups regarding: perceived mental health stigma from nurses, ways to reduce stigma, target message for the mentorship program, characteristics of mentors and logistics in developing such a program within the student nurse curricula.

  5. Reincarceration Risk Among Men with Mental Illnesses Leaving Prison: A Risk Environment Analysis.

    Science.gov (United States)

    Barrenger, Stacey L; Draine, Jeffrey; Angell, Beth; Herman, Daniel

    2017-02-15

    Reentry interventions for persons with mental illness leaving prison have consisted primarily of linkage to mental health services and have produced mixed results on psychiatric and criminal recidivism. These interventions primarily focus on intra-individual risk factors. However, social and environmental factors may also increase risk of reincarceration by constraining choices and pro-social opportunities for community reintegration upon release from prison. In order to add to the knowledge base on understanding reincarceration risk for men with mental illnesses leaving prison, we examined interpersonal and environmental factors that exposed men to heightened risk for reincarceration. As part of a larger study examining the effectiveness of Critical Time Intervention for men with mental illness leaving prison, in-depth interviews were conducted with 28 men within 6 months of release from prison. Policies and practices at local and state levels, community conditions, and interpersonal obligation and conflict were identified as increasing risk for reincarceration.

  6. The focus factor

    DEFF Research Database (Denmark)

    Nicolaisen, Jeppe; Frandsen, Tove Faber

    2015-01-01

    Introduction. We present a new bibliometric indicator to measure journal specialisation over time, named the focus factor. This new indicator is based on bibliographic coupling and counts the percentage of re-citations given in subsequent years. Method. The applicability of the new indicator....... To validate re-citations as caused by specialisation, other possible causes were measured and correlated (obsolescence, journal self-citations and number of references). Results. The results indicate that the focus factor is capable of distinguishing between general and specialised journals and thus...

  7. [Focused musculoskeletal sonography].

    Science.gov (United States)

    Horn, Rudolf

    2015-09-16

    Even in emergent situations, focused musculoskeletal sonography must not be overlooked. It has a place in traumatology no less valuable than its place in internal medicine. It can be used to identify traumatic joint effusions, occult fractures and fissures, joint inflammation, muscle and tendon rupture; it can differentiate soft tissue swelling, locate a foreign body, or identify the location of fractures. Focused ultrasound should be performed by the attending physician directly at the patient’s bedside, in order to answer these specific questions.

  8. [Management of critically ill patients in the resuscitation room. Different than for trauma?].

    Science.gov (United States)

    Bernhard, M; Ramshorn-Zimmer, A; Hartwig, T; Mende, L; Helm, M; Pega, J; Gries, A

    2014-02-01

    The general approach to the initial resuscitation of non-trauma patients does not differ from the ABCDE approach used to evaluate severely injured patients. After initial stabilization of vital functions patients are evaluated based on the symptoms and critical care interventions are initiated as and when necessary. Adequate structural logistics and personnel organization are crucial for the treatment of non-trauma critically ill patients although there is currently a lack of clearly defined requirements. For severely injured patients there are recommendations in the S3 guidelines on treatment of multiple trauma and severely injured patients and these can be modeled according to the white paper of the German Society of Trauma Surgery (DGU). However, structured training programs similar to the advanced trauma life support (ATLS®)/European resuscitation course (ETC®) that go beyond the current scope of advanced cardiac life support training are needed. The development of an advanced critically ill life support (ACILS®) concept for non-trauma critically ill patients in the resuscitation room should be supported.

  9. Personality and illness adaptation in adults with type 1 diabetes: the intervening role of illness coping and perceptions.

    Science.gov (United States)

    Rassart, Jessica; Luyckx, Koen; Klimstra, Theo A; Moons, Philip; Groven, Chris; Weets, Ilse

    2014-03-01

    Inspired by the common sense model, the present cross-sectional study examined illness perceptions and coping as intervening mechanisms in the relationship between Big Five personality traits and illness adaptation in adults with Type 1 diabetes. A total of 368 individuals with Type 1 diabetes (18-35 years old) completed questionnaires on personality, diabetes-related problems, illness perceptions, and illness coping. First, Neuroticism, Agreeableness, and Conscientiousness predicted patients' illness adaptation, above and beyond the effects of sex, age, and illness duration. Second, illness coping was found to be an important mediating mechanism in the relationship between the Big Five and illness adaptation. Finally, perceived consequences and perceived personal control partially mediated the relationship between the Big Five and illness coping. These findings underscore the importance of examining patients' personality to shed light on their daily functioning and, hence, call for tailored intervention programs which take into account the personality of the individual patient.

  10. The economic impact of the insured patients with severe chronic and acute illnesses: a qualitative approach

    Directory of Open Access Journals (Sweden)

    Budi Aji

    2014-10-01

    Full Text Available Background: Little research has focused on the economic hardship among the insured with severe illnesses and high treatment costs, in particular, the consequence of poorer insurance coverage for high-cost illnesses. Therefore, we presented the case for identifying the experiences of insured patients with severe chronic and acute illnesses. This study identified a qualitative understanding of the economic impact of severe chronic and acute illnesses and household strategies to deal with high treatment costs. Design: Interviews were conducted with 19 insured households of three different health insurance programs with a family member that had been hospitalized for severe chronic or acute illnesses in either Banyumas or Margono Sukarjo hospitals in Banyumas, Central Java, Indonesia. A thematic analysis was applied to guide the interpretation of the data. Results: Insured households with a family member that had been hospitalized for severe chronic and acute illnesses were greatly affected by the high treatment costs. Four major issues emerged from this qualitative study: insured patients are still burdened with high out-of-pocket payments, households adopt various strategies to cope with the high cost of treatments, households experience financial hardships, and positive and negative perceptions of the insured regarding their health insurance coverage for acute and chronic illnesses. Conclusions: Askes and Jamsostek patients faced financial burdens from high cost sharing for hospital amenities, non-covered drugs, and treatments and other indirect costs. Meanwhile, Jamkesmas beneficiaries faced no financial burden for related medical services but were rather burdened with indirect costs for the carers. Households relied on internal resources to cover hospital bills as the first strategy, which included the mobilization of savings, sale of assets, and borrowing of money. External support was tapped secondarily and included financial support from

  11. An analysis of two indigenous reproductive health illnesses in a Nahua community in Veracruz, Mexico

    Directory of Open Access Journals (Sweden)

    Smith-Oka Vania

    2012-08-01

    Full Text Available Abstract Background This article describes the local concepts indigenous Nahua women hold regarding their reproduction. Specifically it provides a description of two indigenous illnesses—isihuayo and necaxantle, it discusses their etiology, symptoms, and treatments, and it analyzes them within the local ethnomedical framework and sociopolitical context. A perception of female vulnerability is shown to be an underlying shaper of women’s experiences of these illnesses. Methods This research took place in a small Nahua village in Mexico. Qualitative data on local perceptions of these illnesses were collected by a combination of participant observation and interviews. Ethnobotanical data was obtained through interviews, and medicinal plants were collected in home gardens, fields, stream banks, and forested areas. The total study population consisted of traditional birth attendants (N = 5, clinicians (N = 8, and laywomen (N = 48. Results Results showed that 20% of the village women had suffered from one or both of these illnesses. The article includes a detailed description of the etiology, symptoms, and treatments of these illnesses. Data shows that they were caused by mechanical, physical, and social factors related to a woman’s weakness and/or lack of support. Traditional birth attendants often treated women’s illnesses. Five medicinal plants were salient in the treatment of these illnesses: Ocimum basilicum L., Mentzelia aspera L., Pedilanthus tithymaloides (L. Poit., and Piper umbellatum L. were used for isihuayo, while Solanum wendlandii Hook f. was used for necaxantle. Conclusions The research on these two ethnomedical conditions is a useful case study to understanding how indigenous women experience reproductive health. Reproductive health is not simply about clinically-based medicine but is also about how biomedicine intersects with the local bodily concepts. By describing and analyzing indigenous women’s ill health, one can focus

  12. Understanding international differences in terminology for delirium and other types of acute brain dysfunction in critically ill patients

    NARCIS (Netherlands)

    Morandi, A; Pandharipande, P; Trabucchi, M; Rozzini, R; Mistraletti, G; Trompeo, A C; Gregoretti, C; Gattinoni, L; Ranieri, M V; Brochard, L; Annane, D; Putensen, C; Guenther, U; Fuentes, P; Tobar, E; Anzueto, A R; Esteban, A; Skrobik, Y; Salluh, J I F; Soares, M; Granja, C; Stubhaug, A; de Rooij, S E; Ely, E Wesley

    2008-01-01

    BACKGROUND: Delirium (acute brain dysfunction) is a potentially life threatening disturbance in brain function that frequently occurs in critically ill patients. While this area of brain dysfunction in critical care is rapidly advancing, striking limitations in use of terminology related to delirium

  13. Advances in chemical physics advances in liquid crystals

    CERN Document Server

    Prigogine, Ilya; Vij, Jagdish K

    2009-01-01

    Prigogine and Rice's highly acclaimed series, Advances in Chemical Physics, provides a forum for critical, authoritative reviews of current topics in every area of chemical physics. Edited by J.K. Vij, this volume focuses on recent advances in liquid crystals with significant, up-to-date chapters authored by internationally recognized researchers in the field.

  14. Youth Leadership. IDRA Focus.

    Science.gov (United States)

    IDRA Newsletter, 1995

    1995-01-01

    This theme issue focuses on motivating young people to learn by providing leadership opportunities in school. "Coca-Cola Valued Youth Program: Assessing Progress" (Josie Danini Supik) examines the program's success. This program, which trains high-risk middle and high school students as tutors of younger children, has dramatically…

  15. Neocortical focus: experimental view.

    Science.gov (United States)

    Timofeev, Igor; Chauvette, Sylvain; Soltani, Sara

    2014-01-01

    All brain normal or pathological activities occur in one of the states of vigilance: wake, slow-wave sleep, or REM sleep. Neocortical seizures preferentially occur during slow-wave sleep. We provide a description of neuronal behavior and mechanisms mediating such a behavior within neocortex taking place in natural states of vigilance as well as during seizures pointing to similarities and differences exhibited during sleep and seizures. A concept of epileptic focus is described using a model of cortical undercut, because in that model, the borders of the focus are well defined. In this model, as in other models of acquired epilepsy, the main factor altering excitability is deafferentation, which upregulates neuronal excitability that promotes generation of seizures. Periods of disfacilitation recorded during slow-wave sleep further upregulate neuronal excitability. It appears that the state of neurons and neuronal network in the epileptic focus produced by deafferentation are such that seizures cannot be generated there. Instead, seizures always start around the perimeter of the undercut cortex. Therefore, we define these areas as the seizure focus. In this zone, neuronal connectivity and excitability are moderately enhanced, lowering the threshold for seizure generation.

  16. A Material Focus

    DEFF Research Database (Denmark)

    Vallgårda, Anna K. A.; Sokoler, Tomas

    2009-01-01

    In this paper we build on the notion of computational composites, which hold a material perspective on computational technology. We argue that a focus on the material aspects of the technology could be a fruitful approach to achieve new expressions and to gain a new view on the technology's role...

  17. Adolescent Literacy. Focus On

    Science.gov (United States)

    Molineaux, Rebecca

    2009-01-01

    Evidence suggests that there is a crisis in adolescent literacy. Part of the problem is that students often receive little literacy instruction after elementary school. This "Focus On" examines the literacy instruction that adolescents need to be successful as they move on to more challenging texts in middle and high school. In addition, this…

  18. Curriculum Mapping. Focus On

    Science.gov (United States)

    Molineaux, Rebecca

    2008-01-01

    This "Focus On" discusses curriculum mapping, a process that allows educators to align the curriculum both within and across grades and to ensure that the curriculum is in line with school, local, and state standards. It outlines the steps of the curriculum mapping process from planning the mapping initiative to creating and editing curriculum…

  19. Endocrine and metabolic considerations in critically ill patients 4: Thyroid function in critically ill patients

    OpenAIRE

    Fliers, Eric; Bianco, Antonio C.; Langouche, Lies; Boelen, Anita

    2015-01-01

    Patients in the intensive care unit (ICU) typically present with decreased concentrations of plasma tri-iodothyronine, low thyroxine, and normal range or slightly decreased concentration of thyroid-stimulating hormone. This ensemble of changes is collectively known as non-thyroidal illness syndrome (NTIS). The extent of NTIS is associated with prognosis, but no proof exists for causality of this association. Initially, NTIS is a consequence of the acute phase response to systemic illness and ...

  20. Parents' help-seeking behaviours during acute childhood illness at home: A contribution to explanatory theory.

    Science.gov (United States)

    Neill, Sarah J; Jones, Caroline H D; Lakhanpaul, Monica; Roland, Damian T; Thompson, Matthew J

    2016-03-01

    Uncertainty and anxiety surround parents' decisions to seek medical help for an acutely ill child. Consultation rates for children are rising, yet little is known about factors that influence parents' help-seeking behaviours. We used focus groups and interviews to examine how 27 parents of children under five years, from a range of socioeconomic groups in the East Midlands of England, use information to make decisions during acute childhood illness at home. This article reports findings elucidating factors that influence help-seeking behaviours. Parents reported that decision-making during acute childhood illness was influenced by a range of personal, social and health service factors. Principal among these was parents' concern to do the right thing for their child. Their ability to assess the severity of the illness was influenced by knowledge and experience of childhood illness. When parents were unable to access their general practitioner (GP), feared criticism from or had lost trust in their GP, some parents reported using services elsewhere such as Accident and Emergency. These findings contribute to explanatory theory concerning parents' help-seeking behaviours. Professional and political solutions have not reduced demand; therefore, collaborative approaches involving the public and professionals are now needed to improve parents' access to information.

  1. Psychological distress among survivors of esophageal cancer: the role of illness cognitions and coping.

    Science.gov (United States)

    Dempster, Martin; McCorry, Noleen K; Brennan, Emma; Donnelly, Michael; Murray, Liam; Johnston, Brian T

    2012-04-01

    Leventhal's common sense model has provided a useful framework for explaining psychological distress in several chronic illnesses. The model indicates that a person's perception of their illness and their coping strategies are the key determinants of their experience of psychological distress. The present research examines whether illness perceptions and coping strategies are related to levels of psychological distress among survivors of esophageal cancer. Everyone registered with the Oesophageal Patients' Association in the UK was mailed a questionnaire booklet, which included the Illness Perception Questionnaire-Revised, the Cancer Coping Questionnaire, and the Hospital Anxiety and Depression Scale. Complete responses were received from 484 people. Regression models indicated that the variables measured could explain 51% of the variance in anxiety and 42% of the variance in depression. Perceptions of esophageal cancer explained the majority of this variance. Positive focus coping strategies were also found to be important in explaining psychological distress. The results of this study are consistent with previous research demonstrating that illness perceptions are stronger correlates of adaptive outcomes than coping strategies. The findings suggest that cognition-based interventions could potentially be most effective in minimizing emotional distress among survivors of esophageal cancer.

  2. Why focus on mental health systems?

    Directory of Open Access Journals (Sweden)

    Minas Harry

    2007-08-01

    Full Text Available Abstract The global situation for people with mental illness – in developing and developed countries – is dire. Legislative and human rights protections are frequently lacking. Mental health budgets are inadequate. There are insufficient numbers of skilled policy makers, managers and clinicians. Communities are poorly informed about mental health and illness and not well organised for purposes of advocacy. In most of the world, mental health services are inaccessible or of poor quality. Most people who would benefit from psychiatric treatment and rehabilitation do not have affordable access to such services. Leadership – at all levels – for mental health system development needs to be greatly strengthened. While mental health research attention and funds are devoted predominantly to neuroscience and clinical research, we believe that the highest global mental health research priority is mental health systems research. There is an urgent need to focus on the development of effective, appropriate, affordable mental health services. The evidence base for such development is currently weak. The International Journal of Mental Health Systems aims to stimulate greater attention to the central importance of building functioning mental health systems. Rapid publication and global reach through open access will make this journal a resource for all those who wish to contribute to such development.

  3. Guns, Mental Illness, and the Law: Introduction to This Issue.

    Science.gov (United States)

    Swanson, Jeffrey W; Felthous, Alan R

    2015-06-01

    Firearm violence is a top-tier public health problem in the U.S., killing 33,563 and injuring an additional 81,396 people in 2012 (Centers for Disease Control and Prevention, CDC, ). Given constitutional protection and the cultural entrenchment of private gun ownership in the U.S., it is likely that guns will remain widely accessible--and largely unrestricted--for the foreseeable future. Therefore, most policies and laws intended to reduce firearm violence focus selectively on preventing "dangerous people" from having access to guns. That is a formidable challenge. How do we think productively about guns and mental illness in this context, and about the role of law in lessening the toll of gun violence?

  4. Before and after fieldwork: ingredients for an ethnography of illness.

    Science.gov (United States)

    Lewis, Gilbert

    2012-04-01

    W.H.R. Rivers asked what light anthropology could throw on the emergence of medicine. But this early lead was not soon followed up. Social anthropology had first to establish itself. The new social anthropology championed holistic fieldwork in small-scale societies. Some did choose to study illness or misfortune ethnographically. Evans-Pritchard, Victor Turner and Max Marwick provided outstanding models in this field. Political change and decolonisation made some of the older assumptions about the place and aims of anthropological research less easy to sustain. Growth in the subject encouraged specialisation. Medical anthropology was one among many possible developments. But it also had to identify a distinctive focus and place in relation to medicine and other health-related social studies.

  5. Effect on Public Policy from Macro to Nano Aspects of the Deadliest Illness of Mankind: Important Role of Physics

    Science.gov (United States)

    Saxena, Arjun

    2013-04-01

    The effect on public policy of macro to nano aspects of the deadliest Illness known to mankind is given. The focus is on the important role of physics which has been ignored so far to solve its problems. It is now acknowledged that the deadliest illness is actually a group of illnesses which are lumped together as mental illnesses. They are the most widespread and damaging illnesses in the world. Their impact on the entire society globally is huge because they afflict majority of the people irrespective of race, religion, sex, age, education and economic status. In USA alone, the number afflicted according to the official count is about 80 million (out of a total population of 315 million), and it is projected to increase to about 25 to 30% of the population within two decades. A model is given in this paper to address some of the key issues from macro to nano aspects of the deadliest illness. The information given in this paper is scientific though easy to understand. It will help the elected policy makers, public, physicists, neuroscientists, doctors, and care giving personnel world wide. The model explains the missing links in the diagnosis and treatment of mental illnesses. Additional evidence from other recent studies shall also be given.

  6. Treatment engagement of individuals experiencing mental illness: review and update.

    Science.gov (United States)

    Dixon, Lisa B; Holoshitz, Yael; Nossel, Ilana

    2016-02-01

    Individuals living with serious mental illness are often difficult to engage in ongoing treatment, with high dropout rates. Poor engagement may lead to worse clinical outcomes, with symptom relapse and rehospitalization. Numerous variables may affect level of treatment engagement, including therapeutic alliance, accessibility of care, and a client's trust that the treatment will address his/her own unique goals. As such, we have found that the concept of recovery-oriented care, which prioritizes autonomy, empowerment and respect for the person receiving services, is a helpful framework in which to view tools and techniques to enhance treatment engagement. Specifically, person-centered care, including shared decision making, is a treatment approach that focuses on an individual's unique goals and life circumstances. Use of person-centered care in mental health treatment models has promising outcomes for engagement. Particular populations of people have historically been difficult to engage, such as young adults experiencing a first episode of psychosis, individuals with coexisting psychotic and substance use disorders, and those who are homeless. We review these populations and outline how various evidence-based, recovery-oriented treatment techniques have been shown to enhance engagement. Our review then turns to emerging treatment strategies that may improve engagement. We focus on use of electronics and Internet, involvement of peer providers in mental health treatment, and incorporation of the Cultural Formulation Interview to provide culturally competent, person-centered care. Treatment engagement is complex and multifaceted, but optimizing recovery-oriented skills and attitudes is essential in delivery of services to those with serious mental illness.

  7. Should we mobilise critically ill patients? A review.

    LENUS (Irish Health Repository)

    O'Connor, Enda D

    2009-12-01

    Neuromuscular weakness, a frequent complication of prolonged bed rest and critical illness, is associated with morbidity and mortality. Mobilisation physiotherapy has widespread application in patients hospitalised with non-critical illness.

  8. Clinical use of lactate monitoring in critically ill patients

    NARCIS (Netherlands)

    J. Bakker (Jan); M.W.N. Nijsten (Maarten); T.C. Jansen (Tim)

    2013-01-01

    textabstractIncreased blood lactate levels (hyperlactataemia) are common in critically ill patients. Although frequently used to diagnose inadequate tissue oxygenation, other processes not related to tissue oxygenation may increase lactate levels. Especially in critically ill patients, increased gly

  9. History of febrile illness and variation in semen quality

    DEFF Research Database (Denmark)

    Carlsen, Elisabeth; Andersson, Anna-Maria; Petersen, Jørgen Holm

    2003-01-01

    The purpose of this study was to analyse the effect of a history of febrile illness on semen quality.......The purpose of this study was to analyse the effect of a history of febrile illness on semen quality....

  10. The focus factor

    DEFF Research Database (Denmark)

    Nicolaisen, Jeppe; Frandsen, Tove Faber

    2015-01-01

    is demonstrated on a selection of general science journals and on a selection of medical journals. The reference lists of each journal are compared year by year, and the percentage of re-citations is calculated by dividing the number of re-citations with the total number of citations each year. Analysis......Introduction. We present a new bibliometric indicator to measure journal specialisation over time, named the focus factor. This new indicator is based on bibliographic coupling and counts the percentage of re-citations given in subsequent years. Method. The applicability of the new indicator....... To validate re-citations as caused by specialisation, other possible causes were measured and correlated (obsolescence, journal self-citations and number of references). Results. The results indicate that the focus factor is capable of distinguishing between general and specialised journals and thus...

  11. Focusing of electromagnetic waves

    Energy Technology Data Exchange (ETDEWEB)

    Dhayalan, V.

    1996-12-31

    The focusing of electromagnetic waves inside a slab has been examined together with two special cases in which the slab is reduced to a single interface or a single medium. To that end the exact solutions for the fields inside a layered medium have been used, given in terms of the outside current source in order to obtain the solutions for the focused electric field inside a slab. Both exact and asymptotic solutions of the problem have been considered, and the validity of the latter has been discussed. The author has developed a numerical algorithm for evaluation of the diffraction integral with special emphasis on reducing the computing time. The numerical techniques in the paper can be readily applied to evaluate similar diffraction integrals occurring e.g. in microstrip antennas. 46 refs.

  12. Focus on Succes

    OpenAIRE

    Ivan Slimák; Kristina Zgodavova

    2011-01-01

    The Editor wishes to present the need and form of turning the focus of individuals and organisations to success, based on evaluating understanding of the situation, on complex improving the quality of work, production and life, and on awareness of accountability for consequences of one’s actions in the given environment and time. Understood by success is sustained financial and non-financial prosperity, whilst decisive is the evaluating process, the key element is loyalty of natural and physi...

  13. Dense Plasma Focus Modeling

    Energy Technology Data Exchange (ETDEWEB)

    Li, Hui [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Li, Shengtai [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Jungman, Gerard [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Hayes-Sterbenz, Anna Catherine [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2016-08-31

    The mechanisms for pinch formation in Dense Plasma Focus (DPF) devices, with the generation of high-energy ions beams and subsequent neutron production over a relatively short distance, are not fully understood. Here we report on high-fidelity 2D and 3D numerical magnetohydrodynamic (MHD) simulations using the LA-COMPASS code to study the pinch formation dynamics and its associated instabilities and neutron production.

  14. Subsurface contaminants focus area

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-08-01

    The US Department of Enregy (DOE) Subsurface Contaminants Focus Area is developing technologies to address environmental problems associated with hazardous and radioactive contaminants in soil and groundwater that exist throughout the DOE complex, including radionuclides, heavy metals; and dense non-aqueous phase liquids (DNAPLs). More than 5,700 known DOE groundwater plumes have contaminated over 600 billion gallons of water and 200 million cubic meters of soil. Migration of these plumes threatens local and regional water sources, and in some cases has already adversely impacted off-site rsources. In addition, the Subsurface Contaminants Focus Area is responsible for supplying technologies for the remediation of numerous landfills at DOE facilities. These landfills are estimated to contain over 3 million cubic meters of radioactive and hazardous buried Technology developed within this specialty area will provide efective methods to contain contaminant plumes and new or alternative technologies for development of in situ technologies to minimize waste disposal costs and potential worker exposure by treating plumes in place. While addressing contaminant plumes emanating from DOE landfills, the Subsurface Contaminants Focus Area is also working to develop new or alternative technologies for the in situ stabilization, and nonintrusive characterization of these disposal sites.

  15. A one-season prospective study of injuries and illness in elite junior tennis.

    Science.gov (United States)

    Pluim, B M; Loeffen, F G J; Clarsen, B; Bahr, R; Verhagen, E A L M

    2016-05-01

    The objective of this study was to estimate the incidence and prevalence of injury and illness among elite junior tennis players. A cohort of 73 players (11-14 years) in the 2012-2013 Dutch national high-performance program was followed for 32 weeks; all participants completed the study. The OSTRC Questionnaire on Health Problems was used to record self-reported injuries and illnesses and to record training and match exposure. Main outcome measures were average prevalence of overuse injury and illness and incidence density of acute injury. On average, players practiced 9.1 h/week (SD 0.6; range 2.3-12.0) and had 2.2 h of match play (SD 0.6; range 2.3-12.0). During the course of the study, 67 players reported a total of 187 health problems. The average weekly prevalence of all health problems was 21.3% (95% CI: 19.2-22.9), of which 12.1% (95% CI: 10.9-13.3) constituted overuse injuries and 5.8% (95% CI: 4.6-6.9) illnesses. The incidence of acute injuries was 1.2/1000 h of tennis play (95% CI: 0.7-1.7). The high occurrence of overuse injuries among elite junior tennis players suggests that an early focus on preventative measures is warranted, with a particular focus on the monitoring and management of workload.

  16. Early nutritional depletion in critically ill children.

    Science.gov (United States)

    Pollack, M M; Wiley, J S; Holbrook, P R

    1981-08-01

    Nutritional status was evaluated in 50 medical admissions to a pediatric ICU. All patients were evaluated within 48 h of admission; none had chronic organ failure or malignancies. Nutritional assessment included weight/50th percentile weight for length, length/50th percentile length for age, triceps skinfold thickness, and midarm muscle circumference. Acute protein-energy malnutrition (PEM) occurred in 16% of all children. Chronic PEM also occurred in 16%. The nutrient stores of fat and somatic protein were deficient in 18 and 20% of all children. Acute PEM and deficient somatic protein stores were more frequent in children less than 2 years (p less than 0.05). These findings indicate that malnutrition and nutrient store deficiencies are common early in the course of critical illnesses in children, especially in those less than 2 years of age. However, the findings do not indicate if the severity of illness was the cause or effect of poor nutritional status.

  17. The illness of Vincent van Gogh.

    Science.gov (United States)

    Arnold, Wilfred Niels

    2004-03-01

    Vincent van Gogh (1853-1890) was a wonderfully accomplished artist whose work is now widely appreciated. He created a great number of masterpiece paintings and drawings in just one decade devoted to art. His productivity is even more remarkable when considered in the context of his debilitating illness. He suffered from medical crises that were devastating, but in the intervening periods he was both lucid and creative. He left a profound, soul-searching description of his jagged life in his correspondence, which provides the basis for the present analysis. An inherited metabolic disease, acute intermittent porphyria, accounts for all of the signs and symptoms of van Gogh's underlying illness. On this 150th anniversary of the birth of Vincent van Gogh it is appropriate to revisit the subject and to analyze the lack of organized skepticism in the popular media about other diagnoses.

  18. The interfacility transport of critically ill newborns.

    Science.gov (United States)

    Whyte, Hilary Ea; Jefferies, Ann L

    2015-01-01

    The practice of paediatric/neonatal interfacility transport continues to expand. Transport teams have evolved into mobile intensive care units capable of delivering state-of-the-art critical care during paediatric and neonatal transport. While outcomes are best for high-risk infants born in a tertiary care setting, high-risk mothers often cannot be safely transferred. Their newborns may then have to be transported to a higher level of care following birth. The present statement reviews issues relating to transport of the critically ill newborn population, including personnel, team competencies, skills, equipment, systems and processes. Six recommendations for improving interfacility transport of critically ill newborns are highlighted, emphasizing the importance of regionalized care for newborns.

  19. The discovery of drug-induced illness.

    Science.gov (United States)

    Jick, H

    1977-03-01

    The increased use of drugs (and the concurrent increased risks of drug-induced illness) require definition of relevant research areas and strategy. For established marketed drugs, research needs depend on the magnitudes of risk of an illness from a drug and the base-line risk. With the drug risk high and the base-line risk low, the problem surfaces in premarketing studies or through the epidemic that develops after marketing. If the drug adds slightly to a high base-line risk, the effect is undetectable. When both risks are low, adverse effects can be discovered by chance, but systematic case-referent studies can speed discovery. If both risks are high, clinical trials and nonexperimental studies may be used. With both risks intermediate, systematic evaluations, especially case-referent studies are needed. Newly marketed drugs should be routinely evaluated through compulsory registration and follow-up study of the earliest users.

  20. 2003 Nevada Test Site Annual Illness and Injury Surveillance Report

    Energy Technology Data Exchange (ETDEWEB)

    U.S. Department of Energy, Office of Health, Safety and Security, Office of Illness and Injury Prevention Programs

    2007-05-23

    Annual Illness and Injury Surveillance Program report for 2003 for the Nevada Test Site. The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of epidemiologic surveillance activities that provide an early warning system for health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence of workdays, occupational injuries and illnesses, and disabilities and deaths among current workers.

  1. 2006 Nevada Test Site Annual Illness and Injury Surveillance Report

    Energy Technology Data Exchange (ETDEWEB)

    U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

    2008-04-24

    The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

  2. 2006 Pantex Plant Annual Illness and Injury Surveillance Report

    Energy Technology Data Exchange (ETDEWEB)

    U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

    2008-05-19

    The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

  3. 2010 Sandia National Laboratory Annual Illness and Injury Surveillance Report

    Energy Technology Data Exchange (ETDEWEB)

    U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

    2011-10-26

    The U.S. Department of Energy's (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

  4. 2010 Idaho National Laboratory Annual Illness and Injury Surveillance Report

    Energy Technology Data Exchange (ETDEWEB)

    U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

    2011-09-26

    The U.S. Department of Energy's (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

  5. 2007 Hanford Site Annual Illness and Injury Surveillance Report

    Energy Technology Data Exchange (ETDEWEB)

    U.S. Department of Energy, Office of Health, Safety, and Security

    2009-07-16

    The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

  6. 2010 Pantex Plant Annual Illness and Injury Surveillance Report

    Energy Technology Data Exchange (ETDEWEB)

    U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

    2011-06-29

    The U.S. Department of Energy's (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

  7. 2010 Brookhaven National Laboratory Annual Illness and Injury Surveillance Report

    Energy Technology Data Exchange (ETDEWEB)

    U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

    2011-08-16

    The U.S. Department of Energy's (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

  8. 2007 Brookhaven National Laboratory Annual Illness and Injury Surveillance Report

    Energy Technology Data Exchange (ETDEWEB)

    U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

    2008-07-31

    The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

  9. 2010 Hanford Site Annual Illness and Injury Surveillance Report

    Energy Technology Data Exchange (ETDEWEB)

    U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

    2011-10-05

    The U.S. Department of Energy's (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

  10. 2010 Savannah River Site Annual Illness and Injury Surveillance Report

    Energy Technology Data Exchange (ETDEWEB)

    U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

    2011-09-12

    The U.S. Department of Energy's (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

  11. 2010 Kansas City Plant Annual Illness and Injury Surveillance Report

    Energy Technology Data Exchange (ETDEWEB)

    U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

    2011-06-20

    The U.S. Department of Energy's (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

  12. 2006 Savannah River Site Annual Illness and Injury Surveillance Report

    Energy Technology Data Exchange (ETDEWEB)

    U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

    2008-08-20

    The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

  13. 2007 Idaho National Laboratory Annual Illness and Injury Surveillance Report

    Energy Technology Data Exchange (ETDEWEB)

    U.S. Department of Energy, Office of Health, Safety, and Security

    2009-05-04

    The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

  14. Mental Illness In Nursing Homes: Variations Across States

    OpenAIRE

    Grabowski, David C.; Aschbrenner, Kelly A.; Feng, Zhanlian; Mor, Vincent

    2009-01-01

    The institutionalization of individuals with mental illness in nursing homes is an important policy concern. Using nursing home Minimum Data Set assessments from 2005, we found large cross-state variation in both the rates of mental illness among nursing home admissions and the estimated rates of nursing home admissions among persons with mental illness. We also found that newly admitted individuals with mental illness were younger and more likely to become long-stay residents. Taken together...

  15. 2006 Hanford Site Annual Illness and Injury Surveillance Report

    Energy Technology Data Exchange (ETDEWEB)

    U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

    2008-05-14

    The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

  16. 2006 Kansas City Plant Annual Illness and Injury Surveillance Report

    Energy Technology Data Exchange (ETDEWEB)

    U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

    2008-06-13

    The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

  17. 2006 Brookhaven National Laboratory Annual Illness and Injury Surveillance Report

    Energy Technology Data Exchange (ETDEWEB)

    U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

    2008-03-06

    The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

  18. 2007 Pantex Plant Annual Illness and Injury Surveillance Report

    Energy Technology Data Exchange (ETDEWEB)

    U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

    2008-07-31

    The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

  19. Ill-Posedness of sublinear minimization problems

    Directory of Open Access Journals (Sweden)

    S. Issa

    2011-04-01

    Full Text Available It is well known that minimization problems involving sublinear regularization terms are ill-posed, in Sobolev spaces. Extended results to spaces of bounded variation functions BV were recently showed in the special case of bounded regularization terms. In this note, a generalization to sublinear regularization is presented in BV spaces. Notice that our results are optimal in the sense that linear regularization leads to well-posed minimization problems in BV spaces.

  20. Mental illness in Saudi Arabia: an overview

    OpenAIRE

    Almutairi AF

    2015-01-01

    Adel F Almutairi Population Health Research Section, King Abdullah International Medical Research Center (KAIMRC), Riyadh, Kingdom of Saudi Arabia; King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Kingdom of Saudi ArabiaWhile I was reading on this topic, I came across an online article attributed to a Saudi psychologist that contained information about mental illness among the Saudi population. What really struck me right away was the estimate that was given for the number of m...

  1. DISC1 genetics, biology and psychiatric illness

    OpenAIRE

    2013-01-01

    Psychiatric disorders are highly heritable, and in many individuals likely arise from the combined effects of genes and the environment. A substantial body of evidence points towards DISC1 being one of the genes that influence risk of schizophrenia, bipolar disorder and depression, and functional studies of DISC1 consequently have the potential to reveal much about the pathways that lead to major mental illness. Here, we review the evidence that DISC1 influences disease risk through effects u...

  2. Poliomyelitis-like illness associated with asthma.

    OpenAIRE

    Blomquist, H K; Björkstén, B

    1980-01-01

    A 10-year-old girl with a combination of paralytic disease, resembling poliomyelitis, and asthma is described. The girl developed neurological symptoms 5 days after a severe attack of asthma. No aetiology to the flaccid paralysis could be demonstrated although Coxsackie B5 virus was isolated from a stool. A similar poliomyelitis-like illness associated with asthma has previously been reported in 13 cases from Australia and the UK.

  3. Intravenous levetiracetam in critically ill children

    Directory of Open Access Journals (Sweden)

    Faruk Incecik

    2016-01-01

    Full Text Available Background: To report the effectiveness and safety of intravenous (IV levetiracetam (LEV in the treatment of critically ill children with acute repetitive seizures and status epilepticus (SE in a children′s hospital. Materials and Methods: We retrospectively analyzed data from children treated with IV LEV. Results: The mean age of the 108 children was 69.39 ± 46.14 months (1-192 months. There were 58 (53.1% males and 50 (46.8% females. LEV load dose was 28.33 ± 4.60 mg/kg/dose (10-40 mg/kg. Out of these 108 patients, LEV terminated seizures in 79 (73.1%. No serious adverse effects were observed but agitation and aggression were developed in two patients, and mild erythematous rash and urticaria developed in one patient. Conclusion: Antiepileptic treatment of critically ill children with IV LEV seems to be effective and safe. Further study is needed to elucidate the role of IV LEV in critically ill children.

  4. Energy expenditure of acutely ill hospitalised patients

    Directory of Open Access Journals (Sweden)

    Gariballa Salah

    2006-03-01

    Full Text Available Abstract Objective To measure energy expenditure of acutely ill elderly patients in hospital and following discharge in the community. Design Sixty-three consecutive hospitalised acutely ill elderly patients were recruited. Eight patients were studied to assess the reliability of the Delta Tract Machine as a measure of energy expenditure; 35 patients had their energy expenditure studied in hospital on two occasions and 20 patients had their energy expenditure measured in hospital and at 6 weeks in the community Results Men had higher basal energy expenditure (BMR values compared to women however the difference was not statistically significant [Men, mean (SD 1405 (321 Kcal, women 1238 (322 kcal; mean difference (95% CI 166 kcal (-17 to 531, p = 0.075]. After adjusting for age, gender and body mass index both medication and C-reactive protein (CRP, concentrations showed significant correlation with measured energy expenditure in hospital, (r = -0.36, "p Conclusion Tissue inflammation and medications were associated with change in measured energy expenditure in acutely ill patients.

  5. Travel-associated Illness Trends and Clusters, 2000-2010

    NARCIS (Netherlands)

    Leder, Karin; Torresi, Joseph; Brownstein, John S.; Wilson, Mary E.; Keystone, Jay S.; Barnett, Elizabeth; Schwartz, Eli; Schlagenhauf, Patricia; Wilder-Smith, Annelies; Castelli, Francesco; von Sonnenburg, Frank; Freedman, David O.; Cheng, Allen C.

    2013-01-01

    Longitudinal data examining travel-associated illness patterns are lacking. To address this need and determine trends and clusters in travel-related illness, we examined data for 2000-2010, prospectively collected for 42,223 ill travelers by 18 GeoSentinel sites. The most common destinations from wh

  6. 78 FR 28292 - Gulf War Veterans' Illnesses Task Force

    Science.gov (United States)

    2013-05-14

    ... AFFAIRS Gulf War Veterans' Illnesses Task Force AGENCY: Department of Veterans Affairs (VA). ACTION... the Gulf War Veterans' Illnesses Task Force (GWVI-TF) in August 2009 to conduct a comprehensive review... War Veterans' Illnesses Task Force Draft Written Report is now complete. VA is inviting...

  7. 76 FR 65321 - Gulf War Veterans' Illnesses Task Force

    Science.gov (United States)

    2011-10-20

    ... AFFAIRS Gulf War Veterans' Illnesses Task Force AGENCY: Department of Veterans Affairs (VA). ACTION... the Gulf War Veterans' Illnesses Task Force (GWVI-TF) in August 2009 to conduct a comprehensive review... War Veterans' Illnesses Task Force Draft Written Report is now complete. VA is inviting...

  8. 75 FR 16577 - Gulf War Veterans' Illnesses Task Force

    Science.gov (United States)

    2010-04-01

    ... AFFAIRS Gulf War Veterans' Illnesses Task Force AGENCY: Department of Veterans Affairs (VA). ACTION... the Gulf War Veterans' Illnesses Task Force (GWVI-TF) in August 2009 to conduct a comprehensive review... Veterans' Illnesses Task Force Draft Written Report is now complete. The VA is inviting public comments...

  9. Concepts, Structures, and Goals: Redefining Ill-Definedness

    Science.gov (United States)

    Lynch, Collin; Ashley, Kevin D.; Pinkwart, Niels; Aleven, Vincent

    2009-01-01

    In this paper we consider prior definitions of the terms "ill-defined domain" and "ill-defined problem". We then present alternate definitions that better support research at the intersection of Artificial Intelligence and Education. In our view both problems and domains are ill-defined when essential concepts, relations, or criteria are un- or…

  10. Behavior of Man in Health and Illness, Nursing 103A.

    Science.gov (United States)

    Bakke, Sandra I.

    A description is provided of a course, "Behavior of Man in Health and Illness," designed to introduce first-year undergraduate nursing students to the theories and concepts related to the health-illness continuum, the stress of illness, and coping theory. The description begins with an overview of course content, followed by information on the…

  11. Children's Conceptions of Mental Illness: A Naive Theory Approach

    Science.gov (United States)

    Fox, Claudine; Buchanan-Barrow, Eithne; Barrett, Martyn

    2010-01-01

    This paper reports two studies that investigated children's conceptions of mental illness using a naive theory approach, drawing upon a conceptual framework for analysing illness representations which distinguishes between the identity, causes, consequences, curability, and timeline of an illness. The studies utilized semi-structured interviewing…

  12. Resolving mental illness stigma: should we seek normalcy or solidarity?

    Science.gov (United States)

    Corrigan, Patrick W

    2016-04-01

    Two approaches have emerged to deal with the stigma of mental illness: normalcy, where people with mental illness are framed as 'just like everyone else'; and solidarity, where the public agrees to stand with those with mental illness regardless of their symptoms. Pros and cons of each approach are considered.

  13. Death Education and Attitudes toward Euthanasia and Terminal Illness.

    Science.gov (United States)

    Nagi, Mostafa H.; Lazerine, Neil G.

    1982-01-01

    Analyzed attitudes of 614 Protestant and Catholic Cleveland clergy toward terminal illness and euthanasia. Clergy responses revealed that, although eager to prolong life, terminally ill patients feared prolonged illness more than death. The controversial nature of euthanasia became more apparent with clergy who had more training in death…

  14. Systematic review of character development and childhood chronic illness

    Science.gov (United States)

    Maslow, Gary R; Hill, Sherika N

    2016-01-01

    AIM: To review empirical evidence on character development among youth with chronic illnesses. METHODS: A systematic literature review was conducted using PubMed and PSYCHINFO from inception until November 2013 to find quantitative studies that measured character strengths among youth with chronic illnesses. Inclusion criteria were limited to English language studies examining constructs of character development among adolescents or young adults aged 13-24 years with a childhood-onset chronic medical condition. A librarian at Duke University Medical Center Library assisted with the development of the mesh search term. Two researchers independently reviewed relevant titles (n = 549), then abstracts (n = 45), and finally manuscripts (n = 3). RESULTS: There is a lack of empirical research on character development and childhood-onset chronic medical conditions. Three studies were identified that used different measures of character based on moral themes. One study examined moral reasoning among deaf adolescents using Kohlberg’s Moral Judgement Instrument; another, investigated moral values of adolescent cancer survivors with the Values In Action Classification of Strengths. A third study evaluated moral behavior among young adult survivors of burn injury utilizing the Tennessee Self-Concept, 2nd edition. The studies observed that youth with chronic conditions reasoned at less advanced stages and had a lower moral self-concept compared to referent populations, but that they did differ on character virtues and strengths when matched with healthy peers for age, sex, and race/ethnicity. Yet, generalizations could not be drawn regarding character development of youth with chronic medical conditions because the studies were too divergent from each other and biased from study design limitations. CONCLUSION: Future empirical studies should learn from the strengths and weaknesses of the existing literature on character development among youth with chronic medical conditions

  15. Thrombo-prophylaxis in acutely ill medical and critically ill patients

    Directory of Open Access Journals (Sweden)

    Saurabh Saigal

    2014-01-01

    Full Text Available Thrombo-prophylaxis has been shown to reduce the incidence of pulmonary embolism (PE and mortality in surgical patients. The purpose of this review is to find out the evidence-based clinical practice criteria of deep vein thrombosis (DVT prophylaxis in acutely ill medical and critically ill patients. English-language randomized controlled trials, systematic reviews, and meta-analysis were included if they provided clinical outcomes and evaluated therapy with low-dose heparin or related agents compared with placebo, no treatment, or other active prophylaxis in the critically ill and medically ill population. For the same, we searched MEDLINE, PUBMED, Cochrane Library, and Google Scholar. In acutely ill medical patients on the basis of meta-analysis by Lederle et al. (40 trials and LIFENOX study, heparin prophylaxis had no significant effect on mortality. The prophylaxis may have reduced PE in acutely ill medical patients, but led to more bleeding events, thus resulting in no net benefit. In critically ill patients, results of meta-analysis by Alhazzani et al. and PROTECT Trial indicate that any heparin prophylaxis compared with placebo reduces the rate of DVT and PE, but not symptomatic DVT. Major bleeding risk and mortality rates were similar. On the basis of MAGELLAN trial and EINSTEIN program, rivaroxaban offers a single-drug approach to the short-term and continued treatment of venous thrombosis. Aspirin has been used as antiplatelet agent, but when the data from two trials the ASPIRE and WARFASA study were pooled, there was a 32% reduction in the rate of recurrence of venous thrombo-embolism and a 34% reduction in the rate of major vascular events.

  16. Advance care directives

    Science.gov (United States)

    ... advance directive; Do-not-resuscitate - advance directive; Durable power of attorney - advance care directive; POA - advance care directive; Health care agent - advance care directive; Health care proxy - ...

  17. The Individually Focused Interview

    DEFF Research Database (Denmark)

    Clausen, Aksel Skovgaard

    2012-01-01

    In this paper, I argue—with an example—that under certain conditions replacement of audio transcriptions with a combination of simultaneously taken and jointly produced notes can be done without affecting reliability, validity, and transparency. These conditions are: (1) professional or otherwise...... relatively “strong” interviewees (interview persons: IPs) with diverse backgrounds; (2) thorough planning of the interview with well-focused themes; and (3) a thorough and repeated introduction to the interview. The omission of audio transcriptions is an obvious solution to the researcher who wants a breadth...

  18. antiproton focusing horn

    CERN Multimedia

    1980-01-01

    Was used for the AA (antiproton accumulator). Making an antiproton beam took a lot of time and effort. Firstly, protons were accelerated to an energy of 26 GeV in the PS and ejected onto a metal target. From the spray of emerging particles, a magnetic horn picked out 3.6 GeV antiprotons for injection into the AA through a wide-aperture focusing quadrupole magnet. For a million protons hitting the target, just one antiproton was captured, 'cooled' and accumulated. It took 3 days to make a beam of 3 x 10^11 - three hundred thousand million - antiprotons.

  19. Antiproton Focus Horn

    CERN Multimedia

    1974-01-01

    Was used for the AA (antiproton accumulator). Making an antiproton beam took a lot of time and effort. Firstly, protons were accelerated to an energy of 26 GeV in the PS and ejected onto a metal target. From the spray of emerging particles, a magnetic horn picked out 3.6 GeV antiprotons for injection into the AA through a wide-aperture focusing quadrupole magnet.For a million protons hitting the target, just one antiproton was captured, 'cooled' and accumulated. It took 3 days to make a beam of 3 x 10^11 -, three hundred thousand million - antiprotons.

  20. Rheological phenomena in focus

    CERN Document Server

    Boger, DV

    1993-01-01

    More than possibly any other scientific discipline, rheology is easily visualized and the relevant literature contains many excellent photographs of unusual and often bizarre phenomena. The present book brings together these photographs for the first time. They are supported by a full explanatory text. Rheological Phenomena in Focus will be an indispensable support manual to all those who teach rheology or have to convince colleagues of the practical relevance of the subject within an industrial setting. For those who teach fluid mechanics, the book clearly illustrates the difference be

  1. A social ecological approach to investigating relationships between housing and adaptive functioning for persons with serious mental illness.

    Science.gov (United States)

    Kloos, Bret; Shah, Seema

    2009-12-01

    This paper seeks to advance mental health-housing research regarding which factors of housing and neighborhood environments are critical for adaptive functioning, health, and recovery for persons with serious mental illness (SMI). Housing and neighborhood environments are particularly important for persons with SMI because of the prevalence of poor housing conditions among this population. Most mental health-housing research has been limited by a focus on problems in environments and functioning. The paper seeks to expand the mental health-housing research agenda to consider protective factors that promote community integration and adaptive functioning. We provide an account of how social ecology theory transformed a research program, from examining individual risk factors to investigating the functioning of persons in the contexts of their housing and neighborhood experiences. The resulting housing environment framework-physical aspects of housing and neighborhoods, social environment of neighborhoods, and interpersonal relationships tied to housing-allows for identification of opportunities for health promotion and facilitation of participation in community-based settings. This program of research draws upon several methods to understand the social experience of persons with SMI living in community settings-survey research, qualitative interviews, Geographic Information Systems, participatory research, and visual ethnography. In this paper, we present how social ecology theory was instrumental in the development of new housing environment measures, the selection of appropriate research methods, and framing research questions that are building a new empirical base of knowledge about promoting adaptive functioning, health, and recovery for persons with SMI living in community settings.

  2. Progress in pediatrics in 2013: choices in allergology, endocrinology, gastroenterology, hypertension, infectious diseases, neonatology, neurology, nutrition and respiratory tract illnesses.

    Science.gov (United States)

    Caffarelli, Carlo; Santamaria, Francesca; Vottero, Alessandra; Dascola, Carlotta Povesi; Mirra, Virginia; Sperli, Francesco; Bernasconi, Sergio

    2014-07-12

    This review will provide new information related to pathophysiology and management of specific diseases that have been addressed by selected articles published in the Italian Journal of Pediatrics in 2013, focusing on allergology, endocrinology, gastroenterology, hypertension, infectious diseases, neonatology, neurology, nutrition and respiratory tract illnesses in children. Recommendations for interpretation of skin prick test to foods in atopic eczema, management of allergic conjunctivitis, hypertension and breastfeeding in women treated with antiepileptic drugs and healthy breakfast have been reported. Epidemiological studies have given emphasis to high incidence of autoimmune disorders in patients with Turner syndrome, increasing prevalence of celiac disease, frequency of hypertension in adolescents, incidence and risk factor for retinopathy of prematurity. Advances in prevention include elucidation of the role of probiotics in reducing occurrence of allergies and feeding intolerance, and events of foetal life that influence later onset of diseases. Mechanistic studies suggested a role for vitamin D deficiency in asthma and type 1 diabetes and for reactivation of Varicella-Zoster virus in aseptic meningitis. Regarding diagnosis, a new mean for the diagnosis of hyperbilirubinaemia in newborns, a score for recognition of impaired nutritional status and growth and criteria for early Dyke-Davidoff-Masson Syndrome have been suggested. New therapeutic approaches consist of use of etanercept for reducing insulin dose in type 1 diabetes, probiotics in atopic eczema, and melatonin in viral infections.

  3. Difficulties in diagnosing and treating depression in the terminally ill cancer patient.

    Science.gov (United States)

    Lloyd-Williams, M

    2000-09-01

    It is estimated that for a quarter of all patients with advanced metastatic cancer, depression will be significant symptom. However up to 80% of the psychological and psychiatric morbidity which develops in cancer patients goes unrecognised and untreated. One of the main difficulties in establishing a diagnosis of an illness where there are no biological markers, physical signs, or diagnostics tests is deciding what can be called "appropriate sadness" as patients approach the end of life and what is a depressive illness. Criteria for diagnosing depression are discussed together with reasons why established screening tools used in other populations may not be appropriate to screen for depression in terminally ill patients. The use of antidepressants and the role of cognitive therapies are also discussed. For effective treatment of a depressive illness, treatment with antidepressant medication needs to be initiated sooner rather than later and patients may need close supervision to ensure compliance. The awareness of depression, the identification of symptoms, and the initiation of treatment is essential if patients are to be offered optimum palliation of psychological as well as physical symptoms.

  4. CERN In Focus

    CERN Multimedia

    CERN audiovisual service

    2008-01-01

    First edition 2008 of Cern in Focus. On behalf of the audiovisual team, a selection of the latest videos filmed at CERN. Every six weeks, we will bring you the latest in CERN's activities, from LHC start up to the Computing Grid, featuring the experiments and many other goings-on at CERN. The agenda of this first edition of CERN in Focus features the visit of the prime minister of Malta, Lawrence Gonzi... CMS and the final descent of the YE-1 end cap... The departure of UA1 magnets to Japan... The start up of sectors 4 and 5... And finally, in our sports round up... We'll talk about football. New in brief this month... The final bolt is in place : On 7th November, in the bowels of the LHC tunnel, CERN's Director General Robert Aymar tightened a gold-plated bolt for the last arc interconnection of sector 1-2. This symbolic gesture marks the completion of all the arc interconnections of the LHC. Last welding work: it was never going to be an easy task. On this day last year just one sector had been completed,...

  5. Making sense of illness: late-in-life migration as point of departure for elderly Iranian immigrants' explanatory models of illness.

    Science.gov (United States)

    Emami, Azita; Torres, Sandra

    2005-07-01

    This article is based on data gathered through 60 qualitative interviews conducted within the realm of three research projects that have used "culture-appropriate lenses" to study the postmigration situation of late-in-life Iranian immigrants to Sweden. The findings gathered through these studies were interpreted against the backdrop that culturally appropriate nursing theories provide. This meant that it was, at times, these elders' backgrounds as cultural "others" that were implicitly used to make sense of the various issues that were brought to the fore by these studies. The particular issue with which this article is concerned is the "unusualness" of these elders' explanatory models of illness. Inspired by the concept "definition of situation" in the symbolic interactionist perspective and by the feeling that this perspective might bring about a different interpretation of the original findings regarding their understandings of illness and disease, we set out to conduct a secondary analysis of these elders' explanatory models of illness. The findings presented in this article will show how the elderly Iranian immigrants interviewed in these three studies utilize the process of "late in life migration" as a point of reference for their understandings of what has caused the illnesses from which they suffered. Hereby we will suggest that the "unusualness" of their explanatory models of illness might be best understood if we focus on what they shared as immigrants (i.e., the fact that the process of late-in-life migration has made their culture obsolete) as opposed to what they shared as Iranians (i.e., their culture of origin).

  6. Advanced linear algebra

    CERN Document Server

    Cooperstein, Bruce

    2015-01-01

    Advanced Linear Algebra, Second Edition takes a gentle approach that starts with familiar concepts and then gradually builds to deeper results. Each section begins with an outline of previously introduced concepts and results necessary for mastering the new material. By reviewing what students need to know before moving forward, the text builds a solid foundation upon which to progress. The new edition of this successful text focuses on vector spaces and the maps between them that preserve their structure (linear transformations). Designed for advanced undergraduate and beginning graduate stud

  7. Advances in quantum chemistry

    CERN Document Server

    Sabin, John R

    2013-01-01

    Advances in Quantum Chemistry presents surveys of current topics in this rapidly developing field that has emerged at the cross section of the historically established areas of mathematics, physics, chemistry, and biology. It features detailed reviews written by leading international researchers. This volume focuses on the theory of heavy ion physics in medicine.Advances in Quantum Chemistry presents surveys of current topics in this rapidly developing field that has emerged at the cross section of the historically established areas of mathematics, physics, chemistry, and biology. It features

  8. Moving towards effective chronic illness management: asthma as an exemplar.

    Science.gov (United States)

    Estes, Tracy S

    2011-01-01

    The United States health care system is at a pivotal point in its ability to manage chronic illness. The demands and philosophical differences between the management of acute and chronic illnesses suggest the need for different strategies for effective and efficient management of chronic illness. The purpose of this article is to discuss the Chronic Care Model and the collaborative approach to managing chronic illnesses. Asthma, as an exemplar, will be used to illustrate the need for the development of new models of collaborative care for the treatment of chronic illnesses.

  9. Women’s Perception of Reproductive Illness in Manipur, India

    Directory of Open Access Journals (Sweden)

    Pebam Krishnakumari

    2014-01-01

    Full Text Available Perception of reproductive illness by the women themselves is important in understanding the women's reproductive health in a particular society. It also indicates the possibility of taking perception as a tool for measuring reproductive illness. Though women do not have a “germ theory” to explain their reproductive illness they have a sense of illness pathology. Reproductive illness perceived by women is related to physical symptoms and situations in a network of meanings and different meanings are socially generated to articulate their experiences.

  10. Social inequalities in the experience of illness in Sweden

    DEFF Research Database (Denmark)

    Blank, N; Diderichsen, Finn

    1996-01-01

    daily, weak social network) in the case of men, and virtually entirely in the case of women. Other ill-health dimensions, such as self-rated general health and impaired working capacity, prove to be related to severity of illness, the latter being more strongly associated with experience of severe...... illness than the former irrespective of social class. The results lend support to the hypothesis that manual classes are subjected to what might be called "double suffering"; they have more long-term illnesses and also experience these illnesses with greater intensity and frequency....

  11. Naturally occurring peer support through social media: the experiences of individuals with severe mental illness using YouTube.

    Science.gov (United States)

    Naslund, John A; Grande, Stuart W; Aschbrenner, Kelly A; Elwyn, Glyn

    2014-01-01

    Increasingly, people with diverse health conditions turn to social media to share their illness experiences or seek advice from others with similar health concerns. This unstructured medium may represent a platform on which individuals with severe mental illness naturally provide and receive peer support. Peer support includes a system of mutual giving and receiving where individuals with severe mental illness can offer hope, companionship, and encouragement to others facing similar challenges. In this study we explore the phenomenon of individuals with severe mental illness uploading videos to YouTube, and posting and responding to comments as a form of naturally occurring peer support. We also consider the potential risks and benefits of self-disclosure and interacting with others on YouTube. To address these questions, we used qualitative inquiry informed by emerging techniques in online ethnography. We analyzed n = 3,044 comments posted to 19 videos uploaded by individuals who self-identified as having schizophrenia, schizoaffective disorder, or bipolar disorder. We found peer support across four themes: minimizing a sense of isolation and providing hope; finding support through peer exchange and reciprocity; sharing strategies for coping with day-to-day challenges of severe mental illness; and learning from shared experiences of medication use and seeking mental health care. These broad themes are consistent with accepted notions of peer support in severe mental illness as a voluntary process aimed at inclusion and mutual advancement through shared experience and developing a sense of community. Our data suggest that the lack of anonymity and associated risks of being identified as an individual with severe mental illness on YouTube seem to be overlooked by those who posted comments or uploaded videos. Whether or not this platform can provide benefits for a wider community of individuals with severe mental illness remains uncertain.

  12. Do healthy school meals affect illness, allergies and school attendance in 8- to 11-year-old children?

    DEFF Research Database (Denmark)

    Laursen, Rikke Pilmann; Lauritzen, Lotte; Ritz, Christian

    2015-01-01

    Background/Objectives:A nutritionally adequate diet in childhood is important for health and resistance of allergies and infections. This study explored the effects of school meals rich in fish, vegetables and fibre on school attendance, asthma, allergies and illness in 797 Danish 8- to 11-year-o......, allergies, illness or well-being in 8- to 11-year-old children. The slight increase in occurrence of headaches seems to be related to the physical eating environment.European Journal of Clinical Nutrition advance online publication, 10 December 2014; doi:10.1038/ejcn.2014.263....

  13. Focus issue introduction: nonlinear photonics.

    Science.gov (United States)

    Akhmediev, Nail; Rottwitt, Karsten

    2012-11-19

    It is now 23 years since the first Topical Meeting "Nonlinear Guided Wave Phenomena" (Houston, TX, February 2-4, 1989) has been organised by George Stegeman and Allan Boardman with support of the Optical Society of America. These series of the OSA conferences known as NLGW, continued under the name "Nonlinear Photonics" starting from 2007. The latest one, in Colorado Springs in June 17-21, 2012 has been a great success despite the fierce fires advancing around the city at the time of the conference. This Focus issue is a collection of several papers presented at the conference with extended content submitted to Optics Express. Although this collection is small in comparison to the total number of papers presented at the conference, it gives a flavor of the topics considered at the meeting. It is also worthy to mention here that the next meeting "Nonlinear Photonics" is planned to be held in Barcelona - one of the main European centers on this subject.

  14. Care giving of people with severe mental illness: An Indian experience

    Directory of Open Access Journals (Sweden)

    Navaneetham Janardhana

    2015-01-01

    Full Text Available Background: Caring is a fundamental issue in the rehabilitation of a person with mental illness and more so for people with severe mental illness. The lack of adequate manpower resources in the country is adding and enlisting the responsibility of providing care on the families to provide physical, medical, social and psychological care for their severely unwell mentally ill people. Aim of the Study: To examine the load of caregiving with reference to the types of care during the symptomatic and remission phases of severe mental illness and the various ways in which caregivers adapt their lives to meet the needs of people with severe mental illness. Materials and Methods: The present research draws its data from the 200 families with mental illness in Andra Pradesh and Karnataka in India. The data presented in the study was collected from interviews using an interview schedule with open-ended questions. Results: The study diffuses the notion of ′care′ as ′physical′, ′medical, ′psychological′ and ′social′ care. The present article focuses on the caregiving roles of the caregivers of people with schizophrenia, affective disorders and psychosis not otherwise specified (NOS and found that the caregiving does not differ much between the different diagnosis, but caregiving roles changes from active involvement in physical and medical care to more of social and psychological care during the remission. Conclusion: The study records the incredulous gratitude of caregivers at being acknowledged for the work they do. In that regard, the study itself provides a boost to the morale of tired, unacknowledged caregivers.

  15. Conceptual development of “at-homeness” despite illness and disease: A review

    Directory of Open Access Journals (Sweden)

    Joakim Öhlén

    2014-05-01

    Full Text Available Only one empirical study, the one by Zingmark, Norberg and Sandman published in 1995, explicitly focuses on at-homeness, the feeling of being metaphorically at-home, as a particular aspect of wellness. However, other studies reveal aspects of at-homeness, but if or how such aspects of at-homeness are related to each other is unclear. For this reason, the aim was to review Scandinavian nursing research related to at-homeness in the context of wellness–illness in severe and long-term conditions in order to take a step towards conceptual clarification of “at-homeness.” The review included interpretive studies related to severe and long-term illness conducted in Sweden: 10 original articles and 5 doctoral theses. “At-homeness” was found to be a contextually related meaning of wellness despite illness and disease embedded in the continuum of being metaphorically at-home and metaphorically homeless. This was characterized by three interrelated aspects and four processes: being safe through expanding–limiting experiences of illness and time, being connected through reunifying–detaching ways of relating, and being centred through recognition–non-recognition of oneself in the experience and others giving–withdrawing a place for oneself. This conceptualization is to be regarded as a step in conceptual clarification. Further empirical investigation and theoretical development of “at-homeness” are needed. The conceptualization will be a step of plausible significance for the evaluation of interventions aimed at enhancing wellness for people with severe long-term illness, such as the frail elderly, and people with chronic illness or palliative care needs.

  16. Clinical characteristics associated with illness perception in psoriasis.

    Science.gov (United States)

    Wahl, Astrid K; Robinson, Hilde S; Langeland, Eva; Larsen, Marie H; Krogstad, Anne-Lene; Moum, Torbjørn

    2014-05-01

    Knowledge of illness perception may aid the identification of groups of patients with a higher risk of coping poorly with the demands of their illness. This study aims to investigate associations between illness perception, clinical characteristics, patient knowledge, quality of life and subjective health in persons with psoriasis. The present study was based on cross-sectional data from patients awaiting climate therapy in Gran Canaria. We included 254 eligible patients (74%) who completed a questionnaire including the revised Illness Perception Questionnaire, the Psoriasis Knowledge Questionnaire, and the Dermatological Life Quality Index. Disease severity was measured using the Psoriasis Area and Severity Index. Several statistically significant associations between clinical characteristics, knowledge and various illness perception dimensions were found. Illness perception was also significantly related to disease-specific quality of life and subjective health. These findings contradict previous findings, which suggested that objective disease factors are not relevant to illness perception in psoriasis.

  17. Diagnosis and treatment of mental illness in mentally retarded children: a developmental model.

    Science.gov (United States)

    Dosen, A

    1989-01-01

    Attempts have been made in recent years to discover the roots of psychiatric disorders in mentally retarded children by employing a developmental approach in which the child, not the handicap, is brought more clearly into focus. This paper provides a brief overview of the developmental model that has proven useful for the author in the psychiatric diagnosis of mentally retarded children. Application of this model to the treatment of mentally ill-mentally retarded children is also addressed.

  18. Focus on Succes

    Directory of Open Access Journals (Sweden)

    Ivan Slimák

    2011-10-01

    Full Text Available The Editor wishes to present the need and form of turning the focus of individuals and organisations to success, based on evaluating understanding of the situation, on complex improving the quality of work, production and life, and on awareness of accountability for consequences of one’s actions in the given environment and time. Understood by success is sustained financial and non-financial prosperity, whilst decisive is the evaluating process, the key element is loyalty of natural and physical persons, and the priority is loyalty of external customers. The address is targeted to would-be authors and readers of our Journal interested in engineering and management of quality of mutually correlate entities.

  19. Focus on Delivery

    DEFF Research Database (Denmark)

    Hasman, Kirsten; Barfoed, Anne

    2016-01-01

    to prevent severe perineal injury. This paper describes midwives’ and students’ experiences of performing a structured reflection on clinical skills together. Method: During a six week period in October 2015 midwives and students at Rigshospitalet (Copenhagen) used a Reflection Assessment Tool after having...... attended the delivery, facilitated the midwife’s and the student’s structured reflection. Further, the project midwife held daily simulation workshops with midwives and students. Two focus group interviews with students and midwives were conducted and analyzed using content analysis. Results and conclusion...... (2). It is, however, not clarified which of the multifaceted aspects of preventing perineal injury that might explain the decrease (3). Aims: We hypothesized that the use of structured reflection on a clinical practice by midwives and midwifery students would increase both parts’ knowledge on how...

  20. The FOCUS trial

    DEFF Research Database (Denmark)

    Glenthøj, Louise B; Fagerlund, Birgitte; Randers, Lasse

    2015-01-01

    trial enrolling 126 patients meeting the standardised criteria of being at UHR for psychosis. Patients are recruited from psychiatric in- and outpatient facilities in the Copenhagen catchment area. Patients are randomised to one of the two treatment arms: cognitive remediation plus standard treatment...... functioning, psychosis-like symptoms, negative symptomatology, and depressive symptomatology as measured with the Personal and Social Performance Scale, Brief Psychiatric Rating Scale-Expanded Version, Scale for the Assessment of Negative Symptoms, and the Montgomery-Åsberg Depression Rating Scale. DISCUSSION......: This is the first trial to evaluate the effects of neurocognitive and social cognitive remediation in UHR patients. The FOCUS trial results will provide evidence on the effect of targeted and comprehensive cognitive rehabilitation on cognition, daily living, and symptomatology as well as long-term outcome...

  1. Alliance-focused training.

    Science.gov (United States)

    Eubanks-Carter, Catherine; Muran, J Christopher; Safran, Jeremy D

    2015-06-01

    Alliance-focused training (AFT) aims to increase therapists' ability to recognize, tolerate, and negotiate alliance ruptures by increasing the therapeutic skills of self-awareness, affect regulation, and interpersonal sensitivity. In AFT, therapists are encouraged to draw on these skills when metacommunicating about ruptures with patients. In this article, we present the 3 main supervisory tasks of AFT: videotape analysis of rupture moments, awareness-oriented role-plays, and mindfulness training. We describe the theoretical and empirical support for each supervisory task, provide examples based on actual supervision sessions, and present feedback about the usefulness of the techniques from trainees in our program. We also note some of the challenges involved in conducting AFT and the importance of maintaining a strong supervisory alliance when using this training approach.

  2. Exposing the Expert Discourse in Psychiatry: A Critical Analysis of an Anti-Stigma/Mental Illness Awareness Campaign

    Directory of Open Access Journals (Sweden)

    Jean Daniel Jacob

    2015-01-01

    Full Text Available Drawing on a situational analysis of a recent anti-stigma campaign in psychiatry (Defeat Denial: Help Defeat Mental Illness this paper seeks to engage with the reader on the use of an expert discourse that focuses on the brain and its disruption as a way to address stigma associated with mental illness. To begin, we briefly highlight key statistics regarding the impact of mental illness in Canada and introduce the concept of stigma. We then introduce the Defeat Denial media campaign and describe the analytical process employed for this paper - Situational Analysis with a specific focus on discourse. We then expand on the use of the expert discourse in the awareness campaign by making connections with Rose’s concept of biological citizen and, in the final sections, present recent studies on stigma that highlight the paradox and contested construction of the (biopsychiatric self

  3. Role of lactate in critically ill children

    Directory of Open Access Journals (Sweden)

    Chugh Krishan

    2004-01-01

    Full Text Available Lactic acidosis is a common finding in critically ill patients. It has been used as a prognostic marker of the outcome in Pediatric Intensive Care Unit patients. Lactic acid is produced as a product of anaerobic glycolysis and is reversibly converted to pyruvate in the presence of favorable metabolic environment. All the body tissues can produce and consume lactate with few having predominant function of production and others of consumption. Liver is a major organ for lactate consumption and it is the liver, which metabolizes the increased lactic acid produced in regional tissue beds. The lactate levels can be done on arterial, venous, or mixed venous blood and can be measured by various methods. Serial lactate concentrations and the difference in arterial and mixed venous lactate levels or between the arterial and regional blood lactate levels like jugular venous lactate levels have been shown to have better correlation with the outcome. High initial blood lactate levels and persistently high lactate levels have been correlated with poor outcome. There are various causes of lactic acid overproduction, which may produce either hyperlactatemia or lactic acidosis. High blood lactate levels are found in critically ill patients with shock of any etiology and sepsis due to various reasons, which include increased catecholamine induced glucose flux apart from the tissue hypoperfusion and hypoxia. Various other illnesses can cause an increase in blood lactate levels like acute lung/liver injury, severe asthma, poisoning, post cardiac surgery etc. Treating the underlying disease leading to lactic acidosis is the best measure to control lactic acidosis. Some therapeutic choices are available to neutralize the effect of lactic acid on cell function, but none has stood the test of time and are tried only in desperate situations.

  4. Febrile illness experience among Nigerian nomads

    Directory of Open Access Journals (Sweden)

    Akogun Oladele B

    2012-01-01

    Full Text Available Abstract Background An understanding of the febrile illness experience of Nigerian nomadic Fulani is necessary for developing an appropriate strategy for extending malaria intervention services to them. An exploratory study of their malaria illness experience was carried out in Northern Nigeria preparatory to promoting malaria intervention among them. Methods Ethnographic tools including interviews, group discussions, informal conversations and living-in-camp observations were used for collecting information on local knowledge, perceived cause, severity and health seeking behaviour of nomadic Fulani in their dry season camps at the Gongola-Benue valley in Northeastern Nigeria. Results Nomadic Fulani regarded pabboje (a type of "fever" that is distinct from other fevers because it "comes today, goes tomorrow, returns the next" as their commonest health problem. Pabboje is associated with early rains, ripening corn and brightly coloured flora. Pabboje is inherent in all nomadic Fulani for which treatment is therefore unnecessary despite its interference with performance of duty such as herding. Traditional medicines are used to reduce the severity, and rituals carried out to make it permanently inactive or to divert its recurrence. Although modern antimalaria may make the severity of subsequent pabboje episodes worse, nomads seek treatment in private health facilities against fevers that are persistent using antimalarial medicines. The consent of the household head was essential for a sick child to be treated outside the camp. The most important issues in health service utilization among nomads are the belief that fever is a Fulani illness that needs no cure until a particular period, preference for private medicine vendors and the avoidance of health facilities. Conclusions Understanding nomadic Fulani beliefs about pabboje is useful for planning an acceptable community participatory fever management among them.

  5. Latent viral immune inflammatory response model for chronic multisymptom illness.

    Science.gov (United States)

    Maloney, Sean R; Jensen, Susan; Gil-Rivas, Virginia; Goolkasian, Paula

    2013-03-01

    A latent viral immune inflammatory response (LVIIR) model is presented which integrates factors that contribute to chronic multisymptom illness (CMI) in both the veteran and civilian populations. The LVIIR model for CMI results from an integration of clinical experience with a review of the literature in four distinct areas: (1) studies of idiopathic multisymptom illness in the veteran population including two decades of research on Gulf War I veterans with CMI, (2) new evidence supporting the existence of chronic inflammatory responses to latent viral antigens and the effect these responses may have on the nervous system, (3) recent discoveries concerning the role of vitamin D in maintaining normal innate and adaptive immunity including suppression of latent viruses and regulation of the immune inflammatory response, and (4) the detrimental effects of extreme chronic repetitive stress (ECRS) on the immune and nervous systems. The LVIIR model describes the pathophysiology of a pathway to CMI and presents a new direction for the clinical assessment of CMI that includes the use of neurological signs from a physical exam, objective laboratory data, and a new proposed latent viral antigen-antibody imaging technique for the peripheral and central nervous system. The LVIIR model predicts that CMI can be treated by a focus on reversal of immune system impairment, suppression of latent viruses and their antigens, and healing of nervous system tissue damaged by chronic inflammation associated with latent viral antigens and by ECRS. In addition, the LVIIR model suggests that maintaining optimal serum 25 OH vitamin D levels will maximize immune system suppression of latent viruses and their antigens and will minimize immune system inflammation. This model also emphasizes the importance of decreasing ECRS to improve immune system function and to minimize nervous system injury from excess serum glucocorticoid levels. The proposed model supports growing evidence that increasing

  6. Mental illness-related stigma in healthcare

    Science.gov (United States)

    Mantler, Ed; Szeto, Andrew

    2017-01-01

    Mental illness-related stigma, including that which exists in the healthcare system and among healthcare providers, creates serious barriers to access and quality care. It is also a major concern for healthcare practitioners themselves, both as a workplace culture issue and as a barrier for help seeking. This article provides an overview of the main barriers to access and quality care created by stigmatization in healthcare, a consideration of contributing factors, and a summary of Canadian-based research into promising practices and approaches to combatting stigma in healthcare environments.

  7. How to diagnose a foodborne illness.

    Science.gov (United States)

    Donnenberg, Michael S; Narayanan, Shivakumar

    2013-09-01

    Timely diagnosis of foodborne infection can be critical not only for the patient, but also for the larger community because of the potential to interrupt further spread. This article presents the diagnostic approach to patients with foodborne illness, discussing epidemiologic clues of various foodborne pathogens and their distinguishing clinical features of diagnostic importance. Also discussed are situations whereby stool cultures should be ordered; other helpful stool tests; nonculture methods of identifying organisms and their applicability in clinical settings; the role of pulsed-field gel electrophoresis in typing organisms; and large-scale sharing of data to aid in identification of large outbreaks.

  8. Arranged matches and mental illness: therapists' dilemmas.

    Science.gov (United States)

    Greenberg, David; Buchbinder, Jacob Tuvia; Witztum, Eliezer

    2012-01-01

    Traditional societies place especial value on marriage and having children, and marriages are often arranged. A series of situations and dilemmas associated with arranged matches and their consequences are described in the course of mental health work with ultra-orthodox Jewish people with severe mental illness. Issues of confidentiality may arise with parents and matchmakers; on the other hand, respectful cooperation with religious authorities, counselors in the community, and family members is important. Information on genetic counseling, contraception, medication during pregnancy, and breastfeeding are considered and interact with communal structures and practices. There is a need for close support and evaluation during the process of marriage, childbearing, and parenthood.

  9. Glucose metabolism in critically ill patients

    DEFF Research Database (Denmark)

    Nielsen, Signe Tellerup; Krogh-Madsen, Rikke; Møller, Kirsten

    2015-01-01

    , stimulates insulin secretion and inhibits glucagon release both in healthy individuals and in patients with type 2 diabetes (T2DM). Compared to insulin, GLP-1 appears to be associated with a lower risk of severe hypoglycemia, probably because the magnitude of its insulinotropic action is dependent on blood...... characteristics and are, among other things, both characterized by different grades of systemic inflammation and insulin resistance. The GLP-1 might be a potential new treatment target in critically ill patients with stress-induced hyperglycemia....

  10. Was Maurice Ravel's illness a corticobasal degeneration?

    Science.gov (United States)

    Baeck, E

    1996-02-01

    The French composer Maurice Ravel (1875-1937) was struck down at the peak of his career by an aphasia and apraxia that destroyed his artistic realization but preserved his musical sensibility and judgment. He died after craniotomy. Multiple hypotheses have been formulated to explain the exact nature of his illness, probably corticobasal degeneration. However, in the absence of a post-mortem examination, the diagnosis must remain speculative despite the accurate descriptions of the symptoms in numerous biographies, the neuro-psychological notes of Théophile Alajouanine and the operative findings of Clovis Vincent.

  11. Advance payments

    CERN Multimedia

    Human Resources Division

    2003-01-01

    Administrative Circular N 8 makes provision for the granting of advance payments, repayable in several monthly instalments, by the Organization to the members of its personnel. Members of the personnel are reminded that these advances are only authorized in exceptional circumstances and at the discretion of the Director-General. In view of the current financial situation of the Organization, and in particular the loans it will have to incur, the Directorate has decided to restrict the granting of such advances to exceptional or unforeseen circumstances entailing heavy expenditure and more specifically those pertaining to social issues. Human Resources Division Tel. 73962

  12. ADVANCE PAYMENTS

    CERN Multimedia

    Human Resources Division

    2002-01-01

    Administrative Circular Nº 8 makes provision for the granting of advance payments, repayable in several monthly instalments, by the Organization to the members of its personnel. Members of the personnel are reminded that these advances are only authorized in exceptional circumstances and at the discretion of the Director-General. In view of the current financial situation of the Organization, and in particular the loans it will have to incur, the Directorate has decided to restrict the granting of such advances to exceptional or unforeseen circumstances entailing heavy expenditure and more specifically those pertaining to social issues. Human Resources Division Tel. 73962

  13. Role of Borna Disease Virus in neuropsychiatric illnesses : Are we inching closer ?

    Directory of Open Access Journals (Sweden)

    Thakur R

    2009-01-01

    Full Text Available The biological cause of psychiatric illnesses continues to be under intense scrutiny. Among the various neurotropic viruses, Borna disease virus (BDV is another virus that preferentially targets the neurons of the limbic system and has been shown to be associated with behavioural abnormalities. Presence of various BDV markers, including viral RNA, in patients with affective and mood disorders have triggered ongoing debate worldwide regarding its aetiopathogenic relationship. This article analyses its current state of knowledge and recent advances in diagnosis in order to prove or refute the association of BDV in causation of human neuropsychiatric disorders. This emerging viral causative association of behavioural disorders, which seems to be inching closer, has implication not only for a paradigm shift in the treatment and management of neuropsychiatric illnesses but also has an important impact on the public health systems.

  14. Odilon Redon and the Pasteurian revolution: health, illness, and le monde invisible.

    Science.gov (United States)

    Larson, Barbara

    2004-12-01

    Odilon Redon's dark-spirited charcoals and lithographs of the last quarter of the nineteenth century responded to developments in science, including the Pasteurian revolution. Rather than celebrating the progressive potential of science, Redon's noirs engaged national anxieties that attended scientific advances. His position was close to the Decadents of the 1880s who dwelled on themes of illness and decay. While the artist's original biographer André Mellerio referred to the artist's fascination with Pasteur and his microbial world, where in a single drop of water "there arises the spectacle of giants of a gripping horror and a frightful, predatory nature," the topic has virtually disappeared from Redon literature. By recovering the scientific/medical issues that stimulated Redon's creation, this article restores the subjects of pathogenic organisms and contagious illness to their rightful place in Redon's oeuvre. Further, it provides the reader with a discussion of the cultural context in which Redon's interest was generated.

  15. 体部γ刀立体定向放疗联合高强聚焦超声治疗中晚期胰腺癌12例临床分析%Body gamma knife combined with high intensity focused ultrasound in the treatment of advanced pancreatic cancer in 12 cases

    Institute of Scientific and Technical Information of China (English)

    杜海峰; 魏长宏; 王作志; 赵永生; 卞晓山; 傅振强

    2015-01-01

    目的 观察体部γ刀立体定向放疗(stereotactic body radiation therapy,SBRT)联合高强聚焦超声(high intensity focused ultrasound,HIFU)治疗中晚期胰腺癌的近期疗效及安全性.方法 中晚期胰腺癌患者12例,给予SBRT联合HIFU治疗.SBRT取等剂量线为50%~60%,肿瘤单次周边剂量3.0~4.0 Gy,总剂量35~48 Gy,8~12次,1次/d,5次/周;SBRT期间,SBRT后2~4 h行HIFU治疗,1次/周,靶区温度控制在42℃以上,共3~5次.观察近期临床疗效及不良反应发生情况.结果 治疗结束后2~3个月,肿瘤完全缓解1例,部分缓解8例,无变化1例,恶化2例,近期总有效率75.0%;治疗后11例伴疼痛者疼痛缓解9例,8例合并黄疸者黄疸消退6例;治疗期间出现恶心、呕吐10例,白细胞下降7例,血小板降低5例,均经对症治疗恢复正常.结论 SBRT联合HIFU治疗中晚期胰腺癌疗效满意,不良反应可耐受.%Objective To observe the short-term effect and safety of stereotactic body radiation therapy (SBRT) combined with high intensity focused ultrasound (HIFU) in the treatment of advanced pancreatic cancer.Methods Twelve patients with advanced pancreatic cancer received SBRT plus HIFU.The isodose curve of SBRT was 50% to 60%,tumor single peripheral dose was 3 to 4.0 Gy,and the total dose was 35 to 48 Gy,once a day for 8 to 12 times,five times per week.In 2 to 4 hours after SBRT,the patients received HIFU,once a week,totally for 3 to 5 times at the target zone temperature of over 42 ℃.The short-term effect and adverse reaction were observed.Results After 2-to 3-month treatment,complete remission occurred in 1 patient,partial remission in 8,no change in 1,and deterioration in 2,with the total short-term effective rate of 75.0%.After treatment,11 patients with pain were relieved in 9,and 8 with jaundice were subsided jaundice in 6.The adverse reactions included nausea and vomiting in 10 patients,leukocyte decrease in 7,and decreased platelet in 5,which became

  16. The Role of Focused Echocardiography in Pediatric Intensive Care: A Critical Appraisal

    Directory of Open Access Journals (Sweden)

    Heloisa Amaral Gaspar

    2015-01-01

    Full Text Available Echocardiography is a key tool for hemodynamic assessment in Intensive Care Units (ICU. Focused echocardiography performed by nonspecialist physicians has a limited scope, and the most relevant parameters assessed by focused echocardiography in Pediatric ICU are left ventricular systolic function, fluid responsiveness, cardiac tamponade and pulmonary hypertension. Proper ability building of pediatric emergency care physicians and intensivists to perform focused echocardiography is feasible and provides improved care of severely ill children and thus should be encouraged.

  17. Advances in business ICT

    CERN Document Server

    Pełech-Pilichowski, Tomasz

    2014-01-01

    Futurists and scientists alike profess the coming of a new era in the history – the knowledge era. The notion of knowledge is as old as humans’ self-consciousness, but new challenges appear. The meaning of the word “knowledge” is changing from cognitive notion to a technical term denoting a structured economic resource to be actively managed. This contributed volume is a result of vivid and extremely valuable discussions held at 3rd International Workshop on Advances in Business ICT (ABICT) in Wrocław, Poland, September 9-12, 2012. The workshop focused on Advances in Business ICT approached from a multidisciplinary perspective. It provided an international forum for scientists/experts from academia and industry to discuss and exchange current results, applications, new ideas of ongoing research and experience on all aspects of Business Intelligence. ABICT has also been an opportunity to demonstrate different ideas and tools for developing and supporting organizational creativity, as well as advances ...

  18. Advanced flip chip packaging

    CERN Document Server

    Lai, Yi-Shao; Wong, CP

    2013-01-01

    Advanced Flip Chip Packaging presents past, present and future advances and trends in areas such as substrate technology, material development, and assembly processes. Flip chip packaging is now in widespread use in computing, communications, consumer and automotive electronics, and the demand for flip chip technology is continuing to grow in order to meet the need for products that offer better performance, are smaller, and are environmentally sustainable. This book also: Offers broad-ranging chapters with a focus on IC-package-system integration Provides viewpoints from leading industry executives and experts Details state-of-the-art achievements in process technologies and scientific research Presents a clear development history and touches on trends in the industry while also discussing up-to-date technology information Advanced Flip Chip Packaging is an ideal book for engineers, researchers, and graduate students interested in the field of flip chip packaging.

  19. Advanced Magnetic Nanostructures

    CERN Document Server

    Sellmyer, David

    2006-01-01

    Advanced Magnetic Nanostructures is devoted to the fabrication, characterization, experimental investigation, theoretical understanding, and utilization of advanced magnetic nanostructures. Focus is on various types of 'bottom-up' and 'top-down' artificial nanostructures, as contrasted to naturally occurring magnetic nanostructures, such as iron-oxide inclusions in magnetic rocks, and to structures such as perfect thin films. Chapter 1 is an introduction into some basic concepts, such as the definitions of basic magnetic quantities. Chapters 2-4 are devoted to the theory of magnetic nanostructures, Chapter 5 deals with the characterization of the structures, and Chapters 6-10 are devoted to specific systems. Applications of advanced magnetic nanostructures are discussed in Chapters11-15 and, finally, the appendix lists and briefly discusses magnetic properties of typical starting materials. Industrial and academic researchers in magnetism and related areas such as nanotechnology, materials science, and theore...

  20. White Light Focusing Mirror

    Science.gov (United States)

    Johnson, Eric; Lyndaker, Aaron; Deyhim, Alex; Sullivan, Michael; Chance, Mark; Abel, Don; Toomey, John; Hulbert, Steven

    2007-01-01

    The NSLS X28C white-light beamline is being outfitted with a focusing mirror in order to increase, as well as control, the x-ray intensity at the sample position. The new mirror is a 50 mm × 100 mm × 1100 mm single crystal silicon cylindrical 43.1mm radius substrate bendable to a toroid from infinite to 1200 m radius. The unique feature of this mirror system is the dual use of Indalloy 51 as both a mechanism for heat transfer and a buoyant support to negate the effects of gravity. The benefit of the liquid metal support is the ability to correct for minor slope errors that take the form of a parabola. A bobber mechanism is employed to displace the fluid under the mirror +/- 1.5 mm. This allows RMS slope error correction on the order of 2 urad. The unique mounting of the mirror ensures the contributions to slope error from errant mechanical stresses due to machining tolerances are virtually non-existent. After correction, the surface figure error (measured minus ideal) is <= 0.5 urad rms.

  1. Advances of mechanism of habenula in reward and its role in mental illness%缰核在中枢奖赏调控的机制及其在精神疾病中的作用研究进展

    Institute of Scientific and Technical Information of China (English)

    杨澍均; 张茵; 张富强

    2014-01-01

    缰核是一个在生物进化过程中古老且保守的中枢核团,参与许多重要的生物学功能,如母性行为、疼痛、睡眠、应激、学习和奖赏等。作为多巴胺奖赏网络中一个重要的节点,缰核在奖赏(也包括维持个体生存的趋利避害)过程中的功能和作用机制近年来引起学术界的广泛关注并成为研究的热点中枢核团之一。缰核的功能紊乱与许多精神疾病如抑郁、精神分裂症、成瘾等密切相关,也可能成为这些精神疾病临床治疗的潜在靶点。阐明缰核在奖赏和觅药动机中的作用和神经生物学机制具有重要的理论意义和临床应用价值。%The habenula complex,an ancient and conservative nucleus during biological evolution, is involved in many i mportant biological functions,such as maternal behavior,pain,sleep,learning and reward.As an important node in the dopamine reward network,its functions(including the maintenance of individual survival while avoiding disadvantages)and mechanis m in the reward process have attracted wide attention.The dysfunction of habenula is closely related to many psychotic disorders,such as de-pression,schizophrenia and drug habituation.Habenula may also become a potential target for clinical treatment of these mental illnesses.So clarifying the role and neurobiological mechanisms of habenula in the central nervous system is of great theoretical and clinical value.

  2. Nanoplasmonics advanced device applications

    CERN Document Server

    Chon, James W M

    2013-01-01

    Focusing on control and manipulation of plasmons at nanometer dimensions, nanoplasmonics combines the strength of electronics and photonics, and is predicted to replace existing integrated circuits and photonic devices. It is one of the fastest growing fields of science, with applications in telecommunication, consumer electronics, data storage, medical diagnostics, and energy.Nanoplasmonics: Advanced Device Applications provides a scientific and technological background of a particular nanoplasmonic application and outlines the progress and challenges of the application. It reviews the latest

  3. A cognitive behavioral based group intervention for children with a chronic illness and their parents: a multicentre randomized controlled trial

    NARCIS (Netherlands)

    L. Scholten; A.M. Willemen; M.A. Grootenhuis; H. Maurice-Stam; C. Schuengel; B.F. Last

    2011-01-01

    Coping with a chronic illness (CI) challenges children's psychosocial functioning and wellbeing. Cognitive-behavioral intervention programs that focus on teaching the active use of coping strategies may prevent children with CI from developing psychosocial problems. Involvement of parents in the int

  4. Acute Muscular Sarcocystosis: an international investigation among ill travelers returning from Tioman Island, Malaysia, 2011 and 2012

    Science.gov (United States)

    Two provider-based traveler-focused networks allowed for the detection of a large outbreak of acute muscular sarcocystosis (AMS). Clinicians evaluating travelers returning ill from Malaysia with fever and myalgia noted the biphasic aspect of the disease, the later onset of elevated CPK and eosinophi...

  5. Music as Illness; Music as Healing.

    Science.gov (United States)

    Pritchard, Maureen

    2015-09-01

    Throughout the Soviet Union, the arts became tied to ethnicity through the project of Socialist Realism. When, in 1991, the Kyrgyz Republic became independent from the Soviet Union, its national narrative continued to be built upon tropes of Kyrgyz ethnicity. Through their engagement with images of the ethno-national self, the arts provide a great source of beauty. Defining beauty as a representation of the self that is pure whole, and stable, Julia Kristeva asserts that beauty and suffering are part of the same phenomena. Arthur Kleinman argues that suffering is best understood as existing within the triangulated relationship of cultural representation, collective experience, and subjectivity. Music too is part of this triangulated relationship, and therefore, a part of suffering. Drawing upon ten months of ethnographic fieldwork in Kyrgyzstan, this article explores the illness experience of a single Kyrgyz musician. In doing so, it illustrates music's role in self-formation and the development of social, economic, and political ties and the shifts that occur in these during illness. In drawing forth the role of music in the construction of racialized ethnicities, this article demonstrates how the experience of transformative beauty can coexist with turmoil, marginalization, and violence.

  6. Stress causing psychosomatic illness among nurses

    Directory of Open Access Journals (Sweden)

    Kane Pratibha

    2009-01-01

    Full Text Available Stress in nurses is an endemic problem. It contributes to health problems in nurses and decreases their efficiency. Documenting the causes and extent of stress in any healthcare unit is essential for successful interventions . Aim : Establishing the existence and extent of work stress in nurses in a hospital setting, identifying the major sources of stress, and finding the incidence of psychosomatic illness related to stress. Materials and Methods: This study used a questionnaire relating to stressors and a list of psychosomatic ailments. One hundred and six nurses responded and they were all included in the study. Stressors were based on four main factors: work related, work interactions, job satisfaction, and home stress. The factors relating to stress were given weights according to the severity. The total score of 50 was divided into mild, moderate, severe, and burnout. Results: Most important causes of stress were jobs not finishing in time because of shortage of staff, conflict with patient relatives, overtime, and insufficient pay. Psychosomatic disorders like acidity, back pain, stiffness in neck and shoulders, forgetfulness, anger, and worry significantly increased in nurses having higher stress scores. Increase in age or seniority did not significantly decrease stress. Conclusion: Moderate levels of stress are seen in a majority of the nurses. Incidence of psychosomatic illness increases with the level of stress. Healthcare organizations need to urgently take preemptive steps to counter this problem.

  7. Illness beliefs in African Americans with hypertension.

    Science.gov (United States)

    Pickett, Stephanie; Allen, Wilfred; Franklin, Mary; Peters, Rosalind M

    2014-02-01

    Guided by Leventhal's common sense model of illness representations, this study examined the relationship between hypertension beliefs and self-care behaviors necessary for blood pressure (BP) control in a sample of 111 community-dwelling African Americans with hypertension. Participants completed the revised Illness Perception Questionnaire, BP Self-Care Scale, and a demographic data sheet, and had BP measured. Analyses revealed that beliefs about the causes of hypertension differed by gender and educational level. Stress-related causal attributions accounted for 34.7% of the variance in hypertension beliefs. Participants who believed stress or external factors caused hypertension were less likely to engage in healthy self-care behaviors (e.g., keeping doctor visits, eating low-salt, low-fat diets). Results suggest that patients who are nonadherent with hypertension self-care recommendations may hold hypertension beliefs that are not consistent with the medically endorsed views of this disease. To more effectively treat and control BP, providers should assess patients' hypertension beliefs.

  8. Birds of ill omen in Slavic beliefs

    Directory of Open Access Journals (Sweden)

    Aksić Nina V.

    2015-01-01

    Full Text Available This paper deals with birds of ill omen and beliefs related to their cries and calls. According to the presence of the ill omen attribute, these birds are sorted into three groups. The paper describes various divination types according to the calls of so-called unclean birds, as well as various prophecies, i.e. their ominous „weight“, on the basis of numerous examples from the Slavic cultural sphere, with additional, more recent examples from the Serbian space. The final remarks are related to four segments: the type of the listed birds’ bad omen (death, disease / year of famine, fire, bad weather; prophecy of evil or merely information, i.e. warning about a possible bad event; the manner of the bird’s prophecy or report of misfortune (a call, a manner of flight etc.; existence of undesirable actions related to certain birds (actions that could result in negative consequences for the person who performs them. [Projekat Ministarstva nauke Republike Srbije, br. 47016: Interdisciplinarno istraživanje kulturnog i jezičkog nasleđa Srbije i izrada multimedijalnog internet portala „Pojmovnik srpske kulture

  9. Positive feelings among terminally ill cancer patients.

    Science.gov (United States)

    Van der Lee, M L; Swarte, N B; Van der Bom, J G; Van den Bout, J; Heintz, A P M

    2006-03-01

    For a realistic perspective on what it is like to have cancer and be in the last months of life, it is necessary to also study the positive feelings people may still experience. We set out to describe positive feelings experienced by terminally ill patients. The Depression Adjective Checklist was completed by 96 cancer patients with an estimated life expectancy of less than 3 months. On average patients endorsed 30% (3.6/12) of the positive mood items, and 25% (5.4/22) of the negative mood items. The larger part of terminally ill cancer patients with an estimated life expectancy of less than 3 months reported one or more positive mood states. A positive mood state such as 'being interested' was endorsed by more than half (65%) of the patients, other positive feelings were endorsed by a substantial proportion of patients, for example: 38% of patients endorsed feeling 'jovial' and 35% reported being 'optimistic'. Although having incurable cancer often leads to feelings of depression, mood is variable and many patients experience at least some positive feelings.

  10. The Relationship Between Health Management and Information Behavior Over Time: A Study of the Illness Journeys of People Living With Fibromyalgia

    Science.gov (United States)

    2016-01-01

    Background Over the course of a chronic illness, patients face many challenges, including understanding what is happening to them and developing an effective strategy for managing illness. While there is existing literature concerning how people seek health-related information and cope with chronic illnesses, there is a need for additional research on how information affects patients’ understandings of their illness, and how changes in this understanding affect their health management strategies over time. Objective This study examined how health management, information seeking, and information consumption and use processes are related throughout an illness. Methods A diversified recruitment strategy involving multiple media channels was used to recruit participants for an interview study. During the interviews, participants were asked to draw an “illness journey” timeline. The data were analyzed using a qualitative approach drawn from Interpretative Phenomenological Analysis and Grounded Theory. Results The study identified four main health management features of illness journeys: onset, progression toward diagnosis, acceptance, and development of an effective management strategy. The study then focused on how information seeking changes over illness journeys, particularly in terms of a transition from active information seeking to monitoring with intermittent focused searching. Last, the paper describes the information consumption and use processes that patients engaged in throughout their journey. Conclusions This study makes three important contributions to the field. First, it presents an integrated conceptualization of how health management and information behaviors are related on illness journeys. Second, it adds to our existing knowledge on health literacy and self-management of chronic illness. Third, the study has implications for health interface design. PMID:27780794

  11. The placebo puzzle: examining the discordant space between biomedical science and illness/healing.

    Science.gov (United States)

    Pohlman, Shawn; Cibulka, Nancy J; Palmer, Janice L; Lorenz, Rebecca A; SmithBattle, Lee

    2013-03-01

    The placebo response presents an enigma to biomedical science: how can 'inert' or 'sham' procedures reduce symptoms and produce physiological changes that are comparable to prescribed treatments? In this study, we examine this puzzle by explicating the discordant space between the prevailing biomedical paradigm, which focuses on a technical understanding of diagnosis and treatment, and a broader understanding of illness and healing as relational and embodied. Although biomedical achievements are impressive, the knowledge resulting from this paradigm is limited by its ontological and epistemological assumptions. When the body and world are objectified, illness meanings, therapeutic relationships, and healing practices are dismissed or distorted. In spite of a robust critique of the tenets of biomedicine for guiding practice, the biomedical paradigm retains a tenacious hold on evidence-based medicine and nursing, downplaying our clinical understanding of the sentient body, patients' life-worlds, and illness and healing. In reality, skilled nurses rely on multiple forms of knowledge in providing high-quality care to particular patients. Clinically wise nurses integrate their experience and knowledge of patients' priorities, fears, and illness trajectories along with biomedical findings to make astute judgments and promote health and healing.

  12. Co-construction of chronic illness narratives by older stroke survivors and their spouses.

    Science.gov (United States)

    Radcliffe, Eloise; Lowton, Karen; Morgan, Myfanwy

    2013-09-01

    Illness narratives have mainly focused on individual patients' accounts, and particularly those of people experiencing the onset of chronic illness in mid-life. However, a growing number of older people are spending their later life with their partner, with both experiencing complex morbidities. We examine the shared creation of meanings among older stroke survivors and their spouses and the implications for individual and couple identity. Joint biographical narrative interviews were held with 13 stroke survivors aged 75-85 and their spouses. The analysis examined both narrative content and narrative style. Three main types of co-presentation of identity were identified. The 'united couple' described couples who pulled together and emphasised their accommodation of the stroke and normality as a couple, despite often considerable disability, and was strongly underpinned by collaborative interaction in interviews. Caring relationships were distinguished as 'positive', involving self-reliant couples who took pride in how they managed and 'frustrated' in couples who emphasised the difficulties of caring and hardships experienced and were characterised by a conflictual style of narrative. We argue that joint interviews provide new forms of data that extend notions of how illness is lived and demonstrates how the marital relationship can mediate the experience of chronic illness and disability and its impact on identity.

  13. Gut Microbial Translocation in Critically Ill Children and Effects of Supplementation with Pre- and Pro Biotics

    Directory of Open Access Journals (Sweden)

    Paola Papoff

    2012-01-01

    Full Text Available Bacterial translocation as a direct cause of sepsis is an attractive hypothesis that presupposes that in specific situations bacteria cross the intestinal barrier, enter the systemic circulation, and cause a systemic inflammatory response syndrome. Critically ill children are at increased risk for bacterial translocation, particularly in the early postnatal age. Predisposing factors include intestinal obstruction, obstructive jaundice, intra-abdominal hypertension, intestinal ischemia/reperfusion injury and secondary ileus, and immaturity of the intestinal barrier per se. Despite good evidence from experimental studies to support the theory of bacterial translocation as a cause of sepsis, there is little evidence in human studies to confirm that translocation is directly correlated to bloodstream infections in critically ill children. This paper provides an overview of the gut microflora and its significance, a focus on the mechanisms employed by bacteria to gain access to the systemic circulation, and how critical illness creates a hostile environment in the gut and alters the microflora favoring the growth of pathogens that promote bacterial translocation. It also covers treatment with pre- and pro biotics during critical illness to restore the balance of microbial communities in a beneficial way with positive effects on intestinal permeability and bacterial translocation.

  14. Mechanical prophylaxis of venous thromboembolism in ill hospitalized medical patients: evidence and guidelines

    Directory of Open Access Journals (Sweden)

    Luca Masotti

    2012-07-01

    Full Text Available Venous thromboembolism (VTE represents one of the leading causes of mortality and morbidity in ill medical patients. Avoiding VTE is therefore of utmost importance in clinical practice. VTE prophylaxis can be assured by pharmacological strategies, such as heparinoids, unfractioned heparin, low molecular weight heparins, fondaparinux or oral anticoagulants and, when these are contraindicated, by mechanical measures, such as graduated compression stockings (GCS and/ or intermittent pneumatic compression (ICP. However, due to the lack of solid literature evidence, VTE mechanical prophylaxis is not standardized in hospitalized ill medical patients. Much recently, findings from randomized clinical trials on VTE prophylaxis in ill medical patients, such as CLOTS I in patients with stroke and LIFENOX in patients with other kind of medical diseases, seem to increase doubts and reduce certainness in this context and recommendations from guidelines don’t help in reducing confusion. Therefore the aim of this review is to focus on mechanical prophylaxis of VTE in hospitalized ill medical patients.http://dx.doi.org/10.7175/rhc.v3i3.202

  15. Decision-making capacity in elderly, terminally ill patients with cancer.

    Science.gov (United States)

    Sorger, Brooke Myers; Rosenfeld, Barry; Pessin, Hayley; Timm, Anne Kosinski; Cimino, James

    2007-01-01

    Despite the importance and complexity of evaluating decision-making capacity at the end of life, little research has focused on terminally ill patients' decision-making ability. The purpose of this study was to explore the decision-making capacity of elderly, terminally ill patients and the psychological and physical factors that affect decision making. Decision-making capacity and cognitive abilities were assessed using four measures: the Hopkins Competency Assessment Kit, the Bechara Gambling Task, the Concept Assessment Kit, and the Mini Mental Status Exam. In addition, symptoms of depression, level of physical functioning, and extent of physical symptoms were evaluated in order to identify correlates of decision-making ability. Two samples were compared: elderly, terminally ill patients with cancer (n = 43) and elderly, physically healthy adults living in supportive community residence (n = 35). Results revealed significantly poorer decision-making abilities among the terminal ill sample compared with healthy comparisons, but no association between demographic variables (e.g., age, race, or education) or clinical variables (depression or physical symptoms) and decision making. Implications for evaluating decision-making capacity are addressed.

  16. The role of illness perceptions in labour participation of the chronically ill.

    NARCIS (Netherlands)

    Boot, C.R.L.; Heijmans, M.; Gulden, J.W.J. van der; Rijken, M.

    2008-01-01

    OBJECTIVE: We aimed to investigate associations between work disability and illness perceptions, over and above medical assessment and self-reported health. METHODS: A representative sample of people aged 15-64 years with various chronic physical diseases was derived from the Panel of Patients with

  17. Approaching the concept of self-managing illness in long term illness. A review of literature.

    Directory of Open Access Journals (Sweden)

    Stavrou V

    2014-04-01

    Full Text Available Abstract: The management of long term illness is globally challenging and the common concerns are mainly found in developed, developing and transitory countries as the increase in the ageing of the population deteriorates the problems. For patients who are suffering from long term illnesses, there is an interest for programs of self managing the disease, which highlight the core essence of educating patients on managing the disease. Purpose: The purpose of the current study is to a present the basic definitions of self managing the disease, b identify the current situation and c discuss and support nursing staff in educating the patient on self managing the illness. Materials- Methods: A review of relevant articles was conducted on the electronic database Medline/ Pubmed as well as through Scholar Google search engine and a secondary search on the references found on the articles. This occurred irrespective of the publication time.Conclusions The role of the nurse as a member of the interdisciplinary group is important because it helps the patient to develop skills of self care. Complete programs of self-managing the illness with the participation of the nurses in the planning, application and evaluation of the results, will contribute significantly to the patient, notwithstanding the professional benefit for the nurses.

  18. Stress wave focusing transducers

    Energy Technology Data Exchange (ETDEWEB)

    Visuri, S.R., LLNL

    1998-05-15

    Conversion of laser radiation to mechanical energy is the fundamental process behind many medical laser procedures, particularly those involving tissue destruction and removal. Stress waves can be generated with laser radiation in several ways: creation of a plasma and subsequent launch of a shock wave, thermoelastic expansion of the target tissue, vapor bubble collapse, and ablation recoil. Thermoelastic generation of stress waves generally requires short laser pulse durations and high energy density. Thermoelastic stress waves can be formed when the laser pulse duration is shorter than the acoustic transit time of the material: {tau}{sub c} = d/c{sub s} where d = absorption depth or spot diameter, whichever is smaller, and c{sub s} = sound speed in the material. The stress wave due to thermoelastic expansion travels at the sound speed (approximately 1500 m/s in tissue) and leaves the site of irradiation well before subsequent thermal events can be initiated. These stress waves, often evolving into shock waves, can be used to disrupt tissue. Shock waves are used in ophthalmology to perform intraocular microsurgery and photodisruptive procedures as well as in lithotripsy to fragment stones. We have explored a variety of transducers that can efficiently convert optical to mechanical energy. One such class of transducers allows a shock wave to be focused within a material such that the stress magnitude can be greatly increased compared to conventional geometries. Some transducer tips could be made to operate regardless of the absorption properties of the ambient media. The size and nature of the devices enable easy delivery, potentially minimally-invasive procedures, and precise tissue- targeting while limiting thermal loading. The transducer tips may have applications in lithotripsy, ophthalmology, drug delivery, and cardiology.

  19. A challenging empirical question: What are the effects of media on psychogenic illness during a community crisis?

    Science.gov (United States)

    Bass, Elizabeth; Kaplan-Liss, Evonne; Dorf, Dennis; Broderick, Joan E

    2012-01-01

    Psychogenic illness during disasters can cripple emergency healthcare services. Almost all research into this phenomenon has been retrospective and observational, and much of it suggests that media coverage can amplify psychogenic outbreaks. But there is little empirical evidence that this is true or that, conversely, media reports can mitigate psychogenic symptoms. In their work experimentally inducing psychogenic illness, the authors became sharply aware that it is difficult to experimentally mimic real-time media coverage. Yet clarifying media's effects on psychogenic illness is important if we want to prevent psychological disturbance. To meet this challenge, the authors advocate the funding and development of research protocols in advance of public emergencies, ready to be implemented in real-time. Coupled with digital media, which can track the reading and viewing behavior of millions of people, this approach can help us better understand media's impact on public health during an emergency, for better or for worse.

  20. Questioning the Search for Illness Narratives in Medical Anthropology: Can we talk about actual pain experiences?

    DEFF Research Database (Denmark)

    Tørring, Marie Louise

    of the anthropological literature on pain from the 1950's up to today. RESULTS: The anthropological focus on pain has changed considerably during the last century from exotic tales of cultural codes of pain behaviour to illness narratives of pain experience. This shift in focus not only mirrors changes in our profession......, phenomenological way of understanding pain. CONCLUSION: My empirical findings show that a narrative approach only offer a partial understanding of how we acquire knowledge of other people's pain - this goes for health professionals as well as ethnographers. A more contextual approach - studying pain behaviour...

  1. Prediction of critical illness in elderly outpatients using elder risk assessment: a population-based study

    Directory of Open Access Journals (Sweden)

    Biehl M

    2016-06-01

    receiver operating characteristic curve was 0.75, which indicated good discrimination. Conclusion: A simple model based on easily obtainable administrative data predicted critical illness in the next 2 years in elderly outpatients with up to 14% of the highest risk population suffering from critical illness. This model can facilitate efficient enrollment of patients into clinical programs such as care transition programs and studies aimed at the prevention of critical illness. It also can serve as a reminder to initiate advance care planning for high-risk elderly patients. External validation of this tool in different populations may enhance its generalizability. Keywords: aged, prognostication, critical care, mortality, elder risk assessment

  2. AdvancED Flex 4

    CERN Document Server

    Tiwari, Shashank; Schulze, Charlie

    2010-01-01

    AdvancED Flex 4 makes advanced Flex 4 concepts and techniques easy. Ajax, RIA, Web 2.0, mashups, mobile applications, the most sophisticated web tools, and the coolest interactive web applications are all covered with practical, visually oriented recipes. * Completely updated for the new tools in Flex 4* Demonstrates how to use Flex 4 to create robust and scalable enterprise-grade Rich Internet Applications.* Teaches you to build high-performance web applications with interactivity that really engages your users.* What you'll learn Practiced beginners and intermediate users of Flex, especially

  3. Approach focused on people

    Directory of Open Access Journals (Sweden)

    Roa Ruben

    2010-11-01

    Full Text Available Family and community medicine assumes a new epistemological landmark that also provides the use of instruments and tools related to it. This care model permits carrying out a visit where all categories which the health-disease process is expressed are present. Family Medicine intends to combine both visions and, for such, it gifts elements to incorporate disease as an essential part of our patient's approach systematic being the main focus the approach by problems, which is nothing but that which concerns the individual, his family or the physician, or all of them, and at times there will be nuisances while at other times, there will be diseases, and mil in other instances, all of them will co-exist. It is known that the impact of a health problem on an individual affects not only himself, but also his surroundings. In turn, the environment around this individual can act as the origin or perpetuator of the crisis, or else serve to help in solving the conflict. Distinct tools serve the purpose of knowing the context in which health crisis is developed, such as: genogram, individual and family vital cycle. Every time two people communicate, the agreement or disagreement generate possible variables. In the physician-patient relationship, this is no exception. Values, beliefs, feelings, and information of each individual different and physicians not necessarily in agreement in several issues during a visit. The objective is the need to achieve a minimum of agreements so that this visit has therapeutic effectiveness, thus being if/rpm -taw to find a common territory. Relations in general involve power; care, feelings, trust and goals. The objective in this type of relationship must be obviously shared ly both and cannot be any other than that of achieving, the highest level of health to our patient. So, our specialty, considered of low complexity, becomes a highly cognitive complexity, special and there is no doubt that it is a lot easier to handle

  4. Keskendudes protsessile = Focus on Process

    Index Scriptorium Estoniae

    2004-01-01

    1996. a. arhitektide Juliet Bidgoodi ja Liza Fiori ning kunstnik Katherine Clarke'i loodud Inglise arhitektuuribüroo muf tutvustus ja intervjuu Liza Fioriga. Naistest koosnev büroo tegeleb avaliku sfääriga. muf-i töödest tutvustatakse muuseumipaviljoni St Albansis, 1997. a. alguse saanud Londoni Southwarki tänava ümberkujundamise projekti, ruumiinstallatsiooni "Purity and Tolerance", 2003. a. alustatud Londoni Tilbury linnaosa pargi projekti. 4 ill

  5. Nitrogen Balance and Protein Requirements for Critically Ill Older Patients.

    Science.gov (United States)

    Dickerson, Roland N

    2016-04-18

    Critically ill older patients with sarcopenia experience greater morbidity and mortality than younger patients. It is anticipated that unabated protein catabolism would be detrimental for the critically ill older patient. Healthy older subjects experience a diminished response to protein supplementation when compared to their younger counterparts, but this anabolic resistance can be overcome by increasing protein intake. Preliminary evidence suggests that older patients may respond differently to protein intake than younger patients during critical illness as well. If sufficient protein intake is given, older patients can achieve a similar nitrogen accretion response as younger patients even during critical illness. However, there is concern among some clinicians that increasing protein intake in older patients during critical illness may lead to azotemia due to decreased renal functional reserve which may augment the propensity towards worsened renal function and worsened clinical outcomes. Current evidence regarding protein requirements, nitrogen balance, ureagenesis, and clinical outcomes during nutritional therapy for critically ill older patients is reviewed.

  6. Nitrogen Balance and Protein Requirements for Critically Ill Older Patients

    Directory of Open Access Journals (Sweden)

    Roland N. Dickerson

    2016-04-01

    Full Text Available Critically ill older patients with sarcopenia experience greater morbidity and mortality than younger patients. It is anticipated that unabated protein catabolism would be detrimental for the critically ill older patient. Healthy older subjects experience a diminished response to protein supplementation when compared to their younger counterparts, but this anabolic resistance can be overcome by increasing protein intake. Preliminary evidence suggests that older patients may respond differently to protein intake than younger patients during critical illness as well. If sufficient protein intake is given, older patients can achieve a similar nitrogen accretion response as younger patients even during critical illness. However, there is concern among some clinicians that increasing protein intake in older patients during critical illness may lead to azotemia due to decreased renal functional reserve which may augment the propensity towards worsened renal function and worsened clinical outcomes. Current evidence regarding protein requirements, nitrogen balance, ureagenesis, and clinical outcomes during nutritional therapy for critically ill older patients is reviewed.

  7. Graphic Depictions: Portrayals of Mental Illness in Video Games.

    Science.gov (United States)

    Shapiro, Samuel; Rotter, Merrill

    2016-11-01

    Although studies have examined portrayals of mental illness in the mass media, little attention has been paid to such portrayals in video games. In this descriptive study, the fifty highest-selling video games in each year from 2011 to 2013 were surveyed through application of search terms to the Wikia search engine, with subsequent review of relevant footage on YouTube. Depiction categories were then assigned based on the extent of portrayal and qualitative characteristics compared against mental illness stereotypes in cinema. Twenty-three of the 96 surveyed games depicted at least one character with mental illness. Forty-two characters were identified as portraying mental illness, with most characters classified under a "homicidal maniac" stereotype, although many characters did not clearly reflect cinema stereotypes and were subcategorized based on the shared traits. Video games contain frequent and varied portrayals of mental illness, with depictions most commonly linking mental illness to dangerous and violent behaviors.

  8. Living with an unfixable heart: a qualitative study exploring the experience of living with advanced heart failure.

    LENUS (Irish Health Repository)

    Ryan, Marie

    2012-02-01

    BACKGROUND: Nurses working with patients with advanced heart failure need knowledge that will help us to help patients cope with their situations of chronic illness. However, our knowledge bank is deficient due to the scarcity of inquiry that takes the affected person\\'s point of view as its central focus. AIM: The aim of this study was to describe patients\\' experiences of living with advanced heart failure. METHODS: The study sample (N=9) consisted of male (N=6) and female (N=3) patients with advanced (NYHA classes III-IV) heart failure. The design was qualitative and open unstructured interviews were audio-taped and transcribed verbatim during 2006. RESULTS: Four main themes emerged: Living in the Shadow of Fear; Running on Empty; Living a Restricted life; and Battling the System. The experience of living with advanced heart failure was described as a fearful and tired sort of living characterised by escalating impotence and dependence. CONCLUSIONS: The findings suggest that there may be an illogical but enduring ethos of \\'cure\\' pervading health care worker\\'s attitudes to advanced heart failure care. This mindset might be working to hinder the application of additional or alternative therapies, which might better palliate the physical and psychosocial distress of patients.

  9. RISK FACTORS OF MORTALITY IN NEONATAL ILLNESS

    Directory of Open Access Journals (Sweden)

    Jeyanthi

    2016-03-01

    Full Text Available BACKGROUND Infant Mortality Rate (IMR is high in India. Identification of risk factors of mortality in neonatal illness is essential to reduce Neonatal Mortality Rate (NMR and ultimately the IMR. AIM To identify the risk factors of mortality in neonatal illness. SETTING AND DESIGN It was a nested case control study done at the sick neonatal unit of urban tertiary referral centre. METHODS AND MATERIALS After obtaining ethical committee approval, retrospective analysis of 150 out born neonatal case records of babies admitted during the period from October 2015 to December 2015 was done. Data such as demographic features, maternal details, referral details, perinatal events, clinical features, laboratory reports and outcome were recorded. STATISTICAL ANALYSIS These risk factors were subjected to univariate and multivariate logistic regression analysis and P value calculated for the same to find out significant risk factors of mortality in neonatal illness. RESULTS Neonatal mortality rate was 22%. Male-to-female ratio was 2:1, death occurred more commonly in female neonates (23.1%. Home deliveries carried more risk of mortality. Birth order 4 and above had 25% mortality. Neonates of mother who had primary education and below had higher mortality. Perinatal asphyxia and sepsis were the most common causes of neonatal mortality. By univariate analysis, preterms had 4.9 times increased risk of mortality than term babies. Apnoeic spells, chest retractions and shock had 8 times, 3 times and 3.6 times increased risk of mortality respectively. By multivariate analysis, birth weight below 2 kilograms (kg carried 11.8 times more risk of mortality with a p value 0.00 (95% C.I 3.2, 30.4 and poor maternal intake of iron and folic acid tablets was 3.9 times more risk p value 0.003 (95% C.I 1.6, 9.6, apnoeic spells were 5.8 times more risk of mortality with p value 0.02 (95% C.I 1.3, 26.2. CONCLUSION Birth weight below 2 kg, poor maternal intake of iron and folic

  10. Burden of Self-reported Acute Gastrointestinal Illness in Cuba

    OpenAIRE

    Prieto, Pablo Aguiar; Finley, Rita L; Muchaal, P.K.; Guerin, Michele T; Isaacs, Sandy; Domínguez, Arnaldo Castro; Marie, Gisele Coutín; Perez, Enrique

    2009-01-01

    Acute gastrointestinal illness is an important public-health issue worldwide. Burden-of-illness studies have not previously been conducted in Cuba. The objective of the study was to determine the magnitude, distribution, and burden of self-reported acute gastrointestinal illness in Cuba. A retrospective, cross-sectional survey was conducted in three sentinel sites during June-July 2005 (rainy season) and during November 2005–January 2006 (dry season). Households were randomly selected from a ...

  11. 2008 Nevada Test Site Annual Illness and Injury Surveillance Report

    Energy Technology Data Exchange (ETDEWEB)

    U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

    2009-10-05

    The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of epidemiologic surveillance activities that provide an early warning system for health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence of workdays, occupational injuries and illnesses, and disabilities and deaths among current workers.

  12. 2008 Sandia National Laboratory Annual Illness and Injury Surveillance Report

    Energy Technology Data Exchange (ETDEWEB)

    U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

    2009-09-17

    The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of epidemiologic surveillance activities that provide an early warning system for health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence of workdays, occupational injuries and illnesses, and disabilities and deaths among current workers.

  13. 2009 Argonne National Laboratory Annual Illness and Injury Surveillance Report

    Energy Technology Data Exchange (ETDEWEB)

    U.S. Department of Energy, Office of Health, Safety and Security, Office of Health and Safety, Office of Illness and Injury Prevention Programs

    2010-08-19

    The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of epidemiologic surveillance activities that provide an early warning system for health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence of workdays, occupational injuries and illnesses, and disabilities and deaths among current workers.

  14. 2007 Kansas City Plant Annual Illness and Injury Surveillance Report

    Energy Technology Data Exchange (ETDEWEB)

    U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

    2009-07-13

    The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of epidemiologic surveillance activities that provide an early warning system for health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence of workdays, occupational injuries and illnesses, and disabilities and deaths among current workers.

  15. 2007 Savannah River Site Annual Illness and Injury Surveillance Report

    Energy Technology Data Exchange (ETDEWEB)

    U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

    2009-05-05

    The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of epidemiologic surveillance activities that provide an early warning system for health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence of workdays, occupational injuries and illnesses, and disabilities and deaths among current workers.

  16. 2007 Sandia National Laboratory Annual Illness and Injury Surveillance Report

    Energy Technology Data Exchange (ETDEWEB)

    U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

    2009-02-04

    The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of epidemiologic surveillance activities that provide an early warning system for health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence of workdays, occupational injuries and illnesses, and disabilities and deaths among current workers.

  17. 2009 Brookhaven National Laboratory Annual Illness and Injury Surveillance Report

    Energy Technology Data Exchange (ETDEWEB)

    U.S. Department of Energy, Office of Health, Safety and Security, Office of Health and Safety, Office of Illness and Injury Prevention Programs

    2010-11-24

    The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of epidemiologic surveillance activities that provide an early warning system for health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence of workdays, occupational injuries and illnesses, and disabilities and deaths among current workers.

  18. 2008 Kansas City Plant Annual Illness and Injury Surveillance Report

    Energy Technology Data Exchange (ETDEWEB)

    U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

    2009-09-22

    The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of epidemiologic surveillance activities that provide an early warning system for health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence of workdays, occupational injuries and illnesses, and disabilities and deaths among current workers.

  19. 2009 Hanford Site Annual Illness and Injury Surveillance Report

    Energy Technology Data Exchange (ETDEWEB)

    U.S. Department of Energy, Office of Health, Safety and Security, Office of Health and Safety, Office of Illness and Injury Prevention Programs

    2010-12-01

    The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of epidemiologic surveillance activities that provide an early warning system for health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence of workdays, occupational injuries and illnesses, and disabilities and deaths among current workers.

  20. 2008 Brookhaven National Laboratory Annual Illness and Injury Surveillance Report

    Energy Technology Data Exchange (ETDEWEB)

    U.S. Department of Energy, Office of Health, Safety and Security, Office of Health and Safety, Office of Illness and Injury Prevention Programs

    2009-12-10

    The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of epidemiologic surveillance activities that provide an early warning system for health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence of workdays, occupational injuries and illnesses, and disabilities and deaths among current workers.