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Sample records for understand heat-related illnesses

  1. Heat-Related Illnesses

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    Full Text Available ... Medicine's Front Line Observation Emergency Care Fact Sheet Health & Safety Tips Campaigns SUBSCRIBE Emergencies A-Z Share ... Illnesses Dr. Glenn Mitchell , Emergency physician at Mercy Health System in Chesterfield, Missouri Heat-related illness can ...

  2. Heat-Related Illnesses

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    Full Text Available ... this! Home » Emergency 101 Heat-Related Illnesses Dr. Glenn Mitchell , Emergency physician at Mercy Health System in Chesterfield, Missouri Heat-related illness can be caused by overexposure to the sun or any situation that involves extreme heat. Young children and the elderly are most at risk, ...

  3. Heat-Related Illnesses

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    Full Text Available ... Medicine's Front Line Observation Emergency Care Fact Sheet Health & Safety Tips Campaigns SUBSCRIBE Emergencies A-Z Share this! Home » Emergency 101 Heat-Related Illnesses Dr. Glenn Mitchell , Emergency physician at Mercy Health System in Chesterfield, Missouri Heat-related illness can ...

  4. Heat-Related Illnesses

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    Full Text Available ... ICE” in Your Cell Phone Prepare for Disasters Communication With Your Family And Your Doctor About Your ... Dr. Glenn Mitchell , Emergency physician at Mercy Health System in Chesterfield, Missouri Heat-related illness can be ...

  5. Heat-Related Illnesses

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    Full Text Available ... Emergencies A-Z Share this! Home » Emergency 101 Heat-Related Illnesses Dr. Glenn Mitchell , Emergency physician at ... about heat cramps and heat stroke and exhaustion. Heat Cramps Symptoms include muscle spasms, usually in the ...

  6. Heat-Related Illnesses

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    Full Text Available ... Dr. Glenn Mitchell , Emergency physician at Mercy Health System in Chesterfield, Missouri Heat-related illness can be caused by overexposure to the sun or any situation that involves extreme heat. Young children and the elderly are most at risk, but anyone can be affected. Here ...

  7. Heat-Related Illnesses

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    Full Text Available ... Fact Sheet Health & Safety Tips Campaigns SUBSCRIBE Emergencies A-Z Share this! Home » Emergency 101 Heat-Related ... if the person becomes unconscious. READ IN EMERGENCIES A-Z Adverse Drug Reactions Your Blood Pressure Score ...

  8. Heat-Related Illnesses

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    Full Text Available ... Fact Sheet Health & Safety Tips Campaigns SUBSCRIBE Emergencies A-Z Share this! Home » Emergency 101 Heat-Related ... if the person becomes unconscious. READ IN EMERGENCIES A-Z Seizures Sunburn and Sun Safety Stroke Resources ...

  9. Heat-Related Illnesses

    Medline Plus

    Full Text Available ... illness) include flushed, hot, dry skin; fainting; a rapid, weak pulse; rapid, shallow breathing; vomiting; and increased body temperature of ... for symptoms that include cool, moist, pale skin, rapid pulse, elevated or lowered blood pressure, nausea, loss ...

  10. Heat Related Illnesses

    National Research Council Canada - National Science Library

    Carter, R; Cheuvront, S. N; Sawka, M. N

    2006-01-01

    .... The risk of serious heat illness can be markedly reduced by implementing a variety of countermeasures, including becoming acclimated to the heat, managing heat stress exposure, and maintaining hydration...

  11. Heat-Related Illnesses

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    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, ...

  12. Heat-Related Illnesses

    Science.gov (United States)

    ... I Waiting So Long? Admission to the Hospital Heroes on Medicine's Front Line Observation ... illness can be caused by overexposure to the sun or any situation that involves extreme heat. Young children and the elderly are most at risk, but ...

  13. Heat-Related Illnesses

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    Full Text Available ... I Waiting So Long? Admission to the Hospital Heroes on Medicine's Front Line Observation ... illness can be caused by overexposure to the sun or any situation that involves extreme heat. Young children and the elderly are most at risk, but ...

  14. Heat-related illness among Oregon farmworkers.

    Science.gov (United States)

    Bethel, Jeffrey W; Harger, Renee

    2014-09-05

    Farmworkers are particularly vulnerable to climate-sensitive health outcomes such as heat-related illness (HRI) given their tasks involve heavy exertion in an outdoor setting. The objectives of the study were to: (1) describe symptoms of HRI experienced by farmworkers and (2) explore factors associated with heat knowledge, level of concern regarding HRI, and comfort level taking breaks at work. Bilingual research staff conducted personal interviews of 100 farmworkers during July and August 2013. Data collected included demographics, work history and current work practices, trainings received, HRI symptoms experienced, health status, and health behaviors. Nearly 30% of participants reported experiencing ≥ 2 HRI symptoms during the previous work. Few participants had high level of heat knowledge (21.0%) and 15.6% of participants reported being "very concerned" about the health effects of working in hot conditions. Participants who were paid by the piece were more likely to have a high heat knowledge score and be "very concerned" about HRI but less likely to be "very comfortable" taking a break compared to workers paid by the hour than those who had not received HRI training. Results suggest several areas in which employers and agencies conducting outreach and education to the workers about HRI can change their practices including providing cooling measures and HRI training about risk factors for HRI.

  15. Heat-Related Illness among Oregon Farmworkers

    Directory of Open Access Journals (Sweden)

    Jeffrey W. Bethel

    2014-09-01

    Full Text Available Farmworkers are particularly vulnerable to climate-sensitive health outcomes such as heat-related illness (HRI given their tasks involve heavy exertion in an outdoor setting. The objectives of the study were to: (1 describe symptoms of HRI experienced by farmworkers and (2 explore factors associated with heat knowledge, level of concern regarding HRI, and comfort level taking breaks at work. Bilingual research staff conducted personal interviews of 100 farmworkers during July and August 2013. Data collected included demographics, work history and current work practices, trainings received, HRI symptoms experienced, health status, and health behaviors. Nearly 30% of participants reported experiencing ≥2 HRI symptoms during the previous work. Few participants had high level of heat knowledge (21.0% and 15.6% of participants reported being “very concerned” about the health effects of working in hot conditions. Participants who were paid by the piece were more likely to have a high heat knowledge score and be “very concerned” about HRI but less likely to be “very comfortable” taking a break compared to workers paid by the hour than those who had not received HRI training. Results suggest several areas in which employers and agencies conducting outreach and education to the workers about HRI can change their practices including providing cooling measures and HRI training about risk factors for HRI.

  16. Preventing Heat-Related Illness or Death of Outdoor Workers

    Science.gov (United States)

    Preventing Heat-related Illness or Death of Outdoor Workers Summary Outdoor workers in agricul- ture, construction, and other industries ... a great deal of exertional and environ- mental heat stress that may lead to severe illness or ...

  17. Heat-related illness in China, summer of 2013

    Science.gov (United States)

    Gu, Shaohua; Huang, Cunrui; Bai, Li; Chu, Cordia; Liu, Qiyong

    2016-01-01

    Extreme heat events have occurred more frequently in China in recent years, leading to serious impacts on human life and the health care system. To identify the characteristics of individuals with heat-related illnesses in China during the summer of 2013, we collected the data from the Heat-related Illness Surveillance System in Chinese Center for Disease Control and Prevention (China CDC). A total of 5758 cases were reported in the summer of 2013, mostly concentrated in urban areas around the middle and lower reaches of the Yangtze River. We found a difference in age distribution of percentage of deaths from heat-related illness between males and females. Severe cases in males mostly occurred in the age group 45-74 years but in females mostly in the age group over 75. A distributed lag non-linear model had been used to identify population vulnerabilities in Ningbo and Chongqing. The results show that there was a clear positive relationship between maximum temperature and heat-related illness, and the heat effect was nonlinear and could last for 3 days. The elderly and males in the range of 45-64 years old might be the most vulnerable people of heat-related illness in China. We also highlighted some deficiencies of the surveillance system, such that the reported data were not accurate, comprehensive, or timely enough at this stage.

  18. Risk characterization of hospitalizations for mental illness and/or behavioral disorders with concurrent heat-related illness.

    Directory of Open Access Journals (Sweden)

    Michael T Schmeltz

    Full Text Available Many studies have found significant associations between high ambient temperatures and increases in heat-related morbidity and mortality. Several studies have demonstrated that increases in heat-related hospitalizations are elevated among individuals with diagnosed mental illnesses and/or behavioral disorders (MBD. However, there are a limited number of studies regarding risk factors associated with specific mental illnesses that contribute, at least in part, to heat-related illnesses (HRI in the United States.To identify and characterize individual and environmental risk factors associated with MBD hospitalizations with a concurrent HRI diagnosis.This study uses hospitalization data from the Nationwide Inpatient Sample (2001-2010. Descriptive analyses of primary and secondary diagnoses of MBDs with an HRI were examined. Risk ratios (RR were calculated from multivariable models to identify risk factors for hospitalizations among patients with mental illnesses and/or behavioral disorders and HRI.Nondependent alcohol/drug abuse, dementia, and schizophrenia were among the disorders that were associated with increased frequency of HRI hospitalizations among MBD patients. Increased risk of MBD hospitalizations with HRI was observed for Males (RR, 3.06, African Americans (RR, 1.16, Native Americans (RR, 1.70, uninsured (RR, 1.92, and those 40 years and older, compared to MBD hospitalizations alone.Previous studies outside the U.S. have found that dementia and schizophrenia are significant risk factors for HRI hospitalizations. Our results suggest that hospitalizations among substance abusers may also be an important risk factor associated with heat morbidity. Improved understanding of these relative risks could help inform future public health strategies.

  19. [Characteristics of non-exertional heat-related illness in Japan].

    Science.gov (United States)

    Miyake, Yasufumi

    2012-06-01

    This report shows characteristics of non-exertional heat-related illness in Japan. The findings are similar to those of previous reports in heatwaves of Europe and The United States. Eldery people with pre-existing diseases, homeless, living alone, poverty are independent risk factors of heatstoke and are strongly associated with severity and mortality.

  20. Economic Burden of Hospitalizations for Heat-Related Illnesses in the United States, 2001–2010

    Directory of Open Access Journals (Sweden)

    Michael T. Schmeltz

    2016-09-01

    Full Text Available Understanding how heat waves affect morbidity and mortality, as well as the associated economic costs, is essential for characterizing the human health impacts of extreme heat under a changing climate. Only a handful of studies have examined healthcare costs associated with exposures to high temperatures. This research explores costs associated with hospitalizations for heat-related illness (HRI in the United States using the 2001 to 2010 Nationwide Inpatient Sample (NIS. Descriptive statistics of patient data for HRI hospitalizations were examined and costs of hospitalizations were reported using the all-payer inpatient cost-to-charge ratio. Costs were examined using a log-gamma model with patient and hospital characteristics included as fixed effects. Adjusted mean costs were then compared across racial groups. The mean costs of HRI hospitalizations were higher among racial/ethnic minorities compared to Whites, who accounted for almost 65% of all HRI hospitalizations. Observed differences in costs based on income, insurance, and gender were also significant. These results suggest that these populations are suffering disproportionately from health inequity, thus, they could shoulder greater disease and financial burdens due to climate change. These findings may have important implications in understanding the economic impact public health planning and interventions will have on preventing hospitalizations related to extreme heat.

  1. Summer outdoor temperature and occupational heat-related illnesses in Quebec (Canada)

    Energy Technology Data Exchange (ETDEWEB)

    Adam-Poupart, Ariane [Department of Environmental and Occupational Health, School of Public Health, Université de Montréal, Montreal, QC (Canada); Smargiassi, Audrey [Department of Environmental and Occupational Health, School of Public Health, Université de Montréal, Montreal, QC (Canada); Institut national de santé publique du Québec (INSPQ), Montreal, QC (Canada); Busque, Marc-Antoine; Duguay, Patrice [Institut de recherche Robert-Sauvé en santé et en sécurité du travail (IRSST), Montreal, QC (Canada); Fournier, Michel [Direction de santé publique, Agence de la santé et des services sociaux de Montréal, Montreal, QC (Canada); Zayed, Joseph [Department of Environmental and Occupational Health, School of Public Health, Université de Montréal, Montreal, QC (Canada); Institut de recherche Robert-Sauvé en santé et en sécurité du travail (IRSST), Montreal, QC (Canada); Labrèche, France, E-mail: labreche.france@irsst.qc.ca [Department of Environmental and Occupational Health, School of Public Health, Université de Montréal, Montreal, QC (Canada); Institut de recherche Robert-Sauvé en santé et en sécurité du travail (IRSST), Montreal, QC (Canada)

    2014-10-15

    Background: Predicted rise in global mean temperature and intensification of heat waves associated with climate change present an increasing challenge for occupational health and safety. Although important scientific knowledge has been gathered on the health effects of heat, very few studies have focused on quantifying the association between outdoor heat and mortality or morbidity among workers. Objective: To quantify the association between occupational heat-related illnesses and exposure to summer outdoor temperatures. Methods: We modeled 259 heat-related illnesses compensated by the Workers' Compensation Board of Quebec between May and September, from 1998 to 2010, with maximum daily summer outdoor temperatures in 16 health regions of Quebec (Canada) using generalized linear models with negative binomial distributions, and estimated the pooled effect sizes for all regions combined, by sex and age groups, and for different time lags with random-effect models for meta-analyses. Results: The mean daily compensation count was 0.13 for all regions of Quebec combined. The relationship between daily counts of compensations and maximum daily temperatures was log-linear; the pooled incidence rate ratio (IRR) of daily heat-related compensations per 1 °C increase in daily maximum temperatures was 1.419 (95% CI 1.326 to 1.520). Associations were similar for men and women and by age groups. Increases in daily maximum temperatures at lags 1 and 2 and for two and three-day lag averages were also associated with increases in daily counts of compensations (IRRs of 1.206 to 1.471 for every 1 °C increase in temperature). Conclusion: This study is the first to quantify the association between occupational heat-related illnesses and exposure to summer temperatures in Canada. The model (risk function) developed in this study could be useful to improve the assessment of future impacts of predicted summer outdoor temperatures on workers and vulnerable groups, particularly in

  2. Pediatric heat-related illness: recommendations for prevention and management [digest].

    Science.gov (United States)

    Dunn, Roberta J; Kim, Tommy Y; Chaudhari, Pradip

    2017-08-22

    Infants, children, and adolescents are at increased risk for heat-related illness due to their inability to remove themselves from dangerous environments. Evidence shows that morbidity and mortality from heat illness is related to the length of time core temperature is elevated, so rapid reduction and accurate serial measurements are crucial to prevention of organ system damage and death. The primary methods of patient cooling are conduction (ice-water immersion, cold packs) and convection (moisture and moving air). The choice of method used may depend on availability of equipment, but there is evidence that can guide optimal use of resources. This issue presents evidence-based recommendations and best practices in heat-illness resuscitation, including managing children who are obese, have special needs or take medications, and advocacy for prevention strategies. [Points & Pearls is a digest of Pediatric Emergency Medicine Practice].

  3. Heat-related illness in Washington State agriculture and forestry sectors.

    Science.gov (United States)

    Spector, June T; Krenz, Jennifer; Rauser, Edmund; Bonauto, David K

    2014-08-01

    We sought to describe heat-related illness (HRI) in agriculture and forestry workers in Washington State. Demographic and clinical Washington State Fund workers' compensation agriculture and forestry HRI claims data (1995-2009) and Washington Agriculture Heat Rule citations (2009-2012) were accessed and described. Maximum daily temperature (Tmax) and Heat Index (HImax) were estimated by claim date and location using AgWeatherNet's weather station network. There were 84 Washington State Fund agriculture and forestry HRI claims and 60 Heat Rule citations during the study period. HRI claims and citations were most common in crop production and support subsectors. The mean Tmax (HImax) was 95°F (99°F) for outdoor HRI claims. Potential HRI risk factors and HRI-related injuries were documented for some claims. Agriculture and forestry HRI cases are characterized by potential work-related, environmental, and personal risk factors. Further work is needed to elucidate the relationship between heat exposure and occupational injuries. © 2014 Wiley Periodicals, Inc.

  4. Identifying individual risk factors and documenting the pattern of heat-related illness through analyses of hospitalization and patterns of household cooling.

    Directory of Open Access Journals (Sweden)

    Michael T Schmeltz

    Full Text Available As climate change increases the frequency and intensity of extreme heat events researchers and public health officials must work towards understanding the causes and outcomes of heat-related morbidity and mortality. While there have been many studies on both heat-related illness (HRI, there are fewer on heat-related morbidity than on heat-related mortality.To identify individual and environmental risk factors for hospitalizations and document patterns of household cooling.We performed a pooled cross-sectional analysis of secondary U.S. data, the Nationwide Inpatient Sample. Risk ratios were calculated from multivariable models to identify risk factors for hospitalizations. Hierarchical modeling was also employed to identify relationships between individual and hospital level predictors of hospitalizations. Patterns of air conditioning use were analyzed among the vulnerable populations identified.Hospitalizations due to HRI increased over the study period compared to all other hospitalizations. Populations at elevated risk for HRI hospitalization were blacks, males and all age groups above the age of 40. Those living in zip-codes in the lowest income quartile and the uninsured were also at an increased risk. Hospitalizations for HRI in rural and small urban clusters were elevated, compared to urban areas.Risk factors for HRI include age greater than 40, male gender and hospitalization in rural areas or small urban clusters. Our analysis also revealed an increasing pattern of HRI hospitalizations over time and decreased association between common comorbidities and heat illnesses which may be indicative of underreporting.

  5. Cost of preventing workplace heat-related illness through worker breaks and the benefit of climate-change mitigation

    Science.gov (United States)

    Takakura, Jun'ya; Fujimori, Shinichiro; Takahashi, Kiyoshi; Hijioka, Yasuaki; Hasegawa, Tomoko; Honda, Yasushi; Masui, Toshihiko

    2017-06-01

    The exposure of workers to hot environments is expected to increase as a result of climate change. In order to prevent heat-related illness, it is recommended that workers take breaks during working hours. However, this would lead to reductions in worktime and labor productivity. In this study, we estimate the economic cost of heat-related illness prevention through worker breaks associated with climate change under a wide range of climatic and socioeconomic conditions. We calculate the worktime reduction based on the recommendation of work/rest ratio and the estimated future wet bulb glove temperature, which is an index of heat stresses. Corresponding GDP losses (cost of heat-related illness prevention through worker breaks) are estimated using a computable general equilibrium model throughout this century. Under the highest emission scenario, GDP losses in 2100 will range from 2.6 to 4.0% compared to the current climate conditions. On the other hand, GDP losses will be less than 0.5% if the 2.0 °C goal is achieved. The benefit of climate-change mitigation for avoiding worktime loss is comparable to the cost of mitigation (cost of the greenhouse gas emission reduction) under the 2.0 °C goal. The relationship between the cost of heat-related illness prevention through worker breaks and global average temperature rise is approximately linear, and the difference in economic loss between the 1.5 °C goal and the 2.0 °C goal is expected to be approximately 0.3% of global GDP in 2100. Although climate mitigation and socioeconomic development can limit the vulnerable regions and sectors, particularly in developing countries, outdoor work is still expected to be affected. The effectiveness of some adaptation measures such as additional installation of air conditioning devices or shifting the time of day for working are also suggested. In order to reduce the economic impacts, adaptation measures should also be implemented as well as pursing ambitious climate change

  6. Heat-Related Illnesses

    Medline Plus

    Full Text Available ... weak pulse; rapid, shallow breathing; vomiting; and increased body temperature of more than 104 degrees. People with ... nausea, loss of consciousness, vomiting or a high body temperature. For late stage heat stroke symptoms, cool ...

  7. Heat-Related Illnesses

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  8. Heat-Related Illnesses

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    Full Text Available ... cool place and give small amounts of cool water, juice or a commercial sports liquid. (Do not ... non-caffeinated fluids. Apply cool, wet cloths or water mist while fanning the person. Seek immediate medical ...

  9. Heat-Related Illnesses

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    Full Text Available ... amounts of cool water, juice or a commercial sports liquid. (Do not give liquids if the person ... in a cool, shaded place and (if conscious) drink plenty of non-alcoholic, non-caffeinated fluids. Apply ...

  10. Heat-Related Illnesses

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    Full Text Available ... Listen to your Symptoms - When To Seek Emergency Care Seizures Resources Home Safety Checklist ACEP Coloring Book Download the Coloring Book » Emergency Care For You American College of Emergency Phycisians Copyright © ...

  11. Heat-Related Illnesses

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    Full Text Available ... pulse; rapid, shallow breathing; vomiting; and increased body temperature of more than 104 degrees. People with these ... loss of consciousness, vomiting or a high body temperature. For late stage heat stroke symptoms, cool the ...

  12. Heat-Related Illnesses

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    Full Text Available ... IN EMERGENCIES A-Z Broken Bones Anaphylaxis Adverse Drug Reactions Resources Home Safety Checklist ACEP Coloring Book Download the Coloring Book » Emergency Care For You American College of Emergency Phycisians Copyright © American College of Emergency Physicians 2018 Privacy Policy Terms of Use

  13. Heat-Related Illnesses

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    Full Text Available ... Be Prepared Safe Citizen Day Organize Important Medical Information ER Checklists Preparing for Emergencies Be ready to ... anyone can be affected. Here you will find information about heat cramps and heat stroke and exhaustion. ...

  14. Heat-Related Illnesses

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    Full Text Available ... cool, wet cloths or water mist while fanning the person. Seek immediate medical attention by calling 911 or your local emergency number for symptoms that include cool, moist, pale skin, rapid pulse, elevated or ... stroke symptoms, cool the person further by positioning ice or cold packs ...

  15. Heat-Related Illnesses

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    Full Text Available ... Safe Citizen Day Organize Important Medical Information ER Checklists Preparing for Emergencies Be ready to be a hero. Learn CPR Use “ICE” in Your Cell Phone Prepare for Disasters Communication With Your Family And Your Doctor About Your ...

  16. Heat-Related Illnesses

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    Full Text Available ... legs and stomach area. To treat, have the person rest in a cool place and give small ... sports liquid. (Do not give liquids if the person is unconscious.) Gently stretch and massage the affected ...

  17. Heat-Related Illnesses

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  18. Heat-Related Illnesses

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    Full Text Available ... A-Z Shock Head Injury Snake Bites Resources Home Safety Checklist ACEP Coloring Book Download the Coloring Book » Emergency Care For You American College of Emergency Phycisians Copyright © ...

  19. Heat-Related Illnesses

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    Full Text Available ... Until Help Arrives What To Do In A Medical Emergency Childhood Emergencies Careers in Emergency Medicine Seconds ... Lives Be Prepared Safe Citizen Day Organize Important Medical Information ER Checklists Preparing for Emergencies Be ready ...

  20. Heat-Related Illnesses

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    Full Text Available ... In A Medical Emergency Childhood Emergencies Careers in Emergency Medicine Seconds Save Lives Be Prepared Safe Citizen Day ... So Long? Admission to the Hospital Heroes on Medicine's Front Line Observation Emergency Care Fact Sheet Health & Safety Tips Campaigns SUBSCRIBE ...

  1. Heat-Related Illnesses

    Science.gov (United States)

    1988-04-01

    after the dog star Sirius which accompanies the staner sun.1 4 2 Many military campaigns have been lost due to lack of heat acclimatization and...the dominant mechanism of heat loss. Panting mammals such as dogs have an oropharyngeal countercurrent flow mechanism (carotid rete) which results in...increased glucose utilization and hepatic damage resulting in impaired gluconeogenesis . 7 6 Coagulopathy is frequent. 1 6 7 PATHOPHYSIOLOGY OF HEATSTROKE: A

  2. Heat-Related Illnesses

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  3. Heat-Related Illnesses

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    Full Text Available ... Arrives What To Do In A Medical Emergency Childhood Emergencies Careers in Emergency Medicine Seconds Save Lives ... Medicine's Front Line Observation Emergency Care Fact Sheet Health & Safety Tips Campaigns SUBSCRIBE Emergencies A-Z Share ...

  4. Heat-Related Illnesses

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    Full Text Available ... amounts of cool water, juice or a commercial sports liquid. (Do not give liquids if the person ... becomes unconscious. READ IN EMERGENCIES A-Z Adverse Drug Reactions Bites and Stings Anaphylaxis Resources Home Safety ...

  5. Heat-Related Illnesses

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    Full Text Available ... To Call 911 Until Help Arrives What To Do In A Medical Emergency Childhood Emergencies Careers in ... cool water, juice or a commercial sports liquid. (Do not give liquids if the person is unconscious.) ...

  6. Heat-Related Illnesses

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    Full Text Available ... ready to be a hero. Learn CPR Use “ICE” in Your Cell Phone Prepare for Disasters Communication ... stroke symptoms, cool the person further by positioning ice or cold packs on wrists, ankles, groin and ...

  7. Heat-Related Illnesses

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    Full Text Available ... moist, pale skin, rapid pulse, elevated or lowered blood pressure, nausea, loss of consciousness, vomiting or a ... becomes unconscious. READ IN EMERGENCIES A-Z Your Blood Pressure Score is as Important as Your Credit ...

  8. Heat-Related Illnesses

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    Full Text Available ... weak pulse; rapid, shallow breathing; vomiting; and increased body temperature of more than 104 degrees. People with these ... nausea, loss of consciousness, vomiting or a high body temperature. For late stage heat stroke symptoms, cool the ...

  9. Heat-Related Illnesses

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    Full Text Available ... A Medical Emergency Childhood Emergencies Careers in Emergency Medicine Seconds Save Lives Be Prepared Safe Citizen Day ... So Long? Admission to the Hospital Heroes on Medicine's Front Line Observation Emergency Care Fact Sheet Health & ...

  10. Using near real-time morbidity data to identify heat-related illness prevention strategies in North Carolina.

    Science.gov (United States)

    Rhea, Sarah; Ising, Amy; Fleischauer, Aaron T; Deyneka, Lana; Vaughan-Batten, Heather; Waller, Anna

    2012-04-01

    Timely public health interventions reduce heat-related illnesses (HRIs). HRI emergency department (ED) visit data provide near real-time morbidity information to local and state public health practitioners and may be useful in directing HRI prevention efforts. This study examined statewide HRI ED visits in North Carolina (NC) from 2008-2010 by age group, month, ED disposition, chief complaint, and triage notes. The mean number of HRI ED visits per day was compared to the maximum daily temperature. The percentage of HRI ED visits to all ED visits was highest in June (0.25%). 15-18 year-olds had the highest percentage of HRI visits and were often seen for sports-related heat exposures. Work-related HRI ED visits were more common than other causes in 19-45 year-olds. Individuals ≥65 years were more likely admitted to the hospital than younger individuals. The mean daily number of HRI ED visits increased by 1.4 for each 1°F (degree Fahrenheit) increase from 90°F to 98°F and by 15.8 for each 1°F increase from 98°F to 100°F. Results indicate that HRI prevention efforts in NC should be emphasized in early summer and targeted to adolescents involved in organized sports, young adults with outdoor occupations, and seniors. At a maximum daily temperature of 98°F, there was a substantial increase in the average daily number of HRI ED visits. ED visit data provide timely, sentinel HRI information. Analysis of this near real-time morbidity data may assist local and state public health practitioners in identification of HRI prevention strategies that are especially relevant to their jurisdictions.

  11. 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.

  12. Illness understanding in children and adolescents with heart disease

    OpenAIRE

    Veldtman, G; Matley, S; Kendall, L; Quirk, J; Gibbs, J; Parsons, J; Hewison, J

    2000-01-01

    AIMS—To evaluate illness knowledge and understanding in children and adolescents with congenital and acquired heart disease, and whether the degree of understanding is related to age, sex, or complexity of the heart disease.
DESIGN—Prospective cohort study.
SETTING—Tertiary paediatric cardiac centre.
METHODS—Patients' understanding of their congenital heart disease was assessed in a representative sample of volunteers aged between 7-18 years using semistructured interviews based upon Leventha...

  13. Illness understanding in children and adolescents with heart disease

    OpenAIRE

    Veldtman, G R; Matley, S L; Kendall, L; Quirk, J; Gibbs, J L; Parsons, J M; Hewison, J

    2001-01-01

    Aims To evaluate illness knowledge and understanding in children and adolescents with congenital and acquired heart disease and to assess whether the degree of understanding is related to age, sex, or complexity of the heart disease. Design Prospective cohort study. Setting Tertiary pediatric cardiac center. Methods Patients' understanding of their congenital heart disease was assessed in a representative sample of volunteers aged between 7 and 18 years using semistructured interviews based o...

  14. Understanding Parkinson Disease: A Complex and Multifaceted Illness.

    Science.gov (United States)

    Gopalakrishna, Apoorva; Alexander, Sheila A

    2015-12-01

    Parkinson disease is an incredibly complex and multifaceted illness affecting millions of people in the United States. Parkinson disease is characterized by progressive dopaminergic neuronal dysfunction and loss, leading to debilitating motor, cognitive, and behavioral symptoms. Parkinson disease is an enigmatic illness that is still extensively researched today to search for a better understanding of the disease, develop therapeutic interventions to halt or slow progression of the disease, and optimize patient outcomes. This article aims to examine in detail the normal function of the basal ganglia and dopaminergic neurons in the central nervous system, the etiology and pathophysiology of Parkinson disease, related signs and symptoms, current treatment, and finally, the profound impact of understanding the disease on nursing care.

  15. Clinical Management of Heat-Related Illnesses

    Science.gov (United States)

    2012-01-01

    drugs that decrease thirst •  Haloperidol drugs that decrease Sweating •  Antihistamines •  Anticholinergics •  Phenothiazines •  Benztropine...hyperthermia, but it may also occur as a result of elec- trolyte abnormalities. The use of norepinephrine and other α-adrenergic drugs should be avoided because...they cause vaso- constriction, thereby reducing heat exchange through the skin. Anticholinergic drugs that inhibit sweating (e.g., atropine) should

  16. Pathophysiology of Heat-Related Illnesses

    Science.gov (United States)

    2012-01-01

    approximately 35% decrease in metabolic heat production and the behavioral selection of microclimates that precisely regulated the depth and...puppies are ectothermic species that rely on behavioral adjustments, such as the selection of different microclimates , to control body temperature. Mud...puppies heat shocked to approximately 34° C (93.2° F) behavior- ally selected a cooler microclimate and maintained a significantly lower body

  17. Knowledge and awareness of heat-related morbidity among adult recreational endurance athletes

    Science.gov (United States)

    Shendell, Derek G.; Alexander, Melannie S.; Lorentzson, Lauren; McCarty, Frances A.

    2010-07-01

    Adults have been increasingly motivated to compete in recreational endurance sports events. Amateurs may lack a complete understanding of recommended strategies for handling heat and humidity, making heat-related illnesses increasingly possible. This is compounded by global climate change and increasing average surface and air temperatures, especially in urban areas of industrialized nations in Europe and North America that have hosted most events to date. We conducted an on-line, secure survey at the 2nd Annual ING Georgia Marathon and Half-Marathon in Atlanta, Georgia, in 2008. We included previously validated questions on participant socio-demographics, training locations, and knowledge and awareness of heat-related illnesses. Participants were aware of heat illnesses, and of heat stroke as a serious form of heat stress. However, the majority, across age and gender, did not understand the potential severity of heat stroke. Furthermore, 1-in-5 participants did not understand the concept of heat stress as a form of heat-related illness, and how heat stress may result from buildup of muscle-generated heat in the body. Adult recreational endurance athletes are another susceptible, vulnerable population sub-group for applied research and public health educational interventions, especially in urban areas of industrialized nations in Europe and North America.

  18. Understanding Gulf War Illness: An Integrative Modeling Approach

    Science.gov (United States)

    2017-10-01

    high-order diffusion imaging in a rat model of Gulf War Illness. §These authors contributed equally to the work. Brain Behavior and Immunity. pii...astrocyte specific transcriptome responses to neurotoxicity. §These authors contributed equally to the work. Submitted for Internal CDC-NIOSH...Antagonist: Evaluation of Beneficial Effects for Gulf War Illness 4) GW160116 (Nathanson) Genomics approach to find gender specific mechanisms of GWI

  19. Adults' Explanations and Children's Understanding of Contagious Illnesses, Non-Contagious Illnesses, and Injuries

    Science.gov (United States)

    Toyama, Noriko

    2016-01-01

    The present study examined (1) whether children notice different causes for contagious illnesses, non-contagious illnesses, and injuries and (2) what information adults provide to children and to what extent this information is related to children's causal awareness. Studies 1 and 2 explored preschool teachers' and mothers' explanations of…

  20. Understanding and addressing religion among people with mental illness

    Science.gov (United States)

    Pargament, Kenneth I; Lomax, James W

    2013-01-01

    This article reviews recent advances in the domain of psychiatry and religion that highlight the double-edged capacity of religion to enhance or damage health and well-being, particularly among psychiatric patients. A large body of research challenges stereotyped views of religion as merely a defense or passive way of coping, and indicates that many people look to religion as a vital resource which serves a variety of adaptive functions, such as self-regulation, attachment, emotional comfort, meaning, and spirituality. There is, however, a darker side to religious life. Researchers and theorists have identified and begun to study problematic aspects of religiousness, including religiously-based violence and religious struggles within oneself, with others, and with the divine. Religious problems can be understood as a by-product of psychiatric illness (secondary), a source of psychiatric illness (primary), or both (complex). This growing body of knowledge underscores the need to attend more fully to the potentially constructive and destructive roles of religion in psychiatric diagnosis, assessment, and treatment. In fact, initial evaluative studies of the impact of spiritually integrated treatments among a range of psychiatric populations have shown promising results. The article concludes with a set of recommendations to advance future research and practice, including the need for additional psychiatric studies of people from diverse cultures and religious traditions. PMID:23471791

  1. The contributions of Lavoisier, Carnot, and Mayer to understanding heat illness.

    Science.gov (United States)

    Riggs, Allison J; Millecchia, Ronald J; Riggs, Jack E

    2004-10-01

    Although heat illness has been described throughout recorded history, an understanding of its pathophysiology was only achieved in the 20th century. Lavoisier, Carnot, and Mayer described fundamental concepts about thermodynamics in the late 18th and early 19th centuries that were crucial to the eventual understanding of heat illness. Lavoisier recognized that the human body was a heat engine. Carnot recognized that useful heat engines must dissipate heat. Mayer recognized that humans possess the capacity to regulate body heat. The fundamental contributions of Lavoisier, Carnot, and Mayer to the understanding of heat illness have gone largely unacknowledged.

  2. Understanding the mechanisms of glutamine action in critically ill patients

    Directory of Open Access Journals (Sweden)

    Gisele P. Oliveira

    2010-06-01

    Full Text Available Glutamine (Gln is an important energy source and has been used as a supplementary energy substrate. Furthermore, Gln is an essential component for numerous metabolic functions, including acid-base homeostasis, gluconeogenesis, nitrogen transport and synthesis of proteins and nucleic acids. Therefore, glutamine plays a significant role in cell homeostasis and organ metabolism. This article aims to review the mechanisms of glutamine action during severe illnesses. In critically ill patients, the increase in mortality was associated with a decreased plasma Gln concentration. During catabolic stress, Gln consumption rate exceeds the supply, and both plasma and skeletal muscle pools of free Gln are severely reduced. The dose and route of Gln administration clearly influence its effectiveness: high-dose parenteral appears to be more beneficial than low-dose enteral administration. Experimental studies reported that Gln may protect cells, tissues, and whole organisms from stress and injury through the following mechanisms: attenuation of NF (nuclear factor-kB activation, a balance between pro- and anti-inflammatory cytokines, reduction in neutrophil accumulation, improvement in intestinal integrity and immune cell function, and enhanced of heat shock protein expression. In conclusion, high-doses of parenteral Gln (>0.50 g/kg/day demonstrate a greater potential to benefit in critically ill patients, although Gln pathophysiological mechanisms requires elucidation.A glutamina (Gln é uma importante fonte de energia e tem sido usada como substrato energético suplementar. Além disso, a Gln é um componente essencial para numerosas funções metabólicas tais como: homeostase ácido-base, gliconeogênese, transporte de nitrogênio e síntese de proteínas e ácidos nucléicos. Portanto, a glutamina desempenha um papel importante na homeostase celular e no metabolismo dos órgãos. Esse artigo objetiva rever os mecanismos de ação da glutamina na doen

  3. Computational Psychiatry: towards a mathematically informed understanding of mental illness

    Science.gov (United States)

    Huys, Quentin J M; Roiser, Jonathan P

    2016-01-01

    Computational Psychiatry aims to describe the relationship between the brain's neurobiology, its environment and mental symptoms in computational terms. In so doing, it may improve psychiatric classification and the diagnosis and treatment of mental illness. It can unite many levels of description in a mechanistic and rigorous fashion, while avoiding biological reductionism and artificial categorisation. We describe how computational models of cognition can infer the current state of the environment and weigh up future actions, and how these models provide new perspectives on two example disorders, depression and schizophrenia. Reinforcement learning describes how the brain can choose and value courses of actions according to their long-term future value. Some depressive symptoms may result from aberrant valuations, which could arise from prior beliefs about the loss of agency (‘helplessness’), or from an inability to inhibit the mental exploration of aversive events. Predictive coding explains how the brain might perform Bayesian inference about the state of its environment by combining sensory data with prior beliefs, each weighted according to their certainty (or precision). Several cortical abnormalities in schizophrenia might reduce precision at higher levels of the inferential hierarchy, biasing inference towards sensory data and away from prior beliefs. We discuss whether striatal hyperdopaminergia might have an adaptive function in this context, and also how reinforcement learning and incentive salience models may shed light on the disorder. Finally, we review some of Computational Psychiatry's applications to neurological disorders, such as Parkinson's disease, and some pitfalls to avoid when applying its methods. PMID:26157034

  4. Computational Psychiatry: towards a mathematically informed understanding of mental illness.

    Science.gov (United States)

    Adams, Rick A; Huys, Quentin J M; Roiser, Jonathan P

    2016-01-01

    Computational Psychiatry aims to describe the relationship between the brain's neurobiology, its environment and mental symptoms in computational terms. In so doing, it may improve psychiatric classification and the diagnosis and treatment of mental illness. It can unite many levels of description in a mechanistic and rigorous fashion, while avoiding biological reductionism and artificial categorisation. We describe how computational models of cognition can infer the current state of the environment and weigh up future actions, and how these models provide new perspectives on two example disorders, depression and schizophrenia. Reinforcement learning describes how the brain can choose and value courses of actions according to their long-term future value. Some depressive symptoms may result from aberrant valuations, which could arise from prior beliefs about the loss of agency ('helplessness'), or from an inability to inhibit the mental exploration of aversive events. Predictive coding explains how the brain might perform Bayesian inference about the state of its environment by combining sensory data with prior beliefs, each weighted according to their certainty (or precision). Several cortical abnormalities in schizophrenia might reduce precision at higher levels of the inferential hierarchy, biasing inference towards sensory data and away from prior beliefs. We discuss whether striatal hyperdopaminergia might have an adaptive function in this context, and also how reinforcement learning and incentive salience models may shed light on the disorder. Finally, we review some of Computational Psychiatry's applications to neurological disorders, such as Parkinson's disease, and some pitfalls to avoid when applying its methods. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  5. South African Muslim Faith Healers perceptions of mental illness: understanding, aetiology and treatment.

    Science.gov (United States)

    Ally, Yaseen; Laher, Sumaya

    2008-03-01

    The important role that religious beliefs may have on perceptions of mental illness cannot be ignored. Many religions including Islam advocate witchcraft and spirit possession--all of which are thought to influence the behaviour of a person so as to resemble that of a mentally ill individual. Thus this research explored Muslim Faith Healers perceptions of mental and spiritual illness in terms of their understanding of the distinctions between the two, the aetiologies and the treatments thereof. Six Muslim Healers in the Johannesburg community were interviewed and thematic content analysis was used to analyse the data. From the results it is clear that the faith healers were aware of the distinction between mental and spiritual illnesses. It was also apparent that Islam has a clear taxonomy that distinguishes illness and the causes thereof. Treatments are then advised accordingly. Thus this paper argues that the predominant Western view of the aetiology and understanding of mental illness needs to acknowledge the various culturally inclined taxonomies of mental illness so as to better understand and aid clients.

  6. Gender differences in the evolution of illness understanding among patients with advanced cancer.

    Science.gov (United States)

    Fletcher, Kalen; Prigerson, Holly G; Paulk, Elizabeth; Temel, Jennifer; Finlay, Esme; Marr, Lisa; McCorkle, Ruth; Rivera, Lorna; Munoz, Francisco; Maciejewski, Paul K

    2013-09-01

    Patient understanding of advanced metastatic disease is central to decisions about care near death. Prior studies have focused on gender differences in communication style rather than on illness understanding. : To evaluate gender differences in terminal illness acknowledgement (TIA), understanding that the disease is incurable and the advanced stage of the disease. To evaluate gender differences in patients' reports of discussions of life expectancy with oncology providers and its effect on differences in illness understanding. Coping with Cancer 2 patients (N = 68) were interviewed before and after a visit with their oncology providers to discuss scan results. At the prescan interview, there were no statistically significant gender differences in patient measures of illness understanding. At the postscan interview, women were more likely than men to recognize that their illness was incurable (Adjusted Odds Ratio, [AOR] = 5.29; P = .038), know that their cancer was at an advanced stage (AOR = 6.38; P = .013), and report having had discussions of life expectancy with their oncologist (AOR = 4.77; P = .021). Controlling discussions of life expectancy, women were more likely than men to report that their cancer was at an advanced stage (AOR = 9.53; P = .050). Controlling for gender, discussions of life expectancy were associated with higher rates of TIA (AOR = 4.65; P = .036) and higher rates of understanding that the cancer was incurable (AOR = 4.09; P = .085). Due largely to gender differences in communication, women over time have a better understanding of their illness than men. More frequent discussions of life expectancy should enhance illness understanding and reduce gender differences.

  7. Understanding doctors' attitudes towards self-disclosure of mental ill health.

    Science.gov (United States)

    Cohen, D; Winstanley, S J; Greene, G

    2016-07-01

    Understanding of doctors' attitudes towards disclosing their own mental illness has improved but assumptions are still made. To investigate doctors' attitudes to disclosing mental illness and the obstacles and enablers to seeking support. An anonymous, UK-wide online survey of doctors with and without a history of mental illness. The main outcome measure was likelihood of workplace disclosure of mental illness. In total, 1954 doctors responded and 60% had experienced mental illness. There was a discrepancy between how doctors think they might behave and how they actually behaved when experiencing mental illness. Younger doctors were least likely to disclose, as were trainees. There were multiple obstacles which varied across age and training grade. For all doctors, regardless of role, this study found that what they think they would do is different to what they actually do when they become unwell. Trainees, staff and associate speciality doctors and locums appeared most vulnerable, being reluctant to disclose mental ill health. Doctors continued to have concerns about disclosure and a lack of care pathways was evident. Concerns about being labelled, confidentiality and not understanding the support structures available were identified as key obstacles to disclosure. Addressing obstacles and enablers is imperative to shape future interventions. © The Author 2016. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  8. Concept Communication and Interpretation of Illness: A Holistic Model of Understanding in Nursing Practice.

    Science.gov (United States)

    Nordby, Halvor

    To ensure patient communication in nursing, certain conditions must be met that enable successful exchange of beliefs, thoughts, and other mental states. The conditions that have received most attention in the nursing literature are derived from general communication theories, psychology, and ethical frameworks of interpretation. This article focuses on a condition more directly related to an influential coherence model of concept possession from recent philosophy of mind and language. The basic ideas in this model are (i) that the primary source of understanding of illness experiences is communicative acts that express concepts of illness, and (ii) that the key to understanding patients' concepts of illness is to understand how they depend on patients' lifeworlds. The article argues that (i) and (ii) are especially relevant in caring practice since it has been extensively documented that patients' perspectives on disease and illness are shaped by their subjective horizons. According to coherentism, nurses need to focus holistically on patients' horizons in order to understand the meaning of patients' expressions of meaning. Furthermore, the coherence model implies that fundamental aims of understanding can be achieved only if nurses recognize the interdependence of patients' beliefs and experiences of ill health. The article uses case studies to elucidate how the holistic implications of coherentism can be used as conceptual tools in nursing.

  9. Understanding the suffering of a patient with an illness: signs, context and strategies.

    Science.gov (United States)

    Hueso Montoro, César; Siles González, José; Amezcua, Manuel; Bonill de Las Nieves, Candela; Pastor Montero, Sonia; Celdrán Mañas, Miriam

    2012-01-01

    The aim of this study is to understand the suffering of a patient with an illness, by using a secondary research method, that is, a qualitative meta-study. The primary data source of the meta-study includes "biographical reports". This project is based on a case study, in which the first-hand experiences of a patient with an illness were collected. The findings of the reports were compiled using the Archivos de la Memoria collection of the Index Foundation (Granada, Spain) and journals specialized in editing these materials. A selection of 20 biographical reports was targeted. The results of the meta-study show that suffering is a multidimensional process within a framework of ambiguous feelings. The suffering involves family and social network participation. Patients develop a range of strategies to overcome the illness. One of the effects is the fear of illness relapse or worsening.

  10. Black South African children's understanding of health and illness: colds, chicken pox, broken arms and AIDS.

    Science.gov (United States)

    Peltzer, K; Promtussananon, S

    2003-09-01

    To examine the understanding of both health and illness (colds, broken arms, chicken pox, AIDS) in the same black South African children The sample included 60 children (30 were 5-year-olds and 30 were 9-year-olds) selected by simple random sampling from a rural primary school. They were interviewed, using a semi-structured interview schedule, about their understanding of health issues and their exposure to learning about health or sickness. Differences across age in children's expressed understanding of health and illnesses were found. The 9-year-olds were more likely to give objective signs of chicken pox and AIDS than the 5-year-olds. They also knew more about objective symptoms of colds, chicken pox and AIDS, and were more likely to mention non-observable signs of colds and broken arms. Although there were no differences between the two age groups regarding 'knowing' strategies for avoiding illnesses, the older children had a more accurate knowledge about preventive measures than the younger children. The understanding of AIDS followed the same developmental sequence reported for children's understanding of general physical illness. The results have implications for the creation of developmentally appropriate and effective health and AIDS education curricula for primary and elementary grades.

  11. Expanding the domain of the understandable in psychiatric illness: an updating of the Jasperian framework of explanation and understanding.

    Science.gov (United States)

    Kendler, K S; Campbell, J

    2014-01-01

    Jaspers famously argued that psychiatry has two distinct ways of knowing about psychiatric illness: explanation - which utilizes natural sciences, and objective and empirical methods; and understanding - which reflects our subjective, empathic appreciation of our patients' experiences. He saw a clear division between these two approaches and considered a number of psychotic symptoms to be fundamentally un-understandable. We here argue for an updating of Jasper's view that includes the possibility, due to advances in neuroscience and neuropsychology, for explanation-aided understanding. We describe two scientific explanatory models for kinds of psychotic symptoms deemed un-understandable by Jaspers that illustrate this process. The first describes how dysfunction of the brain dopamine salience system may produce ideas of reference. The second demonstrates that symptoms of made-actions may be caused by abnormalities in the feed-forward motor control system. Both of these models begin at a biological level describing pathological brain processes in neuroscience language but then utilize neuropsychology to 'translate' from brain dysfunction into the mental. Both models break down the pathological pathways into individual subjective elements (particularly misattributing meaning to environmental stimuli and having body parts moved by others) that are understandable because they are common to nearly all of us. The neuropsychology provides hypotheses about the functional and physiological structures underlying familiar subjective experiences. Analyses of disorders of those structures thus provide a scaffold for expanding our empathic understanding of the subjective experiences of those suffering from psychiatric illness.

  12. Chronotope disruption as a sensitizing concept for understanding chronic illness narratives.

    Science.gov (United States)

    Gomersall, Tim; Madill, Anna

    2015-04-01

    This article aims to elaborate chronotope disruption--a changed relation to time and space--as a sensitizing concept for understanding chronic illness narratives. Sixteen men and 16 women with Type 2 diabetes were purposefully sampled. Each was interviewed about his or her experience of diabetes self-management using the biographical-narrative interview method. Transcripts were inspected for key moments defined as emotionally laden stories relevant to the purpose of the research. We present dialogically inflected discursive analysis of exemplar extracts. The analysis demonstrates how the concept of chronotope disruption helps identify, and understand, important aspects of patients' chronic illness narratives. First, we investigate how medical advice can conflict with embodied experience and how progressive bodily deterioration can provoke a reevaluation of past illness (self-mis)management. Second, the increasing temporal and spatial intrusion of chronic illness into participants' lives is examined. Finally, we focus on the masquerade of health as an attempt to manage, hide, or deny that one is physically challenged. Chronotope disruption offers a useful sensitizing concept for approaching chronic illness narratives and around which to organize analytical insights and to develop practice. Chronotope analysis fills an important gap in the science through compensating current health sciences' focus on rationality, cognition, and prospective time (prediction) with a patient-oriented focus on emotionality, embodiment, and retrospective time (nostalgia). Chronotope disruption could be used to develop practice by gaining empathic understanding of patients' life-worlds and provides a tool to examine how new technologies change the way in which the chronically ill have "being" in the world. (c) 2015 APA, all rights reserved).

  13. Chronotope Disruption as a Sensitizing Concept for Understanding Chronic Illness Narratives

    Science.gov (United States)

    2014-01-01

    Objectives: This article aims to elaborate chronotope disruption —a changed relation to time and space— as a sensitizing concept for understanding chronic illness narratives. Methods: Sixteen men and 16 women with Type 2 diabetes were purposefully sampled. Each was interviewed about his or her experience of diabetes self-management using the biographical-narrative interview method. Transcripts were inspected for key moments defined as emotionally laden stories relevant to the purpose of the research. We present dialogically inflected discursive analysis of exemplar extracts. Results: The analysis demonstrates how the concept of chronotope disruption helps identify, and understand, important aspects of patients’ chronic illness narratives. First, we investigate how medical advice can conflict with embodied experience and how progressive bodily deterioration can provoke a reevaluation of past illness (self-mis)management. Second, the increasing temporal and spatial intrusion of chronic illness into participants’ lives is examined. Finally, we focus on the masquerade of health as an attempt to manage, hide, or deny that one is physically challenged. Conclusions: Chronotope disruption offers a useful sensitizing concept for approaching chronic illness narratives and around which to organize analytical insights and to develop practice. Chronotope analysis fills an important gap in the science through compensating current health sciences’ focus on rationality, cognition, and prospective time (prediction) with a patient-oriented focus on emotionality, embodiment, and retrospective time (nostalgia). Chronotope disruption could be used to develop practice by gaining empathic understanding of patients’ life-worlds and provides a tool to examine how new technologies change the way in which the chronically ill have “being” in the world. PMID:25197985

  14. Aquatic Exercise and Heat-Related Injuries.

    Science.gov (United States)

    Sova, Ruth

    1991-01-01

    Heat-related injuries in aquatics classes are possible, though 100 percent preventable. The article discusses heat-related syndromes; how bodies generate and dissipate heat; how elevated heart rates that burn calories differ from those that dissipate heat; and modification of exercise intensity to provide calorie-burning workouts without…

  15. Heat-related illness in the African wilderness | Hofmeyr | South ...

    African Journals Online (AJOL)

    ... and culminate in life-threatening heat stroke. The differential diagnosis in the wilderness is broad and should include exercise-associated hyponatraemia with or without encephalopathy. Clinical guidelines for wilderness and hospital management of these conditions are available. Field management and evacuation are ...

  16. Heat-related illness in the African wilderness

    African Journals Online (AJOL)

    the altitude, ambient temperatures are warm, and the participants have been exposed to the full ... to the deleterious effects of heat stress include obesity, lack of acclimatisation to hot ... on severity, and include cooling, rehydration and assessment of core temperature and serum sodium, if possible. Hyponatraemia should.

  17. Understanding the Relationships Between Inspection Results and Risk of Foodborne Illness in Restaurants.

    Science.gov (United States)

    Lee, Petrona; Hedberg, Craig W

    2016-10-01

    Restaurants are important settings for foodborne disease outbreaks and consumers are increasingly using restaurant inspection results to guide decisions about where to eat. Although public posting of inspection results may lead to improved sanitary practices in the restaurant, the relationship between inspection results and risk of foodborne illness appears to be pathogen specific. To further examine the relationship between inspection results and the risk of foodborne disease outbreaks, we evaluated results of routine inspections conducted in multiple restaurants in a chain (Chain A) that was associated with a large Salmonella outbreak in Illinois. Inspection results were collected from 106 Chain A establishments in eight counties. Forty-six outbreak-associated cases were linked to 23 of these Chain A restaurants. There were no significant differences between the outbreak and nonoutbreak restaurants for overall demerit points or for the number of demerit points attributed to hand washing or cross-contamination. Our analyses strongly suggest that the outbreak resulted from consumption of a contaminated fresh produce item without further amplification within individual restaurants. Inspections at these facilities would be unlikely to detect or predict the foodborne illness outbreak because there are no Food Code items in place to stop the introduction of contaminated food from an otherwise approved commercial food source. The results of our study suggest that the agent and food item pairing and route of transmission must be taken into consideration to improve our understanding of the relationship between inspection results and the risk of foodborne illness in restaurants.

  18. The Role of Degeneration Theory in the Understanding of Mental Illness, Colombia First Half of the Twentieth Century

    Directory of Open Access Journals (Sweden)

    María Fernanda Vásquez Valencia

    2018-01-01

    Full Text Available Based on medical journals and theses from the first half of the twentieth century, this article analyzes the role played by the theory of degeneration in the understanding of mental illness in Colombia. It is particularly interesting to show how Colombian physicians have appropriated concepts such as degeneration, diathesis, morbid heredity and stigmas of degeneration since the early 20th century to describe, classify and define mental illnesses present in Colombian territory. During this period the theory of degeneration served as the conceptual and theoretical framework for understanding the etiology, genesis and evolution of mental illness.

  19. Matricide by Mentally Disordered Sons: Gaining a Criminological Understanding Beyond Mental Illness--A Descriptive Study.

    Science.gov (United States)

    Catanesi, Roberto; Rocca, Gabriele; Candelli, Chiara; Carabellese, Felice

    2015-12-01

    Matricide is one of the rarest of reported murders and has always been considered one of the most abhorrent crimes. Psychiatric investigations as to why a son might murder his mother yield indications of a high rate of mental illness, primarily psychotic disorders, in perpetrators. In an attempt to gain an in-depth understanding of the role of the mother-son bond in the etiology of matricide by mentally disordered sons, this article presents a qualitative study of nine cases of matricide examined at two Italian Forensic Psychiatry Departments between 2005 and 2010 and retrospective analysis of forensic psychiatry reports on the offenders. Most matricides suffered from psychotic disorders, especially schizophrenia. Nevertheless, not all the perpetrators had psychotic symptoms at the time of the crime. A "pathologic" mother-son bond was found in all cases. However, mental illness is not the only variable related to matricide and, taken alone, is not enough to explain the crime. Several factors in the history of the mother and son need to be probed, especially how their relationship developed over the years. The peculiar dynamics of the mother-son relationship and the unique personalities and life experiences of both subjects are the real key to cases of matricide. © The Author(s) 2014.

  20. Healthy eating in persons with serious mental illnesses: understanding and barriers.

    Science.gov (United States)

    Barre, Laura K; Ferron, Joelle C; Davis, Kristin E; Whitley, Rob

    2011-01-01

    To explore the understanding of a healthy diet and the barriers to healthy eating in persons with serious mental illnesses. In-depth semi-structured qualitative interviews about health behaviors were conducted in 31 individuals with serious mental illnesses. Participants were recruited from a mental health center in Chicago, Illinois, and ranged in age from 30 to 61 years old. Most participants described healthy eating as consuming fruits and vegetables, using low fat cooking methods, and limiting sweets, sodas, fast food, and/or junk food. Internal barriers to nutritional change included negative perceptions of healthy eating, the decreased taste and satiation of healthy foods, difficulty changing familiar eating habits, eating for comfort, and the prioritization of mental health. External barriers were the reduced availability and inconvenience of healthy foods, social pressures, and psychiatric medication side effects. This study revealed several modifiable barriers to healthy eating. Interventions that addressed these could aid in improving the diet and lowering the risk of cardiovascular disease in this population. Recommendations are to provide healthy eating education that is individualized, emphasizes the health consequences of poor eating, and provides opportunities to prepare and taste healthy foods. Family and friends should be included in all educational efforts. At community mental health centers and group homes, only healthy foods should be offered. Lastly, practitioners should encourage eating a healthy diet, inquire about eating in response to emotions, and explore the impact of psychiatric medications on eating behaviors.

  1. Understanding family responses to life-limiting illness: In-depth interviews with hospice patients and their family members.

    Science.gov (United States)

    Waldrop, Deborah P; Milch, Robert A; Skretny, Judith A

    2005-01-01

    Understanding family dynamics is a key component in providing comprehensive care for persons with progressive illnesses and their caregivers. The purpose of this study was to investigate what families experience during an advancing illness and to describe their pattems of response. In-depth interviews (n=108) were conducted with families two weeks after hospice admission. Interviews were tape recorded, transcribed, and analyzed using qualitative methods. Six modes were distilled: reactive (illness generates intense responses), advocacy (vulnerability ignites assertive actions), fused (illness and decline are shared experiences), dissonant (diametrically opposed viewpoints cause struggle), resigned (decline and death are anticipated), and closed (outward responses are impassive). Three events triggered movement from one mode to another: (1) functional changes, (2) crisis events, and (3) provider communication. Providers who understand varied family reactions can ease the patient's suffering, assist relatives in providing effective care, and prepare them for the approaching death.

  2. The mediating role of secondary beliefs: enhancing the understanding of emotional responses and illness perceptions in arthritis.

    Science.gov (United States)

    McCracken, James; Lindner, Helen; Sciacchitano, Laura

    2008-01-01

    Chronic illnesses are a significant issue across many health professional domains, becoming an increasing burden on limited and costly resources. The current study investigated the relationship between secondary beliefs and emotional responses, beyond the relationship accounted for by illness perceptions, using the framework of Rational Emotive Behavior Therapy. Sixty-five adults with arthritis participated in the questionnaire-based study. Multivariate analysis found that different emotional representations of the illness were significantly predicted by the individual's secondary belief, above and beyond that predicted by the cognitive representation of their illness alone. The study found that individuals who utilized an achievement secondary belief experienced feelings of worry, whereas individuals who used an approval orientation to understand their arthritis experienced emotions such as depression, being upset, anger, anxiety, and fear. No significant pattern emerged for individuals who used a comfort secondary belief to understand their arthritis. These findings are in line with the theory of secondary beliefs, as articulated by Rational Emotive Behavior Therapy.

  3. Using artwork to understand the experience of mental illness: Mainstream artists and Outsider artists.

    Science.gov (United States)

    Rustin, Terry A

    2008-07-08

    Artwork and psychiatric disorders are often linked. Accomplished artists with psychiatric disorders express themselves and their emotional distress through their works, and art therapists use the visual arts to help clients understand their problems and cope with them. There have been a number of psychiatric patients with no previous art training who produced artwork that many consider museum-worthy (Art Brut, or Outsider Art.) For the past two years, I have used artwork in another way: to better understand my clients and their psychiatric disorders. Presented here are paintings I have made about the mental illness experience of some of my clients, all well known to me through their therapy. It is a form of visual psychodrama, in which I reverse roles with the client through the paintings. My goal has been to experience the stresses felt by my clients so that I can understand them better. The paintings have served as a point of embarkation for therapy sessions, as a means of clarifying a client's experience, and as a way to show clients that their therapist is attending to what they say. Countertransference undoubtedly plays a role in my choice of clients and their portrayals, but the intent is to help me better understand the clients' experiences.Included here are images of some of these paintings with a short psychiatric history of the client about whom they were made. Accompanying each one are responses from the clients upon viewing "their" paintings, and a discussion of the client's psychiatric disorder. Making these paintings has helped me understand better the feelings of isolation, rejection, loss, and alienation that many of my clients experience every day. In turn, they tell me that viewing the paintings is an intense experience for them as well. As an outsider artist, I must leave it to the viewer to determine whether or not these paintings qualify as "art."

  4. The dreams of a cancer patient: a "royal road" to understanding the somatic illness.

    Science.gov (United States)

    Calogeras, R C; Alston, T M

    2000-12-01

    In this paper we have presented the principal dreams of a 39-year-old female patient in order to demonstrate how closely the dreams were linked with the understanding of her cancerous condition. The analysis, lasting over a period of eight years, ended with the remission of the patient's cancerous condition to the point where she was without pain and symptom-free. The findings suggested that her dreams played a special role in her analysis by providing important landmarks regarding her treatment's progress and state of her cancerous condition. In a general sense, it was concluded that the patient's dreams did provide a "royal road" to understanding her somatic illness. Specifically, it was concluded that, first, the patient's dreams were able to represent quite reliably, in symbolic form, the state of her cancerous condition; second, that the cancer condition and transference-countertransference reactions were closely entwined; and third, that each of the patient's dreams seemed to be introduced by a crisis situation connected with a traumatic early memory.

  5. Rethinking the patient: using Burden of Treatment Theory to understand the changing dynamics of illness.

    Science.gov (United States)

    May, Carl R; Eton, David T; Boehmer, Kasey; Gallacher, Katie; Hunt, Katherine; MacDonald, Sara; Mair, Frances S; May, Christine M; Montori, Victor M; Richardson, Alison; Rogers, Anne E; Shippee, Nathan

    2014-06-26

    In this article we outline Burden of Treatment Theory, a new model of the relationship between sick people, their social networks, and healthcare services. Health services face the challenge of growing populations with long-term and life-limiting conditions, they have responded to this by delegating to sick people and their networks routine work aimed at managing symptoms, and at retarding - and sometimes preventing - disease progression. This is the new proactive work of patient-hood for which patients are increasingly accountable: founded on ideas about self-care, self-empowerment, and self-actualization, and on new technologies and treatment modalities which can be shifted from the clinic into the community. These place new demands on sick people, which they may experience as burdens of treatment. As the burdens accumulate some patients are overwhelmed, and the consequences are likely to be poor healthcare outcomes for individual patients, increasing strain on caregivers, and rising demand and costs of healthcare services. In the face of these challenges we need to better understand the resources that patients draw upon as they respond to the demands of both burdens of illness and burdens of treatment, and the ways that resources interact with healthcare utilization. Burden of Treatment Theory is oriented to understanding how capacity for action interacts with the work that stems from healthcare. Burden of Treatment Theory is a structural model that focuses on the work that patients and their networks do. It thus helps us understand variations in healthcare utilization and adherence in different healthcare settings and clinical contexts.

  6. Using Freire's Participatory Educational Method to Understand the Experience of Living With Chronic Illness in the Current Age of Globalization.

    Science.gov (United States)

    Camargo Plazas, Maria del Pilar; Cameron, Brenda L

    2015-06-01

    Many approaches and efforts have been used to better understand chronic diseases worldwide. Yet, little is known about the meaning of living with chronic illness under the pressures of globalization and neoliberal ideologies. Through Freire's participatory educational method, this article presents an innovative approach to understanding the multiple dimensions of living with chronic illness. In this way, we hope to use an innovative approach to address the impact of globalization on the daily life of chronically ill people and thus expand to the body of knowledge on nursing. This article uses Freire's participatory educational method to understand the multiple dimensions of living with chronic illness. This qualitative study follows an interpretive inquiry approach and uses a critical hermeneutic phenomenological method and critical research methodologies. Five participants were recruited for this participatory educational activity. Data collection methods included digitally recorded semistructured individual interviews and a Freire's participatory educational method session. Data analysis included a thematic analysis. Participants reported lacking adequate access to healthcare services because of insurance policies; a general perception that they were an unwanted burden on the healthcare system; and a general lack of government support, advocacy, and political interest. This research activity assisted participants to gain a new critical perspective about the condition of others with chronic diseases and thus provided an enlightening opportunity to learn about the illnesses and experiences of others and to realize that others experienced the same oppression from the healthcare system. Participants became agents of change within their own families and communities. Chronic diseases cause many economic and social consequences in their victims. These findings urge us to move from merely acknowledging the difficulties of people who live with chronic illness in an age of

  7. Projecting future heat-related mortality under climate change scenarios: a systematic review.

    Science.gov (United States)

    Huang, Cunrui; Barnett, Adrian Gerard; Wang, Xiaoming; Vaneckova, Pavla; FitzGerald, Gerard; Tong, Shilu

    2011-12-01

    Heat-related mortality is a matter of great public health concern, especially in the light of climate change. Although many studies have found associations between high temperatures and mortality, more research is needed to project the future impacts of climate change on heat-related mortality. We conducted a systematic review of research and methods for projecting future heat-related mortality under climate change scenarios. A literature search was conducted in August 2010, using the electronic databases PubMed, Scopus, ScienceDirect, ProQuest, and Web of Science. The search was limited to peer-reviewed journal articles published in English from January 1980 through July 2010. Fourteen studies fulfilled the inclusion criteria. Most projections showed that climate change would result in a substantial increase in heat-related mortality. Projecting heat-related mortality requires understanding historical temperature-mortality relationships and considering the future changes in climate, population, and acclimatization. Further research is needed to provide a stronger theoretical framework for projections, including a better understanding of socioeconomic development, adaptation strategies, land-use patterns, air pollution, and mortality displacement. Scenario-based projection research will meaningfully contribute to assessing and managing the potential impacts of climate change on heat-related mortality.

  8. Understanding Response Rates to Surveys About Family Members' Psychological Symptoms After Patients' Critical Illness.

    Science.gov (United States)

    Long, Ann C; Downey, Lois; Engelberg, Ruth A; Nielsen, Elizabeth; Ciechanowski, Paul; Curtis, J Randall

    2017-07-01

    Achieving adequate response rates from family members of critically ill patients can be challenging, especially when assessing psychological symptoms. To identify factors associated with completion of surveys about psychological symptoms among family members of critically ill patients. Using data from a randomized trial of an intervention to improve communication between clinicians and families of critically ill patients, we examined patient-level and family-level predictors of the return of usable surveys at baseline, three months, and six months (n = 181, 171, and 155, respectively). Family-level predictors included baseline symptoms of psychological distress, decisional independence preference, and attachment style. We hypothesized that family with fewer symptoms of psychological distress, a preference for less decisional independence, and secure attachment style would be more likely to return questionnaires. We identified several predictors of the return of usable questionnaires. Better self-assessed family member health status was associated with a higher likelihood and stronger agreement with a support-seeking attachment style with a lower likelihood, of obtaining usable baseline surveys. At three months, family-level predictors of return of usable surveys included having usable baseline surveys, status as the patient's legal next of kin, and stronger agreement with a secure attachment style. The only predictor of receipt of surveys at six months was the presence of usable surveys at three months. We identified several predictors of the receipt of surveys assessing psychological symptoms in family of critically ill patients, including family member health status and attachment style. Using these characteristics to inform follow-up mailings and reminders may enhance response rates. Copyright © 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  9. Intestinal crosstalk: a new paradigm for understanding the gut as the "motor" of critical illness.

    Science.gov (United States)

    Clark, Jessica A; Coopersmith, Craig M

    2007-10-01

    For more than 20 years, the gut has been hypothesized to be the "motor" of multiple organ dysfunction syndrome. As critical care research has evolved, there have been multiple mechanisms by which the gastrointestinal tract has been proposed to drive systemic inflammation. Many of these disparate mechanisms have proved to be important in the origin and propagation of critical illness. However, this has led to an unusual situation where investigators describing the gut as a "motor" revving the systemic inflammatory response syndrome are frequently describing wholly different processes to support their claim (i.e., increased apoptosis, altered tight junctions, translocation, cytokine production, crosstalk with commensal bacteria, etc). The purpose of this review is to present a unifying theory as to how the gut drives critical illness. Although the gastrointestinal tract is frequently described simply as "the gut," it is actually made up of (1) an epithelium; (2) a diverse and robust immune arm, which contains most of the immune cells in the body; and (3) the commensal bacteria, which contain more cells than are present in the entire host organism. We propose that the intestinal epithelium, the intestinal immune system, and the intestine's endogenous bacteria all play vital roles driving multiple organ dysfunction syndrome, and the complex crosstalk between these three interrelated portions of the gastrointestinal tract is what cumulatively makes the gut a "motor" of critical illness.

  10. The politics of knowledge: implications for understanding and addressing mental health and illness.

    Science.gov (United States)

    Jenkins, Emily K

    2014-03-01

    While knowledge represents a valuable commodity, not all forms of knowledge are afforded equal status. The politics of knowledge, which entails the privileging of particular ways of knowing through linkages between the producers of knowledge and other bearers of authority or influence, represents a powerful force driving knowledge development. Within the health research and practice community, biomedical knowledge (i.e. knowledge pertaining to the biological factors influencing health) has been afforded a privileged position, shaping the health research and practice community's view of health, illness and appropriate intervention. The aim of this study is to spark critical reflection and dialogue surrounding the ways in which the politics of knowledge have constrained progress in addressing mental health and illness, one of today's leading public health issues. I argue that the hegemony of biological knowledge represents an ethical issue as it limits the breadth of knowledge available to support practitioners to 'do good' in terms of addressing mental illness. Given the power and influence inherent within the nursing community, I propose that nurses ought to engage in critical reflection and action in an effort to better situate the health research and practice community to effectively address the mental health of populations. © 2013 John Wiley & Sons Ltd.

  11. 'The white blood cell always eat the red': how Jamaicans with sickle cell disease understand their illness.

    Science.gov (United States)

    Anderson, Moji; Asnani, Monika

    2016-01-01

    To explore lay understandings of sickle cell disease (SCD) among Jamaicans living with the illness. There is no qualitative research on this subject in Jamaica, where SCD is the most common genetic disorder. Thirty in-depth semi-structured interviews (50% males, 50% urban residence) were conducted with adult patients attending the Sickle Cell Unit in Jamaica. Transcribed data were analysed using thematic analysis. Patients' narratives focused on two main themes: lay understandings of how SCD works (using ideas of attack and fortification, and blockage and flow); and what causes the illness (lay ideas of inheritance). The most common description of SCD was that their white blood cells were 'eating/sucking out/feeding on' their red blood cells. Hence, treatment required 'building up' their blood, while a key to good health was ensuring an unimpeded flow of blood. Most participants believed SCD was hereditary, but there were various understandings of the mechanism and probability of its transmission. Belief in the possibility of transmitting SCD was not always a barrier to reproduction, nor did participants always insist on their partner or child being tested. Participants engaged in medical pluralism, a dynamic combination of folk and biomedical beliefs. Their concerns, experiences and interpretations were powerful motivators of reproductive and screening behaviour. Their narratives of SCD transcend the individual to express social, societal and cultural realities. Health care professionals and policy-makers should communicate clearly to ensure understanding, and recognize and engage with their patients' sociocultural context.

  12. Understanding the burden of illness associated with hypoparathyroidism reported among patients in the PARADOX study.

    Science.gov (United States)

    Hadker, Nandini; Egan, Jacqueline; Sanders, James; Lagast, Hjalmar; Clarke, Bart L

    2014-07-01

    Hypoparathyroidism is a rare disease caused by lack of parathyroid hormone (PTH) leading to hypocalcemia, hyperphosphatemia, and a variety of symptoms. This study aimed to quantify the clinical and social burden of illness from the perspective of affected patients. A web-based instrument was developed with input from patients, clinical experts, and the Hypoparathyroidism Association. Qualifying participants were ≥18 years old, diagnosed with hypoparathyroidism for ≥6 months, and U.S. residents. Questions focused on demographics, diagnosis perceptions, current attitudes, medical management, current symptoms, acute episodes, comorbidities, personal life, and employment. A total of 374 adults (mean age, 49 ± 12 years; female, 85%) with hypoparathyroidism (mean duration, 13 ± 12 years; severe condition, 30.5%) completed the survey. Patients reported visiting a mean of 6 ± 8 physicians before and after their diagnosis. The majority strongly agreed with feeling unprepared to manage the condition at diagnosis (56%), that controlling their hypoparathyroidism is harder than expected (60%), and that they were concerned about long-term complications of their current medications (75%). More than 10 symptoms were experienced by 72% of patients in the preceding 12 months, despite current management regimens. Symptoms were experienced for a mean of 13 ± 9 hours/day. Hospital stays or emergency department visits were required by 79% of patients. 45% reported significant interference with their lives, 85% reported an inability to perform household activities, and 20% experienced a disease-associated change in employment status. Patients with hypoparathyroidism have a high burden of illness and experience a broad spectrum of symptoms, with a multidimensional impact on their lives.

  13. Self-Regulatory Fatigue: A Missing Link in Understanding Fibromyalgia and Other Chronic MultiSymptom Illnesses.

    Science.gov (United States)

    Nes, Lise Solberg; Ehlers, Shawna L; Whipple, Mary O; Vincent, Ann

    2017-04-01

    Patients with chronic multisymptom illnesses such as fibromyalgia syndrome (FMS) are experiencing a multitude of physical and mental challenges. Facing such challenges may drain capacity to self-regulate, and research suggests patients with these illnesses may experience self-regulatory fatigue (SRF). This study sought to examine whether SRF can be associated with quality of life (QoL) in patients with FMS. Patients (N = 258) diagnosed with FMS completed self-report measures related to demographics, SRF (Self-Regulatory Fatigue 18 [SRF-18]), anxiety (Generalized Anxiety Disorder questionnaire [GAD-7]), depression (Patient Health Questionnaire [PHQ-9]), physical fatigue (Multidimensional Fatigue Inventory [MFI]), symptoms related to FMS (Fibromyalgia Impact Questionnaire [FIQ]), and QoL (36-Item Short-Form Health Survey [SF-36]). Hierarchical regressions showed higher SRF to be associated with lower QoL in terms of lower overall physical QoL, with subscales related to physical functioning, role limitations-physical, bodily pain, and general health (all P's > 0.001), as well as lower overall mental QoL, with subscales related to vitality, social functioning, role limitations-emotional, and mental health (all P's > 0.001). Including traditional predictors such as anxiety, depression, physical fatigue, and FMS-related symptoms as covariates in the analyses reduced the link between SRF and QoL somewhat, but the associations remained generally strong, particularly for SRF and mental QoL. This is the first study to show higher SRF relating to lower QoL for patients with FMS. Results suggest that SRF is distinct from anxiety, depression, and fatigue, and predicts QoL above and beyond these traditional factors in the area of chronic multisymptom illnesses such as FMS. SRF may be a "missing link" in understanding the complex nature of chronic multisymptom illnesses. © 2016 World Institute of Pain.

  14. Understanding the life of illness: learning through the art of Frida Kahlo.

    Science.gov (United States)

    Darbyshire, P

    1994-09-01

    That nursing is an art as well as a science is in danger of becoming a cliché unless attempts are made to reverse the marginalization and exclusion of arts and humanities within nursing. An educational approach to promoting more esthetic and less instrumental thinking and understanding is described. This approach enables nurses to gain a deeper understanding of the lived experiences of suffering, chronic pain, miscarriage, and disability through engaging with the art of Mexican painter Frida Kahlo.

  15. Generating or developing grounded theory: methods to understand health and illness.

    Science.gov (United States)

    Woods, Phillip; Gapp, Rod; King, Michelle A

    2016-06-01

    Grounded theory is a qualitative research methodology that aims to explain social phenomena, e.g. why particular motivations or patterns of behaviour occur, at a conceptual level. Developed in the 1960s by Glaser and Strauss, the methodology has been reinterpreted by Strauss and Corbin in more recent times, resulting in different schools of thought. Differences arise from different philosophical perspectives concerning knowledge (epistemology) and the nature of reality (ontology), demanding that researchers make clear theoretical choices at the commencement of their research when choosing this methodology. Compared to other qualitative methods it has ability to achieve understanding of, rather than simply describing, a social phenomenon. Achieving understanding however, requires theoretical sampling to choose interviewees that can contribute most to the research and understanding of the phenomenon, and constant comparison of interviews to evaluate the same event or process in different settings or situations. Sampling continues until conceptual saturation is reached, i.e. when no new concepts emerge from the data. Data analysis focusses on categorising data (finding the main elements of what is occurring and why), and describing those categories in terms of properties (conceptual characteristics that define the category and give meaning) and dimensions (the variations within properties which produce specificity and range). Ultimately a core category which theoretically explains how all other categories are linked together is developed from the data. While achieving theoretical abstraction in the core category, it should be logical and capture all of the variation within the data. Theory development requires understanding of the methodology not just working through a set of procedures. This article provides a basic overview, set in the literature surrounding grounded theory, for those wanting to increase their understanding and quality of research output.

  16. A comparison of the incidence and understanding of altitude illness between porters and trekkers in the Solu Khumbu Region of Nepal.

    Science.gov (United States)

    Newcomb, Lauren; Sherpa, Chhewang; Nickol, Annabel; Windsor, Jeremy

    2011-09-01

    Altitude illness can occur in anyone who ascends to high altitude. Better understanding of altitude illness is associated with a lower incidence of acute mountain sickness (AMS). The purpose of this study is to compare, for the first time, the incidence and understanding of altitude illness between foreign trekkers and indigenous porters in Nepal. Interviews and questionnaires were completed at the International Porter Protection Group Rescue Post at Machermo (4470 m). Participants completed the Lake Louise acute mountain sickness self-assessment questionnaire. They were also asked about their actions in response to high altitude illness scenarios as well as their perception of the vulnerability of porters vs trekkers to altitude illness. Ascent profile, age, gender, ethnic origin, and altitude of home residence were also obtained. Trekkers (n=131) had a significantly higher incidence of AMS (21% vs 8%) than porters (n=92; P porters (whose home villages were below 3050 m, n=61) had a numerically higher, though not significantly different, incidence of AMS (10% vs 3%) compared to highland porters (n=31). The majority of trekkers and porters recognized the symptoms of altitude illness and the most appropriate action to be taken. Despite the lower incidence of AMS in porters, around half felt that they were at greater risk than trekkers. Porters had a lower incidence of AMS, which may be attributable to repeated ascents through the trekking season, or differences in reporting symptoms. Both trekkers and porters demonstrated appropriate knowledge of actions to be taken in response to altitude illness. Copyright © 2011 Wilderness Medical Society. Published by Elsevier Inc. All rights reserved.

  17. Urban vegetation and heat-related mortality in Seoul, Korea.

    Science.gov (United States)

    Son, Ji-Young; Lane, Kevin J; Lee, Jong-Tae; Bell, Michelle L

    2016-11-01

    Urban areas are particularly vulnerable to heat-related health outcomes. Simultaneous trends of climate change and urbanization may increase the urban heat-related health burden. We investigated the effects of urban vegetation on heat-related mortality, and evaluated whether different levels of vegetation and individuals' characteristics affect the temperature-mortality associations within Seoul, Korea 2000-2009. We used Normalized Difference Vegetation Index (NDVI) to assess the urban vegetation within Seoul. We applied an overdispersed Poisson generalized linear model with interaction term between temperature and indicator of NDVI group (categorized in 3 levels) to assess the effect modification of the temperature-mortality association by urban vegetation. We conducted stratified analysis to explore whether associations are affected by individual characteristics of sex and age. The association between total mortality and a 1°C increase in temperature above the 90th percentile (25.1°C) (the "heat effect") was the highest for gus with low NDVI. The heat effect was a 4.1% (95% confidence interval (CI) 2.3, 5.9%), 3.0% (95% CI 0.2, 5.9%), and 2.2% (95% CI -0.5, 5.0%) increase in mortality risk for low, medium, and high NDVI group, respectively. Estimated risks showed similar effects by sex and age. Our findings suggest a higher mortality effect of high temperature in areas with lower vegetation in Seoul, Korea. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. Compreender as racionalidades leigas sobre saúde e doença Understanding lay rationalities about health and illness

    Directory of Open Access Journals (Sweden)

    Luisa Ferreira da Silva

    2011-12-01

    production has unveiled the contents of lay knowledge and its indisputable presence in individual experience, since the perception of bodily phenomena until the relationship with the medical establishment. This text takes a sociological production on the knowledge issue. Then it reviews the key sociological literature on lay knowledge about health and illness. It concludes with a proposal for understanding lay knowledge processes as rationalities that, in the form of configurations of independent elements, keep health practices in everyday life.

  19. Understanding of Altitude Illness and Use of Pharmacotherapy Among Trekkers and Porters in the Annapurna Region of Nepal.

    Science.gov (United States)

    Havryliuk, Tatiana; Acharya, Bhuwan; Caruso, Emily; Cushing, Tracy

    2015-09-01

    We surveyed Nepali porters and guides as well as English- and non-English-speaking trekkers on their knowledge of altitude illness and its treatment during trekking expeditions to the Annapurna region of Nepal. From March 15 to April 15, 2014, Nepali porters and visiting trekkers were surveyed regarding their ability to recognize and treat altitude illness in Manang, Nepal (3540 m). Their personal use of medications and home remedies and presence of acute mountain sickness (AMS) symptoms were also assessed. 504 subjects were surveyed, including 108 Nepalis. Overall incidence of AMS symptoms was 16%, 5% among Nepalis, and 21% among trekkers. Subjects recognized that headache (88%) was one of the symptoms of AMS, however many reported not knowing the symptoms of high altitude pulmonary edema (40%) or high altitude cerebral edema (42%). 58% of subjects reported carrying and 16% reported taking acetazolamide, while only 2 (0.4%) respondents took dexamethasone. The majority of subjects reported that they would be able to recognize (67%) and treat (62%) altitude illness. Trekkers reported a higher incidence of AMS symptoms than Nepalis. Although most respondents recognized symptoms of AMS, both Nepalis and trekkers lacked knowledge regarding more serious presentations of altitude illness, thus both groups were overconfident in their ability to recognize and treat altitude illness.

  20. Intestinal crosstalk – a new paradigm for understanding the gut as the “motor” of critical illness

    Science.gov (United States)

    Clark, Jessica A; Coopersmith, Craig M

    2007-01-01

    For more than 20 years, the gut has been hypothesized to be the “motor” of multiple organ dysfunction syndrome (MODS). As critical care research has evolved, there have been multiple mechanisms by which the gastrointestinal tract has been proposed to drive systemic inflammation. Many of these disparate mechanisms have proved to be important in the origin and propagation of critical illness. However, this has led to an unusual situation where investigators describing the gut as a “motor” revving the systemic inflammatory response syndrome (SIRS) are frequently describing wholly different processes to support their claim (i.e. increased apoptosis, altered tight junctions, translocation, cytokine production, crosstalk with commensal bacteria, etc). The purpose of this review is to present a unifying theory as to how the gut drives critical illness. Although the gastrointestinal tract is frequently described simply as “the gut,” it is actually made up of a) an epithelium, b) a diverse and robust immune arm, which contains the majority of immune cells in the body, and c) the commensal bacteria, which contain more cells than are present in the entire host organism. We propose that the intestinal epithelium, the intestinal immune system and the intestine’s endogenous bacteria all play vital roles driving MODS, and the complex crosstalk between these three interrelated portions of the gastrointestinal tract are cumulatively what makes the gut a “motor” of critical illness. PMID:17577136

  1. Understanding preventive health screening services use in persons with serious mental illness: how does integrated behavioral health primary care compare?

    Science.gov (United States)

    Xiong, Glen L; Iosif, Ana-Maria; Suo, Shannon; Mccarron, Robert M; Koike, Alan; Onate, John; Carter, Cameron S

    2015-01-01

    People with serious mental illness have reduced life expectancy, in large part due to reduced access to medical services and underutilization of preventive health services. This is a cross-sectional study that compared preventive services use in an integrated behavioral health primary care clinic (IBHPC) with two existing community mental health programs. Participants completed questionnaires about preventive health services use that contained 33 questions about demographic clinical information, and use of preventive health services, from October 2010 to December 2012. Services examined included mammogram, Papanicolaou Test, prostate specific antigen, digital rectal exam, fecal occult blood test, and flexible sigmoidoscopy or colonoscopy; blood pressure, height and weight, cholesterol, and blood sugar for diabetes; and influenza immunization, Hepatitis C Virus (HCV), and Human Immunodeficiency Virus (HIV) antibodies. A health service utilization score was developed and used as primary outcome for data analyses. In the multivariate analyses female gender (p compared to White), program type (p compared to one community mental health program (p compared another (p = 0.34). There was high variability in use of individual services among the clinical programs. More studies are needed to examine the effectiveness of integrated care in improving use of health screening services. Characteristics of the clinic in relation to use of preventive services deserve further study. © 2015, The Author(s).

  2. Raising Awareness on Heat Related Mortality in Bangladesh

    Science.gov (United States)

    Arrighi, J.; Burkart, K.; Nissan, H.

    2017-12-01

    Extreme heat is the leading cause of weather-related deaths in the United States and Europe, and was responsible for four of the ten deadliest natural disasters worldwide in 2015. Near the tropics, where hot weather is considered the norm, perceived heat risk is often low, but recent heat waves in South Asia have caught the attention of the health community, policy-makers and the public. In a recent collaboration between the Red Cross Red Crescent Climate Centre, Columbia University and BBC Media Action the effects of extreme heat in Bangladesh were analyzed and the findings were subsequently used as a basis to raise awareness about the impacts of extreme heat on the most vulnerable, to the general public. Analysis of excess heat in Bangladesh between 2003 and 2007 showed that heatwaves occur between April and June with most extreme heat events occurring in May. Between 2003 and 2007 it is estimated that an average of 1500 people died per year due to heatwaves lasting three days or longer, with an eight-day heatwave in 2005 resulting in a minimum of 3,800 excess deaths. Utilizing these findings BBC Media Action launched an online communications campaign in May 2017 ultimately reaching approximately 3.9 million people with information on reducing the impacts of extreme heat. This presentation will highlight key findings from the study of heat related mortality in Bangladesh as well as highlight the benefit of collaboration between scientists and communicators for increasing awareness about the effects of extreme heat on the most vulnerable.

  3. Understanding the experience of initiating community-based physical activity and social support by people with serious mental illness: a systematic review using a meta-ethnographic approach

    Directory of Open Access Journals (Sweden)

    Helen Quirk

    2017-10-01

    Full Text Available Abstract Background People with long-term serious mental illness live with severe and debilitating symptoms that can negatively influence their health and quality of life, leading to outcomes such as premature mortality, morbidity and obesity. An interplay of social, behavioural, biological and psychological factors is likely to contribute to their poor physical health. Participating in regular physical activity could bring symptomatic improvements, weight loss benefits, enhanced wellbeing and when undertaken in a community-based group setting can yield additional, important social support benefits. Yet poor uptake of physical activity by people with serious mental illness is a problem. This review will systematically search, appraise and synthesise the existing evidence that has explored the experience of community-based physical activity initiation and key features of social support within these contexts by adults with schizophrenia, bipolar affective disorder, major depressive disorder or psychosis using the meta-ethnography approach. This new understanding may be key in designing more acceptable and effective community-based group PA programmes that meet patients’ need and expectations. Methods This will be a systematic review of qualitative studies using the meta-ethnography approach. The following databases will be searched: ASSIA, CINAHL, Cochrane Central Register of Controlled Trials, EMBASE, Health Technology Assessment Database, MEDLINE, PsycINFO, Sociological Abstracts, SPORTDiscus and Web of Science. Grey literature will also be sought. Eligible studies will use qualitative methodology; involve adults (≥18 years with schizophrenia, bipolar affective disorder, major depressive disorder or psychosis; will report community-based group physical activity; and capture the experience of physical activity initiation and key features of social support from the perspective of the participant. Study selection and assessment of quality will

  4. Mapping Heat-related Risks for Community-based Adaptation Planning under Uncertainty

    Science.gov (United States)

    Bai, Yingjiu; Kaneko, Ikuyo; Kobayashi, Hikaru; Kurihara, Kazuo; Sasaki, Hidetaka; Murata, Akihiko; Takayabu, Izuru

    2016-04-01

    Climate change is leading to more frequent and intense heat waves. Recently, epidemiologic findings on heat-related health impacts have reinforced our understanding of the mortality impacts of extreme heat. This research has several aims: 1) to promote climate prediction services with spatial and temporal information on heat-related risks, using GIS (Geographical Information System), and digital mapping techniques; 2) to propose a visualization approach to articulating the evolution of local heat-health responses over time and the evaluation of new interventions for the implementation of valid community-based adaptation strategies and reliable actionable planning; and 3) to provide an appropriate and simple method of adjusting bias and quantifying the uncertainty in future outcomes, so that regional climate projections may be transcribed into useful forms for a wide variety of different users. Following the 2003 European heat wave, climatologists, medical specialists, and social scientists expedited efforts to revise and integrate risk governance frameworks for communities to take appropriate and effective actions themselves. Recently, the Coupled Model Intercomparison Project (CMIP) methodology has made projections possible for anyone wanting to openly access state-of-the-art climate model outputs and climate data to provide the backbone for decisions. Furthermore, the latest high-solution regional climate model (RCM) has been a huge increase in the volumes of data available. In this study, we used high-quality hourly projections (5-km resolution) from the Non-Hydrostatic Regional Climate Model (NHRCM-5km), following the SRES-A1B scenario developed by the Meteorological Research Institute (MRI) and observational data from the Automated Meteorological Data Acquisition System, Japan Meteorological Agency (JMA). The NHRCM-5km is a dynamic downscaling of results from the MRI-AGCM3.2S (20-km resolution), an atmospheric general circulation model (AGCM) driven by the

  5. Understandings of spirituality and its role in illness recovery in persons with schizophrenia and mental-health professionals: a qualitative study.

    Science.gov (United States)

    Ho, Rainbow Tin Hung; Chan, Caitlin Kar Pui; Lo, Phyllis Hau Yan; Wong, Ping Ho; Chan, Cecilia Lai Wan; Leung, Pamela Pui Yu; Chen, Eric Yu Hai

    2016-04-02

    Spirituality has received increased attention in the psychiatric literature; however, it remains underexplored on a global level. Knowledge about spirituality of persons with schizophrenia is often hampered by positive and negative symptoms, which limit their expression of spiritual needs and shift mental-health professionals' focus from spiritual care to symptom control. Differences in the ways that the two parties understand spirituality may create different expectations and further hinder the provision of high-quality holistic care. This study investigated the meaning and roles of spirituality from the perspectives of persons with schizophrenia and mental-health professionals. A qualitative design with semi-structured individual interviews was adopted. The analysis was based on data collected from interviews with 18 clients diagnosed with schizophrenia and 19 mental-health professionals from public hospitals and mental-health community rehabilitation centres in Hong Kong. Data were collected and analysed based on grounded theory principles. Both clients and professionals regarded spirituality as an inherent part of a person's well-being, clients' rehabilitation, and their lives in general. At the personal level, the clients' descriptions were more factual, concrete, short term, and affective, whereas the professionals' descriptions were more abstract, complex, and cognitive. At the communal level, both parties had a similar understanding of spirituality but different interpretations of its role in recovery from mental illness. The clients regarded spirituality as a source of giving and receiving love and care, whereas the professionals regarded it as a means of receiving support and managing symptoms. Building a common understanding on the concept of spirituality and the significant role it plays in rehabilitation between clients and mental-health professionals is an essential first step to support clients' spiritual health. Clients tend to seek for stability

  6. Preventing heat-related morbidity and mortality: new approaches in a changing climate.

    Science.gov (United States)

    O'Neill, Marie S; Carter, Rebecca; Kish, Jonathan K; Gronlund, Carina J; White-Newsome, Jalonne L; Manarolla, Xico; Zanobetti, Antonella; Schwartz, Joel D

    2009-10-20

    Due to global climate change, the world will, on average, experience a higher number of heat waves, and the intensity and length of these heat waves is projected to increase. Knowledge about the implications of heat exposure to human health is growing, with excess mortality and illness occurring during hot weather in diverse regions. Certain groups, including the elderly, the urban poor, and those with chronic health conditions, are at higher risk. Preventive actions include: establishing heat wave warning systems; making cool environments available (through air conditioning or other means); public education; planting trees and other vegetation; and modifying the built environment to provide proper ventilation and use materials and colors that reduce heat build-up and optimize thermal comfort. However, to inspire local prevention activities, easily understood information about the strategies' benefits needs to be incorporated into decision tools. Integrating heat health information into a comprehensive adaptation planning process can alert local decision-makers to extreme heat risks and provide information necessary to choose strategies that yield the largest health improvements and cost savings. Tools to enable this include web-based programs that illustrate effective methods for including heat health in comprehensive local-level adaptation planning; calculate costs and benefits of several activities; maps showing zones of high potential heat exposure and vulnerable populations in a local area; and public awareness materials and training for implementing preventive activities. A new computer-based decision tool will enable local estimates of heat-related health effects and potential savings from implementing a range of prevention strategies.

  7. Caretakers' understanding of malaria, use of insecticide treated net and care seeking-behavior for febrile illness of their children in Ethiopia.

    Science.gov (United States)

    Birhanu, Zewdie; Yihdego, Yemane Ye-Ebiyo; Yewhalaw, Delenasaw

    2017-09-18

    Local understandings of malaria and use of preventive measures-are critical factors in sustained control of malaria. This study assessed caretakers' knowledge on malaria, use of Long Lasting Insecticide Treated Nets (LLINs) and care-seeking behavior for their children's illness in different malaria transmission settings of Ethiopia. Data were collected from 709 caretakers of children of 2-9 years of age during in 2016. A standard questionnaire was used to assess caretakers' perceptions of malaria, use of LLIN and care seeking behavior for febrile illness of children aged 2-9 years. The caretakers recognized malaria mostly by chills (70.4%, 499/709), fever (45.7%, 324/709) and headache (39.8%, 282/709). Overall, only 66.4% (471) of the caretakers knew that mosquito bite caused malaria and that it was quite heterogeneous by localities (ranging from 26.1% to 89.4%) and altitude (p malaria. Overall knowledge on malaria (mean = 51.2%) was very low with significant variations by localities, altitude and levels of malaria transmission, being low in high altitude and low in transmission areas (p malaria related knowledge items, only knowledge of LLIN was associated with net use; non-use of LLN was higher among caretakers who did not know the role of LLIN (AOR = 0.47, 95%CI: 0.28-0.77, p = 0.003). Of course, attributing causation of malaria to stagnant water discouraged use of net (p = 0.021). Of febrile children (n = 122), only 50 (41.0%) sought care with only 17 (34.0%) seeking the care promptly. There was no significant link between knowledge of malaria and care seeking behavior (p > 0.05). However, knowledge of malaria had some level of influence on treatment source preference where caretakers with greater knowledge preferred pharmacy as source of care. The findings demonstrated that caretakers' understanding of malaria was unsatisfactory with marked heterogeneity by localities. The present evidence suggests that knowledge is not sufficient

  8. Heat-related deaths among California residents, May-September, 2000-2009.

    Data.gov (United States)

    California Environmental Health Tracking Program — This dataset contains counts, rates, and confidence intervals of heat-related deaths among California residents for the years 2000-2009. These data are stratified by...

  9. Evaluating penalized logistic regression models to predict Heat-Related Electric grid stress days

    Energy Technology Data Exchange (ETDEWEB)

    Bramer, L. M.; Rounds, J.; Burleyson, C. D.; Fortin, D.; Hathaway, J.; Rice, J.; Kraucunas, I.

    2017-11-01

    Understanding the conditions associated with stress on the electricity grid is important in the development of contingency plans for maintaining reliability during periods when the grid is stressed. In this paper, heat-related grid stress and the relationship with weather conditions is examined using data from the eastern United States. Penalized logistic regression models were developed and applied to predict stress on the electric grid using weather data. The inclusion of other weather variables, such as precipitation, in addition to temperature improved model performance. Several candidate models and datasets were examined. A penalized logistic regression model fit at the operation-zone level was found to provide predictive value and interpretability. Additionally, the importance of different weather variables observed at different time scales were examined. Maximum temperature and precipitation were identified as important across all zones while the importance of other weather variables was zone specific. The methods presented in this work are extensible to other regions and can be used to aid in planning and development of the electrical grid.

  10. Understanding the importance of "symbolic interaction stigma": How expectations about the reactions of others adds to the burden of mental illness stigma.

    Science.gov (United States)

    Link, Bruce G; Wells, Jennifer; Phelan, Jo C; Yang, Lawrence

    2015-06-01

    Important components of stigma include imagining what others might think of a stigmatized status, anticipating what might transpire in an interaction with others, and rehearsing what one might do if something untoward occurs. These imagined relations are here called symbolic interaction stigma and can have an impact even if the internalization of negative stereotypes fails to occur. Concepts and measures that capture symbolic interaction stigma are introduced, and a preliminary assessment of their impact is provided. Four self-report measures of symbolic interaction stigma (perceived devaluation discrimination, anticipation of rejection, stigma consciousness, and concern with staying in) were developed or adapted and administered to a sample of individuals who have experienced mental illness (N = 65). Regression analyses examined whether forms of symbolic interaction stigma were associated with withdrawal, self-esteem, and isolation from relatives independent of measures of internalization of stigma and rejection experiences. As evidenced by scores on 4 distinct measures, symbolic interaction stigma was relatively common in the sample, somewhat more common than the internalization of stigma. In addition, measures of symbolic interaction stigma were significantly associated with withdrawal, self-esteem, and isolation from relatives even when a measure of the internalization of stigma was statistically controlled. The study suggests the potential importance of considering symbolic interaction forms of stigma in understanding and addressing stigma and its consequences. Being aware of symbolic interaction stigma could be useful in enhancing rehabilitation goals if an approach to counteracting the negative effects of these aspects of stigma can be developed. (c) 2015 APA, all rights reserved).

  11. Understanding the Importance of “Symbolic Interaction Stigma:” How Expectations about the Reactions of Others Adds to the Burden of Mental illness Stigma

    Science.gov (United States)

    Link, Bruce G.; Wells, Jennifer; Phelan, Jo C.; Yang, Lawrence

    2017-01-01

    Objective Important components of stigma include imagining what others might think of a stigmatized status, anticipating what might transpire in an interaction with others, and rehearsing what one might do if something untoward occurs. These imagined relations are here called “symbolic interaction stigma” and can be impactful even if the internalization of negative stereotypes fails to occur. Concepts and measures that capture symbolic interaction stigma are introduced and a preliminary assessment of their impact provided. Methods Four self-report measures of symbolic interaction stigma (perceived devaluation discrimination, anticipation of rejection, stigma consciousness and concern with staying in) were developed or adapted and administered to a sample of individuals who have experienced mental illness (N=65). Regression analyses examined whether forms of symbolic interaction stigma were associated with withdrawal, self-esteem and isolation from relatives independent of measures of internalization of stigma and rejection experiences. Results As evidenced by scores on four distinct measures symbolic interaction stigma was relatively common in the sample, somewhat more common than the internalization of stigma. Additionally, measures of symbolic interaction stigma were significantly associated with withdrawal, self-esteem and isolation from relatives even when a measure of the internalization of stigma was statistically controlled. Conclusions and Implications for Practice The study suggests the potential importance of considering symbolic interaction forms of stigma in understanding and addressing stigma and its consequences. Being aware of symbolic interaction stigma could be useful in enhancing rehabilitation goals if an approach to counteracting the negative effects of these aspects of stigma can be developed. PMID:26075528

  12. When expressions make impressions-nurses' narratives about meeting severely ill patients in home nursing care: a phenomenological-hermeneutic approach to understanding.

    Science.gov (United States)

    Devik, Siri Andreassen; Enmarker, Ingela; Hellzen, Ove

    2013-10-17

    Registered nurses (RNs) working in homecare encounter severely ill and palliative patients whose expressions may cause ethical challenges and influence their daily work. The aim of this qualitative study was to illuminate and interpret the meaning of nurses' lived experiences when meeting these patients. Narrative interviews were conducted with 10 RNs working in home nursing care. These interviews were audiotaped and transcribed verbatim to a text and interpreted by a phenomenological-hermeneutic method inspired by Ricoeur. The meaning of the RNs' lived experience of patients' expressions was formulated into four themes. The first theme, Being open for the presence of the Other, includes two subthemes: "Sensing vulnerability" and "Empathizing with." The second theme, Being satisfied, entails the subthemes, "Feeling exceptional" and "Being trusted." The third theme, Being frustrated, contains the subthemes, "Being disappointed" and "Being angry." The fourth and final theme, Being ambivalent, includes one subtheme: "Being generous or reserved." Patients' expressions that make impressions on nurses create emotional waves. Expressions leave impressions that call upon the nurse, and confront her with taking the risk of letting intuition and pre-reflexive feelings gain entry to her care. Allowing for the Other's presence is seen as a precondition, which means facing humanity and sensing a vulnerability in herself as well as in the Other. Understanding and balancing this emotional dimension in care seems to cause confusion and distress within the nurses. Realizing how their feelings may lead to either generosity or aloofness towards the patient is upsetting. Our interpretation suggests that these impressions echo confusion according to the role of being a professional nurse. There is a need to pay more attention to how the emotional dimension in care is understood and impacts the way nurses perform their professional role.

  13. When expressions make impressions—Nurses’ narratives about meeting severely ill patients in home nursing care: A phenomenological-hermeneutic approach to understanding

    Science.gov (United States)

    Devik, Siri Andreassen; Enmarker, Ingela; Hellzen, Ove

    2013-01-01

    Registered nurses (RNs) working in homecare encounter severely ill and palliative patients whose expressions may cause ethical challenges and influence their daily work. The aim of this qualitative study was to illuminate and interpret the meaning of nurses’ lived experiences when meeting these patients. Narrative interviews were conducted with 10 RNs working in home nursing care. These interviews were audiotaped and transcribed verbatim to a text and interpreted by a phenomenological-hermeneutic method inspired by Ricoeur. The meaning of the RNs’ lived experience of patients’ expressions was formulated into four themes. The first theme, Being open for the presence of the Other, includes two subthemes: “Sensing vulnerability” and “Empathizing with.” The second theme, Being satisfied, entails the subthemes, “Feeling exceptional” and “Being trusted.” The third theme, Being frustrated, contains the subthemes, “Being disappointed” and “Being angry.” The fourth and final theme, Being ambivalent, includes one subtheme: “Being generous or reserved.” Patients’ expressions that make impressions on nurses create emotional waves. Expressions leave impressions that call upon the nurse, and confront her with taking the risk of letting intuition and pre-reflexive feelings gain entry to her care. Allowing for the Other's presence is seen as a precondition, which means facing humanity and sensing a vulnerability in herself as well as in the Other. Understanding and balancing this emotional dimension in care seems to cause confusion and distress within the nurses. Realizing how their feelings may lead to either generosity or aloofness towards the patient is upsetting. Our interpretation suggests that these impressions echo confusion according to the role of being a professional nurse. There is a need to pay more attention to how the emotional dimension in care is understood and impacts the way nurses perform their professional role. PMID:24138930

  14. When expressions make impressions—Nurses’ narratives about meeting severely ill patients in home nursing care: A phenomenological-hermeneutic approach to understanding

    Directory of Open Access Journals (Sweden)

    Siri Andreassen Devik

    2013-10-01

    Full Text Available Registered nurses (RNs working in homecare encounter severely ill and palliative patients whose expressions may cause ethical challenges and influence their daily work. The aim of this qualitative study was to illuminate and interpret the meaning of nurses’ lived experiences when meeting these patients. Narrative interviews were conducted with 10 RNs working in home nursing care. These interviews were audiotaped and transcribed verbatim to a text and interpreted by a phenomenological-hermeneutic method inspired by Ricoeur. The meaning of the RNs’ lived experience of patients’ expressions was formulated into four themes. The first theme, Being open for the presence of the Other, includes two subthemes: “Sensing vulnerability” and “Empathizing with.” The second theme, Being satisfied, entails the subthemes, “Feeling exceptional” and “Being trusted.” The third theme, Being frustrated, contains the subthemes, “Being disappointed” and “Being angry.” The fourth and final theme, Being ambivalent, includes one subtheme: “Being generous or reserved.” Patients’ expressions that make impressions on nurses create emotional waves. Expressions leave impressions that call upon the nurse, and confront her with taking the risk of letting intuition and pre-reflexive feelings gain entry to her care. Allowing for the Other's presence is seen as a precondition, which means facing humanity and sensing a vulnerability in herself as well as in the Other. Understanding and balancing this emotional dimension in care seems to cause confusion and distress within the nurses. Realizing how their feelings may lead to either generosity or aloofness towards the patient is upsetting. Our interpretation suggests that these impressions echo confusion according to the role of being a professional nurse. There is a need to pay more attention to how the emotional dimension in care is understood and impacts the way nurses perform their professional

  15. Review: Gisela Brünner & Elisabeth Gülich (Eds. (2002. Krankheit verstehen. Interdisziplinäre Beiträge zur Sprache in Krankheitsdarstellungen [Understanding Illness. Interdisciplinary Approaches to Communication about Illness

    Directory of Open Access Journals (Sweden)

    Rudolf Schmitt

    2002-09-01

    Full Text Available GÜLICH and BRÜNNER's book presents different approaches to linguistics, social science, psychosomatics, literary history and therapeutic approaches in the discourse about somatic and mental illness. Some articles are very inspiring; some seem to have a narrow point of view. Many of them converge on the topic of metaphor and the cognitive metaphor theory of LAKOFF and JOHNSON, that enrich the methodical and theoretical repertoire of qualitative research. URN: urn:nbn:de:0114-fqs020382

  16. "Nothing is absolute in life": understanding uncertainty in the context of psychiatric genetic counseling from the perspective of those with serious mental illness.

    Science.gov (United States)

    Hippman, Catriona; Lohn, Zoe; Ringrose, Andrea; Inglis, Angela; Cheek, Joanna; Austin, Jehannine C

    2013-10-01

    No genetic tests are currently clinically available for serious mental illnesses such as schizophrenia and bipolar disorder. Rather, the full spectrum of genetic variants that confer susceptibility remain unknown, and estimates of probability of condition recurrence typically have the form of ranges rather than single absolute numbers. Genetic counselors have been shown to feel that the information that can be provided for patients with serious mental illness could be more confusing than helpful. However, how those with serious mental illness perceive this uncertainty remains unknown. So, to investigate this, individuals with serious mental illness participated in a psychiatric genetic counseling (GC) session and responded to a single open ended question about their reactions towards the uncertainty that they encountered in their GC session immediately and one month post-counseling (from which themes were identified), and completed the Genetic Counseling Satisfaction Scale immediately post-session (descriptive statistics applied). While some of the 37 participants were disappointed with the uncertainty, twice as many were unconcerned. Overall, responses from immediately and one month after GC were very similar; participants were very satisfied with, and found value in GC despite uncertainty, and four approaches to coping with uncertainty emerged. Ultimately, these findings offer insight into providing GC for those with serious mental illness, and potentially could be applied to other areas of GC where uncertainty lies, with downstream impact on GC practice and future research.

  17. Differences in Heat-Related Mortality by Citizenship Status: United States, 2005-2014.

    Science.gov (United States)

    Taylor, Ethel V; Vaidyanathan, Ambarish; Flanders, W Dana; Murphy, Matthew; Spencer, Merianne; Noe, Rebecca S

    2018-04-01

    To determine whether non-US citizens have a higher mortality risk of heat-related deaths than do US citizens. We used place of residence reported in mortality data from the National Vital Statistics System from 2005 to 2014 as a proxy for citizenship to examine differences in heat-related deaths between non-US and US citizens. Estimates from the US Census Bureau American Community Survey of self-reported citizenship status and place of birth provided the numbers for the study population. We calculated the standardized mortality ratio and relative risk for heat-related deaths between non-US and US citizens nationally. Heat-related deaths accounted for 2.23% (n = 999) of deaths among non-US citizens and 0.02% (n = 4196) of deaths among US citizens. The age-adjusted standardized mortality ratio for non-US citizens compared with US citizens was 3.4 (95% confidence ratio [CI] = 3.2, 3.6). This risk was higher for Hispanic non-US citizens (risk ratio [RR] = 3.6; 95% CI = 3.2, 3.9) and non-US citizens aged 18 to 24 years (RR = 20.6; 95% CI = 16.5, 25.7). We found an increased mortality risk among non-US citizens compared with US citizens for heat-related deaths, especially those younger and of Hispanic ethnicity.

  18. Impact of Climate Change on Heat-Related Mortality in Jiangsu Province, China

    Science.gov (United States)

    Chen, Kai; Horton, Radley M.; Bader, Daniel A.; Lesk, Corey; Jiang, Leiwen; Jones, Bryan; Zhou, Lian; Chen, Xiaodong; Bi, Jun; Kinney, Patrick L.

    2017-01-01

    A warming climate is anticipated to increase the future heat-related total mortality in urban areas. However, little evidence has been reported for cause-specific mortality or nonurban areas. Here we assessed the impact of climate change on heat-related total and cause-specific mortality in both urban and rural counties of Jiangsu Province, China, in the next five decades. To address the potential uncertainty in projecting future heat-related mortality, we applied localized urban- and nonurban-specific exposure response functions, six population projections including a no population change scenario and five Shared Socioeconomic Pathways (SSPs), and 42 temperature projections from 21 global-scale general circulation models and two Representative Concentration Pathways (RCPs). Results showed that projected warmer temperatures in 2016-2040 and 2041-2065 will lead to higher heat-related mortality for total non-accidental, cardiovascular, respiratory, stroke, ischemic heart disease (IHD), and chronic obstructive pulmonary disease (COPD) causes occurring annually during May to September in Jiangsu Province, China. Nonurban residents in Jiangsu will suffer from more excess heat-related cause-specific mortality in 2016-2065 than urban residents. Variations across climate models and RCPs dominated the uncertainty of heat-related mortality estimation whereas population size change only had limited influence. Our findings suggest that targeted climate change mitigation and adaptation measures should be taken in both urban and nonurban areas of Jiangsu Province. Specific public health interventions should be focused on the leading causes of death (stroke, IHD, and COPD), whose health burden will be amplified by a warming climate.

  19. Impact of climate change on heat-related mortality in Jiangsu Province, China.

    Science.gov (United States)

    Chen, Kai; Horton, Radley M; Bader, Daniel A; Lesk, Corey; Jiang, Leiwen; Jones, Bryan; Zhou, Lian; Chen, Xiaodong; Bi, Jun; Kinney, Patrick L

    2017-05-01

    A warming climate is anticipated to increase the future heat-related total mortality in urban areas. However, little evidence has been reported for cause-specific mortality or nonurban areas. Here we assessed the impact of climate change on heat-related total and cause-specific mortality in both urban and rural counties of Jiangsu Province, China, in the next five decades. To address the potential uncertainty in projecting future heat-related mortality, we applied localized urban- and nonurban-specific exposure response functions, six population projections including a no population change scenario and five Shared Socioeconomic Pathways (SSPs), and 42 temperature projections from 21 global-scale general circulation models and two Representative Concentration Pathways (RCPs). Results showed that projected warmer temperatures in 2016-2040 and 2041-2065 will lead to higher heat-related mortality for total non-accidental, cardiovascular, respiratory, stroke, ischemic heart disease (IHD), and chronic obstructive pulmonary disease (COPD) causes occurring annually during May to September in Jiangsu Province, China. Nonurban residents in Jiangsu will suffer from more excess heat-related cause-specific mortality in 2016-2065 than urban residents. Variations across climate models and RCPs dominated the uncertainty of heat-related mortality estimation whereas population size change only had limited influence. Our findings suggest that targeted climate change mitigation and adaptation measures should be taken in both urban and nonurban areas of Jiangsu Province. Specific public health interventions should be focused on the leading causes of death (stroke, IHD, and COPD), whose health burden will be amplified by a warming climate. Copyright © 2017 Elsevier Ltd. All rights reserved.

  20. Determination of susceptibility to heat-related disorders and prevention methods among agriculture workers

    Directory of Open Access Journals (Sweden)

    2012-01-01

    Conclusion: According to the results, agriculture workers based on their age distribution, education, body mass index, health knowledge, drug use and incidence of chronic diseases, are very vulnerable to heat-related disorders. Therefore, training on recognizing the early signs and doing control measures as essential element in heat stress prevention should be seriously considered.

  1. Avoided heat-related mortality through climate adaptation strategies in three US cities.

    Science.gov (United States)

    Stone, Brian; Vargo, Jason; Liu, Peng; Habeeb, Dana; DeLucia, Anthony; Trail, Marcus; Hu, Yongtao; Russell, Armistead

    2014-01-01

    Heat-related mortality in US cities is expected to more than double by the mid-to-late 21st century. Rising heat exposure in cities is projected to result from: 1) climate forcings from changing global atmospheric composition; and 2) local land surface characteristics responsible for the urban heat island effect. The extent to which heat management strategies designed to lessen the urban heat island effect could offset future heat-related mortality remains unexplored in the literature. Using coupled global and regional climate models with a human health effects model, we estimate changes in the number of heat-related deaths in 2050 resulting from modifications to vegetative cover and surface albedo across three climatically and demographically diverse US metropolitan areas: Atlanta, Georgia, Philadelphia, Pennsylvania, and Phoenix, Arizona. Employing separate health impact functions for average warm season and heat wave conditions in 2050, we find combinations of vegetation and albedo enhancement to offset projected increases in heat-related mortality by 40 to 99% across the three metropolitan regions. These results demonstrate the potential for extensive land surface changes in cities to provide adaptive benefits to urban populations at risk for rising heat exposure with climate change.

  2. Heat-Related Mortality in a Warming Climate: Projections for 12 U.S. Cities

    Science.gov (United States)

    Petkova, Elisaveta P.; Bader, Daniel A.; Anderson, G. Brooke; Horton, Radley M.; Knowlton, Kim; Kinney, Patrick L.

    2014-01-01

    Heat is among the deadliest weather-related phenomena in the United States, and the number of heat-related deaths may increase under a changing climate, particularly in urban areas. Regional adaptation planning is unfortunately often limited by the lack of quantitative information on potential future health responses. This study presents an assessment of the future impacts of climate change on heat-related mortality in 12 cities using 16 global climate models, driven by two scenarios of greenhouse gas emissions. Although the magnitude of the projected heat effects was found to differ across time, cities, climate models and greenhouse pollution emissions scenarios, climate change was projected to result in increases in heat-related fatalities over time throughout the 21st century in all of the 12 cities included in this study. The increase was more substantial under the high emission pathway, highlighting the potential benefits to public health of reducing greenhouse gas emissions. Nearly 200,000 heat-related deaths are projected to occur in the 12 cities by the end of the century due to climate warming, over 22,000 of which could be avoided if we follow a low GHG emission pathway. The presented estimates can be of value to local decision makers and stakeholders interested in developing strategies to reduce these impacts and building climate change resilience.

  3. Avoided heat-related mortality through climate adaptation strategies in three US cities.

    Directory of Open Access Journals (Sweden)

    Brian Stone

    Full Text Available Heat-related mortality in US cities is expected to more than double by the mid-to-late 21st century. Rising heat exposure in cities is projected to result from: 1 climate forcings from changing global atmospheric composition; and 2 local land surface characteristics responsible for the urban heat island effect. The extent to which heat management strategies designed to lessen the urban heat island effect could offset future heat-related mortality remains unexplored in the literature. Using coupled global and regional climate models with a human health effects model, we estimate changes in the number of heat-related deaths in 2050 resulting from modifications to vegetative cover and surface albedo across three climatically and demographically diverse US metropolitan areas: Atlanta, Georgia, Philadelphia, Pennsylvania, and Phoenix, Arizona. Employing separate health impact functions for average warm season and heat wave conditions in 2050, we find combinations of vegetation and albedo enhancement to offset projected increases in heat-related mortality by 40 to 99% across the three metropolitan regions. These results demonstrate the potential for extensive land surface changes in cities to provide adaptive benefits to urban populations at risk for rising heat exposure with climate change.

  4. Heat-Related Mortality in a Warming Climate: Projections for 12 U.S. Cities

    Directory of Open Access Journals (Sweden)

    Elisaveta P. Petkova

    2014-10-01

    Full Text Available Heat is among the deadliest weather-related phenomena in the United States, and the number of heat-related deaths may increase under a changing climate, particularly in urban areas. Regional adaptation planning is unfortunately often limited by the lack of quantitative information on potential future health responses. This study presents an assessment of the future impacts of climate change on heat-related mortality in 12 cities using 16 global climate models, driven by two scenarios of greenhouse gas emissions. Although the magnitude of the projected heat effects was found to differ across time, cities, climate models and greenhouse pollution emissions scenarios, climate change was projected to result in increases in heat-related fatalities over time throughout the 21st century in all of the 12 cities included in this study. The increase was more substantial under the high emission pathway, highlighting the potential benefits to public health of reducing greenhouse gas emissions. Nearly 200,000 heat-related deaths are projected to occur in the 12 cities by the end of the century due to climate warming, over 22,000 of which could be avoided if we follow a low GHG emission pathway. The presented estimates can be of value to local decision makers and stakeholders interested in developing strategies to reduce these impacts and building climate change resilience.

  5. Urbanization Level and Vulnerability to Heat-Related Mortality in Jiangsu Province, China.

    Science.gov (United States)

    Chen, Kai; Zhou, Lian; Chen, Xiaodong; Ma, Zongwei; Liu, Yang; Huang, Lei; Bi, Jun; Kinney, Patrick L

    2016-12-01

    Although adverse effects of high temperature on mortality have been studied extensively in urban areas, little is known of the heat-mortality associations outside of cities. We investigated whether heat-mortality associations differed between urban and nonurban areas and how urbanicity affected the vulnerability to heat-related mortality. We first analyzed heat-related mortality risk in each of 102 counties in Jiangsu Province, China, during 2009-2013 using a distributed-lag nonlinear model. The county-specific estimates were then pooled for more urban (percentage of urban population ≥ 57.11%) and less urban (percentage of urban population urban counties and 1.26 (95% PI: 1.23, 1.30) in more urban counties. The heat effects on cardiorespiratory mortality followed a similar pattern. Higher education level and prevalence of air conditioning were significantly associated with counties having lower risks, whereas percentage of elderly people was significantly associated with increased risks. Our findings reveal that nonurban areas have significant heat-related mortality risks in Jiangsu, China. These results suggest the need for enhanced adaptation planning in Chinese nonurban areas under a changing climate. Citation: Chen K, Zhou L, Chen X, Ma Z, Liu Y, Huang L, Bi J, Kinney PL. 2016. Urbanization level and vulnerability to heat-related mortality in Jiangsu Province, China. Environ Health Perspect 124:1863-1869; http://dx.doi.org/10.1289/EHP204.

  6. Urbanization Level and Vulnerability to Heat-Related Mortality in Jiangsu Province, China

    Science.gov (United States)

    Chen, Kai; Zhou, Lian; Chen, Xiaodong; Ma, Zongwei; Liu, Yang; Huang, Lei; Bi, Jun; Kinney, Patrick L.

    2016-01-01

    Background: Although adverse effects of high temperature on mortality have been studied extensively in urban areas, little is known of the heat–mortality associations outside of cities. Objective: We investigated whether heat–mortality associations differed between urban and nonurban areas and how urbanicity affected the vulnerability to heat-related mortality. Methods: We first analyzed heat-related mortality risk in each of 102 counties in Jiangsu Province, China, during 2009–2013 using a distributed-lag nonlinear model. The county-specific estimates were then pooled for more urban (percentage of urban population ≥ 57.11%) and less urban (percentage of urban population urban counties and 1.26 (95% PI: 1.23, 1.30) in more urban counties. The heat effects on cardiorespiratory mortality followed a similar pattern. Higher education level and prevalence of air conditioning were significantly associated with counties having lower risks, whereas percentage of elderly people was significantly associated with increased risks. Conclusion: Our findings reveal that nonurban areas have significant heat-related mortality risks in Jiangsu, China. These results suggest the need for enhanced adaptation planning in Chinese nonurban areas under a changing climate. Citation: Chen K, Zhou L, Chen X, Ma Z, Liu Y, Huang L, Bi J, Kinney PL. 2016. Urbanization level and vulnerability to heat-related mortality in Jiangsu Province, China. Environ Health Perspect 124:1863–1869; http://dx.doi.org/10.1289/EHP204 PMID:27152420

  7. Challenges associated with projecting urbanization-induced heat-related mortality.

    Science.gov (United States)

    Hondula, David M; Georgescu, Matei; Balling, Robert C

    2014-08-15

    Maricopa County, Arizona, anchor to the fastest growing megapolitan area in the United States, is located in a hot desert climate where extreme temperatures are associated with elevated risk of mortality. Continued urbanization in the region will impact atmospheric temperatures and, as a result, potentially affect human health. We aimed to quantify the number of excess deaths attributable to heat in Maricopa County based on three future urbanization and adaptation scenarios and multiple exposure variables. Two scenarios (low and high growth projections) represent the maximum possible uncertainty range associated with urbanization in central Arizona, and a third represents the adaptation of high-albedo cool roof technology. Using a Poisson regression model, we related temperature to mortality using data spanning 1983-2007. Regional climate model simulations based on 2050-projected urbanization scenarios for Maricopa County generated distributions of temperature change, and from these predicted changes future excess heat-related mortality was estimated. Subject to urbanization scenario and exposure variable utilized, projections of heat-related mortality ranged from a decrease of 46 deaths per year (-95%) to an increase of 339 deaths per year (+359%). Projections based on minimum temperature showed the greatest increase for all expansion and adaptation scenarios and were substantially higher than those for daily mean temperature. Projections based on maximum temperature were largely associated with declining mortality. Low-growth and adaptation scenarios led to the smallest increase in predicted heat-related mortality based on mean temperature projections. Use of only one exposure variable to project future heat-related deaths may therefore be misrepresentative in terms of direction of change and magnitude of effects. Because urbanization-induced impacts can vary across the diurnal cycle, projections of heat-related health outcomes that do not consider place

  8. Essential Others and Spontaneous Recovery in the Life and Work of Emily Carr: Implications for Understanding Remission of Illness and Resilience.

    Science.gov (United States)

    Zerbe, Kathryn J

    2016-01-02

    Artist Emily Carr 1 A majority of paintings by Emily Carr are in the permanent collection of the Vancouver Art Gallery. Others may be viewed in the National Gallery of Ontario and the British Columbia Archives in Victoria, BC. They are also available as photographed reproductions on the web at vancouverartgallery.bc.ca. 1 (1871-1945) has attained iconic status in Canada and throughout the world for her prodigious output as a painter and writer of the Pacific Northwest. This article describes how the arrival of three "essential others" at pivotal moments in middle life helped lift Carr out of a serious, lifelong depression and nurtured and inspired her creative output. I propose that Carr's productivity and psychological recovery were facilitated by sequential, cumulative input from these generative human contacts. The creative partnership formed between an artist and her muse has features akin to the patient/therapist dyad, ranging from sparking new and healthier adaptations, to reshaping the internal landscape via internalization, to facilitation and promotion of unique talent. This psychobiographical study of Emily Carr is a vehicle for clinicians to further contemplate elements imbedded in our daily work that give rise to greater resilience, spontaneous recovery from illness, and personal transformation in the lives of our patients.

  9. Essential Others and Spontaneous Recovery in the Life and Work of Emily Carr: Implications for Understanding Remission of Illness and Resilience

    Science.gov (United States)

    Zerbe, Kathryn J.

    2016-01-01

    Artist Emily Carr 1A majority of paintings by Emily Carr are in the permanent collection of the Vancouver Art Gallery. Others may be viewed in the National Gallery of Ontario and the British Columbia Archives in Victoria, BC. They are also available as photographed reproductions on the web at vancouverartgallery.bc.ca. 1 (1871–1945) has attained iconic status in Canada and throughout the world for her prodigious output as a painter and writer of the Pacific Northwest. This article describes how the arrival of three “essential others” at pivotal moments in middle life helped lift Carr out of a serious, lifelong depression and nurtured and inspired her creative output. I propose that Carr’s productivity and psychological recovery were facilitated by sequential, cumulative input from these generative human contacts. The creative partnership formed between an artist and her muse has features akin to the patient/therapist dyad, ranging from sparking new and healthier adaptations, to reshaping the internal landscape via internalization, to facilitation and promotion of unique talent. This psychobiographical study of Emily Carr is a vehicle for clinicians to further contemplate elements imbedded in our daily work that give rise to greater resilience, spontaneous recovery from illness, and personal transformation in the lives of our patients. PMID:27122998

  10. 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.

  11. Projecting future climate change impacts on heat-related mortality in large urban areas in China.

    Science.gov (United States)

    Li, Ying; Ren, Ting; Kinney, Patrick L; Joyner, Andrew; Zhang, Wei

    2018-02-12

    Global climate change is anticipated to raise overall temperatures and has the potential to increase future mortality attributable to heat. Urban areas are particularly vulnerable to heat because of high concentrations of susceptible people. As the world's largest developing country, China has experienced noticeable changes in climate, partially evidenced by frequent occurrence of extreme heat in urban areas, which could expose millions of residents to summer heat stress that may result in increased health risk, including mortality. While there is a growing literature on future impacts of extreme temperatures on public health, projecting changes in future health outcomes associated with climate warming remains challenging and underexplored, particularly in developing countries. This is an exploratory study aimed at projecting future heat-related mortality risk in major urban areas in China. We focus on the 51 largest Chinese cities that include about one third of the total population in China, and project the potential changes in heat-related mortality based on 19 different global-scale climate models and three Representative Concentration Pathways (RCPs). City-specific risk estimates for high temperature and all-cause mortality were used to estimate annual heat-related mortality over two future twenty-year time periods. We estimated that for the 20-year period in Mid-21st century (2041-2060) relative to 1970-2000, incidence of excess heat-related mortality in the 51 cities to be approximately 37,800 (95% CI: 31,300-43,500), 31,700 (95% CI: 26,200-36,600) and 25,800 (95% CI: 21,300-29,800) deaths per year under RCP8.5, RCP4.5 and RCP2.6, respectively. Slowing climate change through the most stringent emission control scenario RCP2.6, relative to RCP8.5, was estimated to avoid 12,900 (95% CI: 10,800-14,800) deaths per year in the 51 cities in the 2050s, and 35,100 (95% CI: 29,200-40,100) deaths per year in the 2070s. The highest mortality risk is primarily in cities

  12. Heat-related inpatient hospitalizations and emergency room visits among California residents, May-September, 2000-2010.

    Data.gov (United States)

    California Environmental Health Tracking Program — This dataset contains case counts, rates, and confidence intervals of heat-related inpatient hospitalizations and ED visits among California residents for the years...

  13. Decompression illness.

    Science.gov (United States)

    Vann, Richard D; Butler, Frank K; Mitchell, Simon J; Moon, Richard E

    2011-01-08

    Decompression illness is caused by intravascular or extravascular bubbles that are formed as a result of reduction in environmental pressure (decompression). The term covers both arterial gas embolism, in which alveolar gas or venous gas emboli (via cardiac shunts or via pulmonary vessels) are introduced into the arterial circulation, and decompression sickness, which is caused by in-situ bubble formation from dissolved inert gas. Both syndromes can occur in divers, compressed air workers, aviators, and astronauts, but arterial gas embolism also arises from iatrogenic causes unrelated to decompression. Risk of decompression illness is affected by immersion, exercise, and heat or cold. Manifestations range from itching and minor pain to neurological symptoms, cardiac collapse, and death. First-aid treatment is 100% oxygen and definitive treatment is recompression to increased pressure, breathing 100% oxygen. Adjunctive treatment, including fluid administration and prophylaxis against venous thromboembolism in paralysed patients, is also recommended. Treatment is, in most cases, effective although residual deficits can remain in serious cases, even after several recompressions. Copyright © 2011 Elsevier Ltd. All rights reserved.

  14. Enhancing Remotely Sensed TIR Data for Public Health Applications: Is West Nile Virus Heat-Related?

    Science.gov (United States)

    Weng, Q.; Liu, H.; Jiang, Y.

    2014-12-01

    Public health studies often require thermal infrared (TIR) images at both high temporal and spatial resolution to retrieve LST. However, currently, no single satellite sensors can deliver TIR data at both high temporal and spatial resolution. This technological limitation prevents the wide usage of remote sensing data in epidemiological studies. To solve this issue, we have developed a few image fusion techniques to generate high temporally-resolved image data. We downscaled GOES LST data to 15-minute 1-km resolution to assess community-based heat-related risk in Los Angeles County, California and simulated ASTER datasets by fusing ASTER and MODIS data to derive biophysical variables, including LST, NDVI, and normalized difference water index, to examine the effects of those environmental characteristics on WNV outbreak and dissemination. A spatio-temporal analysis of WNV outbreak and dissemination was conducted by synthesizing the remote sensing variables and mosquito surveillance data, and by focusing on WNV risk areas in July through September due to data sufficiency of mosquito pools. Moderate- and high-risk areas of WNV infections in mosquitoes were identified for five epidemiological weeks. These identified WNV-risk areas were then collocated in GIS with heat hazard, exposure, and vulnerability maps to answer the question of whether WNV is a heat related virus. The results show that elevation and built-up conditions were negatively associated with the WNV propagation, while LST positively correlated with the viral transmission. NDVI was not significantly associated with WNV transmission. San Fernando Valley was found to be the most vulnerable to mosquito infections of WNV. This research provides important insights into how high temporal resolution remote sensing imagery may be used to study time-dependant events in public health, especially in the operational surveillance and control of vector-borne, water-borne, or other epidemic diseases.

  15. Illness and death literatura

    Directory of Open Access Journals (Sweden)

    Begoña CANTABRANA

    2016-04-01

    Full Text Available Patients need to transform their disease into a fiction, and their stories, once sorted out following the creative process and captured in a paper, constitute the disease literature. Illness adds countless components to literature and, in turn, literature gives back a mixture of fiction and reality which enriches and comforts. Related to disease and death of loved ones there are many books written and published with several aims (altruism, to understand the fact of being sick, as a resistance mechanism… and even for professional reasons. Besides, disease divulgation might be accompanied by beneficial effects at social level such as to normalize the illness, to assume death and to favor the patient´s role in a wide sense that includes the promotion of research development and the pressure on treatments reinforcement.

  16. An ecological time-series study of heat-related mortality in three European cities

    Directory of Open Access Journals (Sweden)

    Russo Antonio

    2008-01-01

    Full Text Available Abstract Background Europe has experienced warmer summers in the past two decades and there is a need to describe the determinants of heat-related mortality to better inform public health activities during hot weather. We investigated the effect of high temperatures on daily mortality in three cities in Europe (Budapest, London, and Milan, using a standard approach. Methods An ecological time-series study of daily mortality was conducted in three cities using Poisson generalized linear models allowing for over-dispersion. Secular trends in mortality and seasonal confounding factors were controlled for using cubic smoothing splines of time. Heat exposure was modelled using average values of the temperature measure on the same day as death (lag 0 and the day before (lag 1. The heat effect was quantified assuming a linear increase in risk above a cut-point for each city. Socio-economic status indicators and census data were linked with mortality data for stratified analyses. Results The risk of heat-related death increased with age, and females had a greater risk than males in age groups ≥65 years in London and Milan. The relative risks of mortality (per °C above the heat cut-point by gender and age were: (i Male 1.10 (95%CI: 1.07–1.12 and Female 1.07 (1.05–1.10 for 75–84 years, (ii M 1.10 (1.06–1.14 and F 1.08 (1.06–1.11 for ≥85 years in Budapest (≥24°C; (i M 1.03 (1.01–1.04 and F 1.07 (1.05–1.09, (ii M 1.05 (1.03–1.07 and F 1.08 (1.07–1.10 in London (≥20°C; and (i M 1.08 (1.03–1.14 and F 1.20 (1.15–1.26, (ii M 1.18 (1.11–1.26 and F 1.19 (1.15–1.24 in Milan (≥26°C. Mortality from external causes increases at higher temperatures as well as that from respiratory and cardiovascular disease. There was no clear evidence of effect modification by socio-economic status in either Budapest or London, but there was a seemingly higher risk for affluent non-elderly adults in Milan. Conclusion We found broadly consistent

  17. 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....... Sources Used:The writing is based on research literature related to illness insight and on personal recovery experiences.Conclusions and Implications for Practice: It is helpful to consider the integration of the issue of illness insight when addressing the questions and consequences of diagnosis...... in relation to the importance of illness insight in the recovery process....

  18. Susceptibility to Heat-Related Fluid and Electrolyte Imbalance Emergency Department Visits in Atlanta, Georgia, USA

    Directory of Open Access Journals (Sweden)

    Leila Heidari

    2016-10-01

    Full Text Available Identification of populations susceptible to heat effects is critical for targeted prevention and more accurate risk assessment. Fluid and electrolyte imbalance (FEI may provide an objective indicator of heat morbidity. Data on daily ambient temperature and FEI emergency department (ED visits were collected in Atlanta, Georgia, USA during 1993–2012. Associations of warm-season same-day temperatures and FEI ED visits were estimated using Poisson generalized linear models. Analyses explored associations between FEI ED visits and various temperature metrics (maximum, minimum, average, and diurnal change in ambient temperature, apparent temperature, and heat index modeled using linear, quadratic, and cubic terms to allow for non-linear associations. Effect modification by potential determinants of heat susceptibility (sex; race; comorbid congestive heart failure, kidney disease, and diabetes; and neighborhood poverty and education levels was assessed via stratification. Higher warm-season ambient temperature was significantly associated with FEI ED visits, regardless of temperature metric used. Stratified analyses suggested heat-related risks for all populations, but particularly for males. This work highlights the utility of FEI as an indicator of heat morbidity, the health threat posed by warm-season temperatures, and the importance of considering susceptible populations in heat-health research.

  19. Projected heat-related mortality under climate change in the metropolitan area of Skopje

    Directory of Open Access Journals (Sweden)

    Gerardo Sanchez Martinez

    2016-05-01

    Full Text Available Abstract Background Excessive summer heat is a serious environmental health problem in Skopje, the capital and largest city of the former Yugoslav Republic of Macedonia. This paper attempts to forecast the impact of heat on mortality in Skopje in two future periods under climate change and compare it with a historical baseline period. Methods After ascertaining the relationship between daily mean ambient air temperature and daily mortality in Skopje, we modelled the evolution of ambient temperatures in the city under a Representative Concentration Pathway scenario (RCP8.5 and the evolution of the city population in two future time periods: 2026–2045 and 2081–2100, and in a past time period (1986–2005 to serve as baseline for comparison. We then calculated the projected average annual mortality attributable to heat in the absence of adaptation or acclimatization during those time windows, and evaluated the contribution of each source of uncertainty on the final impact. Results Our estimates suggest that, compared to the baseline period (1986–2005, heat-related mortality in Skopje would more than double in 2026–2045, and more than quadruple in 2081–2100. When considering the impact in 2081–2100, sampling variability around the heat–mortality relationship and climate model explained 40.3 and 46.6 % of total variability. Conclusion These results highlight the importance of a long-term perspective in the public health prevention of heat exposure, particularly in the context of a changing climate.

  20. 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

  1. Mental Illness Statistics

    Science.gov (United States)

    ... News & Events About Us Home > Health Information Share Statistics Research shows that mental illnesses are common in ... of mental illnesses, such as suicide and disability. Statistics Top ı cs Mental Illness Any Anxiety Disorder ...

  2. 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.

  3. Heat-Related Deaths in Hot Cities: Estimates of Human Tolerance to High Temperature Thresholds

    Directory of Open Access Journals (Sweden)

    Sharon L. Harlan

    2014-03-01

    Full Text Available In this study we characterized the relationship between temperature and mortality in central Arizona desert cities that have an extremely hot climate. Relationships between daily maximum apparent temperature (ATmax and mortality for eight condition-specific causes and all-cause deaths were modeled for all residents and separately for males and females ages <65 and ≥65 during the months May–October for years 2000–2008. The most robust relationship was between ATmax on day of death and mortality from direct exposure to high environmental heat. For this condition-specific cause of death, the heat thresholds in all gender and age groups (ATmax = 90–97 °F; 32.2‒36.1 °C were below local median seasonal temperatures in the study period (ATmax = 99.5 °F; 37.5 °C. Heat threshold was defined as ATmax at which the mortality ratio begins an exponential upward trend. Thresholds were identified in younger and older females for cardiac disease/stroke mortality (ATmax = 106 and 108 °F; 41.1 and 42.2 °C with a one-day lag. Thresholds were also identified for mortality from respiratory diseases in older people (ATmax = 109 °F; 42.8 °C and for all-cause mortality in females (ATmax = 107 °F; 41.7 °C and males <65 years (ATmax = 102 °F; 38.9 °C. Heat-related mortality in a region that has already made some adaptations to predictable periods of extremely high temperatures suggests that more extensive and targeted heat-adaptation plans for climate change are needed in cities worldwide.

  4. Heat-related deaths in hot cities: estimates of human tolerance to high temperature thresholds.

    Science.gov (United States)

    Harlan, Sharon L; Chowell, Gerardo; Yang, Shuo; Petitti, Diana B; Morales Butler, Emmanuel J; Ruddell, Benjamin L; Ruddell, Darren M

    2014-03-20

    In this study we characterized the relationship between temperature and mortality in central Arizona desert cities that have an extremely hot climate. Relationships between daily maximum apparent temperature (ATmax) and mortality for eight condition-specific causes and all-cause deaths were modeled for all residents and separately for males and females ages <65 and ≥ 65 during the months May-October for years 2000-2008. The most robust relationship was between ATmax on day of death and mortality from direct exposure to high environmental heat. For this condition-specific cause of death, the heat thresholds in all gender and age groups (ATmax = 90-97 °F; 32.2-36.1 °C) were below local median seasonal temperatures in the study period (ATmax = 99.5 °F; 37.5 °C). Heat threshold was defined as ATmax at which the mortality ratio begins an exponential upward trend. Thresholds were identified in younger and older females for cardiac disease/stroke mortality (ATmax = 106 and 108 °F; 41.1 and 42.2 °C) with a one-day lag. Thresholds were also identified for mortality from respiratory diseases in older people (ATmax = 109 °F; 42.8 °C) and for all-cause mortality in females (ATmax = 107 °F; 41.7 °C) and males <65 years (ATmax = 102 °F; 38.9 °C). Heat-related mortality in a region that has already made some adaptations to predictable periods of extremely high temperatures suggests that more extensive and targeted heat-adaptation plans for climate change are needed in cities worldwide.

  5. Adaptation to Climate Change: A Comparative Analysis of Modeling Methods for Heat-Related Mortality.

    Science.gov (United States)

    Gosling, Simon N; Hondula, David M; Bunker, Aditi; Ibarreta, Dolores; Liu, Junguo; Zhang, Xinxin; Sauerborn, Rainer

    2017-08-16

    Multiple methods are employed for modeling adaptation when projecting the impact of climate change on heat-related mortality. The sensitivity of impacts to each is unknown because they have never been systematically compared. In addition, little is known about the relative sensitivity of impacts to "adaptation uncertainty" (i.e., the inclusion/exclusion of adaptation modeling) relative to using multiple climate models and emissions scenarios. This study had three aims: a ) Compare the range in projected impacts that arises from using different adaptation modeling methods; b ) compare the range in impacts that arises from adaptation uncertainty with ranges from using multiple climate models and emissions scenarios; c ) recommend modeling method(s) to use in future impact assessments. We estimated impacts for 2070-2099 for 14 European cities, applying six different methods for modeling adaptation; we also estimated impacts with five climate models run under two emissions scenarios to explore the relative effects of climate modeling and emissions uncertainty. The range of the difference (percent) in impacts between including and excluding adaptation, irrespective of climate modeling and emissions uncertainty, can be as low as 28% with one method and up to 103% with another (mean across 14 cities). In 13 of 14 cities, the ranges in projected impacts due to adaptation uncertainty are larger than those associated with climate modeling and emissions uncertainty. Researchers should carefully consider how to model adaptation because it is a source of uncertainty that can be greater than the uncertainty in emissions and climate modeling. We recommend absolute threshold shifts and reductions in slope. https://doi.org/10.1289/EHP634.

  6. Aging Will Amplify the Heat-related Mortality Risk under a Changing Climate: Projection for the Elderly in Beijing, China

    Science.gov (United States)

    Li, Tiantian; Horton, Radley M.; Bader, Daniel A.; Zhou, Maigeng; Liang, Xudong; Ban, Jie; Sun, Qinghua; Kinney, Patrick L.

    2016-06-01

    An aging population could substantially enhance the burden of heat-related health risks in a warming climate because of their higher susceptibility to extreme heat health effects. Here, we project heat-related mortality for adults 65 years and older in Beijing China across 31 downscaled climate models and 2 representative concentration pathways (RCPs) in the 2020s, 2050s, and 2080s. Under a scenario of medium population and RCP8.5, by the 2080s, Beijing is projected to experience 14,401 heat-related deaths per year for elderly individuals, which is a 264.9% increase compared with the 1980s. These impacts could be moderated through adaptation. In the 2080s, even with the 30% and 50% adaptation rate assumed in our study, the increase in heat-related death is approximately 7.4 times and 1.3 times larger than in the 1980s respectively under a scenario of high population and RCP8.5. These findings could assist countries in establishing public health intervention policies for the dual problems of climate change and aging population. Examples could include ensuring facilities with large elderly populations are protected from extreme heat (for example through back-up power supplies and/or passive cooling) and using databases and community networks to ensure the home-bound elderly are safe during extreme heat events.

  7. Heat Illness in Hawai‘i

    OpenAIRE

    Gordon, Sarah

    2014-01-01

    Heat illness is a commonly encountered health problem in the Hawaiian Islands. Year round warm temperatures, proximity to the equator, and high humidity combined with a plethora of opportunities for outdoor activities put many individuals at risk. This paper will focus on the physiology, identification, and treatment of varying forms of heat illness. Severe heat illness can be life threatening. All outdoor enthusiasts should have a basic understanding of how to recognize this potentially life...

  8. Heat-Related Mortality in Japan after the 2011 Fukushima Disaster: An Analysis of Potential Influence of Reduced Electricity Consumption

    Science.gov (United States)

    Kim, Yoonhee; Gasparrini, Antonio; Honda, Yasushi; Ng, Chris Fook Sheng; Armstrong, Ben

    2017-01-01

    Background: In March 2011, the Great East Japan Earthquake devastated several power stations and caused severe electricity shortages. This accident was followed by the implementation of policies to reduce summer electricity consumption in the affected areas, for example, by limiting air-conditioning (AC) use. This provided a natural experimental scenario to investigate if these policies were associated with an increase in heat-related mortality. Objectives: We examined whether the reduced electricity consumption in warm season modified heat-related mortality from 2008 to 2012. Methods: We conducted prefecture-specific interrupted time-series (ITS) analyses to compare temperature–mortality associations before and after the earthquake, and used meta-analysis to generate combined effect estimates for the most affected and less affected areas (prefectures with >10% or ≤10% reductions in electricity consumption, respectively). We then examined whether the temperature–mortality association in Tokyo, one of the most affected areas, was modified by the percent reduction in electricity consumption relative to expected consumption for comparable days before the earthquake. Results: Contrary to expectations, we estimated a 5–9% reduction in all-cause heat-related mortality after the earthquake in the 15 prefectures with the greatest reduction in electricity consumption, and little change in the other prefectures. However, the percent reduction in observed vs. expected daily electricity consumption after the earthquake did not significantly modify daily heat-related mortality in Tokyo. Conclusions: In the prefectures with the greatest reductions in electricity consumption, heat-related mortality decreased rather than increased following the Great East Japan Earthquake. Additional research is needed to determine whether this finding holds for other populations and regions, and to clarify its implications for policies to reduce the consequences of climate change on

  9. Heat-Related Mortality in Japan after the 2011 Fukushima Disaster: An Analysis of Potential Influence of Reduced Electricity Consumption.

    Science.gov (United States)

    Kim, Yoonhee; Gasparrini, Antonio; Hashizume, Masahiro; Honda, Yasushi; Ng, Chris Fook Sheng; Armstrong, Ben

    2017-07-06

    In March 2011, the Great East Japan Earthquake devastated several power stations and caused severe electricity shortages. This accident was followed by the implementation of policies to reduce summer electricity consumption in the affected areas, for example, by limiting air-conditioning (AC) use. This provided a natural experimental scenario to investigate if these policies were associated with an increase in heat-related mortality. We examined whether the reduced electricity consumption in warm season modified heat-related mortality from 2008 to 2012. We conducted prefecture-specific interrupted time-series (ITS) analyses to compare temperature-mortality associations before and after the earthquake, and used meta-analysis to generate combined effect estimates for the most affected and less affected areas (prefectures with >10% or ≤10% reductions in electricity consumption, respectively). We then examined whether the temperature-mortality association in Tokyo, one of the most affected areas, was modified by the percent reduction in electricity consumption relative to expected consumption for comparable days before the earthquake. Contrary to expectations, we estimated a 5-9% reduction in all-cause heat-related mortality after the earthquake in the 15 prefectures with the greatest reduction in electricity consumption, and little change in the other prefectures. However, the percent reduction in observed vs. expected daily electricity consumption after the earthquake did not significantly modify daily heat-related mortality in Tokyo. In the prefectures with the greatest reductions in electricity consumption, heat-related mortality decreased rather than increased following the Great East Japan Earthquake. Additional research is needed to determine whether this finding holds for other populations and regions, and to clarify its implications for policies to reduce the consequences of climate change on health. https://doi.org/10.1289/EHP493.

  10. Dependency in Critically Ill Patients

    Science.gov (United States)

    Yang, Rumei

    2016-01-01

    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. PMID:28462328

  11. 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.

  12. Temperature-Related Death and Illness. Chapter 2

    Science.gov (United States)

    Sarofim, Marcus C.; Saha, Shubhayu; Hawkins, Michelle D.; Mills, David M.; Hess, Jeremy; Horton, Radley; Kinney, Patrick; Schwartz, Joel; St. Juliana, Alexis

    2016-01-01

    Based on present-day sensitivity to heat, an increase of thousands to tens of thousands of premature heat-related deaths in the summer and a decrease of premature cold-related deaths in the winter are projected each year as a result of climate change by the end of the century. Future adaptation will very likely reduce these impacts (see Changing Tolerance to Extreme Heat Finding). The reduction in cold-related deaths is projected to be smaller than the increase in heat-related deaths in most regions. Days that are hotter than usual in the summer or colder than usual in the winter are both associated with increased illness and death. Mortality effects are observed even for small differences from seasonal average temperatures. Because small temperature differences occur much more frequently than large temperature differences, not accounting for the effect of these small differences would lead to underestimating the future impact of climate change. An increase in population tolerance to extreme heat has been observed over time. Changes in this tolerance have been associated with increased use of air conditioning, improved social responses, and or physiological acclimatization, among other factors. Expected future increases in this tolerance will reduce the projected increase in deaths from heat. Older adults and children have a higher risk of dying or becoming ill due to extreme heat. People working outdoors, the socially isolated and economically disadvantaged, those with chronic illnesses, as well as some communities of color, are also especially vulnerable to death or illness.

  13. Heat Illness in Hawai‘i

    Science.gov (United States)

    2014-01-01

    Heat illness is a commonly encountered health problem in the Hawaiian Islands. Year round warm temperatures, proximity to the equator, and high humidity combined with a plethora of opportunities for outdoor activities put many individuals at risk. This paper will focus on the physiology, identification, and treatment of varying forms of heat illness. Severe heat illness can be life threatening. All outdoor enthusiasts should have a basic understanding of how to recognize this potentially life-threatening condition and employ preventive measures. We will discuss appropriate management in pre-hospital and hospital settings. Early recognition and cooling are the most crucial aspects of the management of heat illness. PMID:25478301

  14. Heat illness in Hawai'i.

    Science.gov (United States)

    Gordon, Sarah

    2014-11-01

    Heat illness is a commonly encountered health problem in the Hawaiian Islands. Year round warm temperatures, proximity to the equator, and high humidity combined with a plethora of opportunities for outdoor activities put many individuals at risk. This paper will focus on the physiology, identification, and treatment of varying forms of heat illness. Severe heat illness can be life threatening. All outdoor enthusiasts should have a basic understanding of how to recognize this potentially life-threatening condition and employ preventive measures. We will discuss appropriate management in pre-hospital and hospital settings. Early recognition and cooling are the most crucial aspects of the management of heat illness.

  15. Linking Excessive Heat with Daily Heat-Related Mortality over the Coterminous United States

    Science.gov (United States)

    Quattrochi, Dale A.; Crosson, William L.; Al-Hamdan, Mohammad Z.; Estes, Maurice G., Jr.

    2014-01-01

    temperatures, heat indices, and a new heat stress variable developed as part of this research that gives an integrated measure of heat stress (and relief) over the course of a day. Comparisons are made between projected (2040 and 2090) and past (1990) heat stress statistics. Outputs are aggregated to the county level, which is a popular scale of analysis for public health interests. County-level statistics are made available to public health researchers by the Centers for Disease Control and Prevention (CDC) via the Wide-ranging Online Data for Epidemiologic Research (WONDER) system. This addition of heat stress measures to CDC WONDER allows decision and policy makers to assess the impact of alternative approaches to optimize the public health response to EHEs. Through CDC WONDER, users are able to spatially and temporally query public health and heat-related data sets and create county-level maps and statistical charts of such data across the coterminous U.S.

  16. Urban-hazard risk analysis: mapping of heat-related risks in the elderly in major Italian cities.

    Directory of Open Access Journals (Sweden)

    Marco Morabito

    Full Text Available Short-term impacts of high temperatures on the elderly are well known. Even though Italy has the highest proportion of elderly citizens in Europe, there is a lack of information on spatial heat-related elderly risks.Development of high-resolution, heat-related urban risk maps regarding the elderly population (≥ 65.A long time-series (2001-2013 of remote sensing MODIS data, averaged over the summer period for eleven major Italian cities, were downscaled to obtain high spatial resolution (100 m daytime and night-time land surface temperatures (LST. LST was estimated pixel-wise by applying two statistical model approaches: 1 the Linear Regression Model (LRM; 2 the Generalized Additive Model (GAM. Total and elderly population density data were extracted from the Joint Research Centre population grid (100 m from the 2001 census (Eurostat source, and processed together using "Crichton's Risk Triangle" hazard-risk methodology for obtaining a Heat-related Elderly Risk Index (HERI.The GAM procedure allowed for improved daytime and night-time LST estimations compared to the LRM approach. High-resolution maps of daytime and night-time HERI levels were developed for inland and coastal cities. Urban areas with the hazardous HERI level (very high risk were not necessarily characterized by the highest temperatures. The hazardous HERI level was generally localized to encompass the city-centre in inland cities and the inner area in coastal cities. The two most dangerous HERI levels were greater in the coastal rather than inland cities.This study shows the great potential of combining geospatial technologies and spatial demographic characteristics within a simple and flexible framework in order to provide high-resolution urban mapping of daytime and night-time HERI. In this way, potential areas for intervention are immediately identified with up-to-street level details. This information could support public health operators and facilitate coordination for heat-related

  17. Urban-hazard risk analysis: mapping of heat-related risks in the elderly in major Italian cities.

    Science.gov (United States)

    Morabito, Marco; Crisci, Alfonso; Gioli, Beniamino; Gualtieri, Giovanni; Toscano, Piero; Di Stefano, Valentina; Orlandini, Simone; Gensini, Gian Franco

    2015-01-01

    Short-term impacts of high temperatures on the elderly are well known. Even though Italy has the highest proportion of elderly citizens in Europe, there is a lack of information on spatial heat-related elderly risks. Development of high-resolution, heat-related urban risk maps regarding the elderly population (≥ 65). A long time-series (2001-2013) of remote sensing MODIS data, averaged over the summer period for eleven major Italian cities, were downscaled to obtain high spatial resolution (100 m) daytime and night-time land surface temperatures (LST). LST was estimated pixel-wise by applying two statistical model approaches: 1) the Linear Regression Model (LRM); 2) the Generalized Additive Model (GAM). Total and elderly population density data were extracted from the Joint Research Centre population grid (100 m) from the 2001 census (Eurostat source), and processed together using "Crichton's Risk Triangle" hazard-risk methodology for obtaining a Heat-related Elderly Risk Index (HERI). The GAM procedure allowed for improved daytime and night-time LST estimations compared to the LRM approach. High-resolution maps of daytime and night-time HERI levels were developed for inland and coastal cities. Urban areas with the hazardous HERI level (very high risk) were not necessarily characterized by the highest temperatures. The hazardous HERI level was generally localized to encompass the city-centre in inland cities and the inner area in coastal cities. The two most dangerous HERI levels were greater in the coastal rather than inland cities. This study shows the great potential of combining geospatial technologies and spatial demographic characteristics within a simple and flexible framework in order to provide high-resolution urban mapping of daytime and night-time HERI. In this way, potential areas for intervention are immediately identified with up-to-street level details. This information could support public health operators and facilitate coordination for heat-related

  18. Growing up with an ill parent: An examination of family characteristics and parental illness features.

    Science.gov (United States)

    Stoeckel, Maggie; Weissbrod, Carol

    2015-12-01

    Existing literature suggests that the children of ill parents are vulnerable to a variety of psychosocial difficulties such as depression and anxiety. The purpose of the current study is to investigate the impact of family characteristics (parental involvement, familial support, stress experienced as a result of parental illness) and parental illness features (severity, duration, recovery status, frequency of symptoms, course) on the psychosocial functioning (depression, anxiety, life satisfaction) of late adolescents who have grown up with an ill parent but no longer live with their parents. Participants were 71 college students with a parent who experienced a chronic medical condition while they were growing up. Participants provided information regarding family characteristics, parental illness features, and the impact of parental illness. Impact of parental illness was assessed using the Impact of Illness Scale. Participants also completed measures of depression, anxiety, and life satisfaction. Participants' reported impact of parent illness was positively correlated with participant depression and anxiety. Several family characteristics and parental illness features were significantly associated with participant psychosocial functioning. In particular, lower parental involvement was correlated with greater participant depression and anxiety, as well as lower life satisfaction. These findings extend our understanding of the impact of parental illness on late adolescents' psychosocial functioning. Results could have clinical applications for psychosocial interventions in children and families coping with chronic illness. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

  19. Aging Will Amplify the Heat-Related Mortality Risk Under a Changing Climate: Projection for the Elderly in Beijing, China

    Science.gov (United States)

    Li, Tiantian; Horton, Radley M.; Bader, Daniel A.; Zhou, Maigeng; Liang, Xudong; Ban, Jie; Sun, Qinghua; Kinney, Patrick L.

    2016-01-01

    An aging population could substantially enhance the burden of heat-related health risks in a warming climate because of their higher susceptibility to extreme heat health effects. Here, we project heatrelated mortality for adults 65 years and older in Beijing China across 31 downscaled climate models and 2 representative concentration pathways (RCPs) in the 2020s, 2050s, and 2080s. Under a scenario of medium population and RCP8.5, by the 2080s, Beijing is projected to experience 14,401 heat-related deaths per year for elderly individuals, which is a 264.9% increase compared with the 1980s. These impacts could be moderated through adaptation. In the 2080s, even with the 30% and 50% adaptation rate assumed in our study, the increase in heat-related death is approximately 7.4 times and 1.3 times larger than in the 1980s respectively under a scenario of high population and RCP8.5. These findings could assist countries in establishing public health intervention policies for the dual problems of climate change and aging population. Examples could include ensuring facilities with large elderly populations are protected from extreme heat (for example through back-up power supplies and/or passive cooling) and using databases and community networks to ensure the home-bound elderly are safe during extreme heat events.

  20. Illness as Teacher: Learning from Illness

    Science.gov (United States)

    Yoo, Joanne

    2017-01-01

    This article is a conceptual exploration into the value of illness, bodies and embodied practice in teacher education. It draws on my reflections and practitioner accounts of poor health to investigate the potential to learn from illness. I position myself in this discussion as a non-tenured academic who experiences the challenges of her uncertain…

  1. 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.

  2. The prevalence of heat-related cardiorespiratory symptoms: the vulnerable groups identified from the National FINRISK 2007 Study

    Science.gov (United States)

    Näyhä, Simo; Rintamäki, Hannu; Donaldson, Gavin; Hassi, Juhani; Jousilahti, Pekka; Laatikainen, Tiina; Jaakkola, Jouni J. K.; Ikäheimo, Tiina M.

    2017-04-01

    The prevalence of heat-related cardiorespiratory symptoms among vulnerable groups is not well known. We therefore estimated the prevalence of heat-related cardiorespiratory symptoms among the Finnish population and their associations with social and individual vulnerability factors. The data came from the National FINRISK 2007 Study, in which 4007 men and women aged 25-74 answered questions on heat-related cardiorespiratory symptoms in the Oulu Cold and Heat Questionnaire 2007. Logistic regression was used to calculate odds ratios (ORs), their 95 % confidence intervals (CIs), and model-predicted prevalence figures. The prevalence of heat-related cardiorespiratory symptoms was 12 %. It increased with age, from 3 % at the age of 25 years to 28 % at the age of 75 years. The symptoms were associated with pre-existing lung (OR 3.93; CI 3.01-5.13) and cardiovascular diseases (OR 2.27; 1.78-2.89); being a pensioner (OR 2.91; 1.65-5.28), unemployed (OR 2.82; 1.47-5.48), or working in agriculture (OR 2.27; 1.14-4.46) compared with working in industry; having only basic vs academic education (OR 1.98; 1.31-3.05); being female (OR 1.94; 1.51-2.50); being heavy vs light alcohol consumer (OR 1.89; 1.02-3.32); undertaking hard vs light physical work (OR 1.48;1.06-2.07); and being inactive vs active in leisure time (OR 1.97; 1.39-2.81). The adjusted prevalence of symptoms showed a wide range of variation, from 3 to 61 % depending on sex, age, professional field, education, and pre-existing lung and cardiovascular diseases. In conclusion, heat-related cardiorespiratory symptoms are commonly perceived among people with pre-existing lung or cardiovascular disease, agricultural workers, unemployed, pensioners, and people having only basic education. This information is needed for any planning and targeting measures to reduce the burden of summer heat.

  3. Attributing illness to food

    DEFF Research Database (Denmark)

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

    2005-01-01

    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......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...

  4. 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...

  5. Between health and illness.

    Science.gov (United States)

    Davies, Peter G

    2007-01-01

    This essay explores the connections between health and illness, and the processes of salutogenesis, pathogenesis, and homeostasis. Written from an understanding of human embodiment and the consequences this has for our experiences of health and disease, this essay moves towards a positive definition of health, as an on-going outcome from the processes of a life lived well. "Well" here is measured in terms of wealth, relationships, coherence, fitness, and adaptability. Mencken's criticism that "Hygiene is the corruption of medicine by morality" is answered; the search for health is, in part, a moral as well as a biological enterprise. Both generative processes and remedial measures contribute to health. The patients in my consulting room usually need remedial medicine, but they would also like to flourish as human beings. Doctors should be able to provide a balance of measures towards this end.

  6. Illness anxiety disorder

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/001236.htm Illness anxiety disorder To use the sharing features on this page, please enable JavaScript. Illness anxiety disorder (IAD) is a preoccupation that physical symptoms are ...

  7. Studying Physically Ill Elderly.

    Science.gov (United States)

    Young, Rosalie F.; Kahana, Eva

    Research with older persons suffering from physical illness presents numerous challenges to gerontologists. Issues of conceptualization pertaining to the definition of illness, its location in the research paradigm, and the context in which illness occurs must be addressed prior to dealing with methodological problems. Access to physically ill…

  8. Understanding Resilience

    Directory of Open Access Journals (Sweden)

    Gang eWu

    2013-02-01

    Full Text Available Resilience is the ability to adapt successfully in the face of stress and adversity. Stressful life events, trauma and chronic adversity can have a substantial impact on brain function and structure, and can result in the development of PTSD, depression and other psychiatric disorders. However, most individuals do not develop such illnesses after experiencing stressful life events, and are thus thought to be resilient. Resilience as successful adaptation relies on effective responses to environmental challenges and ultimate resistance to the deleterious effects of stress, therefore a greater understanding of the factors that promote such effects is of great relevance. This review focuses on recent findings regarding genetic, epigenetic, developmental, psychosocial and neurochemical factors that are considered essential contributors to the development of resilience. Neural circuits and pathways involved in mediating resilience are also discussed. The growing understanding of resilience factors will hopefully lead to the development of new pharmacological and psychological interventions for enhancing resilience and mitigating the untoward consequences.

  9. Homeless mentally ill or mentally ill homeless?

    Science.gov (United States)

    Cohen, C I; Thompson, K S

    1992-06-01

    Mainstream psychiatry conceptualizes people who are homeless and mentally ill as distinct from other homeless persons because it is thought that their status stems from their mental disorder and the poor implementation of deinstitutionalization. The authors believe this dichotomy is illusory. They present data indicating that recent socioeconomic and political shifts contributed greatly to homelessness among all groups, regardless of mental illness; that those with and without mental illness have similar biographical and demographic profiles; that high levels of mental distress are common to all homeless persons; and that few mentally ill homeless persons require involuntary hospitalization. This perspective suggests novel responses that de-emphasize clinical solutions and focus on empowerment, consumerism, entitlement, community-level interventions, and closer alliances with other advocates for the homeless.

  10. The application of the European heat wave of 2003 to Korean cities to analyze impacts on heat-related mortality

    Science.gov (United States)

    Greene, J. Scott; Kalkstein, Laurence S.; Kim, Kyu Rang; Choi, Young-Jean; Lee, Dae-Geun

    2016-02-01

    The goal of this research is to transpose the unprecedented 2003 European excessive heat event to six Korean cities and to develop meteorological analogs for each. Since this heat episode is not a model but an actual event, we can use a plausible analog to assess the risk of increasing heat on these cities instead of an analog that is dependent on general circulation (GCM) modeling or the development of arbitrary scenarios. Initially, the 2003 summer meteorological conditions from Paris are characterized statistically and these characteristics are transferred to the Korean cites. Next, the new meteorological dataset for each Korean city is converted into a daily air mass calendar. We can then determine the frequency and character of "offensive" air masses in the Korean cities that are historically associated with elevated heat-related mortality. One unexpected result is the comparative severity of the very hot summer of 1994 in Korea, which actually eclipsed the 2003 analog. The persistence of the offensive air masses is considerably greater for the summer of 1994, as were dew point temperatures for a majority of the Korean cities. For all the Korean cities but one, the summer of 1994 is associated with more heat-related deaths than the analog summer, in some cases yielding a sixfold increase over deaths in an average summer. The Korean cities appear less sensitive to heat-related mortality problems during very hot summers than do large eastern and Midwestern US cities, possibly due to a lesser summer climate variation and efficient social services available during extreme heat episodes.

  11. Urban-Hazard Risk Analysis: Mapping of Heat-Related Risks in the Elderly in Major Italian Cities

    Science.gov (United States)

    Morabito, Marco; Crisci, Alfonso; Gioli, Beniamino; Gualtieri, Giovanni; Toscano, Piero; Di Stefano, Valentina; Orlandini, Simone; Gensini, Gian Franco

    2015-01-01

    Background Short-term impacts of high temperatures on the elderly are well known. Even though Italy has the highest proportion of elderly citizens in Europe, there is a lack of information on spatial heat-related elderly risks. Objectives Development of high-resolution, heat-related urban risk maps regarding the elderly population (≥65). Methods A long time-series (2001–2013) of remote sensing MODIS data, averaged over the summer period for eleven major Italian cities, were downscaled to obtain high spatial resolution (100 m) daytime and night-time land surface temperatures (LST). LST was estimated pixel-wise by applying two statistical model approaches: 1) the Linear Regression Model (LRM); 2) the Generalized Additive Model (GAM). Total and elderly population density data were extracted from the Joint Research Centre population grid (100 m) from the 2001 census (Eurostat source), and processed together using “Crichton’s Risk Triangle” hazard-risk methodology for obtaining a Heat-related Elderly Risk Index (HERI). Results The GAM procedure allowed for improved daytime and night-time LST estimations compared to the LRM approach. High-resolution maps of daytime and night-time HERI levels were developed for inland and coastal cities. Urban areas with the hazardous HERI level (very high risk) were not necessarily characterized by the highest temperatures. The hazardous HERI level was generally localized to encompass the city-centre in inland cities and the inner area in coastal cities. The two most dangerous HERI levels were greater in the coastal rather than inland cities. Conclusions This study shows the great potential of combining geospatial technologies and spatial demographic characteristics within a simple and flexible framework in order to provide high-resolution urban mapping of daytime and night-time HERI. In this way, potential areas for intervention are immediately identified with up-to-street level details. This information could support public

  12. Improving Heat-Related Health Outcomes in an Urban Environment with Science-Based Policy

    Directory of Open Access Journals (Sweden)

    David Sailor

    2016-10-01

    Full Text Available We use the Northeast US Urban Climate Archipelago as a case study to explore three key limitations of planning and policy initiatives to mitigate extreme urban heat. These limitations are: (1 a lack of understanding of spatial considerations—for example, how nearby urban areas interact, affecting, and being affected by, implementation of such policies; (2 an emphasis on air temperature reduction that neglects assessments of other important meteorological parameters, such as humidity, mixing heights, and urban wind fields; and (3 too narrow of a temporal focus—either time of day, season, or current vs. future climates. Additionally, the absence of a direct policy/planning linkage between heat mitigation goals and actual human health outcomes, in general, leads to solutions that only indirectly address the underlying problems. These issues are explored through several related atmospheric modeling case studies that reveal the complexities of designing effective urban heat mitigation strategies. We conclude with recommendations regarding how policy-makers can optimize the performance of their urban heat mitigation policies and programs. This optimization starts with a thorough understanding of the actual end-point goals of these policies, and concludes with the careful integration of scientific knowledge into the development of location-specific strategies that recognize and address the limitations discussed herein.

  13. Community Perceptions of Mental Illness in Jharkhand, India.

    Science.gov (United States)

    Sangeeta, S J; Mathew, K J

    2017-09-01

    Understanding and perceptions about mental illness vary among individuals based on their experience with the illness or their contact with the people affected by it. These may be further influenced by the individuals' sociocultural background. This study aimed to understand the differences in the beliefs about, understanding of, and explanations for mental illness between different population groups of Jharkhand, India. During July 2014 to February 2016, we recruited the following 3 groups of individuals aged between 18 and 60 years: individuals with mental illness (group 1, n = 240), relatives of individuals with mental illness (group 2, n = 240), and the general public (group 3, n = 240). Qualitative and quantitative findings were combined in this study, and participants were asked about their beliefs about, understanding of, and explanations about mental illness. Individuals with mental illness and their relatives shared similar beliefs whereas the general public held a different opinion in various domains. There were significant differences among all groups in their understanding of various aspects of mental illnesses including the definition, causes, signs and symptoms, treatment, and outcomes. Individuals' perception towards different aspects of mental illness varies, despite they are sharing the same sociocultural milieu. Differences in beliefs, understanding, and explanations may lead to conflicts in treatment goals and expectations, and hamper the intervention strategies that promote mental health and patient care. Focused strategies to develop uniformity in beliefs and explanations about various aspects of mental illness may help to develop collaboration with different community groups that may in turn help in developing effective interventions and treatment.

  14. Identifying heat-related deaths by using medical examiner and vital statistics data: Surveillance analysis and descriptive epidemiology - Oklahoma, 1990-2011.

    Science.gov (United States)

    Johnson, Matthew G; Brown, Sheryll; Archer, Pam; Wendelboe, Aaron; Magzamen, Sheryl; Bradley, Kristy K

    2016-10-01

    Approximately 660 deaths occur annually in the United States associated with excess natural heat. A record heat wave in Oklahoma during 2011 generated increased interest concerning heat-related mortality among public health preparedness partners. We aimed to improve surveillance for heat-related mortality and better characterize heat-related deaths in Oklahoma during 1990-2011, and to enhance public health messaging during future heat emergencies. Heat-related deaths were identified by querying vital statistics (VS) and medical examiner (ME) data during 1990-2011. Case inclusion criteria were developed by using heat-related International Classification of Diseases codes, cause-of-death nomenclature, and ME investigation narrative. We calculated sensitivity and predictive value positive (PVP) for heat-related mortality surveillance by using VS and ME data and performed a descriptive analysis. During the study period, 364 confirmed and probable heat-related deaths were identified when utilizing both data sets. ME reports had 87% sensitivity and 74% PVP; VS reports had 80% sensitivity and 52% PVP. Compared to Oklahoma's general population, decedents were disproportionately male (67% vs. 49%), aged ≥65 years (46% vs. 14%), and unmarried (78% vs. 47%). Higher rates of heat-related mortality were observed among Blacks. Of 95 decedents with available information, 91 (96%) did not use air conditioning. Linking ME and VS data sources together and using narrative description for case classification allows for improved case ascertainment and surveillance data quality. Males, Blacks, persons aged ≥65 years, unmarried persons, and those without air conditioning carry a disproportionate burden of the heat-related deaths in Oklahoma. Published by Elsevier Inc.

  15. Patients' Illness Perception as a Tool to Improve Individual Disease Management in Primary Cutaneous Lymphomas

    OpenAIRE

    Stefanie Porkert; Eva Lehner-Baumgartner; Julia Valencak; Robert Knobler; Elisabeth Riedl; Constanze Jonak

    2017-01-01

    The Revised Illness Perception Questionnaire (IPQ-R) has been shown to assess illness perception reproducibly in primary cutaneous T-cell lymphomas (CTCL). Illness perception reflects patients' individual concepts of understanding and interpretation of the disease, influencing illness behaviour and health-related quality of life (HRQOL). This study investigated the clinical relevance of the relationships between illness perception, illness behaviour, and HRQOL in CTCL and cutaneous B-cell lym...

  16. Stigmatization of Mentally Ill Patients through Media.

    Science.gov (United States)

    Babić, Dragan; Babić, Romana; Vasilj, Ivan; Avdibegović, Esmina

    2017-12-01

    The stigmatization of mentally ill patients has negative labelling, marginalization and exclusion of people simply because they have a mental illness. Stigma has negative consequences for the individual and his family, as well as for psychiatry as a profession and the entire community. Stigma weakens the mentally ill, reinforcing a sense of alienation, which has negative consequences on the course of the illness. The media can inform the public about the treatment of mentally ill patients by conveying correct information, who can then act positively towards improving the quality of treatment. Stigma and self-stigma create a feeling of low self-esteem and fear of rejection, due to which mentally ill people avoid the media and very rarely speak publicly about their illness. The realization of information rights is very delicate and it is reflected through two opposing but substantially equivalent human rights: 1. Right to information, 2. Right to privacy. Which of the two rights will get advantage depends on the circumstances of each case and journalism ethics. The relationship of psychiatry with the media and especially the media with psychiatry must be extremely correct and professional, based on facts, and not on the pursuit of media sensationalism. The media can significantly reduce the current level of stigmatization of the mentally ill by adequate and correct reports, and thereby facilitate their role in family and society. Lack of knowledge and understanding of mental illness contributes to stigmatization. Education of patients, their families and journalists is crucial if we want to better understand people with mental illness and reduce stigma.

  17. Heat-Related Mortality Projections for Cardiovascular and Respiratory Disease Under the Changing Climate in Beijing, China

    Science.gov (United States)

    Li, Tiantian; Ban, Jie; Horton, Radley M.; Bader, Daniel A.; Huang, Ganlin; Sun, Qinghua; Kinney, Patrick L.

    2015-01-01

    Because heat-related health effects tend to become more serious at higher temperatures, there is an urgent need to determine the mortality projection of specific heat-sensitive diseases to provide more detailed information regarding the variation of the sensitivity of such diseases. In this study, the specific mortality of cardiovascular and respiratory disease in Beijing was initially projected under five different global-scale General Circulation Models (GCMs) and two Representative Concentration Pathways scenarios (RCPs) in the 2020s, 2050s, and 2080s compared to the 1980s. Multi-model ensembles indicated cardiovascular mortality could increase by an average percentage of 18.4 percent, 47.8 percent, and 69.0 percent in the 2020s, 2050s, and 2080s under RCP 4.5, respectively, and by 16.6 percent, 73.8 percent and 134 percent in different decades respectively, under RCP 8.5 compared to the baseline range. The same increasing pattern was also observed in respiratory mortality. The heat-related deaths under the RCP 8.5 scenario were found to reach a higher number and to increase more rapidly during the 21st century compared to the RCP4.5 scenario, especially in the 2050s and the 2080s. The projection results show potential trends in cause-specific mortality in the context of climate change, and provide support for public health interventions tailored to specific climate-related future health risks.

  18. [Critical illness polyneuropathy and critical illness myopathy].

    Science.gov (United States)

    Grimm, A; Günther, A; Witte, O W; Axer, H

    2012-11-01

    Critical illness polyneuropathy (CIP) and critical illness myopathy (CIM) are frequent complications in critically ill patients and both are associated with sepsis, systemic inflammatory response syndrome (SIRS) and multiorgan failure. Major signs are muscle weakness and problems of weaning from the ventilator. Both CIP and CIM lead to elongated times of ventilation, elongated hospital stay, elongated times of rehabilitation and increased mortality. Electrophysiological measurements help to detect CIP and CIM early in the course of the disease. State of the art sepsis therapy is the major target to prevent the development of CIP and CIM. Although no specific therapy of CIP and CIM has been established in the past, the diagnosis generally improves the therapeutic management (weaning from the ventilator, early physiotherapy, etc.). This review provides an overview of clinical and diagnostic features of CIP and CIM and summarizes current pathophysiological and therapeutic concepts.

  19. Serious Illnesses and Breastfeeding

    Science.gov (United States)

    ... Text Size Email Print Share Serious Illnesses and Breastfeeding Page Content Article Body For some new mothers, concerns about breastfeeding revolve less around their babies’ physical condition than ...

  20. Temperature Observation Time and Type Influence Estimates of Heat-Related Mortality in Seven U.S. Cities.

    Science.gov (United States)

    Davis, Robert E; Hondula, David M; Patel, Anjali P

    2016-06-01

    Extreme heat is a leading weather-related cause of mortality in the United States, but little guidance is available regarding how temperature variable selection impacts heat-mortality relationships. We examined how the strength of the relationship between daily heat-related mortality and temperature varies as a function of temperature observation time, lag, and calculation method. Long time series of daily mortality counts and hourly temperature for seven U.S. cities with different climates were examined using a generalized additive model. The temperature effect was modeled separately for each hour of the day (with up to 3-day lags) along with different methods of calculating daily maximum, minimum, and mean temperature. We estimated the temperature effect on mortality for each variable by comparing the 99th versus 85th temperature percentiles, as determined from the annual time series. In three northern cities (Boston, MA; Philadelphia, PA; and Seattle, WA) that appeared to have the greatest sensitivity to heat, hourly estimates were consistent with a diurnal pattern in the heat-mortality response, with strongest associations for afternoon or maximum temperature at lag 0 (day of death) or afternoon and evening of lag 1 (day before death). In warmer, southern cities, stronger associations were found with morning temperatures, but overall the relationships were weaker. The strongest temperature-mortality relationships were associated with maximum temperature, although mean temperature results were comparable. There were systematic and substantial differences in the association between temperature and mortality based on the time and type of temperature observation. Because the strongest hourly temperature-mortality relationships were not always found at times typically associated with daily maximum temperatures, temperature variables should be selected independently for each study location. In general, heat-mortality was more closely coupled to afternoon and maximum

  1. Illness causal beliefs in Turkish immigrants.

    Science.gov (United States)

    Minas, Harry; Klimidis, Steven; Tuncer, Can

    2007-07-24

    types of causal beliefs are held in relation to somatic or mental illness, and a variety of apparently logically incompatible beliefs may be concurrently held. Illness causal beliefs are dynamic and are related to demographic, modernizing, and acculturative factors, and to the current presence of illness. Any assumption of uniformity of illness causal beliefs within a community, even one that is relatively culturally homogeneous, is likely to be misleading. A better understanding of the diversity, and determinants, of illness causal beliefs can be of value in improving our understanding of illness experience, the clinical process, and in developing more effective health services and population health strategies.

  2. Foodborne Germs and Illnesses

    Science.gov (United States)

    ... Español (Spanish) Recommend on Facebook Tweet Share Compartir What Causes Food Poisoning? Many different disease-causing germs can contaminate ... email address: Enter Email Address What’s this? Submit What's this? Submit Button ... of Foodborne Illness in the U.S. Food Safety is a CDC Winnable Battle Foodborne Illness ...

  3. Real-time appraisal of the spatially distributed heat related health risk and energy demand of cities

    Science.gov (United States)

    Keramitsoglou, Iphigenia; Kiranoudis, Chris T.; Sismanidis, Panagiotis

    2016-08-01

    The Urban Heat Island (UHI) is an adverse environmental effect of urbanization that increases the energy demand of cities, impacts the human health, and intensifies and prolongs heatwave events. To facilitate the study of UHIs the Institute for Astronomy, Astrophysics, Space Applications and Remote Sensing of the National Observatory of Athens (IAASARS/NOA) has developed an operational real-time system that exploits remote sensing image data from Meteosat Second Generation - Spinning Enhanced Visible and Infrared Imager (MSG-SEVIRI) and generates high spatiotemporal land surface temperature (LST) and 2 m air temperature (TA) time series. These datasets form the basis for the generation of higher value products and services related to energy demand and heat-related health issues. These products are the heatwave hazard (HZ); the HUMIDEX (i.e. an index that describes the temperature felt by an individual exposed to heat and humidity); and the cooling degrees (CD; i.e. a measure that reflects the energy needed to cool a building). The spatiotemporal characteristics of HZ, HUMIDEX and CD are unique (1 km/5 min) and enable the appraisal of the spatially distributed heat related health risk and energy demand of cities. In this paper, the real time generation of the high spatiotemporal HZ, HUMIDEX and CD products is discussed. In addition, a case study corresponding to Athens' September 2015 heatwave is presented so as to demonstrate their capabilities. The overall aim of the system is to provide high quality data to several different end users, such as health responders, and energy suppliers. The urban thermal monitoring web service is available at http://snf-652558.vm.okeanos.grnet.gr/treasure/portal/info.html.

  4. Teaching Teaching & Understanding Understanding

    DEFF Research Database (Denmark)

    2006-01-01

    "Teaching Teaching & Understanding Understanding" is a 19-minute award-winning short-film about teaching at university and higher-level educational institutions. It is based on the "Constructive Alignment" theory developed by Prof. John Biggs. The film delivers a foundation for understanding what...

  5. Homelessness and mental illness.

    Science.gov (United States)

    Scott, J

    1993-03-01

    In Great Britain 1-2 million people may be homeless. Most homeless people are men, but about 10-25% are women, of whom about half are accompanied by children. Significant mental illness is present in 30-50% of the homeless: functional psychoses predominate; acute distress and personality dysfunction are also prevalent. Co-morbidity of mental illness and substance abuse occurs in 20%, and physical morbidity rates exceed those of domiciled populations. The homeless mentally ill also have many social needs. Pathways to homelessness are complex; deinstitutionalization may be only one possible cause of the increase in the number of homeless people. There is much recent research estimating the extent of mental illness and the characteristics of selected subgroups of accessible homeless people. The evaluation of potential service solutions has received less attention. This review outlines the research, highlights current views on the definition and classification of homeless populations, and offers some guidelines on avenues which need to be explored.

  6. 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 ...

  7. Vaccines Stop Illness

    Science.gov (United States)

    ... page please turn JavaScript on. Feature: Diseases and Vaccinations Vaccines Stop Illness Past Issues / Spring 2015 Table ... if we take away the protection given by vaccination, more and more people will be infected and ...

  8. Giardia: Illness & Symptoms

    Science.gov (United States)

    ... Illness & Symptoms Recommend on Facebook Tweet Share Compartir Giardia trophozoites stained with trichrome. Credit: Waterborne Disease Prevention Branch, CDC Giardiasis is the most frequently diagnosed intestinal parasitic disease in the United States and among ...

  9. Cholera Illness and Symptoms

    Science.gov (United States)

    ... Search The CDC Cancel Submit Search The CDC Cholera - Vibrio cholerae infection Note: Javascript is disabled or ... message, please visit this page: About CDC.gov . Cholera General Information Illness & Symptoms Sources of Infection & Risk ...

  10. Towards More Comprehensive Projections of Urban Heat-Related Mortality: Estimates for New York City Under Multiple Population, Adaptation, and Climate Scenarios

    Science.gov (United States)

    Petkova, Elisaveta P.; Vink, Jan K.; Horton, Radley M.; Gasparrini, Antonio; Bader, Daniel A.; Francis, Joe D.; Kinney, Patrick L.

    2016-01-01

    High temperatures have substantial impacts on mortality and, with growing concerns about climate change, numerous studies have developed projections of future heat-related deaths around the world. Projections of temperature-related mortality are often limited by insufficient information necessary to formulate hypotheses about population sensitivity to high temperatures and future demographics. This study has derived projections of temperature-related mortality in New York City by taking into account future patterns of adaptation or demographic change, both of which can have profound influences on future health burdens. We adopt a novel approach to modeling heat adaptation by incorporating an analysis of the observed population response to heat in New York City over the course of eight decades. This approach projects heat-related mortality until the end of the 21st century based on observed trends in adaptation over a substantial portion of the 20th century. In addition, we incorporate a range of new scenarios for population change until the end of the 21st century. We then estimate future heat-related deaths in New York City by combining the changing temperature-mortality relationship and population scenarios with downscaled temperature projections from the 33 global climate models (GCMs) and two Representative Concentration Pathways (RCPs).The median number of projected annual heat-related deaths across the 33 GCMs varied greatly by RCP and adaptation and population change scenario, ranging from 167 to 3331 in the 2080s compared to 638 heat-related deaths annually between 2000 and 2006.These findings provide a more complete picture of the range of potential future heat-related mortality risks across the 21st century in New York, and highlight the importance of both demographic change and adaptation responses in modifying future risks.

  11. Illness perceptions in patients with fibromyalgia.

    Science.gov (United States)

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

    2009-01-01

    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 version (IPQ-R FM-Dlv) and to describe illness perceptions of participants with FM. 196 patients completed the IPQ-R FM-Dlv. Internal consistency, domain structure and inter domain correlations were calculated and compared to the IPQ-R English language version. Scores were compared with chronic fatigue syndrome (CFS), rheumatoid arthritis (RA), and coronary heart disease (CHD). Most psychometric properties were comparable to those of the original IPQ-R. Participants showed a lack of understanding of their illness, expected their FM to be chronic and to have a lot of negative consequences on functioning. In 17 out of 24 domains significant differences were found between FM and CFS, RA, and CHD patients. The IPQ-R FM-Dlv showed acceptable psychometric properties, although some aspects need closer examination. Illness perceptions of FM patients on the Dutch questionnaire were non-comparable to CFS, RA, and CHD patients on the English questionnaire. The IPQ-R FM-Dlv can be used to assess illness perceptions of Dutch FM patients.

  12. 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.

  13. The illness/non-illness model: hypnotherapy for physically ill patients.

    Science.gov (United States)

    Navon, Shaul

    2014-07-01

    This article proposes a focused, novel sub-set of the cognitive behavioral therapy approach to hypnotherapy for physically ill patients, based upon the illness/non-illness psychotherapeutic model for physically ill patients. The model is based on three logical rules used in differentiating illness from non-illness: duality, contradiction, and complementarity. The article discusses the use of hypnotic interventions to help physically ill and/or disabled patients distinguish between illness and non-illness in their psychotherapeutic themes and attitudes. Two case studies illustrate that patients in this special population group can be taught to learn the language of change and to use this language to overcome difficult situations. The model suggests a new clinical mode of treatment in which individuals who are physically ill and/or disabled are helped in coping with actual motifs and thoughts related to non-illness or non-disability.

  14. Labour participation of the chronically ill: a profile sketch.

    NARCIS (Netherlands)

    Baanders, A.N.; Rijken, P.M.; Peters, L.

    2002-01-01

    To improve our understanding of the problematic labour market position of people with a chronic disease, this paper describes the participation rates of several subgroups of the chronically ill in the Netherlands, as well as the aspects by which the working chronically ill differ from those who are

  15. Critical illness polyneuropathy and myopathy in pediatric intensive care: A review.

    Science.gov (United States)

    Williams, Stephen; Horrocks, Iain A; Ouvrier, Robert A; Gillis, Jonathan; Ryan, Monique M

    2007-01-01

    To review the medical literature on critical illness polyneuropathy and myopathy in childhood. Medline and EMBASE were searched using the following terms: critical illness (neuropathy, polyneuropathy, and myopathy), critical care (neuropathy, polyneuropathy, and myopathy), acute myopathy, acute necrotizing myopathy, children, and pediatric. The references listed in publications thus identified were also reviewed. All studies relating to pediatric critical illness polyneuropathy and myopathy were included. The adult literature was also reviewed as to the current understanding of critical illness polyneuropathy and myopathy. Critical illness polyneuropathy and critical illness myopathy are well recognized in adults, in whom they commonly cause generalized weakness and muscle wasting, with failure to wean from mechanical ventilation. Critical illness polyneuropathy and critical illness myopathy are reported in 32-100% of critically ill adult patients ventilated for >3 days. There is significant clinical and neurophysiologic overlap between the two conditions, such that the term critical illness polyneuropathy and myopathy (CIPNM) is often used. Critical illness polyneuropathy and critical illness myopathy have only occasionally been reported in childhood, and little is known of their prevalence or clinical significance in this population. This article summarizes the pediatric literature on critical illness polyneuropathy and critical illness myopathy and highlights areas for future research in critically ill children. Critical illness polyneuropathy and myopathy may cause significant morbidity in critically ill children. These conditions seem to be clinically and electrophysiologically similar in children and adults, but prospective studies of these entities are required to better characterize their frequency, natural history, and clinical significance in pediatric practice.

  16. Beethoven's creative illness.

    Science.gov (United States)

    Bower, H

    1989-03-01

    One phase of Beethoven's life, between his 45th and 50th year, characterized by very low creativity and overwhelming stress situations, is subjected to a psychiatric interpretation. The historical background is briefly sketched and 5 precipitating stress factors are outlined. The symptoms of his illness are described, using Beethoven's letters as source material. A brief discussion of Beethoven's musical style prior to and after his illness is based on quotations from three eminent musical scholars. A resume of Beethoven's physical and psychological disorders during his life are given and the conclusion is reached that between 1815 and 1820, Beethoven experienced a creative illness which was psychotic in type, ended in recovery and radically changed his musical creativity.

  17. On being Credibly Ill

    DEFF Research Database (Denmark)

    Mik-Meyer, Nanna

    2011-01-01

    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...... of individuals that are defined by their lack of a bio-medical diagnosis. Their ‘lack’ of identity accentuates how gender and class become central in the categorisation practices, constructing the ill person as either bio-medically sick or as a person who may be suffering but only from diffuse psychological...... 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...

  18. [Mental illness and media].

    Science.gov (United States)

    Magli, Erica; Buizza, Chiara; Pioli, Rosaria

    2004-06-01

    Many knowledges on the mental disease that the community possesses are turning out of information disclosed from the media. It's common in the press to connect actions of violence and murders to the mental diseases. For this reason, the reader is induced to infer that murders and other violent actions are more frequent in people who have suffered from mentally ill, than in the general population. The mystifying impression provided by media accrues from the fact that these reports are rarely compensated from positive reports. Objective of the present study is to characterize the type of information concerning mental illness diffused from the local daily paper "Giornale di Brescia" in the year 2001. The results show that many articles connote negatively the mental disease. The journalistic sensationalism, denounced facing the speech of the prejudgment in the comparisons of the mentally ill people, seems to still remain, in the considered year of publication, one unchanging tendency.

  19. Social participation and heat-related behavior in older adults during heat waves and on other days.

    Science.gov (United States)

    Lindemann, Ulrich; Skelton, Dawn A; Oksa, Juha; Beyer, Nina; Rapp, Kilian; Becker, Clemens; Klenk, Jochen

    2017-11-06

    High indoor temperatures require behavioral adaptation, especially among vulnerable older adults. There are uncertainties as to the degree to which people adapt to these challenging conditions. The aim of this study was to describe the degree of adaptation of social participation and other heat-related behavior with respect to higher indoor temperatures. In this study 81 residents from 10 sheltered living facilities (84% women, mean age 80.9 years) were visited every 4 weeks from May to October 2015 and additionally during 2 heat waves in July and August 2015. The indoor temperature, drinking and clothing and social participation were documented. Baseline documentation of gait speed and residential area were used to create subgroups of people with high or low gait speed and with facility location in a garden city/suburb or city/city center. Social participation and clothing decreased with -4.53 in the World Health Organization participation score units (95% confidence interval CI -5.32; -3.74) and -0.41 for clothing units (95% CI -0.46; -0.37) and volume of drinking increased (0.65 l/day; 95% CI 0.52; 0.77) per increase of indoor temperature by 10 °C. The negative association between indoor temperature and social life participation was stronger if functional capacity was low or if the facility was located in the city/city center. Not all older adults displayed temperature-related adaptive behavior. For older adults the negative association between indoor temperature and social life participation was stronger in the city/city center or if their functional capacity was low. Frequent personal contact and motivation of those who are frail might be helpful to support their adaptive behavior of drinking and clothing during heat stress.

  20. Treatment of Children with Mental Illness: Frequently Asked Questions about the Treatment of Mental Illness in Children

    Science.gov (United States)

    National Institute of Mental Health (NIMH), 2009

    2009-01-01

    Research shows that half of all lifetime cases of mental illness begin by age 14. Scientists are discovering that changes in the body leading to mental illness may start much earlier, before any symptoms appear. Through greater understanding of when and how fast specific areas of children's brains develop, we are learning more about the early…

  1. Imagery, colour and illness: a review.

    Science.gov (United States)

    Carruthers, Helen R

    2011-09-01

    This paper reviews research on the role of colour and imagery in relation to illness and examines how this might improve communication between the sufferer and those treating or caring for them. It describes a method by which colour can be related to situations such as an individual's mood and how this might be used to predict response to treatment. Furthermore, it provides evidence that documenting the imagery of an illness might give insight into the patients' fears and concerns about their condition as well as helping non-sufferers to understand what they are going through.

  2. Major Mental Illness in Those Who Sexually Abuse.

    Science.gov (United States)

    Moulden, Heather M; Marshall, Liam E

    2017-11-09

    There is evidence showing an increasing prevalence of mental illness in those in conflict with the law. However, there are many factors affecting the detection, treatment, and management of criminals who are mentally ill. Sex offenders with major mental illness present many challenges to those providing treatment and management services. For example, it is important to consider whether sexually offensive behavior is the cause of criminal behavior or whether it is reflective of an antisocial orientation. Recent evidence suggests it may help better understand and inform risk assessment and management. This paper will review the literature on mental illness among sexual offenders, present a typology to aid in the assessment, treatment, and management of sexual offender with mental illness, and highlight important considerations when providing treatment to sexual offenders with mental illness.

  3. 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.

  4. Physical and mental illness.

    NARCIS (Netherlands)

    Schellevis, F.G.

    2004-01-01

    This chapter is concerned with the profile of symptoms, illnesses, and diseases (further referred to as 'morbidity') presented to primary care doctors. It is important to acknowledge that morbidity presented to primary care doctors is only a small part of all morbidity perceived by people in the

  5. Conceptualizing Health and Illness

    Czech Academy of Sciences Publication Activity Database

    Kouba, Petr

    2008-01-01

    Roč. 39, č. 1 (2008), s. 59-80 ISSN 0047-2662 R&D Projects: GA AV ČR(CZ) IAA900090603; GA ČR(CZ) GP401/07/P293 Institutional research plan: CEZ:AV0Z90090514 Keywords : health * illness * existence * finitude Subject RIV: AA - Philosophy ; Religion

  6. Feelings of children when witnessing parents' illness

    Directory of Open Access Journals (Sweden)

    Julia Wakiuchi

    2016-12-01

    Full Text Available This study aimed to learn the experiences of children who witness their parents' illness due to cancer. This is a descriptive, qualitative study, with six children between 10 and 12 years of age, children of cancer patients assisted by a support institution. The data were collected from July to August 2015, based on the guiding question:    "How do you feel about your father/mother's illness?" From the analysis, two categories emerged: Recognizing the disease and the possibility of the parents 'death and, Growing as a child and living as an adult: the repercussions of parents with cancer in their children's lives, which reveal that children understand cancer and the possibility of death of their parents, being also affected by the disease. By experiencing the fears and repercussions of cancer, children need assistance by the family and health team during their parents' illness.

  7. Heat illness in athletes: the dangerous combination of heat, humidity and exercise.

    Science.gov (United States)

    Coris, Eric E; Ramirez, Arnold M; Van Durme, Daniel J

    2004-01-01

    In 1980, 1700 people died during a prolonged heat wave in a region under-prepared for heat illness prevention. Dramatically underreported, heat-related pathology contributes to significant morbidity as well as occasional mortality in athletic, elderly, paediatric and disabled populations. Among US high school athletes, heat illness is the third leading cause of death. Significant risk factors for heat illness include dehydration, hot and humid climate, obesity, low physical fitness, lack of acclimatisation, previous history of heat stroke, sleep deprivation, medications (especially diuretics or antidepressants), sweat gland dysfunction, and upper respiratory or gastrointestinal illness. Many of these risk factors can be addressed with education and awareness of patients at risk. Dehydration, with fluid loss occasionally as high as 6-10% of bodyweight, appears to be one of the most common risk factors for heat illness in patients exercising in the heat. Core body temperature has been shown to rise an additional 0.15-0.2 degrees C for every 1% of bodyweight lost to dehydration during exercise. Identifying athletes at risk, limiting environmental exposure, and monitoring closely for signs and symptoms are all important components of preventing heat illness. However, monitoring hydration status and early intervention may be the most important factors in preventing severe heat illness.

  8. Perceived illness intrusion among patients on hemodialysis

    International Nuclear Information System (INIS)

    Bapat, Usha; Kedlaya, Prashanth G; Gokulnath

    2009-01-01

    Dialysis therapy is extremely stressful as it interferes with all spheres of daily activities of the patients. This study is aimed at understanding the perceived illness intrusion among patients 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 sociodemographics and a 13 item illness intrusion checklist covering the various aspects of life was carried out. The study patients were asked to rate the illness intrusion and the extent. The data were analyzed 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 families. 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 relationship 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). (author)

  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. Illness perceptions in mothers with postpartum depression.

    Science.gov (United States)

    Baines, Tineke; Wittkowski, Anja; Wieck, Angelika

    2013-07-01

    to examine perceptions of mothers experiencing postpartum depression utilising the revised Illness Perception Questionnaire (IPQ-R), to explore relationships between illness perceptions, depression severity and perceptions of maternal bonding, and to assess the psychometric properties within this population. longitudinal correlational design. North West of England, UK. 43 mothers, who screened positive for postpartum depression (mean age 29.36 years) with babies whose mean age was 4 months. participants were recruited through health services. Participants completed the IPQ-R and measures of depression severity and maternal bonding. Illness perceptions and depression severity were assessed at 2 time points, 4 weeks apart. mothers endorsed IPQ-R subscales of cyclical timeline, consequences, emotional representations, treatment and personal control. IPQ-R subscale scores and depression severity correlated significantly at Time 1. Initial IPQ-R subscale scores, however, were not associated with and accounted for little variation in depression severity at Time 2. IPQ-R identity and consequence subscales positively correlated with perceived bonding difficulties. the IPQ-R was shown to be a reliable measure of illness perceptions in mothers experiencing postpartum depression. The maternal illness perceptions endorsed in this study have implications for clinical practice. Interventions aimed at developing a more coherent understanding of depression may enhance beliefs of personal control over symptoms, reduce the number of perceived symptoms and associated emotional distress. Educating mothers regarding the benefits of interventions may be important in increasing the number of mothers accessing support for postpartum depression. Copyright © 2012 Elsevier Ltd. All rights reserved.

  11. Illness behavior after severe brain injury: two case reports.

    Science.gov (United States)

    Giles, G M

    1994-03-01

    This paper introduces the concept of illness behavior to occupational therapists working with patients with acquired neurological impairments. The paper presents two case reports of patents with unequivocal severe brain trauma who demonstrated help-seeking and dependency behaviors that could not be accounted for by brain damage alone. Incorporating the illness behavior concept in an understanding of the patients' behavior difficulties assisted in the development of an appropriate treatment plan and interventions. This paper emphasizes that severe neurological sequelae and illness behavior may coexist in the same patient. Without an understanding of the personality and environmental factors that may influence recovery, rehabilitative efforts may be less than optimally effective.

  12. 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...... of individuals that are defined by their lack of a bio-medical diagnosis. Their ‘lack’ of identity accentuates how gender and class become central in the categorisation practices, constructing the ill person as either bio-medically sick or as a person who may be suffering but only from diffuse psychological...... are described by the welfare officers as tired and exhausted or truly stressed after a long working life....

  13. ILL. Annual report 1976

    International Nuclear Information System (INIS)

    In 1976 the three major functions of ILL continued to be generally satisfactorily performed (provision of neutron beams at the high flux reactor, development of advanced instrumentation, establishment of a forum). The implementation of the programme of measurements approved by the Scientific Council was again given absolute priority. This report gives a survey of the state of the experimental facilities at ILL and the scientific work carried out in 1976, and of the main technical and administrative activities of the Institute Chapters correspond to the various colleges (theory, fundamental and nuclear physics, excitations, structures liquid, gases and amorphous materials, impurities, structural biology and chemistry), reactor operation and instrument support services, computing services... A second volume of this report contains more detailed descriptions of the individual experiments

  14. Mental illness: psychiatry's phlogiston.

    Science.gov (United States)

    Szasz, T

    2001-10-01

    In physics, we use the same laws to explain why airplanes fly, and why they crash. In psychiatry, we use one set of laws to explain sane behaviour, which we attribute to reasons (choices), and another set of laws to explain insane behaviour, which we attribute to causes (diseases). God, man's idea of moral perfection, judges human deeds without distinguishing between sane persons responsible for their behaviour and insane persons deserving to be excused for their evil deeds. It is hubris to pretend that the insanity defence is compassionate, just, or scientific. Mental illness is to psychiatry as phlogiston was to chemistry. Establishing chemistry as a science of the nature of matter required the recognition of the non-existence of phlogiston. Establishing psychiatry as a science of the nature of human behaviour requires the recognition of the non-existence of mental illness.

  15. ILL. Annual report 1979. Annex

    International Nuclear Information System (INIS)

    1980-01-01

    This second volume, entitled 'Annex to the Annual Report' deals in more detail with the scientific work of the I.L.L. The scientific activity of theoreticians at the I.L.L. for 1979 is described. The experimental reports giving details on the experiments performed at the I.L.L. up to October 1, 1979 have been compiled. They are published here under their proposal number within the classification cheme in use at the I.L.L

  16. ILL Annual Report 1974

    International Nuclear Information System (INIS)

    1974-01-01

    This annual report provides a general view of the activities of the different sections of the ILL. In 1974, twenty-two different neutron spectrometers with different characteristics were available on a regular basis. Moreover, a number of special neutron sources were employed for on-line experiments. The major effort was devoted to an increase in experimental systems and to the development of new measurement techniques [fr

  17. Extreme heat and occupational heat illnesses in South Australia, 2001-2010.

    Science.gov (United States)

    Xiang, Jianjun; Hansen, Alana; Pisaniello, Dino; Bi, Peng

    2015-08-01

    This study aims to examine the epidemiological characteristics of occupational heat illnesses in South Australia, to quantify the association between ambient temperature and occupational heat illnesses, and to investigate the impact of heatwaves on occupational heat illnesses. Workers' compensation claims data and weather data were obtained from SafeWork South Australia and the Bureau of Meteorology, respectively, for 2001-2010. Time series analysis with generalised estimation equation models and linear spline functions was used to quantify the temperature-heat illness claims association. A case-crossover design was applied to investigate the impact of heatwaves on occupational heat illnesses. There were 306 heat illness claims during the study period, with an incidence rate of 4.5 per 100,000 employees. The overall risk of occupational heat illness was positively associated with maximum temperature (Tmax), especially when Tmax was over the threshold of 35.5 °C. One degree increase of Tmax was associated with a 12.7% (incidence rate ratio 1.127, 95% CI 1.067 to 1.190) increase of occupational heat illness claims. During heatwave periods, the risk of occupational heat illness was about 4-7 times higher than that of non-heatwave periods. There is a need to develop or refine current heat-related regulations and guidelines to minimise the risk of occupational heat illnesses in vulnerable workers in a warming climate. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  18. 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.

  19. Illness perception in Chinese adults with epilepsy.

    Science.gov (United States)

    Ji, Haixia; Zhang, Lei; Li, Lunlan; Gong, Guiping; Cao, Zhaolun; Zhang, Jianfeng; Zhou, Nong; Wang, Yu; Tu, Houmian; Wang, Kai

    2016-12-01

    Epilepsy is among the most common neurological disorders worldwide. Understanding the patient's subjective experience plays an important role in the treatment and rehabilitation of the patient. However, few studies are concerned about the illness perception of Chinese adults with epilepsy. 117 Chinese adults with epilepsy and 87 Chinese adults with chronic liver disease completed the Chinese version of the Revised Illness Perception Questionnaire (CIPQ-R). The Chinese epilepsy patients also completed the Social Support Rating Scale (SSRS) and Simplified Coping Style Questionnaire (SCSQ). A comparison about CIPQ-R score between the epilepsy group and chronic liver group was conducted using the independent sample t test. Partial correlation coefficients were calculated among the eight subscales of the CIPQ-R and its associated factors. Results for the CIPQ-R indicated that both the epilepsy patients and the chronic liver disease patients had a moderate belief in their personal control and treatment control over their disorder. Consistent with our hypothesis, patients with epilepsy and those with chronic liver disease perceived their respective disease similarly in terms of timeline and illness coherence. However, epilepsy patients had a higher negative emotional representations level than that we expected when compared to those of the patients suffering from chronic liver disease. Partial correlation analysis in Chinese epilepsy patients showed that the timeline acute/chronic dimension and emotional representations dimension were closely related to the other dimensions of illness perception. Moreover, the illness perception of the patients was significantly associated with social support, coping style, duration of epilepsy, seizure frequency, and the number of antiepileptic drugs. Chinese patients with epilepsy had limited understanding of the illness, and poor belief in personal control and treatment control. They had a negative emotional response to their illness

  20. Illness representations, coping, and illness outcomes in people with cancer: a systematic review and meta-analysis.

    Science.gov (United States)

    Richardson, Emma M; Schüz, Natalie; Sanderson, Kristy; Scott, Jennifer L; Schüz, Benjamin

    2017-06-01

    Cancer is associated with negative health and emotional outcomes in those affected by it, suggesting the need to better understand the psychosocial determinants of illness outcomes and coping. The common sense model is the leading psychological model of self-regulation in the face of illness and assumes that subjective illness representations explain how people attempt to cope with illness. This systematic review and meta-analysis examines the associations of the common sense model's illness representation dimensions with health and coping outcomes in people with cancer. A systematic literature search located 54 studies fulfilling the inclusion criteria, with 38 providing sufficient data for meta-analysis. A narrative review of the remaining studies was also conducted. Random-effects models revealed small to moderate effect sizes (Fisher Z) for the relations between illness representations and coping behaviors (in particular between control perceptions, problem-focused coping, and cognitive reappraisal) and moderate to large effect sizes between illness representations and illness outcomes (in particular between identity, consequences, emotional representations, and psychological distress). The narrative review of studies with insufficient data provided similar results. The results indicate how illness representations relate to illness outcomes in people with cancer. However, more high-quality studies are needed to examine causal effects of illness representations on coping and outcomes. High heterogeneity indicates potential moderators of the relationships between illness representations and health and coping outcomes, including diagnostic, prognostic, and treatment-related variables. This review can inform the design of interventions to improve coping strategies and mental health outcomes in people with cancer. Copyright © 2016 John Wiley & Sons, Ltd.

  1. Nonthyroidal illness syndrome: evaluation of thyroid function in sick patients.

    Science.gov (United States)

    Langton, Joanne E; Brent, Gregory A

    2002-03-01

    Altered thyroid function tests as a consequence of illness have been recognized for many years, yet the cause and clinical implications remains uncertain. The routine testing of thyroid function in hospitalized patients should be discouraged, as the results are less predictive of primary thyroid disease than in ambulatory patients. Clinicians should be aware of the methods used for thyroid function testing, as the effect of illness on thyroid function varies among the different tests. The most commonly used free T4 assays likely are influenced significantly by nonthyroidal illness. Advances in understanding the basic mechanisms of thyroid hormone metabolism and thyroid hormone action have given insights into the changes in thyroid function tests as a consequence of nonthyroidal illness. In the future, thyroid hormone receptor isoform-specific agonists and antagonists may allow for more specific treatment of select patients with nonthyroidal illness syndrome.

  2. Understanding Gulf War Illness: An Integrative Modeling Approach

    Science.gov (United States)

    2015-10-01

    research assistant Ms. Mariam Viquar, Doctor of Osteopathic Medicine (DOM) class of 2016, to continue genomic analysis of available human data under...Translational Medicine Approach to GWI: From Cells to Therapy.”  Also to promote and forward the momentum of the field, this year we have published 2... veterinarian has decided no more animals may be exposed to DFP until many palliative care studies have been conducted to see if any care conditions

  3. Understanding Gulf War Illness: An Integrative Modeling Approach

    Science.gov (United States)

    2016-10-01

    prepared with Dr. Craddock and other members of the CSB. (Task 4; Subtask1) c) Brainstormed with the Miller and O’Callaghan teams to design animal...for 2-day brainstorming session to review current candidate drug targets and develop methodological approach to computer- based drug screening (Sep. 24...committee, Chemical Hygiene and Biosafety. Important issues are related to DFP purchase, storage, dilution, exposure (injection). (Task 2; Subtask1

  4. Decompression illness - critical review

    Directory of Open Access Journals (Sweden)

    C S Mohanty

    2015-01-01

    Full Text Available Decompression illness is caused by intravascular or extravascular bubbles that are formed as a result of reduction in environmental pressure (decompression. The term covers both arterial gas embolism, in which alveolar gas or venous gas emboli (via cardiac shunts or via pulmonary vessels are introduced into the arterial circulation, and decompression sickness, which is caused by in-situ bubble formation from dissolved inert gas. Both syndromes can occur in divers, compressed air workers, aviators, and astronauts, but arterial gas embolism also arises from iatrogenic causes unrelated to decompression. Risk of decompression illness is affected by immersion, exercise, and heat or cold. Manifestations range from itching and minor pain to neurological symptoms, cardiac collapse, and death. First-aid treatment is 1 0 0 % oxygen and definitive treatment is recompression to increased pressure, breathing 1 0 0 % oxygen. Adjunctive treatment, including fluid administration and prophylaxis against venous thromboembolism in paralysed patients, is also recommended Treatment is, in most cases, effective although residual deficits can remain in serious cases, even after several recompressions.

  5. 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

  6. Understanding the suffering of a patient with an illness: signs, context and strategies Comprendiendo el padecimiento humano ante la enfermedad: manifestaciones, contexto y estrategias Compreendendo o sofrimento humano frente à doença: manifestações, contexto e estratégias

    Directory of Open Access Journals (Sweden)

    César Hueso Montoro

    2012-06-01

    Full Text Available The aim of this study is to understand the suffering of a patient with an illness, by using a secondary research method, that is, a qualitative meta-study. The primary data source of the meta-study includes "biographical reports". This project is based on a case study, in which the first-hand experiences of a patient with an illness were collected. The findings of the reports were compiled using the Archivos de la Memoria collection of the Index Foundation (Granada, Spain and journals specialized in editing these materials. A selection of 20 biographical reports was targeted. The results of the meta-study show that suffering is a multidimensional process within a framework of ambiguous feelings. The suffering involves family and social network participation. Patients develop a range of strategies to overcome the illness. One of the effects is the fear of illness relapse or worsening.El propósito de este trabajo es comprender la experiencia del padecimiento ante la enfermedad mediante la utilización de un método de investigación secundaria, un meta estudio cualitativo. La fuente de datos primarios ha sido el relato biográfico, un diseño basado en el estudio de caso que recoge la experiencia en primera persona, en este caso, ante la enfermedad; la localización de relatos se ha hecho a través del fondo Archivos de la Memoria de la Fundación Index y de revistas especializadas en la edición de estos materiales. Se seleccionaron 20 relatos biográficos. Los resultados del meta estudio muestran que el padecimiento es un proceso multidimensional, caracterizado por la ambigüedad de sentimientos. Es un fenómeno que comparte la familia y la red social. Las personas enfermas desarrollan diferentes estrategias de afrontamiento y es manifiesto el miedo a la recaída o el empeoramiento.O objetivo deste estudo foi compreender a experiência do sofrimento frente à doença, utilizando um método de pesquisa secundário, metaestudo qualitativo. A

  7. Illness perceptions amongst individuals with dental caries.

    Science.gov (United States)

    Mafla, A C; Villalobos-Galvis, F H; Heft, M W

    2018-03-01

    To assess individuals' perception of dental caries, in order to explain how illness representations might influence their coping with the disease. Cross-sectional questionnaire study. 520 consecutive patients (aged ≥18 years) of the General Dentistry Clinic at Universidad Cooperativa de Colombia, Pasto, Colombia who had experienced dental caries. Illness perception of dental caries was assessed using the Illness Perception Questionnaire Revised (IPQ-R). The most frequent self-reported symptoms associated with dental caries were "toothache" (56.2%), "tooth sensitivity" (53.8%) and "mild to sharp pain when eating or drinking" (51.2%). The dimensions of illness perception were related to socio-economic status (SES). Symptoms of "loose or separating teeth" and "pus in your tooth" were associated with dental caries by low SES participants, while "bleeding while brushing, flossing or eating hard food" and "mild to sharp pain when eating or drinking something sweet, hot or cold" were related more to higher SES. Perceptions of caries were related to socioeconomic status. Interventions to promote health literacy in order to improve the capacity to obtain, process and understand basic oral health information could increase an early detection of caries. Copyright© 2018 Dennis Barber Ltd.

  8. Illness Identity in Adults with a Chronic Illness.

    Science.gov (United States)

    Oris, Leen; Luyckx, Koen; Rassart, Jessica; Goubert, Liesbet; Goossens, Eva; Apers, Silke; Arat, Seher; Vandenberghe, Joris; Westhovens, René; Moons, Philip

    2018-02-21

    The present study examines the concept of illness identity, the degree to which a chronic illness is integrated into one's identity, in adults with a chronic illness by validating a new self-report questionnaire, the Illness Identity Questionnaire (IIQ). Self-report questionnaires on illness identity, psychological, and physical functioning were assessed in two samples: adults with congenital heart disease (22-78 year old; n = 276) and with multisystem connective tissue disorders (systemic lupus erythematosus or systemic sclerosis; 17-81 year old; n = 241). The IIQ could differentiate four illness identity states (i.e., engulfment, rejection, acceptance, and enrichment) in both samples, based on exploratory and confirmatory factor analysis. All four subscales proved to be reliable. Rejection and engulfment were related to maladaptive psychological and physical functioning, whereas acceptance and enrichment were related to adaptive psychological and physical functioning. The present findings underscore the importance of the concept of illness identity. The IIQ, a self-report questionnaire, is introduced to measure four different illness identity states in adults with a chronic illness.

  9. Concepts of Illness Among the Swahili of Lamu, Kenya.

    Science.gov (United States)

    Gearhart, Rebecca; Abdulrehman, Munib Said

    2014-07-01

    The Swahili of Lamu, Kenya, understand illness as the result of a spiritual imbalance caused by personal transgression or an attack by harmful forces directed by an envious person. Another underlying component of the Swahili concept of illness is that each person's physical body operates in conjunction with personal attributes that are fixed at birth and determine moral character, behavior, and predisposition to ailments. When physical symptoms occur, the Swahili focus on identifying the human or supernatural entity that caused the illness in consultation with a range of healers who specialize in a variety of curing strategies. Two case studies illustrate how culturally congruent nursing care can be achieved when health care providers understand the Swahili framework of diagnosing and treating illness. © The Author(s) 2013.

  10. Sleep quality in patients with chronic illness.

    Science.gov (United States)

    Kemple, Mary; O'Toole, Sinead; O'Toole, Conor

    2016-11-01

    To explore sleep quality in patients with chronic illness in primary care. Many people suffer from chronic illness with the numbers increasing. One common issue arises from problems that people have with their quality of sleep: a largely under-researched topic. This study exploring poor quality sleep allowed patients to describe their daily struggles with poor sleep in their own lives. This allowed the development of a deeper understanding of what it means to sleep poorly and find out how participants cope with not sleeping well. A qualitative approach enabling a deep exploration of patient's experiences of sleep quality was used. Interviews were conducted with a purposive sample of nine participants from a primary care clinic. Analysis utilised an interpretative approach. Data analysed produced four recurrent themes that were grouped into two categories. First, themes that identified the recognition by participants that 'something was wrong' were abrupt beginning and impact on their life. Second, themes that identified that the participants considered there was 'nothing wrong' were I am fine and I just carry on. Data revealed that poor quality sleep can have a profound effect on quality of life. Participants lived without good quality sleep for years. They had come to accept two seemingly irreconcilable ideas that not being able to sleep is an enduring problem with a distinct starting point, and paradoxically, this is not a problem that deserves much professional attention. Important original data were generated on the impact of poor quality sleep indicating that chronically disturbed sleep can increase the disease burden on patients with chronic illness. The results of this study suggest healthcare professionals need to understand how sleep quality issues impact on patient's experience of chronic illness. Data from this study will help nurses and other health professionals to deepen their understanding of the profound impact of poor quality sleep on patients with

  11. A review of the economic impact of mental illness.

    Science.gov (United States)

    Doran, Christopher M; Kinchin, Irina

    2017-11-13

    Objective To examine the impact and cost associated with mental illness. Methods A rapid review of the literature from Australia, New Zealand, UK and Canada was undertaken. The review included literature pertaining to the cost-of-illness and impact of mental illness as well as any modelling studies. Included studies were categorised according to impact on education, labour force engagement, earlier retirement or welfare dependency. The well-accepted Drummond 10-point economic appraisal checklist was used to assess the quality of the studies. Results A total of 45 methodologically diverse studies were included. The studies highlight the significant burden mental illness places on all facets of society, including individuals, families, workplaces and the wider economy. Mental illness results in a greater chance of leaving school early, a lower probability of gaining full-time employment and a reduced quality of life. Research from Canada suggests that the total economic costs associated with mental illness will increase six-fold over the next 30 years with costs likely to exceed A$2.8 trillion (based on 2015 Australian dollars). Conclusions Mental illness is associated with a high economic burden. Further research is required to develop a better understanding of the trajectory and burden of mental illness so that resources can be directed towards cost-effective interventions. What is known about the topic? Although mental illness continues to be one of the leading contributors to the burden of disease, there is limited information on the economic impact that mental illness imposes on individuals, families, workplaces and the wider economy. What does this paper add? This review provides a summary of the economic impact and cost of mental illness. The included literature highlights the significant burden mental illness places on individuals, families, workplaces, society and the economy in general. The review identified several areas for improvement. For example, only

  12. Constructing mental illness as dangerous: a pilot study.

    Science.gov (United States)

    Wilson, C; Nairn, R; Coverdale, J; Panapa, A

    1999-04-01

    There is a dearth of studies examining how dangerousness is constructed in media depictions of mentally ill individuals who are frequently portrayed as acting violently. The aim of the present study was to identify the contribution of diverse technical, semiotic and discursive resources utilised in portraying a character with a mental illness in a prime-time drama as dangerous. Discourse analytic techniques, involving systematic, repeated, critical viewings, were applied to a single program drawn from a sample of prime-time television drama episodes touching on mental illness. Nine devices (appearance, music and sound effects, lighting, language, intercutting, jump-cutting, point of view shots, horror conventions and intertextuality) were identified as contributing to the signified dangerousness of person receiving care in the community for a mental illness. These techniques combine in signifying mental illness and a person suffering from it as dangerous. The findings suggest that mental health professionals working to reduce the stigma of mental illness need to have a reasonably sophisticated understanding of the practices and priorities of television production if they are to collaborate effectively with producers to create dramas that convey more human and sympathetic understandings of mental illness or to combat the negative effects of such portrayals.

  13. Responding to the needs of the homeless mentally ill.

    Science.gov (United States)

    Frazier, S H

    1985-01-01

    The homeless mentally ill represent a pivotal and urgent challenge to the mental health field in the 1980s. Those homeless who have extended histories of psychiatric hospitalization stand as harsh reminders of the failures of deinstitutionalization, while young mentally ill homeless adults who never have been treated as inpatients testify to the gaps and unrealized promises of community-based care under deinstitutionalization. Homelessness and mental illness are social and clinical problems, respectively, distinct in some ways but intertwined in others. Some of the factors that contribute to homelessness--such as economic deprivations, a dearth of low-cost housing, discontinuities in social service systems, and radical changes in the composition of American families--are felt particularly keenly by many persons who are mentally ill. And symptoms of mental disorders, in turn, frequently impede an individual's capacities to cope with those, as well as other, stressors. Developing appropriate and effective responses to the needs of homeless people who are mentally ill requires precise definition and identification of the target population, innovations in the mental health service system, encouragement of those who staff it to work with homeless mentally ill patients, and public education. Ultimately, however, fundamental answers will be found in an improved understanding of severe mental illness, enhanced treatment capacities, and greater attention to the rehabilitative needs of mentally ill persons.

  14. Parent and child asthma illness representations: a systematic review.

    Science.gov (United States)

    Sonney, Jennifer T; Gerald, Lynn B; Insel, Kathleen C

    2016-06-01

    The purpose of this article is to synthesize the current literature on parent and child asthma illness representations and their consequent impact on parent-child asthma shared management. This systematic review was conducted in concordance with the PRISMA statement. An electronic search of five computerized databases (PubMed, PsycINFO, CINAHL, Cochrane, and EMBASE) was conducted using the following key words: asthma, illness representation, and child. Due to the limited number of articles identified, the search was broadened to include illness perceptions as well. Studies were included if they were specific to asthma and included parent and/or child asthma illness representations or perception, were published after 2000, and available in English. Fifteen articles were selected for inclusion. All of the articles are descriptive studies that used cross-sectional designs. Seven of the studies used parent and child participants, eight used parents only, and none used only child participants. None of the selected studies describe child asthma illness representations, and only three describe parental asthma illness representations. Domains of illness representations, including symptoms, timeline, consequences, cause, and controllability were described in the remaining articles. Symptoms and controllability appear to have the most influence on parental asthma management practices. Parents prefer symptomatic or intermittent asthma management and frequently cite concerns regarding daily controller medication use. Parents also primarily rely on their own objective symptom observations rather than the child's report of symptoms. Asthma illness representations are an important area of future study to better understand parent-child shared asthma management.

  15. Chronic illness in the workplace: stigma, identity threat and strain.

    Science.gov (United States)

    McGonagle, Alyssa K; Barnes-Farrell, Janet L

    2014-10-01

    Chronic illness affects a large and growing number of workers in the United States and globally. Stigmatization (devaluation) at work based on chronic illness may be stressful for individuals and therefore may lead to negative psychological consequences (i.e. strains). In order to better understand stressful experiences of stigma for workers with chronic illnesses, a model of stigma-related identity threat (perceptions that one is at risk of being treated negatively at work because of chronic illness) was tested on a sample of 203 working adults with chronic illnesses. The following variables related to workers' perceptions of chronic illness-related identity threat: workers' boundary flexibility (flexibility in managing their work and life), their meta-perceptions of devaluation (perceptions of others' devaluation of them based on illness) and their job self-efficacy (feelings of confidence related to performing their job). In turn, perceptions of identity threat related to both feelings of psychological strain and (lower levels of) perceived work ability. Surprisingly, neither stigma centrality (how fundamental illness is to one's identity) nor supervisor support related to workers' identity threat perceptions. Copyright © 2013 John Wiley & Sons, Ltd.

  16. 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.

  17. Thyroid function during critical illness.

    Science.gov (United States)

    Economidou, Foteini; Douka, Evangelia; Tzanela, Marinella; Nanas, Serafeim; Kotanidou, Anastasia

    2011-01-01

    The metabolic support of the critically ill patient is a relatively new target of active research and little is as yet known about the effects of critical illness on metabolism. The nonthyroidal illness syndrome, also known as the low T3 syndrome or euthyroid sick syndrome, describes a condition characterized by abnormal thyroid function tests encountered in patients with acute or chronic systemic illnesses. The laboratory parameters of this syndrome include low serum levels of triiodothyronine (T3) and high levels of reverse T3, with normal or low levels of thyroxine (T4) and normal or low levels of thyroid-stimulating hormone (TSH). This condition may affect 60 to 70% of critically ill patients. The changes in serum thyroid hormone levels in the critically ill patient seem to result from alterations in the peripheral metabolism of the thyroid hormones, in TSH regulation, in the binding of thyroid hormone to transport-protein and in receptor binding and intracellular uptake. Medications also have a very important role in these alterations. Hormonal changes can be seen within the first hours of critical illness and, interestingly, these changes correlate with final outcome. Data on the beneficial effect of thyroid hormone treatment on outcome in critically ill patients are so far controversial. Thyroid function generally returns to normal as the acute illness resolves.

  18. Illness management and recovery

    DEFF Research Database (Denmark)

    Dalum, Helle Stentoft; Waldemar, Anna Kristine; Korsbek, Lisa

    2018-01-01

    OBJECTIVE: Illness Management and Recovery (IMR) is a psychosocial intervention with a recovery-oriented approach. The program has been evaluated in different settings; however evidence for the effects of IMR is still deficient. The aim of this trial was to investigate the benefits and harms...... of the IMR program compared with treatment as usual in Danish patients with schizophrenia or bipolar disorder. METHOD: The trial was designed as a randomized, assessor-blinded, multi-center, clinical trial investigating the IMR program compared with usual treatment. 198 people diagnosed with schizophrenia...... or service utilization. CONCLUSION: This randomized trial contributes to the evidence base of IMR by providing a methodological solid base for its conclusions; however the trial has some important limitations. More research is needed to get a firm answer on the effectiveness of the IMR....

  19. Illness narratives in cancer

    DEFF Research Database (Denmark)

    Ulrich, Anita; Evron, Lotte; Ostenfeld-Rosenthal, Ann

    2011-01-01

    Objectives: In this paper,we investigate Danish cancer patients’ narratives on spiritual beliefs and practices and the relationship these practices may have to complementary and alternative medicine (CAM). Design: Narrative inquiry is used to uncover how spiritual beliefs and practices may...... be related to CAM. The analysis is based on empirical findings from a recent PhD project. During a two-year period first author followed 32 cancer patients, family, friends and alternative practitioners through interviews, telephone conversations, treatments and in focus groups. Results: As a general pattern......, religious and spiritual issues were not extensively unfolded in participants’ illness narratives. However, these issues were significantly elaborated on in narratives by four female participants. Conclusion: We propose that for some cancer patients CAM may function, not only or primarily as a treatment...

  20. The Impact of climate change on heat-related mortality in six major cities, South Korea, under representative concentration pathways (RCPs

    Directory of Open Access Journals (Sweden)

    Youngmin eKim

    2014-02-01

    Full Text Available Background: We aimed to quantify the excess mortality associated with increased temperature due to climate change in six major Korean cities under Representative Concentration Pathways (RCPs which are new emission scenarios designed for the fifth assessment report of the Intergovernmental Panel on Climate Change (IPCC. Methods: We first examined the association between daily mean temperature and mortality in each during the summertime (June to September from 2001 to 2008. This was done using a generalized linear Poisson model with adjustment for a long-term time trend, relative humidity, air pollutants, and day of the week. We then computed heat-related mortality attributable to future climate change using estimated mortality risks, projected future populations, and temperature increments for both future years 2041-2070 and 2071-2100 under RCP 4.5 and 8.5. We considered effects from added days with high temperatures over thresholds and shifted effects from high to higher temperature.Results: Estimated excess all-cause mortalities for six cities in Korea ranged from 500 (95% CI: 313-703 for 2041-2070 to 2,320 (95% CI: 1,430-3,281 deaths per year for 2071-2100 under two RCPs. Excess cardiovascular mortality was estimated to range from 192 (95% CI: 41-351 to 896 (95% CI: 185-1,694 deaths per year, covering about 38.5% of all-cause excess mortality. Increased rates of heat-related mortality were higher in cities located at relatively lower latitude than cities with higher latitude. Estimated excess mortality under RCP 8.5, a fossil fuel-intensive emission scenario, was more than twice as high compared with RCP 4.5, low to medium emission scenario.Conclusions: Excess mortality due to climate change is expected to be profound in the future showing spatial variation. Efforts to mitigate climate change can cause substantial health benefits via reducing heat-related mortality.

  1. Normalizing fibromyalgia as a chronic illness.

    Science.gov (United States)

    Clauw, Daniel J; D'Arcy, Yvonne; Gebke, Kevin; Semel, David; Pauer, Lynne; Jones, Kim D

    2018-01-01

    Fibromyalgia (FM) is a complex chronic disease that affects 3-10% of the general adult population and is principally characterized by widespread pain, and is often associated with disrupted sleep, fatigue, and comorbidities, among other symptoms. There are many gaps in our knowledge of FM, such that, compared with other chronic illnesses including diabetes, rheumatoid arthritis, and asthma, it is far behind in terms of provider understanding and therapeutic approaches. The experience that healthcare professionals (HCPs) historically gained in developing approaches to manage and treat patients with these chronic illnesses may help show how they can address similar problems in patients with FM. In this review, we examine some of the issues around the management and treatment of FM, and discuss how HCPs can implement appropriate strategies for the benefit of patients with FM. These issues include understanding that FM is a legitimate condition, the benefits of prompt diagnosis, use of non-drug and pharmacotherapies, patient and HCP education, watchful waiting, and assessing patients by FM domain so as not to focus exclusively on one symptom to the detriment of others. Developing successful approaches is of particular importance for HCPs in the primary care setting who are in the ideal position to provide long-term care for patients with FM. In this way, FM may be normalized as a chronic illness to the benefit of both patients and HCPs.

  2. Modification of Heat-Related Mortality in an Elderly Urban Population by Vegetation (Urban Green) and Proximity to Water (Urban Blue): Evidence from Lisbon, Portugal.

    Science.gov (United States)

    Burkart, Katrin; Meier, Fred; Schneider, Alexandra; Breitner, Susanne; Canário, Paulo; Alcoforado, Maria João; Scherer, Dieter; Endlicher, Wilfried

    2016-07-01

    Urban populations are highly vulnerable to the adverse effects of heat, with heat-related mortality showing intra-urban variations that are likely due to differences in urban characteristics and socioeconomic status. We investigated the influence of urban green and urban blue, that is, urban vegetation and water bodies, on heat-related excess mortality in the elderly > 65 years old in Lisbon, Portugal, between 1998 and 2008. We used remotely sensed data and geographic information to determine the amount of urban vegetation and the distance to bodies of water (the Atlantic Ocean and the Tagus Estuary). Poisson generalized additive models were fitted, allowing for the interaction between equivalent temperature [universal thermal climate index (UTCI)] and quartiles of urban greenness [classified using the Normalized Difference Vegetation Index (NDVI)] and proximity to water (≤ 4 km vs. > 4 km), while adjusting for potential confounders. The association between mortality and a 1°C increase in UTCI above the 99th percentile (24.8°C) was stronger for areas in the lowest NDVI quartile (14.7% higher; 95% CI: 1.9, 17.5%) than for areas in the highest quartile (3.0%; 95% CI: 2.0, 4.0%). In areas > 4 km from water, a 1°C increase in UTCI above the 99th percentile was associated with a 7.1% increase in mortality (95% CI: 6.2, 8.1%), whereas in areas ≤ 4 km from water, the estimated increase in mortality was only 2.1% (95% CI: 1.2, 3.0%). Urban green and blue appeared to have a mitigating effect on heat-related mortality in the elderly population in Lisbon. Increasing the amount of vegetation may be a good strategy to counteract the adverse effects of heat in urban areas. Our findings also suggest potential benefits of urban blue that may be present several kilometers from a body of water. Burkart K, Meier F, Schneider A, Breitner S, Canário P, Alcoforado MJ, Scherer D, Endlicher W. 2016. Modification of heat-related mortality in an elderly urban population by

  3. Caring for children with life-limiting and life-threatening illnesses ...

    African Journals Online (AJOL)

    2011-07-03

    Jul 3, 2011 ... often caused by the fear of the unknown. Children with incurable illnesses generally go through various stages of understanding of illness (Table III).11. Children. Although end-of-life care is an important part of palliative care for children, palliative care begins when the diagnosis is made. Understanding the ...

  4. The transformative effects of illness.

    Science.gov (United States)

    Young-Mason, J; Mastrangelo, M

    1997-09-01

    In "The Soft Core" Arturo Vivante examines the bonds between a middle-aged son and his aging father. Years of habit that had solidified into accustomed but uncomfortable ways of behaving and interacting with each other are altered when the father's stroke evokes a tumultuous range of emotions in the son, leading him, in the end, to feel compassion, not just for his father but also for himself. Vivante shows the reader that illness has the ability to transform an individual who is willing to reexamine and reevaluate the meaning he or she gives to life. This process, however, is not an easy one, as it is often undertaken as in the story, when the individual fears the death of self or of a loved one. The suffering, though, can transform. The self-awareness gained leads to a more gentler way of being, and compassion results. This compassion is borne of understanding, recognition, and appreciation that the frailties of human nature exist in each of us. Recognizing and applying this to all manner of relationships in our lives is the wisdom that compassion gives to our existence.

  5. 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

  6. Heat related deaths to young children in parked cars: an analysis of 171 fatalities in the United States, 1995-2002.

    Science.gov (United States)

    Guard, A; Gallagher, S S

    2005-02-01

    To describe the circumstances surrounding heat related deaths to young children in passenger compartments of motor vehicles. Cases of heat related deaths to children aged features, external temperature, length of time confined, and the responsible adults. Cases were categorized by whether the child gained access to the vehicle or was left by adults. A total of 171 fatalities that met the case criteria were identified. Twenty seven percent (46) were children who gained access to unlocked vehicles and 73% (125) were children who were left by adults. More than a quarter of the adults were aware they were leaving children in the vehicles, while half were unaware or forgot. Forty three percent (54) of deaths to children who were left were associated with childcare: 32 children were left by family members who intended to take them to childcare but forgot and went to work instead; 22 children were left by child care providers or drivers. Many of the deaths reported in this study may have been prevented by keeping cars locked, educating parents, implementing informed child care transportation policies, passing relevant laws, and working with auto and child safety seat manufacturers to build in warnings and other design features. News sources can be useful for obtaining detailed information not otherwise identifiable through standard sources of fatality data.

  7. Exploring the Utility of Model-based Meteorology Data for Heat-Related Health Research and Surveillance

    Science.gov (United States)

    Vaidyanathan, A.; Yip, F.

    2017-12-01

    is an important attribute in understanding potential public health impacts. With the limited geographic scope of station-based measurements, adopting NLDAS-based modeled estimates in CDC's Tracking Network would provide a more comprehensive understanding of specific meteorological exposures on human health.

  8. South African Hindu psychologists' perceptions of mental illness.

    Science.gov (United States)

    Padayachee, Priyanka; Laher, Sumaya

    2014-04-01

    Conceptualisations of mental illness are not universally applicable, as culture shapes the expression, perceptions and treatment preferences thereof. By focusing on the perceptions of Hindu psychologists regarding mental illness, this study aimed to provide a deeper understanding of the impact that religious beliefs have on such conceptualisations. Semi-structured interviews were conducted with six Hindu psychologists around the Johannesburg area, South Africa. Responses were analysed using thematic content analysis. From the findings, it was evident that religion plays a critical role in the understanding and treatment of mental illness. Hindu beliefs around psychological disturbances were salient. Additionally, it was found that a tension existed between psychologists' awareness of the influential function of religion, particularly amongst collectivistic communities such as the Hindu community, and their occupational understandings and practices, which are deeply rooted in Western thought. Furthermore, it was suggested that the fear of stigma prevented Hindu clients from reaping the benefits of seeking help from culturally competent psychologists.

  9. ILL Annual report 97

    International Nuclear Information System (INIS)

    1997-01-01

    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 2π image-plate detector LADI, optimised for Laue measurements on biological crystals. The contrast between biological experiments and for example those on superconductivity or neutron β-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

  10. Illness representations in patients with traumatic injury: a longitudinal study.

    Science.gov (United States)

    Lee, Bih-O; Chaboyer, Wendy; Wallis, Marianne

    2010-02-01

    This study aimed to elucidate the illness representations of patients with traumatic injury and to examine what extent their illness representations change over time. Traumatic injury has attracted global concern because it is the major reason for death and disability in people under 45 years old. One model, the Common Sense Model of Illness Representation (CSMIR), has the potential to help individuals adjust to changes in health status such as traumatic injury. Longitudinal study design. This study was conducted using a and collected data prior to hospital discharge and at three and six months after hospital discharge. One individual question form and the Chinese Illness Perception Questionnaire Revised (IPQ-R) (Trauma) were used to collect demographic data, clinical data and illness representations. A total of 114 participants completed the survey three times. The overall response rate was 79.7%. Six subscales of the Chinese (Trauma): identity, emotional representations, consequences, controllability, illness coherence and causes of the Chinese IPQ-R (Trauma) changed significantly over time. Two subscales, Timeline (acute/chronic) and Timeline Cyclical, did not change significantly. Based on these findings, there may be a window of opportunity to provide appropriate interventions to individuals with traumatic injury at each time point. The results of this study have implications for nursing practice and further nursing research. Understanding illness representation in patients with traumatic injury may help nurses to provide anticipatory guidance and to design nursing interventions before and after hospital discharge, ultimately to improve health outcomes of those patients.

  11. National Estimates of Recovery-Remission From Serious Mental Illness.

    Science.gov (United States)

    Salzer, Mark S; Brusilovskiy, Eugene; Townley, Greg

    2018-02-01

    A broad range of estimates of recovery among previously institutionalized persons has been reported, but no current, community-based national estimate of recovery from serious mental illness exists. This study reports recovery rate results, based on a remission definition, and explores related demographic factors. A national, geographically stratified, and random cross-sectional survey conducted from September 2014 to December 2015 resulted in responses from more than 41,000 individuals. Lifetime prevalence of serious mental illness was assessed by asking about receipt of a diagnosis (major depression, bipolar disorder, manic depression, and schizophrenia or schizoaffective disorder) and hospitalization and impairment associated with the diagnosis. Recovery was determined by asking about impairments over the past 12 months. Almost 17% reported receiving one of the diagnoses in their lifetime, 6% had a lifetime rate of a serious mental illness, and nearly 4% continued to experience interference associated with serious mental illness. One-third of those with a lifetime serious mental illness reported having been in remission for at least the past 12 months. Recovery rates were low until age 32 and then progressively increased. Lifetime estimates of diagnosed illness and current prevalence of serious mental illness are consistent with previous research. Results indicate that recovery is possible and is associated with age. Further research is needed to understand factors that promote recovery, and sustained evaluation efforts using similar parsimonious approaches may be useful in conducting timely assessments of national and local mental health policies.

  12. A false dichotomy? Mental illness and lone-actor terrorism.

    Science.gov (United States)

    Corner, Emily; Gill, Paul

    2015-02-01

    We test whether significant differences in mental illness exist in a matched sample of lone- and group-based terrorists. We then test whether there are distinct behavioral differences between lone-actor terrorists with and without mental illness. We then stratify our sample across a range of diagnoses and again test whether significant differences exist. We conduct a series of bivariate, multivariate, and multinomial statistical tests using a unique dataset of 119 lone-actor terrorists and a matched sample of group-based terrorists. The odds of a lone-actor terrorist having a mental illness is 13.49 times higher than the odds of a group actor having a mental illness. Lone actors who were mentally ill were 18.07 times more likely to have a spouse or partner who was involved in a wider movement than those without a history of mental illness. Those with a mental illness were more likely to have a proximate upcoming life change, more likely to have been a recent victim of prejudice, and experienced proximate and chronic stress. The results identify behaviors and traits that security agencies can utilize to monitor and prevent lone-actor terrorism events. The correlated behaviors provide an image of how risk can crystalize within the individual offender and that our understanding of lone-actor terrorism should be multivariate in nature.

  13. Stigma and intellectual disability: potential application of mental illness research.

    Science.gov (United States)

    Ditchman, Nicole; Werner, Shirli; Kosyluk, Kristin; Jones, Nev; Elg, Brianna; Corrigan, Patrick W

    2013-05-01

    Individuals with intellectual disabilities (ID) and individuals with mental illness are consistently found to be among the most socially excluded populations and continue to face substantial health, housing, and employment disparities due to stigma. Although this has spurred extensive research efforts and theoretical advancements in the study of stigma toward mental illness, the stigma of ID has received only limited attention. In this article we explore the application of mental illness stigma research for ID. We carefully reviewed the existing research on mental illness stigma as a foundation for a parallel summary of the empirical literature on attitudes and stigma related to ID. Based on our review, there has not been a systematic approach to the study of stigma toward ID. However, multilevel conceptual models of stigma have received much attention in the mental illness literature. These models have been used to inform targeted interventions and have application to the study of the stigma process for individuals with ID. Nonetheless, there are indeed key differences between-as well as substantial variability within-the ID and mental illness populations that must be considered. Stigma is an issue of social justice impacting the lives of individuals with ID, yet there remains virtually no systematic framework applied to the understanding of the stigma process for this group. Future research can draw on the stigma models developed in the mental illness literature to guide more rigorous research efforts and ultimately the development of effective, multilevel stigma-change strategies for ID.

  14. Understanding Carbohydrates

    Science.gov (United States)

    ... Size: A A A Listen En Español Understanding Carbohydrates How much and what type of carbohydrate foods ... glucose levels in your target range. Explore: Understanding Carbohydrates Glycemic Index and Diabetes Learn about the glycemic ...

  15. 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. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  16. Care for a terminally ill person: A guide for pastors

    Directory of Open Access Journals (Sweden)

    H. Powell

    2004-08-01

    Full Text Available Everybody is faced with unique challenges and experiences during his/her life cycle. Some experiences are sudden and untimely, whereas others are expected. Terminal illness remains an unpleasant experience of an emotional, psychological, social and spiritual nature, whether it was sudden or expected. In order to deal with or care for the terminally ill in an effective way, it is important for professionals such as pastors to understand the terminally ill person’s fears, his/her needs and emotional experiences. In this article attention is given to the latter as well as to the specialised skills and techniques that could be implemented to ensure efficient humane and compassionate care for the terminally ill.

  17. Disaster related heat illness

    International Nuclear Information System (INIS)

    Miyake, Yasufumi

    2012-01-01

    Explained and discussed are the outline of heat illness (HI), its raised risk and measures taken at the disaster of the Fukushima Nuclear Power Plant Accident (FNPPA; Mar. 2011). High temperature and humid environment induce HI through the fervescence and dehydration resulting in the intestinal ischemia/hypoxia and organ failure. Epidemiologic data of the heatstroke in Japan suggest its seemingly parallel incidence to seasonal hotness of the summer. HI is classified in either classical (non-exertional) or exertional heatstroke, both with severity of I (slight), II (slight symptom of the central nervous system (CNS); necessary for consultation) and III (most serious; having dysfunction of CNS, organ or coagulation). Therapy depends on the severity: I for the first aid on site, II necessary for carrying to hospital and III for hospitalization. Protection is possible by personal, neighbors' and managers' carefulness, and supply of sufficient water and minerals. Risk of HI was suddenly raised at taking measures to meet with the FNPPA. Japanese Association for Acute Medicine (JAAM) promptly organized JAAM-FNPPA Working Group to treat the emergent multiple incidents including the radiation exposure and HI as well. Exertional HI was mainly in labors wearing rather sealed closes to protect radiation to work for steps of the Accident, and which was similar to evacuees temporarily entering the evacuation area for visit to their own vacant houses. In the summer, classical HI was also a problem mainly in elderly living in the evacuation dwellings. Document of HI incidents and patients at FNPPA should be recorded for the reference to possible disaster in future. (T.T.)

  18. [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. Copyright © 2010 Elsevier Masson SAS. All rights reserved.

  19. The illness of Vincent van Gogh.

    Science.gov (United States)

    Blumer, Dietrich

    2002-04-01

    Vincent van Gogh (1853-1890) had an eccentric personality and unstable moods, suffered from recurrent psychotic episodes during the last 2 years of his extraordinary life, and committed suicide at the age of 37. Despite limited evidence, well over 150 physicians have ventured a perplexing variety of diagnoses of his illness. Henri Gastaut, in a study of the artist's life and medical history published in 1956, identified van Gogh's major illness during the last 2 years of his life as temporal lobe epilepsy precipitated by the use of absinthe in the presence of an early limbic lesion. In essence, Gastaut confirmed the diagnosis originally made by the French physicians who had treated van Gogh. However, van Gogh had earlier suffered two distinct episodes of reactive depression, and there are clearly bipolar aspects to his history. Both episodes of depression were followed by sustained periods of increasingly high energy and enthusiasm, first as an evangelist and then as an artist. The highlights of van Gogh's life and letters are reviewed and discussed in an effort toward better understanding of the complexity of his illness.

  20. Illness perspectives of Thais diagnosed with schizophrenia.

    Science.gov (United States)

    Sanseeha, Ladda; Chontawan, Ratanawadee; Sethabouppha, Hunsa; Disayavanish, Chamlong; Turale, Sue

    2009-09-01

    This study explored the perceptions of 18 people diagnosed with schizophrenia from 1-10 years to uncover how they perceived themselves and their illness. It also involved 12 family members who added their perceptions. The data were collected using in-depth interviews, reflective journaling, and observations. The data were analyzed through the lens of Heidegger's hermeneutic phenomenology. Four themes emerged: perceptions of mental illness, perceptions of the causes of illness, perceptions of discrimination, and attempting to live with schizophrenia. The findings included strong underlying cultural and spiritual beliefs, and attitudes unique to the Thai participants, including the causation of schizophrenia by supernatural powers, black magic, and bad karma stemming from past deeds. Understanding the perceptions of the participants might help health-care providers to be more sensitive to those living with schizophrenia in Thailand and elsewhere. In particular, the findings could be useful in informing psychiatric careproviders about developing better caring systems for clients diagnosed with schizophrenia. This should help the sufferers of schizophrenia to live their lives to their own satisfaction and as normally as possible.

  1. Cost of illness and illness perceptions in patients with fibromyalgia.

    Science.gov (United States)

    Vervoort, Vera M; Vriezekolk, Johanna E; Olde Hartman, Tim C; Cats, Hans A; van Helmond, Toon; van der Laan, Willemijn H; Geenen, Rinie; van den Ende, Cornelia H

    2016-01-01

    The disease impact and economic burden of fibromyalgia (FM) are high for patients and society at large. Knowing potential determinants of economic costs may help in reducing this burden. Cognitive appraisals (perceptions) of the illness could affect costs. The present study estimated costs of illness in FM and examined the association between these costs and illness perceptions. Questionnaire data of FM severity (FIQ), illness perceptions (IPQ-R-FM), productivity losses (SF-HLQ) and health care use were collected in a cohort of patients with FM. Costs were calculated and dichotomised (median split). Univariate and hierarchic logistic regression models examined the unique association of each illness perception with 1) health care costs and 2) costs of productivity losses. Covariates were FM severity, comorbidity and other illness perceptions. 280 patients participated: 95% female, mean age 42 (SD=12) years. Annualised costs of FM per patient were €2944 for health care, and €5731 for productivity losses. In multivariate analyses, a higher disease impact (FIQ) and two of seven illness perceptions (IPQ-R-FM) were associated with high health care costs: 1) high scores on 'cyclical timeline' reflecting a fluctuating, unpredictable course and 2) low scores on 'emotional representations', thus not perceiving a connection between fibromyalgia and emotions. None of the variables was associated with productivity losses. Our study indicates that perceiving a fluctuating course and low emotional representation, which perhaps reflects somatic fixation, are associated with health care costs in FM. Future studies should examine whether targeting these illness perceptions results in reduction of costs.

  2. Parvovirus B19 and Other Illnesses

    Science.gov (United States)

    ... Cheek Rash Parvovirus B19 and Other Illnesses References Parvovirus B19 and Other Illnesses Recommend on Facebook Tweet ... disease is the most common illness caused by parvovirus B19 infection. Learn More Parvovirus B19 infection can ...

  3. Reinforcing stigmatization: coverage of mental illness in Spanish newspapers.

    Science.gov (United States)

    Aragonès, Enric; López-Muntaner, Judit; Ceruelo, Santiago; Basora, Josep

    2014-01-01

    Because the media influences society's perceptions of reality, the treatment of mental illness in the news can have an effect on the societal stigma related to it. This study aimed to analyze the content and form of news items related to mental illness in Spanish newspapers in order to understand their role in propagating or attenuating stereotypes, prejudices, and stigma. The authors conducted a cross-sectional descriptive study on the basis of a review of news items related to mental illness appearing in the Spanish print media. A sample was taken from articles published on the subject in the 20 Spanish newspapers with the widest circulations over the course of the year 2010. Formal elements and content were analyzed by means of a structured evaluation system. The authors analyzed 695 news items. The content of 47.9% (n = 333) of the articles was not strictly related to mental illness, but rather clinical or psychiatric terms were used metaphorically, and frequently in a pejorative sense. The remaining 52.1% (n = 362) consisted of news items related specifically to mental illness. Of these, news items linking mental illness to danger were the most common (178 texts, 49.2%), specifically those associating mental illness with violent crime (130 texts, 35.9%) or a danger to others (126 texts, 34.8%). The results confirm the hypothesis that the press treats mental illness in a manner that encourages stigmatization. The authors appeal to the press's responsibility to society and advocate an active role in reducing the stigma towards mental illness.

  4. Differences in illness perception between children with cancer and other chronic diseases and their parents.

    Science.gov (United States)

    Szentes, Annamária; Kökönyei, Gyöngyi; Békési, Andrea; Bokrétás, Ildikó; Török, Szabolcs

    2017-10-01

    The purpose of this study was to explore the differences in illness perception between children with cancer and other chronic diseases. A secondary aim was to examine the similarities and differences between the illness perception of these children and their parents. The Revised Illness Perception Questionnaire (IPQ-R) was used to measure the children's and parents' illness perceptions. In this study, 184 children (ages 8-18 years) and their caregivers completed the questionnaires. This study shows that children with cancer feel that they have greater control over their treatment compared to the other two groups. The children's parents have more pessimistic views of the illness than their children. Examinations of illness perceptions among paediatric cancer patients and their families are essential in designing psychosocial interventions for these families. The clinical value of our results can help better understand the cancer-specific features of illness perceptions.

  5. 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...... 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...... 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...

  6. 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)

  7. Visualizing tissue molecular structure of a black type of canola (Brassica) seed with a thick seed coat after heat-related processing in a chemical way.

    Science.gov (United States)

    Yu, Peiqiang

    2013-02-20

    Heat-related processing of cereal grains, legume seeds, and oil seeds could be used to improve nutrient availability in ruminants. However, different types of processing may have a different impact on intrinsic structure of tissues. To date, there is little research on structure changes after processing within intact tissues. The synchrotron-based molecular imaging technique enables us to detect inherent structure change on a molecular level. The objective of this study was to visualize tissue of black-type canola (Brassica) seed with a thick seed coat after heat-related processing in a chemical way using the synchrotron imaging technique. The results showed that the chemical images of protein amides were obtained through the imaging technique for the raw, wet, and dry heated black type of canola seed tissues. It seems that different types of processing have a different impact on the protein spectral profile in the black type of canola tissues. Wet heating had a greater impact on the protein α-helix to β-sheet ratio than dry heating. Both dry and wet heating resulted in different patterns in amide I, the second derivative, and FSD spectra. However, the exact differences in the tissue images are relatively difficult to be obtained through visual comparison. Future studies should focus on (1) comparing the response and sensitivity of canola seeds to various processing methods between the yellow-type and black-type of canola seeds; (2) developing a sensitive method to compare the image difference between tissues and between treatments; (3) developing a method to link images to nutrient digestion, and (4) revealing how structure changes affect nutrient absorption in humans and animals.

  8. I'll pick forgiving.

    Science.gov (United States)

    Lowenstein, Elisabeth

    2014-01-01

    In this essay, the author gives voice to turning points in her life related to infidelity, mental illness, and forgiveness. By melding poetry, prose, dream journal entries, and medical case notes, she tells the story of how she became a single parent of a young man with mental illness. This narrative constitutes a defining moment in which she reframes an unforgivable relational transgression as an unforgettable opportunity for forgiveness.

  9. Understanding classification

    NARCIS (Netherlands)

    Subianto, M.

    2009-01-01

    In practical data analysis, the understandability of models plays an important role in their acceptance. In the data mining literature, however, understandability plays is hardly ever mentioned. If it is mentioned, it is interpreted as meaning that the models have to be simple. In this thesis we

  10. Embodied understanding.

    Science.gov (United States)

    Johnson, Mark

    2015-01-01

    Western culture has inherited a view of understanding as an intellectual cognitive operation of grasping of concepts and their relations. However, cognitive science research has shown that this received intellectualist conception is substantially out of touch with how humans actually make and experience meaning. The view emerging from the mind sciences recognizes that understanding is profoundly embodied, insofar as our conceptualization and reasoning recruit sensory, motor, and affective patterns and processes to structure our understanding of, and engagement with, our world. A psychologically realistic account of understanding must begin with the patterns of ongoing interaction between an organism and its physical and cultural environments and must include both our emotional responses to changes in our body and environment, and also the actions by which we continuously transform our experience. Consequently, embodied understanding is not merely a conceptual/propositional activity of thought, but rather constitutes our most basic way of being in, and engaging with, our surroundings in a deep visceral manner.

  11. Is mental illness complex? From behavior to brain.

    Science.gov (United States)

    Yang, Albert C; Tsai, Shih-Jen

    2013-08-01

    A defining but elusive feature of the human brain is its astonishing complexity. This complexity arises from the interaction of numerous neuronal circuits that operate over a wide range of temporal and spatial scales, enabling the brain to adapt to the constantly changing environment and to perform various amazing mental functions. In mentally ill patients, such adaptability is often impaired, leading to either ordered or random patterns of behavior. Quantification and classification of these abnormal human behaviors exhibited during mental illness is one of the major challenges of contemporary psychiatric medicine. In the past few decades, attempts have been made to apply concepts adopted from complexity science to better understand complex human behavior. Although considerable effort has been devoted to studying the abnormal dynamic processes involved in mental illness, unfortunately, the primary features of complexity science are typically presented in a form suitable for mathematicians, physicists, and engineers; thus, they are difficult for practicing psychiatrists or neuroscientists to comprehend. Therefore, this paper introduces recent applications of methods derived from complexity science for examining mental illness. We propose that mental illness is loss of brain complexity and the complexity of mental illness can be studied under a general framework by quantifying the order and randomness of dynamic macroscopic human behavior and microscopic neuronal activity. Additionally, substantial effort is required to identify the link between macroscopic behaviors and microscopic changes in the neuronal dynamics within the brain. Copyright © 2012 Elsevier Inc. All rights reserved.

  12. Say 'trouble's gone': chronic illness and employability in job training programmes.

    Science.gov (United States)

    Tsui, Emma K

    2013-01-01

    The concept of biographical disruption has unique relevance for socioeconomically disadvantaged groups who participate in entry-level job training programmes. In these programmes trainees often suffer from various forms of chronic illness and must arrange these illnesses into a picture of employability. In this article I use ethnographic data and narrative analysis to examine closely two trainees' illness-related experiences, expressions and talk, and find that their ability to present their illnesses in ways that are consistent with programmatic goals is strongly influenced by family support, responsibilities and roles, as well as particular aspects of illness, like the interpretability of symptoms. I also find that the concept of biographical disruption has a curious traction in the world of job training, particularly among job training programme staff who would like to see trainees mobilise a variety of resources to help manage their illness. However, for trainees, many of whom have lived with chronic illness for years, the concept of biographical disruption may be more limited as a tool for understanding the experiences of illness. A more meaningful disruptive force in the lives of trainees appears to be the programme itself and the strategies for dealing with illness that programme staff may extend. © 2012 The Author. Sociology of Health & Illness © 2012 Foundation for the Sociology of Health & Illness/Blackwell Publishing Ltd.

  13. Individual Differences on Job Stress and Related Ill Health

    Directory of Open Access Journals (Sweden)

    Miodraga Stefanovska Petkovska

    2014-03-01

    Conclusion: Employees are exposed to many potential work related stressors which differently affect their job satisfaction and result in ill health. A better understanding of the individual characteristics and potential stressors should subsequently help managers' better deal with this problem. This underlines the need for further research and design of stress reduction interventions.

  14. Prevalence of early warning signs and symptoms of mental illness ...

    African Journals Online (AJOL)

    Background: Mental illness is a psychological, emotional and mental health problems that affects the physical, behavioral and occupational functioning of an individual. The understand of the signs and symptoms of the disorder in a typical setting and by ordinary people or even among the literate is often difficulty; talk more ...

  15. Mental Illness, Metaphysics, Facts and Values | Megone ...

    African Journals Online (AJOL)

    A number of prominent writers on the concept of mental illness/disease are committed to accounts which involve rejecting certain plausible widely held beliefs, namely: that it is part of the meaning of illness that it is bad for its possessor, so the concept of illness is essentially evaluative; that if a person has a mental illness, ...

  16. Health professionals’ familiarity and attributions to mental illness

    Directory of Open Access Journals (Sweden)

    Aghukwa Nkereuwem Chikaodiri

    2010-01-01

    Full Text Available A few months from the time of this survey, the nearly completed inpatient psychiatric facility within the Aminu Kano Teaching Hospital’s complex would be ready for admissions. Understanding the health workers’ level of experience of mental illness and their likely behavioural responses towards people with psychiatric illness, therefore, should be a good baseline to understanding their likely reactions towards admitting such patients within a general hospital setting. The study, which used a pre-tested and adapted attribution questionnaire, was pro­spective and cross-sectional. Randomly selected health workers in Aminu Kano Teaching Hospital had their level of familiarity and attributions towards psychiatric patients assessed. The respondents showed a high level of experience with mental illness, with more than 3 in 5 of them having watched movies on mental illness before. More than half of them held positive (favorable attributions towards persons with mental illness on nine of the ten assessed attribution factors. Almost all held negative (unfavourable opinion towards intimate relationships with such persons. Attribution factors, “Responsibility, “Anger”, “Dangerousness”, “Fear” and “Segregation” were significantly related to the respondents’ level of education (P less than 0.05. Marital status of the respondents related significantly to “Pity” and “Avoidance” factors (P less than 0.05. Having watched movies on mental illness significantly related to “Responsibility” and “Fear” factors (P less than 0.05. Programs designed to improve the health workers mental health literacy, and increased positive professional contacts with mentally ill persons on treatment, would further enhance their perceived positive attributions towards them.

  17. How medical technologies shape the experience of illness.

    Science.gov (United States)

    Hofmann, Bjørn; Svenaeus, Fredrik

    2018-02-03

    In this article we explore how diagnostic and therapeutic technologies shape the lived experiences of illness for patients. By analysing a wide range of examples, we identify six ways that technology can (trans)form the experience of illness (and health). First, technology may create awareness of disease by revealing asymptomatic signs or markers (imaging techniques, blood tests). Second, the technology can reveal risk factors for developing diseases (e.g., high blood pressure or genetic tests that reveal risks of falling ill in the future). Third, the technology can affect and change an already present illness experience (e.g., the way blood sugar measurement affects the perceived symptoms of diabetes). Fourth, therapeutic technologies may redefine our experiences of a certain condition as diseased rather than unfortunate (e.g. assisted reproductive technologies or symptom based diagnoses in psychiatry). Fifth, technology influences illness experiences through altering social-cultural norms and values regarding various diagnoses. Sixth, technology influences and changes our experiences of being healthy in contrast and relation to being diseased and ill. This typology of how technology forms illness and related conditions calls for reflection regarding the phenomenology of technology and health. How are medical technologies and their outcomes perceived and understood by patients? The phenomenological way of approaching illness as a lived, bodily being-in-the-world is an important approach for better understanding and evaluating the effects that medical technologies may have on our health, not only in defining, diagnosing, or treating diseases, but also in making us feel more vulnerable and less healthy in different regards.

  18. Illness Causation and Interpretation in a Newar Town

    Directory of Open Access Journals (Sweden)

    Madhusudan Subedi

    2012-06-01

    Full Text Available One of the core concerns of medical anthropology is to explore how people in different cultures and social groups explain the causes of ill health, the type of treatment they believe in, and to whom they turn if they do become ill. This article focuses on the understanding of illness causation by the Newars in Kirtipur and their concern about biological and socio-cultural aspects of healthy behavior, and particularly with the ways in which they have been coping in everyday life. The basic method of data collection for this study was formal and informal discussions with the elderly Newar males and females, followed by discussions with youths to explore the variations in their perceptions. The findings show that the understanding of illness etiology is multi-causal. The individual, natural, social, and supernatural causes are not mutually exclusive but are usually linked together in a particular case. In any specific case of illness, moreover, people’s explanatory model varies in how they explain its etiology.DOI: http://dx.doi.org/10.3126/dsaj.v5i0.6358 Dhaulagiri Journal of Sociology and Anthropology Vol. 5, 2011: 101-120    

  19. Students′ perception about mental illness

    Directory of Open Access Journals (Sweden)

    R K Mahto

    2009-01-01

    Full Text Available Background: In developing countries like India, there are evidences that stigma associated with mental illness is increasing. As in parts of the developing world, with advancement of urbanization and rapid industrialization, people tend to react in a very peculiar and biased way when they confront a mentally ill person. Materials and Methods: The present study aimed to find out students′ opinion about mental illness. A total of 100 students (50 male and 50 female from Ranchi University were purposively recruited for the study, and the 51-item Opinion about Mental Illness (OMI Scale was administered. Results: Majority of the students were from Hindu families, of whom 42 (84% were males and 38 (68% were females. With regard to OMI scale, the item, viz., ′The law should allow a woman to divorce her husband as soon as he has been confined in mental hospital with a severe mental illness′, both male (46% and female (56% students were neutral (significant at 0.014, P < 0.05. Conclusion: Overall no significant level of difference emerged between male and female students with regard to opinion about mental illness.

  20. The Injury/Illness Performance Project (IIPP: A Novel Epidemiological Approach for Recording the Consequences of Sports Injuries and Illnesses

    Directory of Open Access Journals (Sweden)

    Debbie Palmer-Green

    2013-01-01

    Full Text Available Background. Describing the frequency, severity, and causes of sports injuries and illnesses reliably is important for quantifying the risk to athletes and providing direction for prevention initiatives. Methods. Time-loss and/or medical-attention definitions have long been used in sports injury/illness epidemiology research, but the limitations to these definitions mean that some events are incorrectly classified or omitted completely, where athletes continue to train and compete at high levels but experience restrictions in their performance. Introducing a graded definition of performance-restriction may provide a solution to this issue. Results. Results from the Great Britain injury/illness performance project (IIPP are presented using a performance-restriction adaptation of the accepted surveillance consensus methodologies. The IIPP involved 322 Olympic athletes (males: 172; female: 150 from 10 Great Britain Olympic sports between September 2009 and August 2012. Of all injuries (n=565, 216 were classified as causing time-loss, 346 as causing performance-restriction, and 3 were unclassified. For athlete illnesses (n=378, the majority (P<0.01 resulted in time-loss (270 compared with performance-restriction (101 (7 unclassified. Conclusions. Successful implementation of prevention strategies relies on the correct characterisation of injury/illness risk factors. Including a performance-restriction classification could provide a deeper understanding of injuries/illnesses and better informed prevention initiatives.

  1. Understanding semantics

    DEFF Research Database (Denmark)

    Thrane, Torben

    1997-01-01

    Understanding natural language is a cognitive, information-driven process. Discussing some of the consequences of this fact, the paper offers a novel look at the semantic effect of lexical nouns and the identification of reference types....

  2. Understanding Alzheimer's

    Science.gov (United States)

    ... Navigation Bar Home Current Issue Past Issues Understanding Alzheimer's Past Issues / Fall 2007 Table of Contents For ... and brain scans. No treatment so far stops Alzheimer's. However, for some in the disease's early and ...

  3. Legal aspects with regard to mentally ill offenders in South Africa ...

    African Journals Online (AJOL)

    The purpose of this note is to discuss legal aspects with regard to mentally ill offenders with specific reference to the defence raised as a result of mental illness. In order to fully understand this defence it is important to provide a clinical background on what forensic psychiatry is. It is also necessary to define certain clinical ...

  4. John Stuart Mill on the liberty of the mentally ill: a historical note.

    Science.gov (United States)

    Monahan, J

    1977-12-01

    The author discusses the quote from Mill's On Liberty that is often cited by libertarians in opposition to involuntary commitment of the mentally ill. This quote has been taken out of context; other statements in the document indicate that Mill excluded from his libertarian credo those "without the ordinary amount of understanding," i.e., those people who would now be considered mentally ill.

  5. Do everyday problems of people with chronic illness interfere with their self-management?

    NARCIS (Netherlands)

    Houtum, L. van; Rijken, M.; Groenewegen, P.

    2015-01-01

    Background: Being chronically ill is a continuous process of balancing the demands of the illness and the demands of everyday life. Understanding how everyday life affects self-management might help to provide better professional support. However, little attention has been paid to the influence of

  6. Do everyday problems of people with chronic illness interfere with their disease management? Chronic Disease epidemiology

    NARCIS (Netherlands)

    Van Houtum, Lieke; Rijken, Mieke; Groenewegen, Petrus

    2015-01-01

    Background: Being chronically ill is a continuous process of balancing the demands of the illness and the demands of everyday life. Understanding how everyday life affects self-management might help to provide better professional support. However, little attention has been paid to the influence of

  7. Mining and Analyzing Circulation and ILL Data for Informed Collection Development

    Science.gov (United States)

    Link, Forrest E.; Tosaka, Yuji; Weng, Cathy

    2015-01-01

    The authors investigated quantitative methods of collection use analysis employing library data that are available in ILS and ILL systems to better understand library collection use and user needs. For the purpose of the study, the authors extracted circulation and ILL records from the library's systems using data-mining techniques. By comparing…

  8. Regional Variation in Travel-related Illness acquired in Africa, March 1997-May 2011

    NARCIS (Netherlands)

    Mendelson, Marc; Han, Pauline V.; Vincent, Peter; von Sonnenburg, Frank; Cramer, Jakob P.; Loutan, Louis; Kain, Kevin C.; Parola, Philippe; Hagmann, Stefan; Gkrania-Klotsas, Effrossyni; Sotir, Mark; Schlagenhauf, Patricia; Anand, Rahul; Ásgeirsson, Hilmir; Barnett, Elizabeth D.; Borwein, Sarah; Burchard, Gerd Dieter; Cahill, John D.; Campion, Daniel; Castelli, Francesco; Caumes, Eric; Chen, Lin H.; Connor, Bradley A.; Coyle, Christina M.; Cramer, Jakob; Eason, Jane; Ficko, Cécile; Field, Vanessa; Freedman, David O.; Goorhuis, Abram; Grobusch, Martin P.; Gurtman, Alejandra; Hale, Devon C.; Hern, Annemarie; Hynes, Noreen; Jensenius, Mogens; Kass, Robert; Klion, Amy D.; Kozarsky, Phyllis E.; Leder, Karin; Licitra, Carmelo; López-Vélez, Rogelio; Lynch, Michael W.; Matteelli, Alberto; McCarthy, Anne; McKinley, George; McLellan, Susan; Molina, José Antonio Pérez; Muller, Robert; Nutman, Thomas B.; Pérignon, Alice; Phu, Phi Truong Hoang; Piyaphanee, Watcharapong; Rapp, Christophe; Roesel, David; Schwartz, Eli; Shaw, Marc; Silachamroon, Udomsak; Stauffer, William; Tachikawa, Natsuo; Torresi, Joseph; Ursing, Johan; Vincelette, Jean; Walker, Patricia; Wang, Andy; Wilson, Mary E.; Wu, Henry; Yoshimura, Yukihiro

    2014-01-01

    To understand geographic variation in travel-related illness acquired in distinct African regions, we used the Geo Sentinel Surveillance Network database to analyze records for 16,893 ill travelers returning from Africa over a 14-year period. Travelers to northern Africa most commonly reported

  9. Understanding homelessness

    OpenAIRE

    Somerville, Peter

    2013-01-01

    This paper reviews the literature on understanding homelessness. It criticizes approaches that ignore, distort or diminish the humanity of homeless people, or else, add little to our understanding of that humanity. In particular, it rejects what it calls “epidemiological” approaches, which deny the possibility of agency for homeless people, insofar as those approaches view the situation of those people largely as a “social fact”, to be explained in terms of causal variables or “risk factors” ...

  10. Cost of illness and illness perceptions in patients with fibromyalgia

    NARCIS (Netherlands)

    Vervoort, V.M.; Vriezekolk, J.E.; Olde Hartman, T.C.; Cats, H.A.; Helmond, T. van; Laan, W.H. van der; Geenen, R.; Ende, C.H.M. van den

    2016-01-01

    OBJECTIVES: The disease impact and economic burden of fibromyalgia (FM) are high for patients and society at large. Knowing potential determinants of economic costs may help in reducing this burden. Cognitive appraisals (perceptions) of the illness could affect costs. The present study estimated

  11. [Strategies of coping with chronic illness in adolescents].

    Science.gov (United States)

    Flores-Carvajal, Daniel; Urzúa M, Alfonso

    2016-01-01

    To develop a tool to evaluate coping strategies for chronic illness in adolescents. Based on a theoretical review and semi-structured interviews with adolescents, a questionnaire was prepared that was finally evaluated by judges experienced in in understanding, relevance and viability. A scale is proposed that consists of 60 items grouped into 12 coping families. The scale may be a useful clinical tool to provide key information about the experience and ways to cope with illness in adolescents. Copyright © 2015 Sociedad Chilena de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

  12. Understanding Maple

    CERN Document Server

    Thompson, Ian

    2016-01-01

    Maple is a powerful symbolic computation system that is widely used in universities around the world. This short introduction gives readers an insight into the rules that control how the system works, and how to understand, fix, and avoid common problems. Topics covered include algebra, calculus, linear algebra, graphics, programming, and procedures. Each chapter contains numerous illustrative examples, using mathematics that does not extend beyond first-year undergraduate material. Maple worksheets containing these examples are available for download from the author's personal website. The book is suitable for new users, but where advanced topics are central to understanding Maple they are tackled head-on. Many concepts which are absent from introductory books and manuals are described in detail. With this book, students, teachers and researchers will gain a solid understanding of Maple and how to use it to solve complex mathematical problems in a simple and efficient way.

  13. Understanding traditional African healing.

    Science.gov (United States)

    Mokgobi, M G

    2014-09-01

    Traditional African healing has been in existence for many centuries yet many people still seem not to understand how it relates to God and religion/spirituality. Some people seem to believe that traditional healers worship the ancestors and not God. It is therefore the aim of this paper to clarify this relationship by discussing a chain of communication between the worshipers and the Almighty God. Other aspects of traditional healing namely types of traditional healers, training of traditional healers as well as the role of traditional healers in their communities are discussed. In conclusion, the services of traditional healers go far beyond the uses of herbs for physical illnesses. Traditional healers serve many roles which include but not limited to custodians of the traditional African religion and customs, educators about culture, counselors, social workers and psychologists.

  14. Understanding physics

    CERN Document Server

    Mansfield, Michael

    2011-01-01

    Understanding Physics - Second edition is a comprehensive, yet compact, introductory physics textbook aimed at physics undergraduates and also at engineers and other scientists taking a general physics course. Written with today's students in mind, this text covers the core material required by an introductory course in a clear and refreshing way. A second colour is used throughout to enhance learning and understanding. Each topic is introduced from first principles so that the text is suitable for students without a prior background in physics. At the same time the book is designed to enable

  15. A pill for every ill?

    OpenAIRE

    Buhagiar, Marc

    2015-01-01

    In the US, non-medical use of prescription drugs is second only to marijuana. Marc Buhagiar meets up with Prof. Marilyn Clark to investigate just how dangerous this problem is around Europe. Illustrations by Sonya Hallett. http://www.um.edu.mt/think/a-pill-for-every-ill/

  16. Family Therapy and Psychosomatic Illness.

    Science.gov (United States)

    Waring, Edward M.

    1980-01-01

    Reviews the use of family therapy in dealing with illnesses such as childhood diabetes, asthma, pain, and anorexia nervosa. Marital and family therapy may be effective in treating some psychosomatic problems. Family assessment is helpful in the management of all psychosomatic problems. (Author/JAC)

  17. Monitoring microcirculation in critical illness

    NARCIS (Netherlands)

    Kara, Atila; Akin, Sakir; Ince, Can

    2016-01-01

    Purpose of reviewCritical illness includes a wide range of conditions from sepsis to high-risk surgery. All these diseases are characterized by reduced tissue oxygenation. Macrohemodynamic parameters may be corrected by fluids and/or vasoactive compounds; however, the microcirculation and its

  18. Delirium in critically ill patients

    NARCIS (Netherlands)

    Slooter, A J C; Van De Leur, R R; Zaal, I J

    2017-01-01

    Delirium is common in critically ill patients and associated with increased length of stay in the intensive care unit (ICU) and long-term cognitive impairment. The pathophysiology of delirium has been explained by neuroinflammation, an aberrant stress response, neurotransmitter imbalances, and

  19. 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).

  20. Illness perceptions in patients with systemic lupus erythematosus and proliferative lupus nephritis.

    Science.gov (United States)

    Daleboudt, G M N; Broadbent, E; Berger, S P; Kaptein, A A

    2011-03-01

    This study investigated the illness perceptions of patients with systemic lupus erythematosus (SLE) and whether perceptions are influenced by type of treatment for proliferative lupus nephritis. In addition, the illness perceptions of SLE patients were compared with those of patients with other chronic illnesses. Thirty-two patients who had experienced at least one episode of proliferative lupus nephritis were included. Patients were treated with either a high or low-dose cyclophosphamide (CYC) regimen (National Institutes of Health [NIH] vs. Euro-Lupus protocol). Illness perceptions were measured with the Brief Illness Perception Questionnaire (B-IPQ) and a drawing assignment. The low-dose CYC group perceived their treatment as more helpful than the high-dose CYC group. In comparison with patients with asthma, SLE patients showed more negative illness perceptions on five of the eight illness perception domains. Drawings of the kidney provided additional information about perceptions of treatment effectiveness, kidney function and patients' understanding of their illness. Drawing characteristics showed associations with perceptions of consequences, identity, concern and personal control. These findings suggest that the type of treatment SLE patients with proliferative lupus nephritis receive may influence perceptions of treatment effectiveness. In addition, patients' drawings reveal perceptions of damage caused by lupus nephritis to the kidneys and the extent of relief provided by treatment. The finding that SLE is experienced as a more severe illness than other chronic illnesses supports the need to more frequently assess and aim to improve psychological functioning in SLE patients.

  1. Patients' Illness Perception as a Tool to Improve Individual Disease Management in Primary Cutaneous Lymphomas

    Directory of Open Access Journals (Sweden)

    Stefanie Porkert

    2017-11-01

    Full Text Available The Revised Illness Perception Questionnaire (IPQ-R has been shown to assess illness perception reproducibly in primary cutaneous T-cell lymphomas (CTCL. Illness perception reflects patients' individual concepts of understanding and interpretation of the disease, influencing illness behaviour and health-related quality of life (HRQOL. This study investigated the clinical relevance of the relationships between illness perception, illness behaviour, and HRQOL in CTCL and cutaneous B-cell lymphomas (CBCL. A total of 92 patients completed the IPQ-R, the Scale for the Assessment of Illness Behavior (SAIB, and a skin-specific HRQOL tool (Skindex-29. Data on illness behaviour were not evidently related to illness perception, whereas illness perception was significantly associated with HRQOL. Both, IPQ-R and HRQOL results correlated with disease entity, stage, and socio-demographics. Only IPQ-R results provided practical information on patients' needs to train personal coping strategies. IPQ-R assessment in CTCL and CBCL might be a useful instrument to improve individual disease management.

  2. Patients' Illness Perception as a Tool to Improve Individual Disease Management in Primary Cutaneous Lymphomas.

    Science.gov (United States)

    Porkert, Stefanie; Lehner-Baumgartner, Eva; Valencak, Julia; Knobler, Robert; Riedl, Elisabeth; Jonak, Constanze

    2018-02-07

    The Revised Illness Perception Questionnaire (IPQ-R) has been shown to assess illness perception reproducibly in primary cutaneous T-cell lymphomas (CTCL). Illness perception reflects patients' individual concepts of understanding and interpretation of the disease, influencing illness behaviour and health-related quality of life (HRQOL). This study investigated the clinical relevance of the relationships between illness perception, illness behaviour, and HRQOL in CTCL and cutaneous B-cell lymphomas (CBCL). A total of 92 patients completed the IPQ-R, the Scale for the Assessment of Illness Behavior (SAIB), and a skin-specific HRQOL tool (Skindex-29). Data on illness behaviour were not evidently related to illness perception, whereas illness perception was significantly associated with HRQOL. Both, IPQ-R and HRQOL results correlated with disease entity, stage, and socio-demographics. Only IPQ-R results provided practical information on patients' needs to train personal coping strategies. IPQ-R assessment in CTCL and CBCL might be a useful instrument to improve individual disease management.

  3. Abnormal illness behaviour: physiological, psychological and social dimensions of coping with distress.

    Science.gov (United States)

    Kirmayer, Laurence J; Looper, Karl J

    2006-01-01

    Pilowsky introduced the term 'abnormal illness behaviour' to characterize syndromes of excessive or inadequate response to symptoms, including hypochondriasis, somatization, and denial of illness. This review summarizes recent work from sociology, health psychology and psychiatry that contributes to an understanding of the processes that may underlie abnormal illness behaviour. Disturbances in the regulation of physiological systems may account for many 'unexplained' symptoms and sickness behaviour. Increased attention to bodily sensations, sensitivity to pain and catastrophizing play important roles in illness behaviour in medical illness. Developmental adversities and parental modelling of illness behaviour in childhood may increase bodily preoccupation and health care utilization. Apparent cross-national differences in illness behaviour may reflect differences in health care systems, but cultural models of illness and social stigma remain important determinants of illness denial and avoidance of mental health services. Research into illness behaviour is relevant to efforts to rethink the psychiatric nosology of somatoform disorders. The discrete somatoform disorders might well be replaced by a dimensional framework that identifies specific pathological processes in cognition, perception and social behaviour that contribute to bodily distress, impaired coping, inappropriate use of health services, chronicity and disability.

  4. Understanding Energy

    Science.gov (United States)

    Menon, Deepika; Shelby, Blake; Mattingly, Christine

    2016-01-01

    "Energy" is a term often used in everyday language. Even young children associate energy with the food they eat, feeling tired after playing soccer, or when asked to turn the lights off to save light energy. However, they may not have the scientific conceptual understanding of energy at this age. Teaching energy and matter could be…

  5. Motherhood in women with serious mental illness.

    Science.gov (United States)

    Benders-Hadi, Nikole; Barber, Mary; Alexander, Mary Jane

    2013-03-01

    This study aimed to determine the prevalence of motherhood among inpatient females at a large state psychiatric hospital in suburban New York, as well as develop an understanding of the characteristics and needs of this unique population. Data on motherhood status was gathered from October 2010 through April 2011 via medical records. Data on custody status, frequency of contacts with children, and effect of mental illness on parenting was assessed through patient surveys and focus groups. 38.5 % of female inpatients were found to be mothers, almost half of whom reported at least weekly contact with children despite their inpatient status. The majority of identified mothers reported having maintained custody of their minor children and expressed great pride at being primary caretakers for their children, yet also emphasized the challenging effects of stigma associated with mental illness and parenting. A significant proportion of women at this psychiatric hospital were found to be mothers. Although acknowledged by some clinicians at the individual level, motherhood appears to remain a forgotten role systemically. Determining motherhood status and recognizing the varied roles our patients have is one more way mental health providers can model and promote recovery-oriented care.

  6. 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.

  7. Sleep Disturbance after Hospitalization and Critical Illness: A Systematic Review.

    Science.gov (United States)

    Altman, Marcus T; Knauert, Melissa P; Pisani, Margaret A

    2017-09-01

    Sleep disturbance during intensive care unit (ICU) admission is common and severe. Sleep disturbance has been observed in survivors of critical illness even after transfer out of the ICU. Not only is sleep important to overall health and well being, but patients after critical illness are also in a physiologically vulnerable state. Understanding how sleep disturbance impacts recovery from critical illness after hospital discharge is therefore clinically meaningful. This Systematic Review aimed to summarize studies that identify the prevalence of and risk factors for sleep disturbance after hospital discharge for critical illness survivors. PubMed (January 4, 2017), MEDLINE (January 4, 2017), and EMBASE (February 1, 2017). Databases were searched for studies of critically ill adult patients after hospital discharge, with sleep disturbance measured as a primary outcome by standardized questionnaire or objective measurement tools. From each relevant study, we extracted prevalence and severity of sleep disturbance at each time point, objective sleep parameters (such as total sleep time, sleep efficiency, and arousal index), and risk factors for sleep disturbance. A total of 22 studies were identified, with assessment tools including subjective questionnaires, polysomnography, and actigraphy. Subjective questionnaire studies reveal a 50-66.7% (within 1 mo), 34-64.3% (>1-3 mo), 22-57% (>3-6 mo), and 10-61% (>6 mo) prevalence of abnormal sleep after hospital discharge after critical illness. Of the studies assessing multiple time points, four of five questionnaire studies and five of five polysomnography studies show improved aspects of sleep over time. Risk factors for poor sleep varied, but prehospital factors (chronic comorbidity, pre-existing sleep abnormality) and in-hospital factors (severity of acute illness, in-hospital sleep disturbance, pain medication use, and ICU acute stress symptoms) may play a role. Sleep disturbance was frequently associated with

  8. Recruitment, Methods, and Descriptive Results of a Physiologic Assessment of Latino Farmworkers: The California Heat Illness Prevention Study.

    Science.gov (United States)

    Mitchell, Diane C; Castro, Javier; Armitage, Tracey L; Vega-Arroyo, Alondra J; Moyce, Sally C; Tancredi, Daniel J; Bennett, Deborah H; Jones, James H; Kjellstrom, Tord; Schenker, Marc B

    2017-07-01

    The California heat illness prevention study (CHIPS) devised methodology and collected physiological data to assess heat related illness (HRI) risk in Latino farmworkers. Bilingual researchers monitored HRI across a workshift, recording core temperature, work rate (metabolic equivalents [METs]), and heart rate at minute intervals. Hydration status was assessed by changes in weight and blood osmolality. Personal data loggers and a weather station measured exposure to heat. Interviewer administered questionnaires were used to collect demographic and occupational information. California farmworkers (n = 588) were assessed. Acceptable quality data was obtained from 80% of participants (core temperature) to 100% of participants (weight change). Workers (8.3%) experienced a core body temperature more than or equal to 38.5 °C and 11.8% experienced dehydration (lost more than 1.5% of body weight). Methodology is presented for the first comprehensive physiological assessment of HRI risk in California farmworkers.

  9. Relatives perception of writing diaries for critically ill

    DEFF Research Database (Denmark)

    Nielsen, Anne Højager; Angel, Sanne

    2015-01-01

    for the critically patients, they experienced that writing and reading the diary allowed for the unloading of emotions and expression of feelings. Writing a diary was a meaningful activity while enduring a situation of uncertainty and furthermore it created a distance that allowed understanding of the critical......BACKGROUND: Diaries written by nurses for the critically ill patient help the relatives cope and support the patient. Relatives may participate in writing a diary for the critically ill and when they do this is appreciated by the patients. However, the relative's perception of writing a diary has...... not previously been explored. AIM: To explore how relatives perceive writing a diary for the critically ill patient. METHOD: In a phenomenological-hermeneutic study building on the theory of Ricoeur interviews with seven relatives were conducted and interpreted. FINDINGS: When relatives wrote a diary...

  10. Illness perceptions in Greek patients with cancer: a validation of the Revised-Illness Perception Questionnaire.

    Science.gov (United States)

    Giannousi, Zoe; Manaras, Irene; Georgoulias, Vassilis; Samonis, George

    2010-01-01

    The Revised-Illness Perception Questionnaire (IPQ-R) assesses illness perceptions according to Leventhal's self-regulatory model. The aim of this paper is to present findings on the reliability and validity of the IPQ-R in a population of Greek cancer patients. A total of 206 patients completed a Greek translation of the IPQ-R and the Greek version of the Beck Depression Inventory (BDI). The scale's reliability was investigated by examining its internal consistency (Cronbach's alpha) and its test-retest reliability. Structural validity was examined through factor analyses. Predictive validity was tested by regressing BDI scores on IPQ subscale scores. Inter-relationships between IPQ-R dimensions were also examined by computing Pearson's Correlation Coefficients. Cronbach's alpha showed satisfactory internal consistency for the IPQ-R subscales. Paired samples' t-test showed good test-retest reliability. Factor analysis of the IPQ-R items revealed that the Greek version reflects the structure of the original with the only difference being that the 'Consequences' and 'Emotional Representations' subscales loaded on one factor. Factor analysis of the causal dimension items revealed a different structure of Causal Representations than that of the original questionnaire yielding three main factors: Psychological Attributions, Behavioral, and External Factors. Multiple regression analyses showed that Consequences, Emotional Representations, Illness Identity, and Psychological Attributions were the best predictors for depression. Translation of the IPQ-R has good reliability and similar structure to that of the original. Difficulties to confirm the structure of Causal Representations may represent cultural differences in understanding illness causation. (c) 2009 John Wiley & Sons, Ltd.

  11. Writing about an experience of illness in medical students.

    Science.gov (United States)

    Hwang, Kun; Fan, Huan; Hwang, Se Won

    2013-01-01

    Pathography is defined as "historical biography from a medical, psychological, and psychiatric viewpoint." We thought that writing about an experience of illness might help students understand patients' experience and in turn grow in terms of self-understanding. Participants included 151 medical students. Students wrote about their own experience of illness and were asked to answer questions from the Likert scale. Most students wrote about themselves (79.2%); however, some students (20.8%) wrote about the illness of others. Among the 149 pathographies, ecopathography was most frequent (30.9%), followed by testimonial pathography (25.5%); angry pathography (13.4%) and alternative pathography (12.1%) were relatively less frequent. Eighty-eight pathographies (59.1%) showed 120 expressions of family relationship. Among the 120 cases, worrying about family members was most frequent (47.5%), followed by reliance on a family member (32.5%). All students wrote about the enlightenment experienced on returning to daily life. The sense of belonging together was most frequent (38.3%), followed by gratitude for living (20.8%), resolution to be a good doctor (18.1%), and a will to live and be healthy (12.1%). Answers on the Likert scale (total 5) for pathography beneficence were very high in understanding desirable doctor image (4.46), attaining morals and personality as a health care professional (4.49), and understanding basic communication skills (4.46). Writing about an experience of illness allows students to better understand patients' experience and to grow in self-understanding.

  12. Illness representations of cancer among healthy residents of Kolkata, India.

    Science.gov (United States)

    Das, Lala Tanmoy; Wagner, Christina D; Bigatti, Silvia M

    2015-01-01

    Cancer illness representations and screening history among residents of Kolkata, India, were investigated along with socio-demographic characteristics in an effort to understand possible motivations for health behavior. A total of 106 participants were recruited from community locations in Kolkata, India and completed surveys including demographics, the illness perception questionnaire-revised (IPQ-R), and previous experience with cancer and screening practices. Participants were 51.5% college educated, 57% female, 51.5% full-time employed with average age of 32.7 years (R: 18-60 years). Descriptive statistics were generated for the subscales of the IPQ-R, cancer-screening practices and cancer experience. Correlation analyses were conducted to investigate associations between cancer representations and socio-demographic variables. Univariate ANOVAs were calculated to determine gender differences in IPQ-R subscales and differences between participants who knew someone diagnosed with cancer versus those who did not. While 76% of participants knew someone with cancer, only 5% of the sample engaged in cancer screening. Participants perceived cancer as a serious illness with negative emotional valence. Younger age (r(100)=-.36, p<0.001) and male gender (F(1, 98)=5.22, p=0.01, η2=0.05) were associated with better illness coherence. Males also reported greater personal control (F(1, 98)=5.34, p=0.02, η2=0.05) were associated with better illness coherence. Low screening rates precluded analyses of the relationship between illness representations and cancer screening. Cancer was viewed as a threatening and uncontrollable disease among this sample of educated, middle class Kolkata residents. This view may act as a barrier to seeking cancer screening. Public awareness campaigns aimed at improving understanding of the causes, symptoms and consequences of cancer might reduce misunderstandings and fear, especially among women and older populations, who report less

  13. Comparison of illness representations dimensions and illness representation clusters in predicting outcomes in the first year following diagnosis of type 2 diabetes

    DEFF Research Database (Denmark)

    Skinner, T. C.; Carey, M. E.; Cradock, S.

    2011-01-01

    description of the data. The mean profiles of these clusters were comparable with groups identified by the independent qualitative analysis, and predicted the trajectory of illness outcomes over the 1-year follow-up. Combining illness beliefs into discrete clusters may be more useful in understanding patterns......This article explores the utility of cluster analysis of illness representations, in comparison to analysing each dimension of the individual's illness representation, to predict an individual's response to diagnosis of type 2 diabetes. Participants in a large multi-centre randomised controlled...... of the cluster analysis were compared with an independent qualitative study of participants' responses to diagnosis and participation in the study. The quantitative analysis of 564 participants for whom complete data were available, identified four clusters of illness representations as the most parsimonious...

  14. Understanding translation

    DEFF Research Database (Denmark)

    Schjoldager, Anne Gram; Gottlieb, Henrik; Klitgård, Ida

    Understanding Translation is designed as a textbook for courses on the theory and practice of translation in general and of particular types of translation - such as interpreting, screen translation and literary translation. The aim of the book is to help you gain an in-depth understanding...... of the phenomenon of translation and to provide you with a conceptual framework for the analysis of various aspects of professional translation. Intended readers are students of translation and languages, but the book will also be relevant for others who are interested in the theory and practice of translation...... - translators, language teachers, translation users and literary, TV and film critics, for instance. Discussions focus on translation between Danish and English....

  15. Illness perceptions in adolescents with a psychiatric diagnosis in Pakistan

    Science.gov (United States)

    Imran, Nazish; Azeem, Muhammad Waqar; Chaudhry, Mansoor R.; Butt, Zeeshan

    2015-01-01

    Aims and method To assess adolescents' perceptions of their psychiatric illness and the role of various demographic factors in a Pakistani setting. Adolescents with various psychiatric diagnoses were interviewed using a structured questionnaire including the Illness Perceptions Questionnaire–Revised (IPQ-R). Results Fifty-two adolescents with various psychiatric illnesses were interviewed; their mean age was 12.7 years and the majority (67%) were female. Males had significantly higher scores on timeline and emotional representation (P<0.05), suggesting strongly held beliefs about chronicity of their illness and anger and worry about their condition. Adolescents' own emotional state, stress, family problems and bad luck were endorsed by participants as some of the causal factors in their mental illness. Clinical implications Despite the importance of early intervention in psychiatric problems, engaging youth in the treatment process in Pakistan remains difficult. Better understanding of how adolescents perceive their psychiatric difficulties may play a significant role in developing culturally sensitive interventions and better utilisation of services. PMID:26755949

  16. DIFFERENCES IN ILLNESS REPRESENTATIONS IN PATIENTS WITH CHRONIC KIDNEY DISEASE.

    Science.gov (United States)

    Pagels, Agneta A; Söderquist, Birgitta Klang; Heiwe, Susanne

    2015-09-01

    To explore the impact of chronic kidney disease (CKD) on individual illness representations, including symptoms and causal attributions. Fifty-four patients responded to the Illness Perception Questionnaire (IPQ-R) and a further seven patients undertook cognitive interviews regarding the IPQ-R. All respondents had CKD stage 2-5, not undergoing renal replacement therapy. Those in earlier CKD stages and those with fewer symptoms perceived a significantly different understanding of their condition than those in more advanced disease stages or with more symptoms. Behavioural and psychological attributions were commonly referred to as contributing causes to CKD. These attributions were associated to negative illness representations. An uncertainty assessing symptoms attributed to CKD was indicated, especially in earlier disease stages. Illness representations differ with CKD stages and symptom burden. The patients in earlier disease stages or with fewer symptoms did not hold as strong beliefs about their illness as being a threat as those in advanced stages or with more symptoms. Self-blame emerged as a common causal attribution. Patients did not always relate symptoms to CKD, therefore this study identifies a gap in patients' disease knowledge, especially in earlier stages of the condition. © 2015 European Dialysis and Transplant Nurses Association/European Renal Care Association.

  17. Understand electronics

    CERN Document Server

    Bishop, Owen

    2013-01-01

    Understand Electronics provides a readable introduction to the exciting world of electronics for the student or enthusiast with little previous knowledge. The subject is treated with the minimum of mathematics and the book is extensively illustrated.This is an essential guide for the newcomer to electronics, and replaces the author's best-selling Beginner's Guide to Electronics.The step-by-step approach makes this book ideal for introductory courses such as the Intermediate GNVQ.

  18. Understanding users

    DEFF Research Database (Denmark)

    Johannsen, Carl Gustav Viggo

    2014-01-01

    Segmentation of users can help libraries in the process of understanding user similarities and differences. Segmentation can also form the basis for selecting segments of target users and for developing tailored services for specific target segments. Several approaches and techniques have been...... segmentation project using computer-generated clusters. Compared to traditional marketing texts, this article also tries to identify user segments or images or metaphors by the library profession itself....

  19. Understanding unemployment

    OpenAIRE

    Guillaume Rocheteau

    2006-01-01

    Modern economists have built models of the labor market, which isolate the market’s key drivers and describe the way these interact to produce particular levels of unemployment. One of the most popular models used by macroeconomists today is the search-matching model of equilibrium unemployment. We explain this model, and show how it can be applied to understand the way various policies, such as unemployment benefits, taxes, or technological changes, can affect the unemployment rate.

  20. Understanding Technology?

    Directory of Open Access Journals (Sweden)

    Erik Bendtsen

    2016-11-01

    Full Text Available We are facing radical changes in our ways of living in the nearest future. Not necessarily of our own choice, but because tchnological development is moving so fast, that it will have still greater impact on many aspects of our lives. We have seen the beginnings of that change within the latest 35 years or so, but according to newest research that change will speed up immensely in the nearest years to come. The impact of that change or these changes will affect our working life immensely as a consequence of automation. How these changes are brought about and which are their consequences in a broad sense is being attempted to be understood and guessed by researchers. No one knows for sure, but specific patterns are visible. This paper will not try to guess, what will come, but will rather try to understand the deepest ”nature” of technology in order to understand the driving factors in this development: the genesis of technology in a broad sense in order to contibute to the understanding of the basis for the expected development.

  1. "Remember the bubbles hurt you when you cook in the pan": young children's views of illness causality.

    Science.gov (United States)

    McIntosh, Caroline; Stephens, Christine; Lyons, Antonia

    2013-01-01

    The present study examines four-year-old children's everyday understandings of illness causality. Research into young children's conceptualisation of illness has led to different expectations of children's comprehension and ongoing debate regarding the nature of children's knowledge. Awareness of preschoolers' spontaneous views of illness causality, rather than explanations restricted by predetermined response categories, is likely to assist practitioners to provide more appropriate interventions for young children. Adopting a socio-constructivist perspective of children's learning and development, and using a narrative methodology, we interviewed five preschoolers regarding their views of illness causality. As part of the interview process children were invited to construct their own storybooks about illness using photographs of children experiencing illness and a variety of art materials. Analysis of young children's narrative accounts revealed two major threads regarding children's illness causality constructions: (1) "behaviour-based explanations for illness", and (2) "illness prevention messages and behavioural rules". Findings suggest that four-year-olds' understanding may be more sophisticated than traditionally maintained, and that the illness prevention messages and behavioural rules within sociocultural contexts may significantly influence children's conceptualisation of illness causality.

  2. Machismo sustains health and illness beliefs of Mexican American men.

    Science.gov (United States)

    Sobralske, Mary

    2006-08-01

    To inform nurse practitioners (NPs) about Mexican American men's health and illness beliefs and the ways in which these are influenced by their masculine identity and how they view themselves as men in their culture. The data sources used were based on a selected review of the literature about Mexican American men's health and illness beliefs and the concept of machismo. Several studies, including the author's study on Mexican American men's healthcare-seeking beliefs and behaviors and experience in providing primary health care to men across cultures, contributed new data. The meaning of manhood in the Mexican American culture is critical in understanding how men perceive health and illness and what they do when they are ill. Machismo enhances men's awareness of their health because they have to be healthy to be good fathers, husbands, brothers, sons, workers, and community members. Pain and disability are motivating factors in finding ways to regain their health. Men's health beliefs across cultures need further investigation by nurse researchers and NPs. How culture influences healthcare delivery to men should be better understood. If NPs are aware of men's views on masculinity, they are better prepared to understand and assist men in becoming more aware of their health status and to seek health care when appropriate.

  3. Adult Neurogenesis and Mental Illness

    Science.gov (United States)

    Schoenfeld, Timothy J; Cameron, Heather A

    2015-01-01

    Several lines of evidence suggest that adult neurogenesis, the production of new neurons in adulthood, may play a role in psychiatric disorders, including depression, anxiety, and schizophrenia. Medications and other treatments for mental disorders often promote the proliferation of new neurons; the time course for maturation and integration of new neurons in circuitry parallels the delayed efficacy of psychiatric therapies; adverse and beneficial experiences similarly affect development of mental illness and neurogenesis; and ablation of new neurons in adulthood alters the behavioral impact of drugs in animal models. At present, the links between adult neurogenesis and depression seem stronger than those suggesting a relationship between new neurons and anxiety or schizophrenia. Yet, even in the case of depression there is currently no direct evidence for a causative role. This article reviews the data relating adult neurogenesis to mental illness and discusses where research needs to head in the future. PMID:25178407

  4. 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.

  5. Understanding uncertainty

    CERN Document Server

    Lindley, Dennis V

    2013-01-01

    Praise for the First Edition ""...a reference for everyone who is interested in knowing and handling uncertainty.""-Journal of Applied Statistics The critically acclaimed First Edition of Understanding Uncertainty provided a study of uncertainty addressed to scholars in all fields, showing that uncertainty could be measured by probability, and that probability obeyed three basic rules that enabled uncertainty to be handled sensibly in everyday life. These ideas were extended to embrace the scientific method and to show how decisions, containing an uncertain element, could be rationally made.

  6. Mental illness disclosure in Chinese immigrant communities

    OpenAIRE

    Chen, Fang-pei; Ying-Chi Lai, Grace; Yang, Lawrence

    2013-01-01

    Support from social networks is imperative to mental health recovery of persons with mental illness. However, disclosing mental illness may damage a person’s participation in networks due to mental illness stigma, especially in Chinese-immigrant communities where social networks (the guanxi network) has specific social-cultural significance. This study focused on mental illness disclosure in Chinese-immigrant communities in New York City. Fifty-three Chinese psychiatric patients were recruite...

  7. Illness narratives of people who are homeless

    OpenAIRE

    H?kanson, Cecilia; ?hl?n, Joakim

    2016-01-01

    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...

  8. Mechanisms in Chronic Multisympton Illnesses

    Science.gov (United States)

    2007-10-01

    total hip arthroplasty : an outcome measure of hip osteoarthritis? J Rheumatol 1999;26: 855–61. 3506 BINGHAM ET AL 53. Adami S, Pavelka K, Cline GA...have recruited 125 new subjects. This brings our total number of subjects for the Registry to 504. We have continued to schedule and screen...accepted with revisions . 13 Title: Mechanisms in Chronic Multisymptom Illnesses PI: Clauw *Petrou M, Harris RE, Foerster BR, Mclean SA, Sen A

  9. Stereotactic lesioning for mental illness.

    Science.gov (United States)

    Kim, M-C; Lee, T-K

    2008-01-01

    The authors report stereotactically created lesioning by radiofrequency or Cyberknife radiosurgery for patients with mental illness. Since 1993, thirty-eight patients have undergone stereotactic psychosurgery for medically intractable mental illnesses. Two patients had aggressive behavior. Twenty-five patients suffered from Obsessive-Compulsive Disorder (OCD) and ten patients had depression. Another patient suffered from atypical psychosis. Bilateral amygdalotomy and subcaudate tractotomy were done for aggressive behavior. Limbic leucotomy or anterior cingulotomy was done for OCD and subcaudate tractotomy with or without cingulotomy was done for depression. In twenty-three patients, the lesions were made by a radiofrequency (RF) lesion generator. In fifteen cases, the lesions were made with CyberKnife Radiosurgery (CKRS). The Overt Aggression Scale (OAS) declined from 8 to 2 with clinical improvement during follow up period. With long-term follow up (meaning 57 months) in 25 OCDs, the mean Yale Brown Obsessive Compulsive Score (YBOCS) declined from 34 to 13 (n = 25). The Hamilton Depression scale (HAMD) for ten patients with depression declined from 38.5 to 10.5 (n = 10). There was no operative mortality and no significant morbidity except one case with transient urinary incontinence. Authors suggest that stereotactic psychosurgery by RF and CKRS could be a safe and effective means of treating some medically intractable mental illnesses.

  10. Stereotactic lesioning for mental illness

    International Nuclear Information System (INIS)

    Kim, M.-C.; Lee, T.-K.

    2008-01-01

    The authors report stereotactically created lesioning by radiofrequency or Cyberknife radiosurgery for patients with mental illness. Since 1993, thirty-eight patients have undergone stereotactic psychosurgery for medically intractable mental illnesses. Two patients had aggressive behavior. Twenty-five patients suffered from Obsessive-Compulsive Disorder (OCD) and ten patients had depression. Another patient suffered from atypical psychosis. Bilateral amygdalotomy and subcaudate tractotomy were done for aggressive behavior. Limbic leucotomy or anterior cingulotomy was done for CCD and subcaudate tractotomy with or without cingulotomy was done for depression. In twenty-three patients, the lesions were made by a radiofrequency (RF) lesion generator. In fifteen cases, the lesions were made with Cyberknife Radiosurgery (CKRS). The Overt Aggression Scale (OAS) declined from 8 to 2 with clinical improvement during follow up period. With long-term follow up (meaning 57 months) in 25 OCDs, the mean Yale Brown Obsessive Compulsive Score (YBOCS) declined from 34 to 13 (n = 25). The Hamilton Depression scale (HAMD) for ten patients with depression declined from 38.5 to 10.5 (n = 10). There was no operative mortality and no significant morbidity except one case with transient urinary incontinence. Authors suggest that stereotactic psychosurgery by RF and CKRS could be a safe and effective means of treating some medically intractable mental illnesses. (author)

  11. Delirium in critically ill patients.

    Science.gov (United States)

    Slooter, A J C; Van De Leur, R R; Zaal, I J

    2017-01-01

    Delirium is common in critically ill patients and associated with increased length of stay in the intensive care unit (ICU) and long-term cognitive impairment. The pathophysiology of delirium has been explained by neuroinflammation, an aberrant stress response, neurotransmitter imbalances, and neuronal network alterations. Delirium develops mostly in vulnerable patients (e.g., elderly and cognitively impaired) in the throes of a critical illness. Delirium is by definition due to an underlying condition and can be identified at ICU admission using prediction models. Treatment of delirium can be improved with frequent monitoring, as early detection and subsequent treatment of the underlying condition can improve outcome. Cautious use or avoidance of benzodiazepines may reduce the likelihood of developing delirium. Nonpharmacologic strategies with early mobilization, reducing causes for sleep deprivation, and reorientation measures may be effective in the prevention of delirium. Antipsychotics are effective in treating hallucinations and agitation, but do not reduce the duration of delirium. Combined pain, agitation, and delirium protocols seem to improve the outcome of critically ill patients and may reduce delirium incidence. © 2017 Elsevier B.V. All rights reserved.

  12. Understanding analysis

    CERN Document Server

    Abbott, Stephen

    2015-01-01

    This lively introductory text exposes the student to the rewards of a rigorous study of functions of a real variable. In each chapter, informal discussions of questions that give analysis its inherent fascination are followed by precise, but not overly formal, developments of the techniques needed to make sense of them. By focusing on the unifying themes of approximation and the resolution of paradoxes that arise in the transition from the finite to the infinite, the text turns what could be a daunting cascade of definitions and theorems into a coherent and engaging progression of ideas. Acutely aware of the need for rigor, the student is much better prepared to understand what constitutes a proper mathematical proof and how to write one. Fifteen years of classroom experience with the first edition of Understanding Analysis have solidified and refined the central narrative of the second edition. Roughly 150 new exercises join a selection of the best exercises from the first edition, and three more project-sty...

  13. Understanding ayurveda.

    Science.gov (United States)

    Gadgil, Vaidya Dilip

    2010-01-01

    Ayurveda needs to achieve its full potential both in India and globally. This requires imparting to its students full appreciation of Ayurveda's power and strength, particularly proper understanding of the advantages of applying it to treat chronic and acute diseases. To this end, we explain the necessity of learning Sanskrit as a medium of study, and the advantages of learning the Texts in the traditional way, rather than relying on translations with all the loss of meaning and precision, which that entails. We emphasize the use of Triskandhakosha as a means to fully understand Ayurveda fundamental concepts and technical terms, so that all their shades of meaning are fully understood, and all their usages given in different places in the texts. Only by such methods can full appreciation of Ayurvedic wisdom be achieved, and the full depth and power of its knowledge be applied. Only then will its true status among systems of medicine come to be appreciated, either in India or more widely in the world as a whole.

  14. Understanding Ayurveda

    Directory of Open Access Journals (Sweden)

    Vaidya Dilip Gadgil

    2010-01-01

    Full Text Available Ayurveda needs to achieve its full potential both in India and globally. This requires imparting to its students full appreciation of Ayurveda′s power and strength, particularly proper understanding of the advantages of applying it to treat chronic and acute diseases. To this end, we explain the necessity of learning Sanskrit as a medium of study, and the advantages of learning the Texts in the traditional way, rather than relying on translations with all the loss of meaning and precision, which that entails. We emphasize the use of Triskandhakosha as a means to fully understand Ayurveda fundamental concepts and technical terms, so that all their shades of meaning are fully understood, and all their usages given in different places in the texts. Only by such methods can full appreciation of Ayurvedic wisdom be achieved, and the full depth and power of its knowledge be applied. Only then will its true status among systems of medicine come to be appreciated, either in India or more widely in the world as a whole.

  15. Pathways to homelessness among the mentally ill.

    Science.gov (United States)

    Sullivan, G; Burnam, A; Koegel, P

    2000-10-01

    Persons with mental illness are over-represented among the homeless relative to the general population, and mental illness is most likely one of many vulnerabilities that confer risk for homelessness. This paper elucidates the pathways to homelessness for persons with mental illness by comparing and contrasting groups of mentally ill homeless persons, non-mentally ill homeless persons, and housed mentally ill persons drawn from RAND's Course of Homelessness (COH) study and the Epidemiological Catchment Area (ECA) survey. Homeless persons share childhood histories of economic and social disadvantage. The mentally ill homeless appear to have a "double dose" of disadvantage: poverty with the addition of childhood family instability and violence. Among the mentally ill homeless, those who became homeless prior to becoming mentally ill have the highest levels of disadvantage and disruption; while those who become homeless after becoming ill have an especially high prevalence of alcohol dependence. Mental illness may play a role in initiating homelessness for some, but is unlikely in and of itself to be a sufficient risk factor for homelessness. In addition to outreach and treatment programs for adult mentally ill homeless persons, emphasis should be placed on interventions with children and on addressing more pervasive causes of homelessness.

  16. Art promoting mental health literacy and a positive attitude towards people with experience of mental illness.

    Science.gov (United States)

    Koh, Eugen; Shrimpton, Bradley

    2014-03-01

    Exhibitions of art by people with experience of mental illness are increasingly being staged to improve awareness of mental health issues in the general community and to counter the stigma of mental illness. However, few exhibitions have incorporated research to ascertain their actual effectiveness. This paper reports the results of a study that considered the responses of 10,000 people after they viewed exhibitions of art produced by people with experience of mental illness. These works were selected from the Cunningham Dax Collection, one of the world's most extensive collection of artworks by people with experience of mental illness and/or psychological trauma. More than 90% of respondents agreed with three propositions that the exhibitions helped them: (1) gain a better understanding of mental illness; (2) gain a more sympathetic understanding of the suffering of people with mental illness; and (3) appreciate the ability and creativity of people with mental illness. The results suggest that exhibitions can successfully promote mental health literacy and contribute to positive attitudes towards people with experience of mental illness. This paper explores these findings and raises questions about how the presentation of artworks in an exhibition influences their effectiveness in mental health promotion.

  17. Communicating the experience of chronic pain and illness through blogging.

    Science.gov (United States)

    Ressler, Pamela Katz; Bradshaw, Ylisabyth S; Gualtieri, Lisa; Chui, Kenneth Kwan Ho

    2012-10-23

    Although more individuals are sharing their experiences with chronic pain or illness through blogging (writing an Internet web log), research on the psychosocial effects and motivating factors for initiating and maintaining a blog is lacking. The objective was to examine via online questionnaire the perceived psychosocial and health benefits of blogging among patients who use this media to communicate their experience of chronic pain or illness. A 34-item online questionnaire was created, tested, and promoted through online health/disease forums. The survey employed convenience sampling and was open from May 5 to July 2, 2011. Respondents provided information regarding demographics, health condition, initiation and upkeep of blogs, and dynamics of online communication. Qualitative data regarding respondents' blogging experiences, expectations for blogging, and the perceived effects from blogging on the blogger's health, interpersonal relationships, and quality of life were collected in the form of written narrative. Out of 372 respondents who started the survey, 230 completed the entire questionnaire. Demographic data showed survey respondents to be predominantly female (81.8%) and highly educated (97.2% > high school education and 39.6% with graduate school or professional degrees). A wide spectrum of chronic pain and illness diagnoses and comorbidities were represented. Respondents reported that initiating and maintaining an illness blog resulted in increased connection with others, decreased isolation, and provided an opportunity to tell their illness story. Blogging promoted accountability (to self and others) and created opportunities for making meaning and gaining insights from the experience of illness, which nurtured a sense of purpose and furthered their understanding of their illness. Results suggest that blogging about chronic pain and illness may decrease a sense of isolation through the establishment of online connections with others and increases a

  18. Understanding diversity in impact and responses among HIV/AIDS ...

    African Journals Online (AJOL)

    AIDS-related illnesses on people's mind and spirit (the internal environment), and 2) the influence of institutional structures and processes (the external environment), in order to better understand 3) the actions taken by individuals and households ...

  19. Mental Health Professionals' Attitudes Toward Offenders With Mental Illness (Insanity Acquittees) in Ghana.

    Science.gov (United States)

    Adjorlolo, Samuel; Abdul-Nasiru, Inusah; Chan, Heng Choon Oliver; Bambi, Laryea Efua

    2018-02-01

    Mental health professionals' attitudes toward offenders with mental illness have significant implications for the quality of care and treatment rendered, making it imperative for these professionals to be aware of their attitudes. Yet, this topical issue has received little research attention. Consequently, the present study investigates attitudes toward offenders with mental illness (insanity acquittees) in a sample of 113 registered mental health nurses in Ghana. Using a cross-sectional survey and self-report methodology, the participants respond to measures of attitudes toward offenders with mental illness, attitudes toward mental illness, conviction proneness, and criminal blameworthiness. The results show that mental health nurses who reportedly practiced for a longer duration (6 years and above) were more likely to be unsympathetic, while the male nurses who were aged 30 years and above were more likely to hold offenders with mental illness strictly liable for their offenses. Importantly, the nurses' scores in conviction proneness and criminal blameworthiness significantly predict negative attitudes toward the offenders even after controlling for their attitudes toward mental illness. Yet, when the nurses' conviction proneness and criminal blameworthiness were held constant, their attitudes toward mental illness failed to predict attitudes toward the offenders. This initial finding implies that the nurses' views regarding criminal blameworthiness and conviction may be more influential in understanding their attitudes toward offenders with mental illness relative to their attitudes toward mental illness.

  20. Understanding physics

    CERN Document Server

    Cassidy, David; Rutherford, James

    2002-01-01

    Understanding Physics provides a thorough grounding in contemporary physics while placing physics into its social and historical context Based in large part on the highly respected Project Physics Course developed by two of the authors, it also integrates the results of recent pedagogical research The text thus - teaches about the basic phenomena in the physical world and the concepts developed to explain them - shows that science is a rational human endeavor with a long and continuing tradition, involving many different cultures and people - develops facility in critical thinking, reasoned argumentation, evaluation of evidence, mathematical modeling, and ethical values The treatment emphasizes not only what we know but also how we know it, why we believe it, and what effects that knowledge has - Why do we believe the Earth and planets revolve around the Sun? - Why do we believe that matter is made of atoms? - How do relativity theory and quantum mechanics alter our conception of Nature and in what ways do th...

  1. Mental Illness and Firearms: Legal Context and Clinical Approaches.

    Science.gov (United States)

    Pinals, Debra A; Anacker, Lisa

    2016-12-01

    Gun violence and mental illness is a major area of media attention, especially because highly publicized mass shootings seem to have become more commonly reported in the press. Gun access also is undergoing a highly politicized debate in the United States. It is important for mental health practitioners to understand the background and context of laws related to firearms access, and to understand data related to risk of suicide and violence toward others caused by gun violence among persons with mental illness. In addition, clinically driven risk assessments with specific inquiry related to firearms can be important for identifying individuals for whom firearm-focused clinical risk mitigation may be warranted. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. Associations between illness perceptions and health-related quality of life in adults with cystic fibrosis.

    Science.gov (United States)

    Sawicki, Gregory S; Sellers, Deborah E; Robinson, Walter M

    2011-02-01

    The objective of this work was to examine the relationship between illness perception, health status, and health-related quality of life (HRQOL) in a cohort of adults with cystic fibrosis (CF). In the Project on Adult Care in Cystic Fibrosis, we administered five subscales (Illness Consequences, Illness Coherence, Illness Timeline--Cyclical, Personal Control, and Treatment Control) of the Illness Perception Questionnaire--Revised (IPQ-R). Multivariable linear regression analyses explored the associations between illness perception, health status, symptom burden, and physical and psychosocial HRQOL, as measured by various domains of the Cystic Fibrosis Questionnaire--Revised (CFQ-R). Among the 199 respondents (63% female; mean age, 36.8 ± 10.2 years), IPQ-R scores did not differ on age, gender, or lung function. In multivariable regression models, neither clinical characteristics nor physical or psychological symptom burden scores were associated with CFQ-R physical domains. In contrast, higher scores on Illness Consequences were associated with lower psychosocial CFQ-R scores. Higher scores on the Illness Coherence and Personal Control scales were associated with higher psychosocial CFQ-R scores. Adults with CF report a high understanding of their disease, feel that CF has significant consequences, and endorse both personal and treatment control over their outcomes. Illness perceptions did not vary with increased age or worsening disease severity, suggesting that illness perceptions may develop during adolescence. Illness perceptions were associated with psychosocial, but not physical, aspects of HRQOL. Efforts to modify illness perceptions as part of routine clinical care and counseling may lead to improved quality of life for adults with CF. Copyright © 2011 Elsevier Inc. All rights reserved.

  3. Information processing in illness representation: Implications from an associative-learning framework.

    Science.gov (United States)

    Lowe, Rob; Norman, Paul

    2017-03-01

    The common-sense model (Leventhal, Meyer, & Nerenz, 1980) outlines how illness representations are important for understanding adjustment to health threats. However, psychological processes giving rise to these representations are little understood. To address this, an associative-learning framework was used to model low-level process mechanics of illness representation and coping-related decision making. Associative learning was modeled within a connectionist network simulation. Two types of information were paired: Illness identities (indigestion, heart attack, cancer) were paired with illness-belief profiles (cause, timeline, consequences, control/cure), and specific illness beliefs were paired with coping procedures (family doctor, emergency services, self-treatment). To emulate past experience, the network was trained with these pairings. As an analogue of a current illness event, the trained network was exposed to partial information (illness identity or select representation beliefs) and its response recorded. The network (a) produced the appropriate representation profile (beliefs) for a given illness identity, (b) prioritized expected coping procedures, and (c) highlighted circumstances in which activated representation profiles could include self-generated or counterfactual beliefs. Encoding and activation of illness beliefs can occur spontaneously and automatically; conventional questionnaire measurement may be insensitive to these automatic representations. Furthermore, illness representations may comprise a coherent set of nonindependent beliefs (a schema) rather than a collective of independent beliefs. Incoming information may generate a "tipping point," dramatically changing the active schema as a new illness-knowledge set is invoked. Finally, automatic activation of well-learned information can lead to the erroneous interpretation of illness events, with implications for [inappropriate] coping efforts. (PsycINFO Database Record (c) 2017 APA, all

  4. Psychosocial characteristics of chronically ill child

    OpenAIRE

    Tomažič, Tjaša

    2016-01-01

    In this thesis, I would like to draw attention to the impact of long-term illness and prolonged hospitalization on the life of the ill child and his family. The effects of the illness are often overlooked and people do not receive the assistance they need to deal with it. In the theoretical part of the thesis, I define the term »long-term« illness and I pay attention to different strategies to cope with it. I indicate signs that show the presence of consequences of the long-term illness and p...

  5. The cool seal system: a practical solution to the shaft seal problem and heat related complications with implantable rotary blood pumps.

    Science.gov (United States)

    Yamazaki, K; Mori, T; Tomioka, J; Litwak, P; Antaki, J F; Tagusari, O; Koyanagi, H; Griffith, B P; Kormos, R L

    1997-01-01

    offers a practical solution to the shaft seal problem and heat related complications, which currently limit the use of implantable rotary blood pumps.

  6. Understanding healthful eating from a salutogenic perspective

    NARCIS (Netherlands)

    Swan, E.C.

    2016-01-01

    The biomedical model of health orients towards pathogenesis, the study of disease origins and causes. The starting point is to understand determinants of ill-health, and health is defined in this model as the absence of disease. When applied to nutrition research, the underlying assumption is that

  7. Understanding healthful eating from a salutogenic perspective

    NARCIS (Netherlands)

    Swan, E.C.

    2016-01-01

    The biomedical model of health orients towards pathogenesis, the study of disease origins and causes. The starting point is to understand determinants of ill-health, and health is defined in this model as the absence of disease. When applied to nutrition research, the underlying assumption is

  8. New frontiers in animal research of psychiatric illness.

    Science.gov (United States)

    Kaffman, Arie; Krystal, John H; Krystal, John J

    2012-01-01

    Alterations in neurodevelopment are thought to modify risk of numerous psychiatric disorders, including schizophrenia, autism, ADHD, mood and anxiety disorders, and substance abuse. However, little is known about the cellular and molecular changes that guide these neurodevelopmental changes and how they contribute to mental illness. In this review, we suggest that elucidating this process in humans requires the use of model organisms. Furthermore, we advocate that such translational work should focus on the role that genes and/or environmental factors play in the development of circuits that regulate specific physiological and behavioral outcomes in adulthood. This emphasis on circuit development, as a fundamental unit for understanding behavior, is distinct from current approaches of modeling psychiatric illnesses in animals in two important ways. First, it proposes to replace the diagnostic and statistical manual of mental disorders (DSM) diagnostic system with measurable endophenotypes as the basis for modeling human psychopathology in animals. We argue that a major difficulty in establishing valid animal models lies in their reliance on the DSM/International Classification of Diseases conceptual framework, and suggest that the Research Domain Criteria project, recently proposed by the NIMH, provides a more suitable system to model human psychopathology in animals. Second, this proposal emphasizes the developmental origin of many (though clearly not all) psychiatric illnesses, an issue that is often glossed over in current animal models of mental illness. We suggest that animal models are essential to elucidate the mechanisms by which neurodevelopmental changes program complex behavior in adulthood. A better understanding of this issue, in animals, is the key for defining human psychopathology, and the development of earlier and more effective interventions for mental illness.

  9. The burden of illness of rheumatoid arthritis.

    Science.gov (United States)

    Boonen, Annelies; Severens, Johan L

    2011-03-01

    It is necessary to understand the full burden of illness of a disease before the value of interventions can be assessed. Rheumatoid arthritis (RA) has an impact on a variety of stakeholders, including patients, healthcare systems, and society as a whole. This overview discusses the societal and patient perspectives, distinguishing several domains of impact. Epidemiology is important from a societal perspective, as it affects the total impact on health and costs related to RA and influences healthcare organization priorities. Co-morbidities, such as cardiovascular disease, are important factors contributing to the impact of RA. The impact on health is, naturally, relevant to both patients and society as a whole, and is summarized by health-related quality-of-life measures from the point of view of the patient and by utilities from the societal perspective. Similarly, work participation is important for both patients and society. Withdrawal from the labor force and short- and long-term sick leave are extensively studied in RA and lead to substantial productivity costs at the societal level and to income loss for patients. In addition, the recent concept of presenteeism, which reflects the problems that patients experience while at work, is considered. Finally, the costs of illness of RA are summarized. Societal costs are mainly driven by the costs of drug treatment and inpatient care, including surgery. Patient and family costs are mainly driven by the need for formal and informal care. Overall, RA has a significant impact on the health of and costs to patients and society, suggesting that effective interventions to reduce the impact are of value.

  10. Irradiation's promise: fewer foodborne illnesses?

    International Nuclear Information System (INIS)

    Roberts, T.

    1986-01-01

    Food irradiation offers a variety of potential benefits to the food supply. It can delay ripening and sprouting of fruits and vegetables, and substitute for chemical fumigants to kill insects. However, one of the most important benefits of food irradiation is its potential use for destroying microbial pathogens that enter the food supply, including the two most common disease causing bacteria: salmonella and campylobacter. Animal products are one of the primary carriers of pathogens. Food borne illnesses are on the rise, and irradiation of red meats and poultry could significantly reduce their occurrence. Food irradiation should be examined more closely to determine its possible benefits in curtailing microbial diseases

  11. Understanding PISA

    Directory of Open Access Journals (Sweden)

    Stephen DOWNES

    2005-04-01

    Full Text Available Understanding PISA Stephen DOWNESMoncton, CANADA ABSTRACT The headline was dramatic enough to cause a ripple in the reading public. "Students who use computers a lot at school have worse maths and reading performance," noted the BBC news article, citing a 2004 study by Ludger Woessmann and Thomas Fuchs (Fuchs and Woessman, 2004. It was not long before the blogosphere took notice. Taking the theme and running with it, Alice and Bill ask, "Computers Make School Kids Dumber?" They theorize, "If you track the admitted decline of education, you'll probably notice that it follows along with the increase of technology in the classroom." In a similar vein, James Bartholomew asks, "Do you think that the government will turn down the volume of its boasting about how it has spent billions introducing computers in schools (while keeping down the pay of teachers so much that there are shortages? Do you think it will stop sending governors of state schools glossy pamphlets about insisting that computers are used in their schools as much as possible?" In this study, therefore, PISA looks well beyond educational attainment, and also includes school demographics, such as whether it is a public or private school, has large or small classes, or has access or not to technological resources. Finally, it does measure student information-their family background, access to books and computers and parental support as well. The PISA survey departs from previous surveys in disregarding the stated curricula of the schools being measured. Therefore, the conclusion is not surprising, nor even wrong for him to consider independently of any parental or teacher support, considered without reference to the software running on it, considered without reference to student attitudes and interests, does not positively impact an education. Finally, he focus on missing the reporting of results

  12. Beethoven's terminal illness and death.

    Science.gov (United States)

    Mai, F M M

    2006-10-01

    There is dispute about the cause of Beethoven's death; alcoholic cirrhosis, syphilis, infectious hepatitis, lead poisoning, sarcoidosis and Whipple's disease have all been proposed. In this article all primary source documents related to Beethoven's terminal illness and death are reviewed. The documents include his letters, the report of his physician Andreas Wawruch, his Conversation Books, the autopsy report, and a new toxicological report of his hair. His terminal illness was characterised by jaundice, ascites, ankle oedema and abdominal pain. The autopsy data indicate that Beethoven had cirrhosis of the liver, and probably also renal papillary necrosis, pancreatitis and possibly diabetes mellitus. His lifestyle for at least the final decade of his life indicated that he overindulged in alcohol in the form of wine. Alcohol was by far the most common cause of cirrhosis at that period. Toxicological analysis of his hair showed that the level of lead was elevated. During the eighteenth and early nineteenth centuries, lead was added illegally to inexpensive wines to sweeten and refresh them. These findings strongly suggest that liver failure secondary to alcoholic cirrhosis, associated with terminal spontaneous bacterial peritonitis, was the cause of death. This was complicated in the end stages by renal failure. If the presence of endogenous lead was verified by analysis of Beethoven's skeletal remains, it would suggest that the lead was derived from wine that he drank. Lead poisoning may account for some of his end-of-life symptoms. There is little clinical or autopsy evidence that Beethoven suffered from syphilis.

  13. OBESITY AND CRITICAL ILLNESS: INSIGHTS FROM ANIMAL MODELS.

    Science.gov (United States)

    Mittwede, Peter N; Clemmer, John S; Bergin, Patrick F; Xiang, Lusha

    2016-04-01

    Critical illness is a major cause of morbidity and mortality around the world. While obesity is often detrimental in the context of trauma, it is paradoxically associated with improved outcomes in some septic patients. The reasons for these disparate outcomes are not well understood. A number of animal models have been used to study the obese response to various forms of critical illness. Just as there have been many animal models that have attempted to mimic clinical conditions, there are many clinical scenarios that can occur in the highly heterogeneous critically ill patient population that occupies hospitals and intensive care units. This poses a formidable challenge for clinicians and researchers attempting to understand the mechanisms of disease and develop appropriate therapies and treatment algorithms for specific subsets of patients, including the obese. The development of new, and the modification of existing animal models, is important in order to bring effective treatments to a wide range of patients. Not only do experimental variables need to be matched as closely as possible to clinical scenarios, but animal models with pre-existing comorbid conditions need to be studied. This review briefly summarizes animal models of hemorrhage, blunt trauma, traumatic brain injury, and sepsis. It also discusses what has been learned through the use of obese models to study the pathophysiology of critical illness in light of what has been demonstrated in the clinical literature.

  14. Illness representations in caregivers of people with dementia.

    Science.gov (United States)

    Quinn, Catherine; Jones, Ian Rees; Clare, Linda

    2017-05-01

    Illness representations shape responses to illness experienced by the self or by others. The illness representations held by family members of those with long-term conditions such as dementia influence their understanding of what is happening to the person and how they respond and provide support. The aim of this study is to explore components of illness representations (label, cause, control and timeline) in caregivers of people with dementia. This was an exploratory study; the data reported came from the Memory Impairment and Dementia Awareness Study (MIDAS). Data from semi-structured interviews with 50 caregivers of people with dementia were analysed using content analysis. The majority of caregivers gave accounts that appeared to endorse a medical/diagnostic label, although many used different terms interchangeably. Caregivers differentiated between direct causes and contributory factors, but the predominant explanation was that dementia had a biological cause. Other perceived causes were hereditary factors, ageing, lifestyle, life events and environmental factors. A limited number of caregivers were able to identify things that people with dementia could do to help manage the condition, while others thought nothing could be done. There were varying views about the efficacy of medication. In terms of timeline, there was considerable uncertainty about how dementia would progress over time. The extent of uncertainty about the cause, timeline and controllability of dementia indicated that caregivers need information on these areas. Tailored information and support taking account of caregivers' existing representations may be most beneficial.

  15. [Chronic illnesses and education. Diabetes mellitus as a paradigm].

    Science.gov (United States)

    Viniegra-Velázquez, Leonardo

    2006-01-01

    The purpose of this essay is to controvert ideas that prevail about chronic illnesses, using type 2 diabetes mellitus as an example, and to propose another way of thinking, perceiving, and acting towards them. Initially the dominant vision of the disease as a deviation from the health path is confronted with another one that considers it as a specific way of being of certain groups of persons. It brings out how the idea of deviation, when favoring the technical aspects of medical practice, often compares the organism with a machine. On the other hand, the idea of disease as a way of being when rescuing the most distinctive qualities of life, allows a more penetrating understanding of the patient and his illness. Trying to overcome the limitations that the notion of natural history of disease impose, the concept of cultural history of disease is proposed, showing how culture has a determining role in the expression of illnesses. The role and type of education within the strategies of health care in chronic diseases are discussed. Participatory education--particularly in the therapeutic communities of patients--is proposed as the most powerful resource to bring the patient closer to better life circumstances and healthier habits that allow the self-control of the illness.

  16. Rethinking 'risk' and self-management for chronic illness.

    Science.gov (United States)

    Morden, Andrew; Jinks, Clare; Ong, Bie Nio

    2012-02-01

    Self-management for chronic illness is a current high profile UK healthcare policy. Policy and clinical recommendations relating to chronic illnesses are framed within a language of lifestyle risk management. This article argues the enactment of risk within current UK self-management policy is intimately related to neo-liberal ideology and is geared towards population governance. The approach that dominates policy perspectives to 'risk' management is critiqued for positioning people as rational subjects who calculate risk probabilities and act upon them. Furthermore this perspective fails to understand the lay person's construction and enactment of risk, their agenda and contextual needs when living with chronic illness. Of everyday relevance to lay people is the management of risk and uncertainty relating to social roles and obligations, the emotions involved when encountering the risk and uncertainty in chronic illness, and the challenges posed by social structural factors and social environments that have to be managed. Thus, clinical enactments of self-management policy would benefit from taking a more holistic view to patient need and seek to avoid solely communicating lifestyle risk factors to be self-managed.

  17. Approaches to self-management in chronic illness.

    Science.gov (United States)

    Novak, Marta; Costantini, Lucia; Schneider, Sabrina; Beanlands, Heather

    2013-01-01

    Management of a chronic medical condition is a complex process and requires coordinated action between healthcare providers and patients. This process is further complicated by the fact that an increasing number of patients suffer from multiple chronic conditions. Self-management involves active participation of the patients in the everyday care of the symptoms of their illness(es) and medical treatments, as well as maintaining general health and prevention of progression of medical conditions. Managing the psychosocial consequences of illness is also an important component of self-management. Data have demonstrated that enhancing self-management improves quality of life, coping, symptom management, disability, and reduces healthcare expenditures and service utilization. To foster self-management, potential barriers to implementation as well as facilitators and supports for this approach must be acknowledged. In this article, we review various aspects of self-management in chronic illness, focusing on chronic kidney disease. Better understanding of these concepts will facilitate patient-provider collaboration, improve patient care with increased patient and staff satisfaction, and may ultimately result in better clinical outcomes and enhanced quality of life for both the patients and their families. © 2013 Wiley Periodicals, Inc.

  18. Causal attributions in Brazilian children's reasoning about health and illness

    Directory of Open Access Journals (Sweden)

    Boruchovitch Evely

    2000-01-01

    Full Text Available INTRODUCTION: At a time when a great number of diseases can be prevented by changing one's habits and life style, investigations have focused on understanding what adults and children believe to be desirable health practices and uncovering the factors associated with successful adherence to such practices. For these, causal attributions for health and illness were investigated among 96 Brazilian elementary school students. METHODS: Ninety six subjects, aged 6 to 14, were interviewed individually and their causal attributions were assessed through 14 true-false items (e.g. people stay well [healthy] because they are lucky. The relationship between the children's causal attributions and demographic characteristics were also examined. RESULTS: Overall, the results were consistent with previous researches. "Taking care of oneself" was considered the most important cause of good health. "Viruses and germs" and "lack of self-care" were the most selected causes of illness. Analyses revealed significant relationship between subjects' causal attribution and their age, school grade level, socioeconomic status and gender. CONCLUSIONS: The study findings suggest that there may be more cross-cultural similarities than differences in children's causal attributions for health and illness. Finding ways to help individuals engage in appropriate preventive-maintenance health practices without developing an exaggerated notion that the individuals can control their own health and illness is a challenge which remains to be addressed by further research.

  19. CharlesTaylor, phronesis, and medicine: ethics and interpretation in illness narrative.

    Science.gov (United States)

    Schultz, Dawson Stafford; Flasher, Lydia Victoria

    2011-08-01

    This paper provides a brief overview and critique of the dominant objectivist understanding and use of illness narrative in Enlightenment (scientific) medicine and ethics, as well as several revisionist accounts, which reflect the evolution of this approach. In light of certain limitations and difficulties endemic in the objectivist understanding of illness narrative, an alternative phronesis approach to medical ethics influenced by Charles Taylor's account of the interpretive nature of human agency and language is examined. To this end, the account of interpretive medical responsibility previously described by Schultz and Carnevale as "clinical phronesis" (based upon Taylor's notion of "strong" or "radical evaluation") is reviewed and expanded. The thesis of this paper is that illness narrative has the ability to benefit patients as well as the potential to cause harm or iatrogenic effects. This benefit or harm is contingent upon how the story is told and understood. Consequently, these tales are not simply "nice stories," cathartic gestures, or mere supplements to scientific procedures and decision making, as suggested by the objectivist approach. Rather, they open the agent to meanings that provide a context for explanation and evaluation of illness episodes and therapeutic activities. This understanding provides indicators (guides) for right action. Hence, medical responsibility as clinical phronesis involves, first, the patient and provider's coformulation and cointerpretation of what is going on in the patient's illness narrative, and second, the patient and provider's response to interpretation of the facts of illness and what they signify-not simply a response to the brute facts of illness, alone. The appeal to medical responsibility as clinical phronesis thus underscores the importance of getting the patient's story of illness right. It is anticipated that further elaboration concerning the idea of clinical phronesis as interpretive illness narrative will

  20. 'Intensive care unit survivorship' - a constructivist grounded theory of surviving critical illness.

    Science.gov (United States)

    Kean, Susanne; Salisbury, Lisa G; Rattray, Janice; Walsh, Timothy S; Huby, Guro; Ramsay, Pamela

    2017-10-01

    To theorise intensive care unit survivorship after a critical illness based on longitudinal qualitative data. Increasingly, patients survive episodes of critical illness. However, the short- and long-term impact of critical illness includes physical, psychological, social and economic challenges long after hospital discharge. An appreciation is emerging that care needs to extend beyond critical illness to enable patients to reclaim their lives postdischarge with the term 'survivorship' being increasingly used in this context. What constitutes critical illness survivorship has, to date, not been theoretically explored. Longitudinal qualitative and constructivist grounded theory. Interviews (n = 46) with 17 participants were conducted at four time points: (1) before discharge from hospital, (2) four to six weeks postdischarge, (3) six months and (4) 12 months postdischarge across two adult intensive care unit setting. Individual face-to-face interviews. Data analysis followed the principles of Charmaz's constructivist grounded theory. 'Intensive care unit survivorship' emerged as the core category and was theorised using concepts such as status passages, liminality and temporality to understand the various transitions participants made postcritical illness. Intensive care unit survivorship describes the unscheduled status passage of falling critically ill and being taken to the threshold of life and the journey to a life postcritical illness. Surviving critical illness goes beyond recovery; surviving means 'moving on' to life postcritical illness. 'Moving on' incorporates a redefinition of self that incorporates any lingering intensive care unit legacies and being in control of one's life again. For healthcare professionals and policymakers, it is important to realise that recovery and transitioning through to survivorship happen within an individual's time frame, not a schedule imposed by the healthcare system. Currently, there are no care pathways or policies in

  1. 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

  2. Motor skills, cognition, and work performance of people with severe mental illness.

    Science.gov (United States)

    Lipskaya-Velikovsky, Lena; Elgerisi, Dikla; Easterbrook, Adam; Ratzon, Navah Z

    2018-01-12

    Employment offers many benefits to people with mental illness, yet their employment rate is much lower than that of the general population. We investigated the effect of work-related motor skills, neurocognition, and job attitudes on the work performance of people with mental illness, comparing those working in sheltered workshops, with controls working in similar jobs. Twenty-nine adults with severe mental illness and 27 controls matched by gender and age were enrolled into the study using convenience sampling. They were assessed for gross and fine motor hand functioning, job attitudes, work performance, and cognition. People with mental illness scored lower on work performance, cognitive functioning, and hand dexterity while sitting and working with tools. They were assigned lower job loads than were controls, and perceived the physical environment at work as more constraining than did controls. Assembling motor skills significantly explained the work performance of people with mental illness. The results expand our understanding of the complexities involved in the employment of people with severe mental illness, and point to new paths for improving vocational outcomes of people with severe mental illness, taking into account their motor skills and job attitudes. Implications for rehabilitation Therapists should be aware that employed people with severe mental illness may have various unmet needs, affecting their work performance and experience of stress. This study results demonstrate importance of motor skills and perception of the work environment for the promotion of vocational outcomes among individuals with severe mental illness. Employment of people with severe mental illness should be viewed from holistic perspective as with general population, rather than focused on traditionally illness-related factors.

  3. 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.

  4. Mass psychogenic illness after vaccination.

    Science.gov (United States)

    Clements, C John

    2003-01-01

    When vaccines are administered to groups, the physical reactions of the recipients may be similar, causing a form of mass reaction, the mechanism for which is the same as that for mass reactions from other causes. These phenomena have been categorised as mass psychogenic illness (MPI), and have been defined as the collective occurrence of a constellation of symptoms suggestive of organic illness but without an identified cause in a group of people with shared beliefs about the cause of the symptom(s). A review of the literature shows that such outbreaks have been reported in differing cultural and environmental settings including developing and industrialised countries, in the work place, on public transport, in schools, and the military. The perceived threats have been against agents such as food poisoning, fire and toxic gases. Whatever the place or perceived threat, the response seems to be similar. The symptoms generally included headache, dizziness, weakness, and loss of consciousness. Once under way, MPIs are not easy to stop. Incidents reported in the literature show that they can quickly gather momentum and can be amplified by the press who disseminate information rapidly, escalating the events. Management of such mass events can be extremely difficult. Should the public health official in charge continue to try and determine the cause, or should this person call off the entire investigation? It is suggested here that once vaccines are identified as a probable cause of the phenomenon, a dismissive approach may actually be harmful. Unless the spokesperson has already earned a high level of trust, the public are not likely to be convinced easily that nothing was wrong with the vaccine until it has been tested. An increased awareness of MPIs on the part of organisers of future mass vaccination campaigns seems appropriate. Immunisation managers should be aware that mass immunisation campaigns could generate such mass reactions. It is therefore essential that

  5. Illness perceptions in patients with fibromyalgia

    OpenAIRE

    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 version (IPQ-R FM-Dlv) and to describe illness perceptions of participants with FM. Methods: 196 patients completed the IPQ-R FM-Dlv. Internal consistency, domain structure and inter domain correlat...

  6. Developing an Estimate of Supported Housing Needs for Persons with Serious Mental Illnesses

    OpenAIRE

    Waegemakers Schiff, Jeannette; Schiff, Rebecca; Schneider, Barbara

    2014-01-01

    A rich body of literature attests to the importance of affordable accommodation and support services necessary, appropriate, and acceptable to persons disabled by a mental illness. However, there is a little which provides a means for housing and service planners to determine the gap between available supportive housing and need. Such understandings are needed to prepare strategies and develop the resources needed to accommodate persons with a disabling mental illness in the community. While ...

  7. Walking a mile in their shoes... Symbolic interactionism for families living with severe mental illness.

    Science.gov (United States)

    Saunders, J

    1997-06-01

    1. With deinstitutionalization and changes in legal rights of patients, care of patients with severe mental illness has shifted from a hospital-based to a community-centered system. 2. Families often serve as an extension of the mental health system, providing important case management functions such as assessment, monitoring, crisis management, and advocacy. 3. Symbolic interactionism provides a framework for understanding the role of meaning in individual and family responses to the disruption of life that results from severe mental illness.

  8. Stigma associated with mental illness: perspectives of university students in Qatar.

    Science.gov (United States)

    Zolezzi, Monica; Bensmail, Nawal; Zahrah, Farah; Khaled, Salma Mawfek; El-Gaili, Tayseer

    2017-01-01

    Stigma in relation to mental illness is one of the main factors inhibiting people from seeking help. Studies have been undertaken looking into the knowledge, attitudes, and beliefs (KAB) about mental illness among residents in Qatar; however, none have looked specifically at students in higher education. The aim of this study was to understand the KAB toward mental illness among students at a Qatari university and determine if there are any differences based on gender, nationality, and college type. A convenience sample of students from all genders, colleges, and nationalities was approached to participate in a survey that consisted of four sections: demographic, beliefs, attitudes, and help-seeking and treatment preferences associated with mental illness. Chi-square testing was performed to test for differences in the distribution of proportions of our primary outcomes (students' beliefs, attitudes, and help-seeking and treatment preferences). A total of 282 students completed the survey. The majority of the participating students were females (59.3%), non-Qataris (64.3%), and enrolled in science-based colleges (62.7%). Beliefs reflecting poor mental health literacy, such as "medications to treat mental illness can cause addiction", "mental illness is not like any other illness", or that "mental illness is a punishment from God", were reported by a majority of students (84.4%, 56.7%, and 50.2%, respectively). Stigmatizing attitudes that were endorsed by a majority of students included believing that people with mental illness cannot have regular jobs (60.2%), that people with mental illness are dangerous (65.7%), and that they would not marry someone with a mental illness (88.9%). Additionally, 33.6% of students indicated they would be ashamed to mention if someone in their family or they themself, had a mental illness. A vast majority of students (86.3%) indicated to prefer family and friend's support as treatment options. Significant differences in KAB about

  9. Depression in medically ill patients.

    Science.gov (United States)

    Rackley, Sandra; Bostwick, J Michael

    2012-03-01

    In medically ill patients, given the many entities the phenotype of depression may represent, clinicians must be prepared to cast their diagnostic nets widely, not settling for the obvious but frequently incorrect choice of major depressive episode and throwing antidepressants at it willy nilly. Having chosen the correct diagnosis from among a broad differential of depression “look-alikes,” clinicians can draw upon a broad swath of treatment modalities including medications, psychotherapy, social supports, and spiritual interventions. Working as a psychiatrist in the medical arena requires the curiosity and analytic skills of a detective and the breadth of knowledge of a polymath adapting therapeutic tools from across the biopsychosociospiritual spectrum to the specific needs of the patient.

  10. Delirium in the Critically Ill Child: Assessment and Sequelae.

    Science.gov (United States)

    Paterson, Rebecca S; Kenardy, Justin A; De Young, Alexandra C; Dow, Belinda L; Long, Debbie A

    2017-01-01

    Delirium is a common and serious neuropsychiatric complication in critically ill patients of all ages. In the context of critical illness, delirium may emerge as a result of a cascade of underlying pathophysiologic mechanisms and signals organ failure of the brain. Awareness of the clinical importance of delirium in adults is growing as emerging research demonstrates that delirium represents a serious medical problem with significant sequelae. However, our understanding of delirium in children lags significantly behind the adult literature. In particular, our knowledge of how to assess delirium is complicated by challenges in recognizing symptoms of delirium in pediatric patients especially in critical and intensive care settings, and our understanding of its impact on acute and long-term functioning remains in its infancy. This paper focuses on (a) the challenges associated with assessing delirium in critically ill children, (b) the current literature on the outcomes of delirium including morbidity following discharge from PICU, and care-giver well-being, and (c) the importance of assessment in determining impact of delirium on outcome. Current evidence suggests that delirium is a diagnostic challenge for clinicians and may play a detrimental role in a child's recovery after discharge from the pediatric intensive care unit (PICU). Recommendations are proposed for how our knowledge and assessment of delirium in children could be improved.

  11. Illness Uncertainty and Illness Intrusiveness as Predictors of Depressive and Anxious Symptomology in College Students with Chronic Illnesses

    Science.gov (United States)

    Mullins, Alexandria J.; Gamwell, Kaitlyn L.; Sharkey, Christina M.; Bakula, Dana M.; Tackett, Alayna P.; Suorsa, Kristina I.; Chaney, John M.; Mullins, Larry L.

    2017-01-01

    Objective: To examine predictors of psychological functioning in college students with chronic illnesses. Participants: Participants (N = 1413) included 364 students with self-reported diagnoses of asthma or allergies, 148 students with other chronic illnesses (eg, epilepsy, type 1 diabetes), and 901 healthy students. Data were collected between…

  12. Understanding Tattoos in Medicolegal Assessments.

    Science.gov (United States)

    Klein, Carolina A; Kenedi, Christopher

    2018-03-01

    Tattoos have held different meanings throughout history, with particular significance in cultural, social, and clinical contexts. Psychiatrists have long been interested in understanding the relevance of the tattooed body in a clinical or forensic evaluation and in settling on interpretive models that hold reliable value. Some studies have indicated that tattoos may be associated with markers of high-risk behaviors, mental illness diagnosis, and personality disorders. We attempt to provide an updated and comprehensive guide for forensic evaluators, so they can incorporate the observation of tattoos into their assessments with a review of the scientific literature that supports the interpretations and places them in context. The association between tattoos and risk, mental health, or behavioral implications is not as clear or linear as one might initially imagine, and mental health professionals should have a sophisticated understanding of the practice. © 2018 American Academy of Psychiatry and the Law.

  13. Factors associated with illness perception among critically ill patients and surrogates.

    Science.gov (United States)

    Ford, Dee; Zapka, Jane; Gebregziabher, Mulugeta; Yang, Chengwu; Sterba, Katherine

    2010-07-01

    We investigated illness perceptions among critically ill patients or their surrogates in a university medical ICU using a prospective survey. We hypothesized that these would vary by demographic, personal, and clinical measures. Patients (n = 23) or their surrogates (n = 77) were recruited. The Illness Perception Questionnaire-Revised (IPQ-R) measured six domains of illness perception: timeline-acute/chronic, consequences, emotional impact, personal control, treatment efficacy, and illness comprehension. Multiple variable linear regression models were developed with IPQ-R scores as the outcomes. African Americans tended to perceive the illness as less enduring and reported more confidence in treatment efficacy (P < .01 for each). They also tended to report the illness as less serious, having less emotional impact, and having greater personal control (P = .0002 for each). Conversely, African Americans reported lower illness comprehension (P = .002). Faith/religion was associated with positive illness perceptions, including less concern regarding consequences (P = .02), less emotional impact (P = .03), and more confidence in treatment efficacy (P < .01). Lower patient quality of life (QOL) precritical illness was associated with negative perceptions, including greater concern about illness duration and consequences as well as perception of less personal control and less confidence in treatment efficacy (P < .01 for each). These variables were independently associated with illness perceptions after controlling for race, faith/religion, and survival to hospital discharge, whereas clinical measures were not. Illness perceptions among critically ill patients and surrogates are influenced by patient/surrogate factors, including race, faith, and precritical illness QOL, rather than clinical measures. Clinicians should recognize the variability in illness perceptions and the possible implications for patient/surrogate communication.

  14. Brain Immune Interactions as the Basis of Gulf War Illness: Gulf War Illness Consortium (GWIC)

    Science.gov (United States)

    2015-10-01

    priming of glial responses that cause a chronic activation loop of stronger and longer proinflammatory signaling effects between the immune system and the...AWARD NUMBER: W81XWH-13-2-0072 TITLE: Brain Immune Interactions as the Basis of Gulf War Illness: Gulf War Illness Consortium (GWIC) PRINCIPAL...4. TITLE AND SUBTITLE Brain Immune Interactions as the Basis of Gulf War Illness: Gulf War Illness Consortium (GWIC) 5a. CONTRACT NUMBER 5b. GRANT

  15. Illness narratives of people who are homeless.

    Science.gov (United States)

    Håkanson, Cecilia; Öhlén, Joakim

    2016-01-01

    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.

  16. Illness narratives of people who are homeless

    Science.gov (United States)

    Håkanson, Cecilia; Öhlén, Joakim

    2016-01-01

    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. PMID:27914194

  17. 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.

  18. Serious Illness Conversations: Paving the Road with Metaphors.

    Science.gov (United States)

    Hui, David; Zhukovsky, Donna S; Bruera, Eduardo

    2018-01-25

    Serious illness conversations can influence the direction of care by supporting decision-making compatible with the patient's goals. Effective use of core communication techniques, such as active listening and empathic statements, allows for a deeper understanding of the patients' goals, concerns, communication preferences, and questions. Metaphors can be used to augment end-of-life care planning. Used inappropriately, metaphors can cause misunderstandings and confusion. Applied skillfully, metaphors can personalize challenging discussions, improving patient comprehension and helping patients and their families to plan ahead. The art of communication is to use the right tool for the right person at the right time. Discussions with patients about serious illness concerns are especially challenging for the oncologist. This article provides guidance for preparing for such conversations, including examples of the use of metaphors to personalize and improve communication. © AlphaMed Press 2018.

  19. Tolerance and illness: the politics of medical and psychiatric classification.

    Science.gov (United States)

    Glackin, Shane Nicholas

    2010-08-01

    In this paper, I explore the links between liberal political theory and the evaluative nature of medical classification, arguing for stronger recognition of those links in a liberal model of medical practice. All judgments of medical or psychiatric "dysfunction," I argue, are fundamentally evaluative, reflecting our collective willingness or reluctance to tolerate and/or accommodate the conditions in question. Illness, then, is "socially constructed." But the relativist worries that this loaded phrase evokes are unfounded; patients, doctors, and communities will agree in the vast majority of cases about what counts as illness. Where they cannot come to agreement, however, we are faced with precisely the sort of dispute about values and ways of life that the institutions of the liberal state are designed to accommodate. I accordingly sketch a model of medical practice, based loosely on Jürgen Habermas's political theories, designed to maximize both our awareness and our understanding of these disputes.

  20. Describing the homeless mentally ill: cluster analysis results.

    Science.gov (United States)

    Mowbray, C T; Bybee, D; Cohen, E

    1993-02-01

    Presented descriptive data on a group of homeless, mentally ill individuals (N = 108) served by a two-site demonstration project, funded by NIMH. Comparing results with those from other studies of this population produced some differences and some similarities. Cluster analysis techniques were applied to the data, producing a 4-group solution. Data validating the cluster solution are presented. It is suggested that the cluster results provide a more meaningful and useful method of understanding the descriptive data. Results suggest that while the population of individuals served as homeless and mentally ill is quite heterogeneous, many have well-developed functioning skills--only one cluster, making up 35.2% of the sample, fits the stereotype of the aggressive, psychotic individual with skill deficits in many areas. Further discussion is presented concerning the implications of the cluster analysis results for demonstrating contextual effects and thus better interpreting research results from other studies and assisting in future services planning.

  1. Economic hardship associated with managing chronic illness: a qualitative inquiry

    Directory of Open Access Journals (Sweden)

    Jan Stephen

    2009-10-01

    Full Text Available Abstract Background Chronic illness and disability can have damaging, even catastrophic, socioeconomic effects on individuals and their households. We examined the experiences of people affected by chronic heart failure, complicated diabetes and chronic obstructive pulmonary disease to inform patient centred policy development. This paper provides a first level, qualitative understanding of the economic impact of chronic illness. Methods Interviews were conducted with patients aged between 45 and 85 years who had one or more of the index conditions and family carers from the Australian Capital Territory and Western Sydney, Australia (n = 66. Content analysis guided the interpretation of data. Results The affordability of medical treatments and care required to manage illness were identified as the key aspects of economic hardship, which compromised patients' capacity to proactively engage in self-management and risk reduction behaviours. Factors exacerbating hardship included ineligibility for government support, co-morbidity, health service flexibility, and health literacy. Participants who were on multiple medications, from culturally and linguistically diverse or Indigenous backgrounds, and/or not in paid employment, experienced economic hardship more harshly and their management of chronic illness was jeopardised as a consequence. Economic hardship was felt among not only those ineligible for government financial supports but also those receiving subsidies that were insufficient to meet the costs of managing long-term illness over and above necessary daily living expenses. Conclusion This research provides insights into the economic stressors associated with managing chronic illness, demonstrating that economic hardship requires households to make difficult decisions between care and basic living expenses. These decisions may cause less than optimal health outcomes and increased costs to the health system. The findings support the necessity

  2. Economic hardship associated with managing chronic illness: a qualitative inquiry.

    Science.gov (United States)

    Jeon, Yun-Hee; Essue, Beverley; Jan, Stephen; Wells, Robert; Whitworth, Judith A

    2009-10-09

    Chronic illness and disability can have damaging, even catastrophic, socioeconomic effects on individuals and their households. We examined the experiences of people affected by chronic heart failure, complicated diabetes and chronic obstructive pulmonary disease to inform patient centred policy development. This paper provides a first level, qualitative understanding of the economic impact of chronic illness. Interviews were conducted with patients aged between 45 and 85 years who had one or more of the index conditions and family carers from the Australian Capital Territory and Western Sydney, Australia (n = 66). Content analysis guided the interpretation of data. The affordability of medical treatments and care required to manage illness were identified as the key aspects of economic hardship, which compromised patients' capacity to proactively engage in self-management and risk reduction behaviours. Factors exacerbating hardship included ineligibility for government support, co-morbidity, health service flexibility, and health literacy. Participants who were on multiple medications, from culturally and linguistically diverse or Indigenous backgrounds, and/or not in paid employment, experienced economic hardship more harshly and their management of chronic illness was jeopardised as a consequence. Economic hardship was felt among not only those ineligible for government financial supports but also those receiving subsidies that were insufficient to meet the costs of managing long-term illness over and above necessary daily living expenses. This research provides insights into the economic stressors associated with managing chronic illness, demonstrating that economic hardship requires households to make difficult decisions between care and basic living expenses. These decisions may cause less than optimal health outcomes and increased costs to the health system. The findings support the necessity of a critical analysis of health, social and welfare policies to

  3. Close relationship and chronic illness : The interrelations between illness perceptions and social support

    NARCIS (Netherlands)

    Salewski, Christel; Vollmann, Manja

    2014-01-01

    The aims of this study were (1) to explore the degree of concordance/discordance between the illness perceptions of patients with a chronic illness and those of their partners, and (2) to examine the relationship between the concordance/discordance of couples’ illness perceptions and social support

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

    Science.gov (United States)

    ... specifically in focusing efforts on the top known pathogens and identifying the additional causes of foodborne illness and death. CDC provides estimates for two major groups of foodborne illnesses Known foodborne pathogens — 31 pathogens known to cause foodborne illness. Many ...

  5. A Literature Review on the Experience of Long-Term Mental Illness.

    Science.gov (United States)

    Collier, Elizabeth; Grant, Maria J

    2018-02-13

    To illuminate long-term experiences of mental illness from both research and autobiographical accounts. A literature review of English-language papers, 1950-2014, relating to the experience of long-term mental illness indexed in AgeInfo, AMED, ASSIA, British Nursing Index (BNI), CINAHL, MEDLINE, PsycEXTRA, and PsychINFO. Twenty-five research papers and nine autobiographic accounts met the review criteria. Thematic analysis revealed nine themes: fear, explanation seeking, stigma, disability, coping strategies, control, support, change and learning, and life history. Specific gaps of note relate to age differences, acknowledgement of longevity of mental illnesses, and different cultural perspectives. Research Implications: There is an absence of longitudinal studies focused on experiences of long-term mental illness. The considerable length-of-time implicated in the experiences suggests that more individual life experience rather than illness focused studies are needed, enabling a holistic understanding. This includes studies from cultures other than the Western world. Greater transparency is needed in justifying age inclusions or passive exclusion of older peoples' perspectives. Knowledge of long-term mental illness experiences is of great importance to mental health practitioners. Evidence-based services cannot be provided if we do not have an holistic understanding of long-term mental illness. Social Implications: This review questions our ability to provide effective support for those experiencing long-term mental illness, in particular older people and different cultural perspectives. There appear to be no literature reviews that focus on the individual experience of long-term mental illness. It highlights the surprisingly small number of research studies available to inform mental health practitioners.

  6. 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.

  7. A systematic review of the literature exploring illness perceptions in mental health utilising the self-regulation model.

    Science.gov (United States)

    Baines, Tineke; Wittkowski, Anja

    2013-09-01

    Psychologists have utilised a range of social cognition models to understand variation in physical health and illness-related behaviours. The most widely studied model of illness perceptions has been the Self-Regulation Model (SRM, Leventhal, Nerenz, & Steele, 1984). The illness perceptions questionnaire (IPQ) and its revised version (IPQ-R) have been utilised to explore illness beliefs in physical health. This review examined 13 quantitative studies, which used the IPQ and IPQ-R in mental health in their exploration of illness perceptions in psychosis, bipolar disorder, eating disorders, depression and adolescents experiencing mood disorders. Across these studies the SRM illness dimensions were largely supported. Mental illnesses were commonly viewed as cyclical and chronic, with serious negative consequences. Perceptions regarding chronicity, controllability and negative consequences were associated with coping and help seeking, while engagement with services and help seeking were also related to illness coherence beliefs. Treatment adherence was linked to beliefs that treatment could control one's illness. Whilst a major limitation of the reviewed studies was the use of cross-sectional designs, overall the applicability of the SRM to mental health was supported. The IPQ and IPQ-R were shown to be valuable measures of illness perceptions in mental health, offering implications for clinical practice.

  8. Perceived quality of chronic illness care is associated with self-management: Results of a nationwide study in the Netherlands.

    Science.gov (United States)

    van Houtum, L; Heijmans, M; Rijken, M; Groenewegen, P

    2016-04-01

    Healthcare providers are increasingly expected to help chronically ill patients understand their own central role in managing their illness. The aim of this study was to determine whether experiencing high-quality chronic illness care and having a nurse involved in their care relate to chronically ill people's self-management. Survey data from 699 people diagnosed with chronic diseases who participated in a nationwide Dutch panel-study were analysed using linear regression analysis, to estimate the association between chronic illness care and various aspects of patients' self-management, while controlling for their socio-demographic and illness characteristics. Chronically ill patients reported that the care they received was of high quality to some extent. Patients who had contact with a practise nurse or specialised nurse perceived the quality of the care they received as better than patients who only had contact with a GP or medical specialist. Patients' perceptions of the quality of care were positively related to all aspects of their self-management, whereas contact with a practise nurse or specialised nurse in itself was not. Chronically ill patients who have the experience to receive high-quality chronic illness care that focusses on patient activation, decision support, goal setting, problem solving, and coordination of care are better self-managers. Having a nurse involved in their care seems to be positively valued by chronically ill patients, but does not automatically imply better self-management. Copyright © 2016. Published by Elsevier Ireland Ltd.

  9. 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

  10. Illness perceptions and fatigue in systemic vasculitis.

    Science.gov (United States)

    Grayson, Peter C; Amudala, Naomi A; Mcalear, Carol A; Leduc, Renée L; Shereff, Denise; Richesson, Rachel; Fraenkel, Liana; Merkel, Peter A

    2013-11-01

    To compare illness perceptions among patients with different forms of vasculitis, identify risk factors for negative illness perceptions, and determine the association between illness perceptions and fatigue. Participants were recruited from an online vasculitis registry to complete the revised Illness Perception Questionnaire (IPQ-R). The mean scores on each IPQ-R dimension were compared across different types of vasculitis. Cluster analysis and stepwise regression identified predictors of negative illness perception. Fatigue was measured using the general subscale of the Multidimensional Fatigue Inventory (MFI-20). Patient-reported measures of disease activity and IPQ-R dimensions were assessed in relation to MFI-20 scores using linear regression in sequential, additive models with model-fit comparisons. In total, 692 participants with 9 types of vasculitis completed the IPQ-R. For 6 of the 8 IPQ-R dimensions, there were no significant differences in mean scores between the different vasculitides. Scores in the identity and cyclical dimensions were significantly higher in Behçet’s disease compared with other types of vasculitis (13.5 versus 10.7 for identity and 4.0 versus 3.2 for cyclical [P IPQ-R dimensions explained an equivalent proportion of variability in fatigue scores compared with measures of disease activity. Illness perceptions are similar across different types of vasculitis, and younger age is a risk factor for negative illness perceptions. Illness perceptions explain differences in fatigue scores beyond what can be explained by measures of disease activity.

  11. Social Work Faculty and Mental Illness Stigma

    Science.gov (United States)

    Watson, Amy C.; Fulambarker, Anjali; Kondrat, David C.; Holley, Lynn C.; Kranke, Derrick; Wilkins, Brittany T.; Stromwall, Layne K.; Eack, Shaun M.

    2017-01-01

    Stigma is a significant barrier to recovery and full community inclusion for people with mental illnesses. Social work educators can play critical roles in addressing this stigma, yet little is known about their attitudes. Social work educators were surveyed about their general attitudes about people with mental illnesses, attitudes about practice…

  12. 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…

  13. Chronic illness and poverty in The Netherlands

    NARCIS (Netherlands)

    van Agt, H. M. E.; Stronks, K.; Mackenbach, J. P.

    2000-01-01

    Background: The actual financial situation of chronically ill people is not known. Methods: A postal questionnaire was conducted among a sample of the non-institutionalised population (4,206 respondents). Results: Fourteen percent of chronically ill people were found to be poor as compared to 5% of

  14. Administrative Segregation for Mentally Ill Inmates

    Science.gov (United States)

    O'Keefe, Maureen L.

    2007-01-01

    Largely the result of prison officials needing to safely and efficiently manage a volatile inmate population, administrative segregation or supermax facilities are criticized as violating basic human needs, particularly for mentally ill inmates. The present study compared Colorado offenders with mental illness (OMIs) to nonOMIs in segregated and…

  15. 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.

  16. Nutrition, Illness, and Injury in Aquatic Sports

    NARCIS (Netherlands)

    Pyne, D.B.; Verhagen, E.A.L.M.; Mountjoy, M.

    2014-01-01

    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

  17. 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.

    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

  18. Mental illness among journalists: a systematic review.

    Science.gov (United States)

    Aoki, Yuta; Malcolm, Estelle; Yamaguchi, Sosei; Thornicroft, Graham; Henderson, Claire

    2013-06-01

    Mass media depictions of people with mental illness have a strong influence on public attitudes, to the extent that changes in these depictions can reduce public stigmatization of people with such illness. Journalists' mental health may influence their depiction of those with mental illness, but little is known about this. To investigate mental illness among journalists in five key areas: (1) journalists' mental health status; (2) journalists' personal attitudes towards mental illness; (3) attitudes and support journalists expect or have experienced from colleagues when they have a mental health problem; (4) effect of journalism's professional culture on the course of mental illness; and (5) effect of journalism's professional culture on mass media depictions of people with mental illness. We performed a systematic screening of MEDLINE, PsycINFO, EMBASE, Web of Science and the Cochrane Library regarding the study aims. We identified 19, 12, seven and four studies for aims 1, 2, 3, and 4, respectively. No articles were found for aim 5. The prevalence of post-traumatic stress disorder (PTSD) among journalists is higher than that among the general population. Journalists have positive personal attitudes towards mental illness, but there are perceived workplace disincentives to disclose mental health problems.

  19. Comorbid medical illness in bipolar disorder.

    Science.gov (United States)

    Forty, Liz; Ulanova, Anna; Jones, Lisa; Jones, Ian; Gordon-Smith, Katherine; Fraser, Christine; Farmer, Anne; McGuffin, Peter; Lewis, Cathryn M; Hosang, Georgina M; Rivera, Margarita; Craddock, Nick

    2014-12-01

    Individuals with a mental health disorder appear to be at increased risk of medical illness. To examine rates of medical illnesses in patients with bipolar disorder (n = 1720) and to examine the clinical course of the bipolar illness according to lifetime medical illness burden. Participants recruited within the UK were asked about the lifetime occurrence of 20 medical illnesses, interviewed using the Schedules for Clinical Assessment in Neuropsychiatry (SCAN) and diagnosed according to DSM-IV criteria. We found significantly increased rates of several medical illnesses in our bipolar sample. A high medical illness burden was associated with a history of anxiety disorder, rapid cycling mood episodes, suicide attempts and mood episodes with a typically acute onset. Bipolar disorder is associated with high rates of medical illness. This comorbidity needs to be taken into account by services in order to improve outcomes for patients with bipolar disorder and also in research investigating the aetiology of affective disorder where shared biological pathways may play a role. Royal College of Psychiatrists.

  20. Clinical Pharmacology Studies in Critically Ill Children

    Science.gov (United States)

    Thakkar, Nilay; Salerno, Sara; Hornik, Christoph P.; Gonzalez, Daniel

    2016-01-01

    Developmental and physiological changes in children contribute to variation in drug disposition with age. Additionally, critically ill children suffer from various life-threatening conditions that can lead to pathophysiological alterations that further affect pharmacokinetics (PK). Some factors that can alter PK in this patient population include variability in tissue distribution caused by protein binding changes and fluid shifts, altered drug elimination due to organ dysfunction, and use of medical interventions that can affect drug disposition (e.g., extracorporeal membrane oxygenation and continuous renal replacement therapy). Performing clinical studies in critically ill children is challenging because there is large inter-subject variability in the severity and time course of organ dysfunction; some critical illnesses are rare, which can affect subject enrollment; and critically ill children usually have multiple organ failure, necessitating careful selection of a study design. As a result, drug dosing in critically ill children is often based on extrapolations from adults or non-critically ill children. Dedicated clinical studies in critically ill children are urgently needed to identify optimal dosing of drugs in this population. This review will summarize the effect of critical illness on pediatric PK, the challenges associated with performing studies in this vulnerable subpopulation, and the clinical PK studies performed to date for commonly used drugs. PMID:27585904

  1. Glucose metabolism in critically ill patients

    DEFF Research Database (Denmark)

    Nielsen, Signe Tellerup; Krogh-Madsen, Rikke; Møller, Kirsten

    2015-01-01

    glucose (BG). This is taken advantage of in the treatment of patients with T2DM, for whom GLP-1 analogs have been introduced during the recent years. Infusion of GLP-1 also lowers the BG level in critically ill patients without causing severe hypoglycemia. The T2DM and critical illness share similar...

  2. Combating the Stigma of Mental Illness. Revised.

    Science.gov (United States)

    National Inst. of Mental Health (DHHS), Rockville, MD.

    Many former mental patients see their biggest problem in resuming community life to be their inability to be accepted by other people. The National Institute of Mental Health has worked to remove the stigma associated with mental illness and research has unraveled many of the mysteries about the origins of mental illness. Deinstitutionalization,…

  3. Time spent on health related activities associated with chronic illness: a scoping literature review

    Directory of Open Access Journals (Sweden)

    Jowsey Tanisha

    2012-12-01

    Full Text Available Abstract Background The management of health care, particularly for people with chronic conditions, combines the activities of health professionals, patients, informal carers and social networks that support them. Understanding the non-professional roles in health management requires information about the health related activities (HRA that are undertaken by patients and informal carers. This understanding allows management planning that incorporates the capacity of patients and informal carers, as well as identifying the particular skills, knowledge and technical support that are necessary. This review was undertaken to identify how much time people with chronic illness and their informal carers spend on HRA. Methods Literature searches of three electronic databases (CINAHL, Medline, and PubMed and two journals (Time and Society, Sociology of Health and Illness were carried out in 2011 using the following search terms (and derivatives: chronic illness AND time AND consumer OR carer. The search was aimed at finding studies of time spent on HRA. A scoping literature review method was utilised. Results Twenty-two peer reviewed articles published between 1990 and 2010 were included for review. The review identified limited but specific studies about time use by people with a chronic illness and/or their carers. While illness work was seen as demanding, few studies combined inquiry about both defined tasks and defined time use. It also identified methodological issues such as consistency of definition and data collection methods, which remain unresolved. Conclusions While HRA are seen as demanding by people doing them, few studies have measured actual time taken to carry out a comprehensive range of HRA. The results of this review suggest that both patients with chronic illness and informal carers may be spending 2 hours a day or more on HRA. Illnesses such as diabetes may be associated with higher time use. More empirical research is needed to

  4. Time spent on health related activities associated with chronic illness: a scoping literature review.

    Science.gov (United States)

    Jowsey, Tanisha; Yen, Laurann; W, Paul Mathews

    2012-12-03

    The management of health care, particularly for people with chronic conditions, combines the activities of health professionals, patients, informal carers and social networks that support them. Understanding the non-professional roles in health management requires information about the health related activities (HRA) that are undertaken by patients and informal carers. This understanding allows management planning that incorporates the capacity of patients and informal carers, as well as identifying the particular skills, knowledge and technical support that are necessary. This review was undertaken to identify how much time people with chronic illness and their informal carers spend on HRA. Literature searches of three electronic databases (CINAHL, Medline, and PubMed) and two journals (Time and Society, Sociology of Health and Illness) were carried out in 2011 using the following search terms (and derivatives): chronic illness AND time AND consumer OR carer. The search was aimed at finding studies of time spent on HRA. A scoping literature review method was utilised. Twenty-two peer reviewed articles published between 1990 and 2010 were included for review. The review identified limited but specific studies about time use by people with a chronic illness and/or their carers. While illness work was seen as demanding, few studies combined inquiry about both defined tasks and defined time use. It also identified methodological issues such as consistency of definition and data collection methods, which remain unresolved. While HRA are seen as demanding by people doing them, few studies have measured actual time taken to carry out a comprehensive range of HRA. The results of this review suggest that both patients with chronic illness and informal carers may be spending 2 hours a day or more on HRA. Illnesses such as diabetes may be associated with higher time use. More empirical research is needed to understand the time demands of self-management, particularly for

  5. Media depictions of mental illness: an analysis of the use of dangerousness.

    Science.gov (United States)

    Allen, R; Nairn, R G

    1997-06-01

    To explore how the commonsense understanding, that those with a mental illness are dangerous, is deployed in a small sample of print media. The print media sample was subjected to a discourse analysis informed by knowledge of media practices. Materials were read closely and references to mental illness were identified, classified and analysed. This non-sensational material was shown to provide repeated confirmations of the commonsense understanding that mental illnesses make people unpredictable and dangerous. Close study of the lead article suggested that it was written so that readers had to draw on such understandings to make sense of the account it presented. The study challenges the notion that media present negative depictions of mental illnesses either because journalists are poorly informed or because 'sensation sells'. It is concluded that media practices directed at engaging readers require the use of cases and a style of writing that forces readers to draw upon commonsense knowledge of mental illness to understand the text. It is argued that this is a deliberate effort to enlist readers as co-creators of the text and thereby increase their interest.

  6. Integrated management of childhood illness

    Directory of Open Access Journals (Sweden)

    1997-01-01

    Full Text Available Millones de defunciones en niños menores de 5 años se podrían prevenir en países en desarrollo si se aplicaran las medidas de control y los tratamientos eficaces que se usan normalmente en países desarrollados. Conscientes de la necesidad de hacer frente a las principales causas de enfermedad y muerte en la infancia (infecciones respiratorias agudas, enfermedades diarreicas, desnutrición, malaria y enfermedades prevenibles por medio de la vacunación mediante una iniciativa global, la OMS y el UNICEF han desarrollado una estrategia conocida por Atención Integrada de las Enfermedades Prevalentes de la Infancia (Integrated Management of Childhood Illness, IMCI. Sus oficinas regionales para las Américas, que son la OPS y el UNICEF-TACRO, han aceptado los objetivos y actividades descritos en el presente informe a fin de reorientar su labor y dirigirla hacia el mejoramiento del estado de salud infantil en este hemisferio.

  7. 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.

  8. Traditional medicine and childcare in Western Africa: mothers' knowledge, folk illnesses, and patterns of healthcare-seeking behavior.

    Directory of Open Access Journals (Sweden)

    Alexandra M Towns

    Full Text Available In spite of the strong role of traditional medicine in childcare in the pluralistic healthcare system in Western Africa, little information is known on mothers' domestic plant knowledge. Identifying local perspectives and treatments of children's illnesses, including folk illnesses, is essential to having a comprehensive understanding of how mothers make healthcare treatment decisions. We aimed to identify which infant illnesses Beninese and Gabonese mothers knew to treat with medicinal plants and for which illnesses they sought biomedical care or traditional healers.We conducted 81 questionnaires with mothers in Bénin and Gabon and made 800 botanical specimens of cited medicinal plants. We calculated the number of species cited per illness and the proportion of participants knowledgeable on at least one herbal remedy per illness. Using qualitative data, we described folk illnesses in each country and summarized responses on preferences for each of the three healthcare options.Participants from both countries were most knowledgeable on plants to treat respiratory illnesses, malaria, diarrhea, and intestinal ailments. Mothers also frequently mentioned the use of plants to encourage children to walk early, monitor the closure of fontanels, and apply herbal enemas. Major folk illnesses were atita and ka in Bénin and la rate and fesses rouges in Gabon. Traditional healers were reported to have specialized knowledge of cultural bound illnesses. Malaria was frequently cited as an illness for which mothers would directly seek biomedical treatment.Mothers largely saw the three systems as complementary, seamlessly switching between different healing options until a remedy was found. Folk illnesses were found to give insight into local treatments and may reveal important neglected diseases. Due to high reported levels of knowledge on treating top statistical causes of infant mortality and folk illnesses, mothers' medicinal plant knowledge should be

  9. Traditional medicine and childcare in Western Africa: mothers' knowledge, folk illnesses, and patterns of healthcare-seeking behavior.

    Science.gov (United States)

    Towns, Alexandra M; Mengue Eyi, Sandra; van Andel, Tinde

    2014-01-01

    In spite of the strong role of traditional medicine in childcare in the pluralistic healthcare system in Western Africa, little information is known on mothers' domestic plant knowledge. Identifying local perspectives and treatments of children's illnesses, including folk illnesses, is essential to having a comprehensive understanding of how mothers make healthcare treatment decisions. We aimed to identify which infant illnesses Beninese and Gabonese mothers knew to treat with medicinal plants and for which illnesses they sought biomedical care or traditional healers. We conducted 81 questionnaires with mothers in Bénin and Gabon and made 800 botanical specimens of cited medicinal plants. We calculated the number of species cited per illness and the proportion of participants knowledgeable on at least one herbal remedy per illness. Using qualitative data, we described folk illnesses in each country and summarized responses on preferences for each of the three healthcare options. Participants from both countries were most knowledgeable on plants to treat respiratory illnesses, malaria, diarrhea, and intestinal ailments. Mothers also frequently mentioned the use of plants to encourage children to walk early, monitor the closure of fontanels, and apply herbal enemas. Major folk illnesses were atita and ka in Bénin and la rate and fesses rouges in Gabon. Traditional healers were reported to have specialized knowledge of cultural bound illnesses. Malaria was frequently cited as an illness for which mothers would directly seek biomedical treatment. Mothers largely saw the three systems as complementary, seamlessly switching between different healing options until a remedy was found. Folk illnesses were found to give insight into local treatments and may reveal important neglected diseases. Due to high reported levels of knowledge on treating top statistical causes of infant mortality and folk illnesses, mothers' medicinal plant knowledge should be included in the

  10. 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

  11. Heat illness surveillance in schoolboys participating in physical education class in tropical climate: an analytical prospective descriptive study.

    Science.gov (United States)

    Somboonwong, Juraiporn; Sanguanrungsirikul, Sompol; Pitayanon, Chatchatchai

    2012-01-01

    This study aimed to determine thermoregulatory and cardiovascular responses as well as the occurrence of heat illness in children exercising outdoors in physical education class under hot and humid climate. Little information regarding this issue under real-life situation is available, especially in the Southeast Asia. Analytical, prospective descriptive study. A primary school in Bangkok, Thailand. A total of 457 schoolboys (aged 5.5-12 years) were observed while exercising outdoors during their physical education classes throughout the academic year of 2009, including semester 1 (between July and September 2009) and semester 2 (between November 2009 and February 2010). Primary outcome measure was tympanic temperature. Secondary outcome measures included blood pressure, heart rate, hydration status and the occurrence of heat-related illness. Outdoor physical activity consisted of skill practice (duration 24.11±11.04 min, intensity risk for heat illness during outdoor activities in physical education class in primary school children, especially those who are overweight and have poor hydration status.

  12. Espaço e gênero na compreensão do processo saúde-doença da mulher brasileira Espacio y género en la comprensión del proceso salud enfermedad Space and gender understanding brazilian woman's health-illness process

    Directory of Open Access Journals (Sweden)

    Rosa Maria Godoy Serpa da Fonseca

    1997-01-01

    Full Text Available Trata-se de um ensaio onde é abordada a questão da determinação social do processo saúde-doença da mulher (através da sua inserção em classes sociais e da condição de gênero, articulada à noção de espaço social e historicamente construído, dada pela geografia crítica. As reflexões são ilustradas com dados de um estudo sobre determinação social do perfil reprodutivo de mulheres atendidas em unidades básicas de saúde de um município da Região Metropolitana de são Paulo.Se trata de un ensayo donde se aborda la cuestión de la determinación del proceso salud-enfermedad de la mujer (a través de su inserción de las clases sociales y de la condición de género, articulada a la, noción de espacio social históricamente construido, dado por la geografía crítica. Las reflexiones son ilustradas con datos de un estudio sobre determinación social del perfil reproductivo de mujeres atendidas en unidades básicas de salud de un municipio de la región metropolitana de São Paulo.The author deals with the social determination of the woman's health-illness process (through her social class and gender linking it to the concept of social space, historically constructed, based on critical geography. The considerations made are illustrated with data collected in a study about the reproductive profile of woman who are assisted in public health units of the municipality of São Paulo.

  13. Perception and beliefs about mental illness among adults in Karfi village, northern Nigeria

    Directory of Open Access Journals (Sweden)

    Kabir Mohammed

    2004-08-01

    Full Text Available Abstract Background This study was designed to examine the knowledge, attitude and beliefs about causes, manifestations and treatment of mental illness among adults in a rural community in northern Nigeria. Methods A cross sectional study design was used. A pre-tested, semi-structured questionnaire was administered to 250 adults residing in Karfi village, northern Nigeria. Results The most common symptoms proffered by respondents as manifestations of mental illness included aggression/destructiveness (22.0%, loquaciousness (21.2%, eccentric behavior (16.1% and wandering (13.3%. Drug misuse including alcohol, cannabis, and other street drugs was identified in 34.3% of the responses as a major cause of mental illness, followed by divine wrath/ God's will (19%, and magic/spirit possession (18.0%. About 46% of respondents preferred orthodox medical care for the mentally sick while 34% were more inclined to spiritual healing. Almost half of the respondents harbored negative feelings towards the mentally ill. Literate respondents were seven times more likely to exhibit positive feelings towards the mentally ill as compared to non-literate subjects (OR = 7.6, 95% confidence interval = 3.8–15.1. Conclusions Our study demonstrates the need for community educational programs in Nigeria aimed at demystifying mental illness. A better understanding of mental disorders among the public would allay fear and mistrust about mentally ill persons in the community as well as lessen stigmatization towards such persons.

  14. The costs of respiratory illnesses arising from Florida gulf coast Karenia brevis blooms.

    Science.gov (United States)

    Hoagland, Porter; Jin, Di; Polansky, Lara Y; Kirkpatrick, Barbara; Kirkpatrick, Gary; Fleming, Lora E; Reich, Andrew; Watkins, Sharon M; Ullmann, Steven G; Backer, Lorraine C

    2009-08-01

    Algal blooms of Karenia brevis, a harmful marine algae, occur almost annually off the west coast of Florida. At high concentrations, K. brevis blooms can cause harm through the release of potent toxins, known as brevetoxins, to the atmosphere. Epidemiologic studies suggest that aerosolized brevetoxins are linked to respiratory illnesses in humans. We hypothesized a relationship between K. brevis blooms and respiratory illness visits to hospital emergency departments (EDs) while controlling for environmental factors, disease, and tourism. We sought to use this relationship to estimate the costs of illness associated with aerosolized brevetoxins. We developed a statistical exposure-response model to express hypotheses about the relationship between respiratory illnesses and bloom events. We estimated the model with data on ED visits, K. brevis cell densities, and measures of pollen, pollutants, respiratory disease, and intra-annual population changes. We found that lagged K. brevis cell counts, low air temperatures, influenza outbreaks, high pollen counts, and tourist visits helped explain the number of respiratory-specific ED diagnoses. The capitalized estimated marginal costs of illness for ED respiratory illnesses associated with K. brevis blooms in Sarasota County, Florida, alone ranged from $0.5 to $4 million, depending on bloom severity. Blooms of K. brevis lead to significant economic impacts. The costs of illness of ED visits are a conservative estimate of the total economic impacts. It will become increasingly necessary to understand the scale of the economic losses associated with K. brevis blooms to make rational choices about appropriate mitigation.

  15. Belief in supernatural causes of mental illness among Malay patients: impact on treatment.

    Science.gov (United States)

    Razali, S M; Khan, U A; Hasanah, C I

    1996-10-01

    The concept of aetiology of mental illness in 134 Malay patients was investigated by means of a 20-item checklist. About 53% of the patients attributed their illnesses to supernatural agents. Witchcraft and possession by evil spirits were regarded as common causes of illness. The number of patients who believed in supernatural causes of their mental illness was significantly higher among those who had consulted bomohs (Malay traditional healers) than among those who had not consulted them. The belief that mental illness is caused by supernatural agents is firmly held by bomohs, who reinforce this notion in those who seek their advice. Belief in supernatural causes of mental illness was not significantly associated with age, gender, level of education or occupation of the patients. Patients who believed in supernatural causes of mental illness were also found to show poor drug compliance, and the number of such patients at 6 months follow-up was significantly lower than the corresponding figure for those who did not believe in supernatural causes. The importance of understanding the patients' cultural background when treating psychiatric patients is highlighted.

  16. Experiences of case management with chronic illnesses: a qualitative systematic review.

    Science.gov (United States)

    Joo, J Y; Liu, M F

    2018-03-01

    This qualitative systematic review aimed to identify and synthesize recent qualitative studies to improve understanding of the experiences and perceptions of case management interventions that individuals with chronic illnesses and their caregivers have. Case management has been shown to be effective at improving quality of care and lowering costs for individuals with chronic illnesses. However, no qualitative review has been synthesized with recent qualitative studies about case management experiences by individual with chronic illnesses. This qualitative systematic review uses a thematic synthesis method to review 10 qualitative studies published within the last 10 years, from 2007 to 2016, thereby identifying and discussing the understandings that individuals with chronic illnesses and their caregivers have about case management. From this synthesis, three themes were identified as facilitators of case management (access to healthcare resources, health status supports and emotional aid) and two themes were identified as barriers to it (low information about case management and time constraints). This is the first qualitative systematic review of the perceptions and experiences that individuals with chronic illnesses and their caregivers have about case management. The facilitators of case management can be employed to inform patients about the benefits of case management and to improve population health. The findings about barriers to case management can be used to reform case management for populations with chronic illnesses. These factors should be considered by nursing researchers and healthcare policymakers when implementing case management. © 2018 International Council of Nurses.

  17. Safety in the Heat: a comprehensive program for prevention of heat illness among workers in Abu Dhabi, United Arab Emirates.

    Science.gov (United States)

    Joubert, Darren; Thomsen, Jens; Harrison, Oliver

    2011-03-01

    The Safety in the Heat program was developed in response to the extreme heat stress conditions experienced by workers in the United Arab Emirates and other Middle Eastern countries each summer, where ambient air temperatures often reach 45°C (135°F) and higher with 90% humidity. A comprehensive, multimedia, economical education and awareness program targeting companies in the region was developed; 465 companies employing 814 996 heat-exposed workers across 6254 work and labor residence sites were reached. Feedback from program participants indicated a high level of support and satisfaction. Results indicated a marked reduction in heat related illness over a period of 2 years (2008-2009) at 2 companies, one of which reported a combined 79.5% decrease in cases (15.3 vs 1.16 cases per 1000 workers) while the other experienced a 50% reduction in serious cases (0.08-0.04 cases per 100,000 work hours).

  18. Families living with parental mental illness and their experiences of family interventions.

    Science.gov (United States)

    Afzelius, M; Plantin, L; Östman, M

    2018-03-01

    WHAT IS KNOWN ON THE SUBJECT?: Coping with parental mental illness in families can be challenging for both children and parents. Providing evidence-based family interventions to families where a parent has a mental illness can enhance the relationships in the family. Although psychiatric research has shown that evidence-based family interventions may improve the communication and understanding of parental mental illness, there is a lack in this area of research from an everyday clinical context. WHAT DOES THIS PAPER ADD TO EXISTING KNOWLEDGE?: Our study reinforces the fact that parents with mental illnesses are searching for support from psychiatric services in order to talk to their children about their illness. The finding that under-age children comply when they are told by their parents to join an intervention in psychiatric services supporting the family is something not observed earlier in research. This study once more illuminates the fact that partners of a person with parental mental illness are seldom, in an obvious way, included in family support interventions. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Psychiatric services, and especially mental health nurses, have an important task in providing families with parental mental illness with support concerning communication with their children and in including the "healthy" partner in family support interventions. Introduction Although research has shown that evidence-based family interventions in research settings improve the communication and understanding of parental mental illness, there is a lack of knowledge about interventions in an everyday clinical context. Aim This study explores how families with parental mental illness experience family interventions in a natural clinical context in psychiatric services. Method Five families with children aged 10-12 were recruited from psychiatric services in southern Sweden and interviewed in a manner inspired by naturalistic inquiry and content analysis. Both

  19. Mental illness in Disney animated films.

    Science.gov (United States)

    Lawson, Andrea; Fouts, Gregory

    2004-05-01

    To examine the prevalence of verbalizations about mental illness in the animated feature films of The Walt Disney Company (TWDC). We discuss the results within the context of children's repeated exposure to popular animated movies and their learning of labels and stereotypes associated with mental illness. We recommend further research on this topic. We coded 34 animated feature films produced by TWDC for mental illness references (for example, "crazy" or "nuts"). We developed a coding manual to systematize the content analysis, to ensure accuracy of the data, and to ascertain intercoder reliability. Most of the films (that is, 85%) contain verbal references to mental illness, with an average of 4.6 references per film. The references were mainly used to set apart and denigrate the characters to whom they referred. Twenty-one percent of the principal characters were referred to as mentally ill. We discuss the contributions and limitations of the study. The findings have implications for child viewers in terms of their potentially learning prejudicial attitudes and distancing behaviours toward individuals perceived as being mentally ill. To further verify this connection, an assessment of the incidence of Disney film exposure and attitudes toward people with a mental illness, using a sample of school-aged children, is needed.

  20. Illness Perceptions and Fatigue in Systemic Vasculitis

    Science.gov (United States)

    Grayson, Peter C.; Amudala, Naomi A.; McAlear, Carol A.; Leduc, Renée L.; Shereff, Denise; Richesson, Rachel; Fraenkel, Liana; Merkel, Peter A.

    2014-01-01

    Objective To compare illness perceptions among patients with different forms of vasculitis, identify risk factors for negative illness perceptions, and determine the association between illness perceptions and fatigue. Methods Participants were recruited from an online registry in vasculitis to complete the revised Illness Perception Questionnaire (IPQ-R). Mean scores on each IPQ-R dimension were compared across types of vasculitis. Cluster analysis and stepwise regression identified predictors of negative illness perception. Fatigue was measured using the general subscale of the Multidimensional Fatigue Inventory (MFI). Patient-reported measures of disease activity and IPQ-R dimensions were assessed in relation to MFI scores using linear regression in sequential, additive models with model-fit comparisons. Results 692 participants with 9 forms of vasculitis completed the IPQ-R. For 6 out of 8 IPQ-R dimensions, there were no significant differences in mean scores between the different vasculitides. Scores in identity and cyclical dimensions were significantly higher in Behçet’s disease compared to other types of vasculitis (13.5 vs 10.7; 4.0 vs 3.2, pvasculitis, and younger age is a risk factor for negative illness perceptions. Illness perceptions explain differences in fatigue scores beyond what can be explained by measures of disease activity. PMID:23861259

  1. Mental Illness, Healthcare, and Homelessness in Mississippi

    Directory of Open Access Journals (Sweden)

    Tamara Stewart

    2017-09-01

    Full Text Available Mental illness is prevalent among the homeless population and the rate of mentally ill homeless individuals has increased since deinstitutionalization. There is little information about homeless population mental health and access to mental healthcare. This study sought to describe the mental health status and utilization of mental healthcare services among homeless individuals in Mississippi. This is a cross-sectional study with 3,375 adults participants. There were 58% males, 42% females, 45% Caucasian, 54% African Americans, and 1% other minorities (Asian, Indian, and Pacific Islander at intake into Mississippi United to End Homelessness' (MUTEH Homeless Management Information System (HMIS program. The data was collected during the initial screening of homeless individuals. The screening documented mental illness and utilization of healthcare. Frequency tables and Chi-SQ was used to test the relationship between mental illness and utilization of mental healthcare among the homeless in Mississippi. The result of the analysis revealed that 83% of the chronically homeless individual had a mental illness, and 78% of the chronically homeless participants were not receiving mental healthcare. Mental health services were successful in connecting mentally ill homeless individuals to mental healthcare in lieu of institutionalization. However, chronically homeless mentally ill individuals struggle with obtaining appropriate care.

  2. Mental Illness in Children: Childhood Illness and Supporting the Family.

    Science.gov (United States)

    Sheehan, Rosemary

    2017-08-08

    Childhood is a stage of life that is filled with potential for development, and the early years of childhood see immense physical changes in growth; mastery over body functions like movement; the acquisition of language and cognitive development to understand their own and others' thinking and reasoning; and the psychosocial development of trust in the world, comfort in the care they receive from parents and caregivers, and the sense of being secure in themselves that this engenders. [...].

  3. Virtual voices: social support and stigma in postnatal mental illness Internet forums.

    Science.gov (United States)

    Moore, Donna; Ayers, Susan

    2017-06-01

    Many women with postnatal mental illness do not get the treatment they need and this is often because stigma prevents disclosure. The purpose of this study was to explore online social support for postnatal mental illness, how women experience stigma and potential disadvantages of using Internet forums. Interviews were conducted with fifteen participants who had suffered postnatal mental illness and had used forums. Systematic thematic analysis identified common themes in relation to social support, stigma and disadvantages of using forums. Most women felt they benefited from visiting forums by developing a shared understanding and discourse about their illness. Findings suggest future research should investigate if women benefit from using online social support provided by forums, if use challenges stigma and further explore potential concerns about using forums.

  4. The psychological impact of arthritis: the effects of illness perception and coping.

    LENUS (Irish Health Repository)

    Zyrianova, Y

    2012-02-01

    BACKGROUND: Coping and illness perception are considered to be important contributors in the relationship between physical and psychological factors in rheumatoid arthritis (RA). AIMS: The aim of this study was to examine the complex relationship of coping and illness perception on physical and psychological factors in RA using a structural model. METHODS: We assessed coping, illness perception, depression, anxiety, pain, arthritis-related disability and perceived social support in 68 adults with RA. RESULTS: Greater pain was detected in patients with increased scores on passive coping scale, greater severity of physical disability and increased depression and anxiety. Illness perception was found to be a mediator in the relationship between physical disability and passive coping on one hand and depression, anxiety and pain on the other. CONCLUSIONS: The hypothesised structural model has proven to be a useful paradigm for understanding the associations between multiple factors in RA presentation: clinical, emotional, personal and cognitive.

  5. Exploring the occupations of homeless adults living with mental illnesses in Toronto.

    Science.gov (United States)

    Illman, Sarah C; Spence, Sandy; O'Campo, Patricia J; Kirsh, Bonnie H

    2013-10-01

    The nature of occupational engagement for homeless people living with mental illnesses is not well understood, and there are few studies to date that examine the occupational lives of these individuals. This research study seeks to understand how this group of individuals engages in occupations. The central question is "What is the nature of occupational engagement by homeless adults living with mental illnesses in Toronto?" A constant comparative method of analysis was used in a secondary analysis of 60 interviews with homeless adults experiencing mental illness. Four themes emerged that describe the nature of occupational engagement for this group: occupations as enjoyment, occupations as survival/risk, occupations as passing time, and occupations as self-management. Implications. This research informs occupational therapy interventions aimed at optimizing engagement, health, and well-being for homeless adults living with mental illnesses.

  6. The Role of University Support Services on Academic Outcomes for Students with Mental Illness

    Directory of Open Access Journals (Sweden)

    Andrea Simpson

    2014-01-01

    Full Text Available Mental illness in the university student population has come under increased scrutiny in recent years. Students with mental illness are understandably highly reluctant to disclose their condition to others due to fear of prejudice, “not blending in,” and a strong desire to appear self-reliant. This study considered whether disclosure to university support services, with all its perceived risks, had academic benefits for students with mental illness. Preliminary evidence was found that, for those students with mental illness who registered with the University’s Disability Support Service for assistance, academic achievement was significantly higher on average in the year following their joining the service. Academic retention for these students was comparable to their university peers. A number of recommendations are discussed that could accommodate for students’ learning needs, thereby benefitting those experiencing mental health difficulties.

  7. Unsolicited written narratives as a methodological genre in terminal illness: challenges and limitations.

    Science.gov (United States)

    O'Brien, Mary R; Clark, David

    2012-02-01

    Stories about illness have proven invaluable in helping health professionals understand illness experiences. Such narratives have traditionally been solicited by researchers through interviews and the collection of personal writings, including diaries. These approaches are, however, researcher driven; the impetus for the creation of the story comes from the researcher and not the narrator. In recent years there has been exponential growth in illness narratives created by individuals, of their own volition, and made available for others to read in print or as Internet accounts. We sought to determine whether it was possible to identify such material for use as research data to explore the subject of living with the terminal illness amyotrophic lateral sclerosis/motor neuron disease--the contention being that these accounts are narrator driven and therefore focus on issues of greatest importance to the affected person. We encountered and sought to overcome a number of methodological and ethical challenges, which is our focus here.

  8. A Self-Study Of My Life With A Chronic Illness

    Directory of Open Access Journals (Sweden)

    Taunya WIDEMAN-JOHNSTON

    2015-07-01

    Full Text Available The following paper is a self-study identifying and examining obstacles I have encountered from living with a chronic illness (CI. In particular, I intend to connect my life experiences as both an individual and educator in academia. The focus of this paper is to reveal my life experiences with a CI, the challenges I encounter, and how I learn I can foster change in the community. A serious failure in my health from the rare chronic gastrointestinal illness I have been diagnosed with initiated a journey of questioning both my knowledge and understandings regarding my life. I was forced to reconnect with my body and yet again, accept the illness inside me. The findings from my recovery included four main themes that illuminate transformative learning with a chronic illness. The themes are betrayed by my body, trying to live, societal differences, and seeking wellness.

  9. Transfusion-related immunomodulation: review of the literature and implications for pediatric critical illness.

    Science.gov (United States)

    Muszynski, Jennifer A; Spinella, Philip C; Cholette, Jill M; Acker, Jason P; Hall, Mark W; Juffermans, Nicole P; Kelly, Daniel P; Blumberg, Neil; Nicol, Kathleen; Liedel, Jennifer; Doctor, Allan; Remy, Kenneth E; Tucci, Marisa; Lacroix, Jacques; Norris, Philip J

    2017-01-01

    Transfusion-related immunomodulation (TRIM) in the intensive care unit (ICU) is difficult to define and likely represents a complicated set of physiologic responses to transfusion, including both proinflammatory and immunosuppressive effects. Similarly, the immunologic response to critical illness in both adults and children is highly complex and is characterized by both acute inflammation and acquired immune suppression. How transfusion may contribute to or perpetuate these phenotypes in the ICU is poorly understood, despite the fact that transfusion is common in critically ill patients. Both hyperinflammation and severe immune suppression are associated with poor outcomes from critical illness, underscoring the need to understand potential immunologic consequences of blood product transfusion. In this review we outline the dynamic immunologic response to critical illness, provide clinical evidence in support of immunomodulatory effects of blood product transfusion, review preclinical and translational studies to date of TRIM, and provide insight into future research directions. © 2016 AABB.

  10. [Illness Experience of Married Korean Women with Epilepsy].

    Science.gov (United States)

    Shon, Young Min; Joung, Woo Joung

    2017-06-01

    The purpose of this study was to understand and describe the illness experience of married Korean women with epilepsy. Data were collected during 2015~2016 through individual in-depth interviews with 12 married women with epilepsy. Verbatim transcripts were analyzed using Giorgi's phenomenological analysis to uncover the meaning of the illness experience of the participants. The study results showed that the illness experience of married Korean women with epilepsy was clustered into a specific description of situated structure and a general description of situated structure. Six themes from 20 meaning units were identified: 1) Undermined self-esteem with stigma of being epileptic; 2) Limited social interaction; 3) Suffering sorrow as a 'disqualified being'; 4) Shuttling back and forth across the boundary between healthy and epileptic; 5) Desperate struggle to meet the expectation of given role; 6) Self-empowering through self-restriction and realization. The findings from this study show that both the enacted and felt stigma of epilepsy impact on the life of married Korean women with epilepsy. Although the participants face social and interpersonal restriction and prejudices, they try their best to fulfill their role rather than to be cared for as patients. As the stigma and hardships of the participants are related to lack of knowledge, health professionals should focus not just on clinical intervention but also on providing targeted educational programs and counseling for these women to dispel the stigma of the disease and to increase their quality of life. © 2017 Korean Society of Nursing Science

  11. Barriers to exercise among people with severe mental illnesses.

    Science.gov (United States)

    Glover, Crystal M; Ferron, Joelle C; Whitley, Rob

    2013-03-01

    Lack of exercise is a risk factor for various negative health outcomes. Some research suggests people with severe mental illnesses are less likely to engage in exercise than the general population. The purpose of this report is to document, analyze, and understand self-identified barriers to exercise that may be especially specific to people living with serious mental illnesses. Producing such knowledge can assist in the development of effective interventions. Thirty-one people with serious mental illnesses participated in in-depth one-on-one interviews to discuss health behaviors in general and exercise more specifically. The authors then engaged in thematic analysis of data to identify common barriers to exercise. Participants reported psychiatric medication side effects, symptoms related to SMI, and physical comorbidities as barriers. Clinicians should incorporate physical health goals as a part of treatment planning. Agencies also can play a role in increasing exercise through the implementation of programs. PsycINFO Database Record (c) 2013 APA, all rights reserved

  12. Will we save the homeless mentally ill?

    Science.gov (United States)

    Lamb, H R

    1990-05-01

    Progress in alleviating the plight of the homeless mentally ill has been very slow and disappointing. After reviewing the needs of the homeless mentally ill, the author makes recommendations for immediate action. Extensive case management services should be implemented rather than simply discussed. All incompetent and/or dangerous or gravely disabled homeless mentally ill persons should be brought to hospitals, involuntarily if necessary. Cost-effective alternatives to hospitals with varying degrees of structure should be provided. Involuntary mechanisms such as conservatorship and outpatient commitment should be used when needed. The emphasis should be on timely transfer to acceptable treatment and living situations rather than waiting for the ideal.

  13. Outbreak of Mysterious Illness Among Hospital Staff

    DEFF Research Database (Denmark)

    Jacobsen, Peter; Ebbehøj, Niels Erik

    2016-01-01

    BACKGROUND: Hospitals are rarely reported as settings for mass psychogenic illness (MPI). The present report scrutinizes an outbreak of probable MPI among hospital staff, with medical intervention reinforcing the course of the illness. CASE REPORT: Four of seven staff members in an emergency...... the following 9 days, 14 possible poisoning victims were identified, 6 of whom were transferred for HBO. After hospital stays with repeated HBO treatment and examinations without identification of significant physical disease, the majority of the 10 HBO-treated victims remained symptomatic, some on prolonged....... Outbreaks of illness in a group of symptomatic victims without indication of significant physical disease should be managed by observation and limited intervention....

  14. 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.

  15. ILL experimental reports and theory college activities

    International Nuclear Information System (INIS)

    1987-01-01

    This volume is the collection of reports describing experimental work performed at the I.L.L. They have been arranged by subject (from the I.L.L. classification scheme) and are published under their proposal number. (Only those reports received up to Jan. 19, 1987 have been included). In order to have connection between the theory group and the experimental activities of the I.L.L., scientific activity of theoreticians has been included in the form of a personal review of activity. For any further details, readers should contact directly individual scientists

  16. Inequality in the social consequences of illness

    DEFF Research Database (Denmark)

    Burström, B; Whitehead, M; Lindholm, C

    2000-01-01

    ) 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...... 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...

  17. Toward a theory of online communication in illness: concept analysis of illness blogs.

    Science.gov (United States)

    Heilferty, Catherine McGeehin

    2009-07-01

    This paper is a report of a concept analysis of illness blogs and their relevance to nursing research on communication during illness. Blogs are being used by patients and family members to describe the experience of illness, but very little is known about this phenomenon. Seventeen English language databases and one Internet search engine were searched from 1990 to 2007 using the truncated term 'blog*'. Specific illness terms together with 'blog*', for example, blog* and diabetes; and blog* and cancer, were used to expand the search. Reports were included if they were of qualitative or quantitative research that included a definition of blogs or blogging and some identification or description of blog uses pertinent to the discipline. Specific emphasis was placed on blog use by individuals coping with illness experiences. 'Meta' writings by authors about their own blogging intentions and experiences were excluded. An illness blog is the online expression of the narrative of illness. Theoretical and operational definitions, defining attributes, uses, antecedents and consequences were developed. The literature search returned 45 works from 17 disciplines referring to the definition and uses of blogging. Support is offered from the review of literature and analysis of the concept for the development of a theory of online communication during illness. Reading and incorporating illness blogs into care will enhance patient-provider relationships. Analysis of the narratives being created online about the illness experience will contribute significantly to nursing's body of knowledge.

  18. Illness perceptions in patients with osteoarthritis: change over time and association with disability.

    Science.gov (United States)

    Bijsterbosch, J; Scharloo, M; Visser, A W; Watt, I; Meulenbelt, I; Huizinga, T W J; Kaptein, A A; Kloppenburg, M

    2009-08-15

    To investigate changes in illness perceptions in patients with osteoarthritis (OA) and the association of those changes with disability, and to determine the predictive value of illness perceptions in disability. Illness perceptions and disability were measured at baseline and after 6 years in 241 patients with OA at multiple sites (mean age 59.0 years, 82.2% women) using the revised Illness Perception Questionnaire (IPQ-R) and the Health Assessment Questionnaire (HAQ), respectively. Mean changes for each IPQ-R dimension were reported and related to progression of disability, defined as the highest quartile of HAQ score change. The predictive value of baseline illness perceptions in disability at 6 years (with high disability defined as the highest quartile of HAQ score) was assessed using logistic regression. Illness perceptions changed over time, and these changes were related to the progression of disability. Patients with progression of disability had an increase in symptoms attributed to OA, perceived consequences, perceived disease chronicity, negative emotions associated with OA and beliefs about immunity as causal factor, and a decrease in perceived control and understanding of OA compared with patients without progression of disability. Moreover, a higher number of symptoms attributed to OA, less perceived control, and more perceived consequences of OA at baseline were predictive of high disability after 6 years. Illness perceptions in patients with OA changed over time, and these changes were related to outcome. Moreover, illness perceptions were predictive of disability. This may imply that interventions aimed at changing illness perceptions can contribute to better functional outcome.

  19. Complete mental health in adult siblings of those with a chronic illness or disability.

    Science.gov (United States)

    Hallion, Madeleine; Taylor, Amanda; Roberts, Rachel

    2018-02-01

    Sibling relationships have lifelong significance and childhood chronic illness and disability can have considerable impacts on healthy siblings, influencing development into adulthood. Research has not yet assessed well-being in this population using measures of both mental health and mental illness. Thus, this study assessed well-being in a comprehensive manner using the complete mental health (CMH) model. Participants (N = 144) included both adult siblings of those with chronic illness or disability and adults with healthy siblings. Measures of positive social, psychological and emotional well-being were used to assess mental health and a measure of depression, anxiety, and stress was used to assess mental illness. A high proportion of participants, both with and without siblings with a chronic illness or disability, were experiencing symptoms of mental illness, accompanied by high wellbeing. This indicates that many participants fit into the struggling category of the CMH model. The present research highlights the need for early intervention services to ensure that siblings of those with a chronic illness or disability are well supported in developing strengths, as well as managing difficulties. Results also indicate that targeting students in mental health promotion is important to encourage participation in services. Implications for rehabilitation Siblings of those with a chronic illness or disability need to be included in assessments in order to understand the experience of the family unit. It is important for families and clinicians to be aware of the needs of healthy siblings and encourage them to interact with support services in order to maximise and maintain well-being. Skills-based support could be beneficial, particularly for providing caregivers with strategies to meet the needs of both their child with a chronic illness or disability and their healthy children.

  20. Physiological and management implications of obesity in critical illness.

    Science.gov (United States)

    Shashaty, Michael G S; Stapleton, Renee D

    2014-10-01

    Obesity is highly prevalent in the United States and is becoming increasingly common worldwide. The anatomic and physiological changes that occur in obese individuals may have an impact across the spectrum of critical illness. Obese patients may be more susceptible to hypoxemia and hypercapnia. During mechanical ventilation, elevated end-expiratory pressures may be required to improve lung compliance and to prevent ventilation-perfusion mismatch due to distal airway collapse. Several studies have shown an increased risk of organ dysfunction such as the acute respiratory distress syndrome and acute kidney injury in obese patients. Predisposition to ventricular hypertrophy and increases in blood volume should be considered in fluid management decisions. Obese patients have accelerated muscle losses in critical illness, making nutrition essential, although the optimal predictive equation to estimate nutritional needs or formulation for obese patients is not well established. Many common intensive care unit medications are not well studied in obese patients, necessitating understanding of pharmacokinetic concepts and consultation with pharmacists. Obesity is associated with higher risk of deep venous thrombosis and catheter-associated bloodstream infections, likely related to greater average catheter dwell times. Logistical issues such as blood pressure cuff sizing, ultrasound assistance for procedures, diminished quality of some imaging modalities, and capabilities of hospital equipment such as beds and lifts are important considerations. Despite the physiological alterations and logistical challenges involved, it is not clear whether obesity has an effect on mortality or long-term outcomes from critical illness. Effects may vary by type of critical illness, obesity severity, and obesity-associated comorbidities.

  1. Illness cognitions and family adjustment: psychometric properties of the Illness Cognition Questionnaire for parents of a child with cancer

    NARCIS (Netherlands)

    Sint Nicolaas, Simone M.; Schepers, Sasja A.; van den Bergh, Esther M. M.; Evers, Andrea W. M.; Hoogerbrugge, Peter M.; Grootenhuis, Martha A.; Verhaak, Christianne M.

    2016-01-01

    Illness cognitions are an important mediator between disease and psychological adjustment. This study assessed the psychometric properties of the Illness Cognition Questionnaire (ICQ), adjusted for the parents of an ill child. Participants were recruited from two multicenter studies: sample 1

  2. Illness cognitions and family adjustment: psychometric properties of the Illness Cognition Questionnaire for parents of a child with cancer

    NARCIS (Netherlands)

    Sint Nicolaas, S.M.; Schepers, S.A.; Bergh, E.M. van den; Evers, A.W.M.; Hoogerbrugge, P.M.; Grootenhuis, M.A.; Verhaak, C.M.

    2016-01-01

    PURPOSE: Illness cognitions are an important mediator between disease and psychological adjustment. This study assessed the psychometric properties of the Illness Cognition Questionnaire (ICQ), adjusted for the parents of an ill child. METHODS: Participants were recruited from two multicenter

  3. Energy Requirements in Critically Ill Patients

    Science.gov (United States)

    2018-01-01

    During the management of critical illness, optimal nutritional support is an important key for achieving positive clinical outcomes. Compared to healthy people, critically ill patients have higher energy expenditure, thereby their energy requirements and risk of malnutrition being increased. Assessing individual nutritional requirement is essential for a successful nutritional support, including the adequate energy supply. Methods to assess energy requirements include indirect calorimetry (IC) which is considered as a reference method, and the predictive equations which are commonly used due to the difficulty of using IC in certain conditions. In this study, a literature review was conducted on the energy metabolic changes in critically ill patients, and the implications for the estimation of energy requirements in this population. In addition, the issue of optimal caloric goal during nutrition support is discussed, as well as the accuracy of selected resting energy expenditure predictive equations, commonly used in critically ill patients.

  4. Barbecue Basics: Tips to Prevent Foodborne Illness

    Medline Plus

    Full Text Available ... from becoming ill,” says Marjorie Davidson, Ph.D., education team leader in FDA’s Center for Food Safety and Applied Nutrition. Wash hands. It seems basic, but not everyone ...

  5. Advanced Illness: Feeding Tubes and Ventilators

    Science.gov (United States)

    ... are here Home Advanced Illness: Feeding Tubes and Ventilators Order this publication Printer-friendly version Introduction Families ... a Family Meeting for additional help. Pneumonia and Ventilators One of the other choices a patient or ...

  6. Wound management in patients with advanced illness.

    Science.gov (United States)

    Maida, Vincent

    2013-03-01

    To emphasize that the management of wounds represents a significant component within the overall supportive and palliative care of patients with advanced illness. It is also intended to clarify the linguistics that are commonly used around patients with wounds. New paradigms for wound management, wound outcomes, and goal setting have been defined and graphically depicted. Recent studies show that wounds may be used as prognostic factors for patients with advanced illness. Data from recent studies also demonstrate that marginal levels of wound healing are possible for all wound classes affecting patients with advanced illness. When indicated, time-limited trials of wound healing strategies should be facilitated by the Wound Bed Preparation Paradigm. Wound palliation may be guided through the use of the Toronto Symptom Assessment System for Wounds (TSAS-W). Wound management must continue to evolve as a tenet within the overall supportive and palliative care of patients with advanced illness.

  7. RelaisILL instructions in English

    International Development Research Centre (IDRC) Digital Library (Canada)

    Julie Cassone

    . RelaisILL is IDRC's document delivery and interlibrary loan request and tracking system. Follow the steps below to order journal articles and books through interlibrary loan. Note: Grantees can only request articles and book chapters, which ...

  8. The meaning of illness in nursing practice: a philosophical model of communication and concept possession.

    Science.gov (United States)

    Nordby, Halvor

    2016-04-01

    It is fundamental assumption in nursing theory that it is important for nurses to understand how patients experience states of ill health. This assumption is often related to aims of empathic understanding, but normative principles of social interpretation can have an important action-guiding role whenever nurses seek to understand patients' subjective horizons on the basis of active or passive expressions of meaning. The aim of this article is to present a philosophical theory of concept possession and to argue that it can shed light on how nurses should seek to understand patients' subjective perspectives on the meaning of illness. The two basic ideas in the theory are that patients' beliefs and thoughts about their experiences involve concepts and that concepts can be communicated on the basis of shared implicit conceptions of what they mean. These conditions of understanding have a striking application: nurse-patient communication is limited by many contextual factors, but it is often possible for nurses to detect shared implicit conceptions of the meaning of concepts of disease and illness. Furthermore, by acting as sympathetic linguistic experts and creating an atmosphere for dialogue, nurses can make patients feel comfortable about deferring to medical explanations of meaning that can constitute a communicative platform. The last part of the article uses a number of cases studies to show how these implications can be implemented as conceptual tools for securing meaningful communication about illness experiences in patient dialogue. © 2016 John Wiley & Sons Ltd.

  9. Physiotherapy in critically ill patients

    Directory of Open Access Journals (Sweden)

    N. Ambrosino

    2011-11-01

    Full Text Available Prolonged stay in Intensive Care Unit (ICU can cause muscle weakness, physical deconditioning, recurrent symptoms, mood alterations and poor quality of life.Physiotherapy is probably the only treatment likely to increase in the short- and long-term care of the patients admitted to these units. Recovery of physical and respiratory functions, coming off mechanical ventilation, prevention of the effects of bed-rest and improvement in the health status are the clinical objectives of a physiotherapy program in medical and surgical areas. To manage these patients, integrated programs dealing with both whole-body physical therapy and pulmonary care are needed.There is still limited scientific evidence to support such a comprehensive approach to all critically ill patients; therefore we need randomised studies with solid clinical short- and long-term outcome measures. Resumo: Uma estadia prolongada na Unidade de Cuidados Intensivos (UCI pode causar fraqueza muscular, descondicionamento físico, sintomas recorrentes, alterações de humor e má qualidade de vida.A fisioterapia é, provavelmente, o único tratamento com potencial para aumentar nos cuidados a curto e longo prazo aos pacientes internados nestas unidades. A recuperação das funções físicas e respiratórias, retirar a ventilação mecânica, prevenção de efeitos do repouso na cama e melhoria do estado de saúde são objectivos clínicos de um programa de fisioterapia nas áreas médicas e cirúrgicas. Para tratar estes pacientes, são necessários programas integrados que englobem tanto a fisioterapia global como os cuidados respiratórios necessários.A evidência científica para apoiar esta abordagem abrangente para todos os doentes críticos é ainda limitada; portanto, são necessários estudos aleatorizados com medidas de resultados a curto e longo prazo. Keywords: Rehabilitation, Mechanical ventilation, Physiotherapy, Weaning, Palavras-chave: Reabilitação, Ventilação mec

  10. Physiotherapy in critically ill patients

    Directory of Open Access Journals (Sweden)

    N. Ambrosino

    2011-11-01

    Full Text Available Prolonged stay in Intensive Care Unit (ICU can cause muscle weakness, physical deconditioning, recurrent symptoms, mood alterations and poor quality of life. Physiotherapy is probably the only treatment likely to increase in the short- and long-term care of the patients admitted to these units. Recovery of physical and respiratory functions, coming off mechanical ventilation, prevention of the effects of bed-rest and improvement in the health status are the clinical objectives of a physiotherapy program in medical and surgical areas. To manage these patients, integrated programs dealing with both whole-body physical therapy and pulmonary care are needed. There is still limited scientific evidence to support such a comprehensive approach to all critically ill patients; therefore we need randomised studies with solid clinical short- and long-term outcome measures. Resumo: Uma estadia prolongada na Unidade de Cuidados Intensivos (UCI pode causar fraqueza muscular, descondicionamento físico, sintomas recorrentes, alterações de humor e má qualidade de vida. A fisioterapia é, provavelmente, o único tratamento com potencial para aumentar nos cuida-dos a curto e longo prazo aos pacientes internados nestas unidades. A recuperação das funções físicas e respiratórias, retirar a ventilação mecânica, prevenção de efeitos do repouso na cama e melhoria do estado de saúde são objectivos clínicos de um programa de fisioterapia nas áreas médicas e cirúrgicas. Para tratar estes pacientes, são necessários programas integrados que englobem tanto a fisioterapia global como os cuidados respiratórios necessários. A evidência científica para apoiar esta abordagem abrangente para todos os doentes críticos é ainda limitada; portanto, são necessários estudos aleatorizados com medidas de resultados a curto e longo prazo. Keywords: Rehabilitation, Mechanical ventilation, Physiotherapy, Weaning, Palavras chave: Reabilitação, Ventilação mec

  11. Illness representations in patients with hand injury.

    Science.gov (United States)

    Chan, Jeffrey C Y; Ong, Joshua C Y; Avalos, Gloria; Regan, Padraic J; McCann, Jack; Groarke, AnnMarie; Kelly, John L

    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. The disability and severity of injury were assessed using the Disability of the Arm, Shoulder and Hand (DASH) questionnaire and the Hand Injury Severity Score (HISS). The revised Illness Perception Questionnaire (IPQ-R) was used to explore patients' illness beliefs and perception on hand injury. Fifty seven patients were recruited over the 2 month period. The IPQ-R showed good internal reliability (Cronbach's alpha, 0.68-0.86). There was no correlation between the DASH or HISS scores and the various components of the IPQ-R scores, suggesting that illness perceptions were not influenced by the recent trauma experience. Patients with dominant hand injuries and females reported significantly higher subjective disability. Younger patients believed their injury would last for a limited duration but reported a significantly higher number of related symptoms. Overall, the cohort was optimistic about their treatment and duration of recovery (high treatment control score and low time line score). Beliefs of negative consequences, chronic/cyclical duration and low illness coherence were linked with negative emotional response. High illness identity was associated with perception of pessimistic outcome (high consequences score) and negative emotional response. The lack of correlations suggests that illness perceptions of patients do not necessarily relate to the recent trauma experience or the severity of their hand injury. Patients in this cohort were optimistic about treatment and their recovery. There was some evidence to suggest that patients with severe injury were over-optimistic about recovery. These findings suggest that there could be a role for

  12. Mental Illness, Healthcare, and Homelessness in Mississippi

    OpenAIRE

    Tamara Stewart

    2017-01-01

    Mental illness is prevalent among the homeless population and the rate of mentally ill homeless individuals has increased since deinstitutionalization. There is little information about homeless population mental health and access to mental healthcare. This study sought to describe the mental health status and utilization of mental healthcare services among homeless individuals in Mississippi. This is a cross-sectional study with 3,375 adults participants. There were 58% males, 42% females, 4...

  13. Electrotherapy and mental illness: then and now

    OpenAIRE

    Gilman, Sander L.

    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...

  14. Perceived Social Support among Mentally Ill Patients

    OpenAIRE

    Bandana Pokharel; Anupama Pokharel

    2014-01-01

    Introduction: Social support is the perception that one is cared for, has assistance available from significant others and its benefit is by buffering stress by influencing the ability to adjust and live with illness. Social support can uplift the quality and subjective wellbeing of people. The objective of this study was to examine the perceived social support and factors influencing it among mentally ill patients. Methods: A descriptive cross-sectional study was carried out. Ninety cas...

  15. ILL. Annex to the annual report 1976

    International Nuclear Information System (INIS)

    The first volume of the Annual Report gives a general survey of the activities in the various sections of the ILL, whereas this second volume, deals in more detail with the individual works carried out at the ILL from 1st October 1975 up to 1st October 1976. Main chapters correspond to theory, nuclear physics, excitations, magnetic and crystallographic structures, liquids and amorphous substances, imperfections, biology and chemistry. (Only those reports received up to 1st February 1977 have been included)

  16. [Characteristics of heat illness in older people].

    Science.gov (United States)

    Iwata, Mitsunaga; Umegaki, Hiroyuki; Kuzuya, Masafumi; Kitagawa, Yoshimi

    2008-05-01

    As summer become hotter due to rapid climate change, older people suffering from heat illness are increasing. The aim of our study was to examine the characteristics of older people who suffered from heat illness. We analyzed the 65 years or older patients admitted for acute care of Nagoya Ekisaikai Hospital via the emergency department (ED) during the summer seasons of 2006 and 2007. Demographic data, functional status, use situation of care services, climate of the onset day, use of an air conditioners, and cognitive status, length of hospital stay and disposition following their discharge were recorded. During the study period, 104 patients visited the ED because of heat illness. Twenty older patients were admitted for acute care. In hospitalized patients, the mean length of stay was 27.5+/-18.6 days. Sixty percent of patients were discharged to long-term care facilities (12/20). Sixteen patients suffered from heat illness inside their home. Most of the patients had characteristics such as living alone or with their spouses only (14/16), cognitive dysfunction (12/16), lack or no use of an air conditioner (11/16) , no use of care service (11/16) , and preserved functional status (10/16) . Many older patients suffered from heat illness in their home, and their ED visits were associated with prolonged admissions and post-discharge institutionalizations. It is important to give education to prevent heat illness in older people.

  17. [Delirium in the critically ill patient].

    Science.gov (United States)

    Pessoa, Renata Fittipaldi; Nácul, Flávio Eduardo

    2006-06-01

    Delirium is a frequent finding in the critically ill patient. Although it is associated with increased morbidity and mortality, it is often not recognized by intensive care doctors. This review will address the main issues regarding delirium in critically ill patients. Definition, incidence, mortality, risk factors, diagnosis, and treatment of delirium in the critically ill. Deliriumis defined as a disturbance of consciousness, attention, cognition and perception that occurs frequently in critically ill patients. It occurs in as many as 80% of mechanically ventilated ICU patients. Risk factors for delirium include acute systemic illnesses, older age, pre-existing cognitive impairment, sleep deprivation, and medications with anticholinergic activity. Although new assessment tools are available for rapidly and accurately measuring deliriumin critically ill patients, healthcare professionals still do not regularly monitor for this condition. In recent years, the emphasis in the approach to delirium has shifted to systematic screening and prevention. Haloperidol remains the standard treatment for delirium, but there is some evidence for the efficacy of risperidone.

  18. Shape understanding system machine understanding and human understanding

    CERN Document Server

    Les, Zbigniew

    2015-01-01

    This is the third book presenting selected results of research on the further development of the shape understanding system (SUS) carried out by authors in the newly founded Queen Jadwiga Research Institute of Understanding. In this book the new term Machine Understanding is introduced referring to a new area of research aiming to investigate the possibility of building machines with the ability to understand. It is presented that SUS needs to some extent mimic human understanding and for this reason machines are evaluated according to the rules applied for the evaluation of human understanding. The book shows how to formulate problems and how it can be tested if the machine is able to solve these problems.    

  19. Good-parent beliefs of parents of seriously ill children.

    Science.gov (United States)

    Feudtner, Chris; Walter, Jennifer K; Faerber, Jennifer A; Hill, Douglas L; Carroll, Karen W; Mollen, Cynthia J; Miller, Victoria A; Morrison, Wynne E; Munson, David; Kang, Tammy I; Hinds, Pamela S

    2015-01-01

    Parents' beliefs about what they need to do to be a good parent when their children are seriously ill influence their medical decisions, and better understanding of these beliefs may improve decision support. To assess parents' perceptions regarding the relative importance of 12 good-parent attributes. A cross-sectional, discrete-choice experiment was conducted at a children's hospital. Participants included 200 parents of children with serious illness. Ratings of 12 good-parent attributes, with subsequent use of latent class analysis to identify groups of parents with similar ratings of attributes, and ascertainment of whether membership in a particular group was associated with demographic or clinical characteristics. The highest-ranked good-parent attribute was making sure that my child feels loved, followed by focusing on my child's health, making informed medical care decisions, and advocating for my child with medical staff. We identified 4 groups of parents with similar patterns of good-parent-attribute ratings, which we labeled as: child feels loved (n=68), child's health (n=56), advocacy and informed (n=55), and spiritual well-being (n=21). Compared with the other groups, the child's health group reported more financial difficulties, was less educated, and had a higher proportion of children with new complex, chronic conditions. Parents endorse a broad range of beliefs that represent what they perceive they should do to be a good parent for their seriously ill child. Common patterns of how parents prioritize these attributes exist, suggesting future research to better understand the origins and development of good-parent beliefs among these parents. More important, engaging parents individually regarding what they perceive to be the core duties they must fulfill to be a good parent may enable more customized and effective decision support.

  20. Insight in Psychosis: An Indicator of Severity of Psychosis, an Explanatory Model of Illness, and a Coping Strategy

    Science.gov (United States)

    Jacob, K. S.

    2016-01-01

    Recent studies related to insight, explanatory models (EMs) of illness and their relationship to outcome of psychosis are reviewed. The traditional argument that insight predicts outcome in psychosis is not supported by recent longitudinal data, which has been analyzed using multivariable statistics that adjust for severity and quality of illness. While all cognition will have a neurobiological representation, if “insight” is related to the primary psychotic process, then insight cannot be seen as an independent predictor of outcome but a part of the progression of illness. The evidence suggests insight, like all EMs, is belief which interacts with the trajectory of the person's illness and the local culture to produce a unique understanding of the illness for the particular individual and his/her family. PMID:27335513

  1. 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.

  2. Beliefs regarding diet during childhood illness.

    Science.gov (United States)

    Benakappa, Asha D; Shivamurthy, Poojita

    2012-01-01

    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. 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. 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. 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. 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.

  3. Psychiatry and the homeless mentally ill: a reply to Dr. Lamb.

    Science.gov (United States)

    Mossman, D; Perlin, M L

    1992-07-01

    Homeless mentally ill persons are highly visible subjects of ongoing public discussion and potent symbols of a host of contemporary social problems. They present psychiatry with a scientific challenge that calls for further elucidation of the sources of their mental illness and for fashioning possible solutions to their problems. They also present a moral challenge that requires psychiatrists to acknowledge the cultural, political, legal, and economic context of the mental problems of the homeless in the course of deciding what should be done to help them. H. Richard Lamb has proposed a program of aggressive outreach and psychiatric hospitalization for the homeless mentally ill. The authors believe that his proposal misconstrues the problems and needs of homeless mentally ill individuals; it would also needlessly infringe upon their freedom, further stigmatize them, and probably not help them. The authors offer an alternative understanding of the plight of the homeless mentally ill which places their problems within a larger context of social trends and domestic issues that society has been reluctant to confront. Psychiatrists can help the homeless mentally ill by championing their liberty rights and by focusing public discourse on the broad national need for improved access to medical and psychiatric care.

  4. Spiritual beliefs in bipolar affective disorder: their relevance for illness management.

    Science.gov (United States)

    Mitchell, Logan; Romans, Sarah

    2003-08-01

    There has been growing interest in investigating religion as a relevant element in illness outcome. Having religious beliefs has been shown repeatedly to be associated with lessened rates of depression. Most of the limited published research has been restricted to elderly samples. Religious coping is thought to play a key role in religion's effects. Strangely, psychiatric research has neglected this area. A questionnaire covering religious, spiritual and philosophical beliefs and religious practice was given to a sample of patients with bipolar affective disorder in remission. Most patients often held strong religious or spiritual beliefs (78%) and practised their religion frequently (81.5%). Most saw a direct link between their beliefs and the management of their illness. Many used religious coping, and often religio-spiritual beliefs and practice put them in conflict with illness models (24%) and advice (19%) used by their medical advisors. This was a cross-sectional design without a control group and thus it is not possible to determine causal associations from the data set. Religio-spiritual ideas are of great salience to many patients with bipolar disorder and shape the ways in which they think about their illness. Many reported experiencing significant paradigm conflict in understanding and managing their illness between medical and their spiritual advisors. These data suggest that the whole area of religion and spirituality is directly relevant to people living with a chronic psychiatric illness and should be firmly on the discussion agenda of clinicians working with patients with bipolar disorder.

  5. A breath of fresh air: images of respiratory illness in novels, poems, films, music, and paintings.

    Science.gov (United States)

    Kaptein, Ad A; Meulenberg, Frans; Smyth, Joshua M

    2015-03-01

    The nature and severity of respiratory disease are typically expressed with biomedical measures such as pulmonary function, X-rays, blood tests, and other physiological characteristics. The impact of respiratory illness on the sufferer, however, is reflected in the stories patients tell: to themselves, their social environment, and their health care providers. Behavioral research often applies standardized questionnaires to assess this subjective impact. Additional approaches to sampling patients' experience of respiratory illness may, however, provide important and clinically useful information that is not captured by other methods. Herein, we assert that novels, poems, movies, music, and paintings may represent a rich, experiential understanding of the patient's point of view of asthma, cystic fibrosis, lung cancer, and tuberculosis. Examination of these works illustrates the broad range and major impact of respiratory illness on patients' quality of life. We suggest that examining how illness is represented in various art forms may help patients, their social environment, and their health care providers in coping with the illness and in humanizing medical care. Medical students' clinical skills may benefit when illness experiences as expressed in art are incorporated in the medical curriculum. More generally, Narrative Health Psychology, Narrative Medicine, and Medical Humanities deserve more attention in education, training, and clinical care of (respiratory) physicians, medical students, and other health care professionals. © The Author(s) 2015.

  6. Attitudes of Mental Health Professionals about Mental Illness: A Review of the Recent Literature

    Science.gov (United States)

    Wahl, Otto; Aroesty-Cohen, Eli

    2010-01-01

    A large body of research has documented public attitudes toward people with mental illness. The current attitudes of the people who provide services to those with psychiatric disorders are important to understand, as well. The authors review what studies over the past 5 years reveal about the attitudes of psychiatric professionals. Empirical…

  7. Strategies for parenting by mothers and fathers with a mental illness

    NARCIS (Netherlands)

    van der Ende, P C; van Busschbach, J T; Nicholson, J; Korevaar, E L; van Weeghel, J

    2016-01-01

    ABSTRACT: Introduction Understanding of the problems of parents with mental illness is growing. Gaining insight into strategies for parenting, while taking the opportunities formulated by these parents themselves as a starting point is fairly new. Question What are the strategies of parents with a

  8. Mental illness and parenthood: being a parent in secure psychiatric care

    NARCIS (Netherlands)

    Parrott, F.R.; Macinnes, D.I.; Parrott, J.

    2015-01-01

    Background: Research into parenting and mental illness seldom includes forensic mental health service users, despite its relevance to therapeutic, family work and risk management. Aims: This study aimed to understand the experiences of parents and the variety of parenting roles maintained during

  9. Patients' perceptions and illness severity at start of antidepressant treatment in general practice

    NARCIS (Netherlands)

    Van Geffen, Erica C.G.; Heerdink, Eiebert R.; Hugtenburg, Jacqueline G.; Siero, Frans W.; Egberts, Antoine C.G.; Van Hulten, Rolf

    2010-01-01

    Objectives Patients' perceptions are important to consider when trying to understand why patients often do not follow prescriptions for antidepressant treatment. This study aimed to investigate the influence of patients' perceptions and illness severity at the start on antidepressant-medication-

  10. Sailing the Stormy Seas: The Illness Experience of Persons with Parkinson's Disease

    Science.gov (United States)

    Stanley-Hermanns, Melinda; Engebretson, Joan

    2010-01-01

    Parkinson's disease is a chronic, progressive disorder with no known cause or promising cure. While substantial information is known about the pathophysiology, little is known about the illness experience of living with the disease. A qualitative study using an ethnographic approach was conducted to provide a rich understanding of the illness…

  11. Ni-Vanuatu health-seeking practices for general health and childhood diarrheal illness: results from a qualitative methods study.

    Science.gov (United States)

    File, Karen; McLaws, Mary-Louise

    2015-05-08

    A local perspective on diarrheal illness has been shown to enhance control strategies for diarrheal disease in traditional rural settings. We aimed to assess caregivers' understandings of childhood general and diarrheal illness, in one rural community in Vanuatu, to help formulate control strategies for preventing diarrheal disease. This was a descriptive study using qualitative analysis of responses to open-ended questions to provide a fuller understanding of illness. Thematic analysis with categories derived from medical anthropology was used to analyse responses and draw conclusions. Twenty-nine participants were interviewed; 22 were maternal responses, three were traditional practitioners, two were rural health care workers, one was a spiritual healer and one had a caregiver role. Respondents categorised illness as biomedical or traditional. Explanations of illness were enmeshed in and derived from both the traditional and biomedical system as the illness experience in the child under their care unfolded. Diarrheal severity influenced treatment selection and respondents expressed a preference for biomedical assistance. Respondents articulated a preference for biomedicine as the primary help-seeking resort for small children. Exclusive reliance on either traditional or biomedical options was uncommon. Local herbal remedies were the preferred home treatment when illness was known or mild, while oral rehydration therapy was used when accessing biomedical practitioners. Belief about diarrheal illness was influenced by traditional medicine and biomedicine. New evidence points to a growing preference for biomedicine as the first choice for severe childhood diarrheal illness. Diarrheal illness could be countered by maternal hand hygiene education at the medical dispensary and rural aid post.

  12. 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.

    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

  13. 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…

  14. 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

  15. The gendered experience of stigmatization in severe and persistent mental illness in Lima, Peru.

    Science.gov (United States)

    Robillard, Chantal

    2010-12-01

    Although power differentials which enable the components of stigma to unfold have been identified, literature that demonstrates the gendered disparities in stigmatization is scarce. Using a gender-based framework, this paper aims first at understanding the gendered social cues which produce the stigma in mental illness enacted by the general population. Second, it highlights the influence of gender on the everyday experiences of a severe and persistent mental illness and the related stigmatization. Results are drawn from a combination of ethnographic and qualitative methods including a field ethnography of two health centres, one psychiatric hospital, and participants' households and neighbourhoods, two group discussions with members of the general population participating in gender-specific social support groups (N = 12 women/5 men), and illness narratives of men and women with a severe and persistent mental illness (N = 22), which was conducted from May to August 2006 in a poor, urban district of Peru. It is argued that in a society like that of Peru where gender roles are segregated into specific social and economic fields, gendered expectations shape both the experience of a severe and persistent mental illness and the stigmatization of people with such a mental illness in a gender-specific way. Not only do gender inequalities create the conditions leading to a power differential which enables stigmatization to unfold, but stigma is constructed as much around gendered-defined social roles as it is enacted in distinct social spheres for men and women with a severe and persistent mental illness. The gendered experience of stigmatization must, therefore, be fully understood in order to design more effective interventions that would challenge stereotypical perceptions and discriminatory practices, and reduce their effect on the everyday life of the mentally ill in Peru. Copyright © 2010 Elsevier Ltd. All rights reserved.

  16. Do everyday problems of people with chronic illness interfere with their disease management?

    Science.gov (United States)

    van Houtum, Lieke; Rijken, Mieke; Groenewegen, Peter

    2015-10-01

    Being chronically ill is a continuous process of balancing the demands of the illness and the demands of everyday life. Understanding how everyday life affects self-management might help to provide better professional support. However, little attention has been paid to the influence of everyday life on self-management. The purpose of this study is to examine to what extent problems in everyday life interfere with the self-management behaviour of people with chronic illness, i.e. their ability to manage their illness. To estimate the effects of having everyday problems on self-management, cross-sectional linear regression analyses with propensity score matching were conducted. Data was used from 1731 patients with chronic disease(s) who participated in a nationwide Dutch panel-study. One third of people with chronic illness encounter basic (e.g. financial, housing, employment) or social (e.g. partner, children, sexual or leisure) problems in their daily life. Younger people, people with poor health and people with physical limitations are more likely to have everyday problems. Experiencing basic problems is related to less active coping behaviour, while experiencing social problems is related to lower levels of symptom management and less active coping behaviour. The extent of everyday problems interfering with self-management of people with chronic illness depends on the type of everyday problems encountered, as well as on the type of self-management activities at stake. Healthcare providers should pay attention to the life context of people with chronic illness during consultations, as patients' ability to manage their illness is related to it.

  17. Relatives perception of writing diaries for critically ill. A phenomenological hermeneutical study.

    Science.gov (United States)

    Nielsen, Anne H; Angel, Sanne

    2015-09-28

    Diaries written by nurses for the critically ill patient help the relatives cope and support the patient. Relatives may participate in writing a diary for the critically ill and when they do this is appreciated by the patients. However, the relative's perception of writing a diary has not previously been explored. To explore how relatives perceive writing a diary for the critically ill patient. In a phenomenological-hermeneutic study building on the theory of Ricoeur interviews with seven relatives were conducted and interpreted. When relatives wrote a diary for the critically patients, they experienced that writing and reading the diary allowed for the unloading of emotions and expression of feelings. Writing a diary was a meaningful activity while enduring a situation of uncertainty and furthermore it created a distance that allowed understanding of the critical situation. Involving relatives in writing a diary may support relatives and help them cope with the critical situation. Relatives are distressed and struggle to understand what is happening during the patient's course of illness. Involving relatives in writing a diary for the critically ill could be one way to meet their needs in the critical situation. © 2015 British Association of Critical Care Nurses.

  18. A Research Agenda for Communication Between Health Care Professionals and Patients Living With Serious Illness.

    Science.gov (United States)

    Tulsky, James A; Beach, Mary Catherine; Butow, Phyllis N; Hickman, Susan E; Mack, Jennifer W; Morrison, R Sean; Street, Richard L; Sudore, Rebecca L; White, Douglas B; Pollak, Kathryn I

    2017-09-01

    Poor communication by health care professionals contributes to physical and psychological suffering in patients living with serious illness. Patients may not fully understand their illness, prognosis, and treatment options or may not receive medical care consistent with their goals. Despite considerable research exploring the role of communication in this setting, many questions remain, and a clear agenda for communication research is lacking. Through a consensus conference and subsequent activities, we reviewed the state of the science, identified key evidence gaps in understanding the impact of communication on patient outcomes, and created an agenda for future research. We considered 7 broad topics: shared decision making, advance care planning, communication training, measuring communication, communication about prognosis, emotion and serious illness communication, and cultural issues. We identified 5 areas in which further research could substantially move the field forward and help enhance patient care: measurement and methodology, including how to determine communication quality; mechanisms of communication, such as identifying the specific clinician behaviors that patients experience as both honest and compassionate, or the role of bias in the clinical encounter; alternative approaches to advance care planning that focus on the quality of serious illness communication and not simply completion of forms; teaching and disseminating communication skills; and approaches, such as economic incentives and other clinician motivators, to change communication behavior. Our findings highlight the urgent need to improve quality of communication between health care professionals and patients living with serious illness through a broad range of research that covers communication skills, tools, patient education, and models of care.

  19. Nutrition therapy in the critically ill child.

    Science.gov (United States)

    Skillman, Heather E; Mehta, Nilesh M

    2012-04-01

    Malnutrition and obesity are prevalent in children admitted to the pediatric intensive care unit. Nutritional deterioration secondary to suboptimal nutrient delivery can adversely affect outcomes during pediatric critical illness. This review highlights the recent investigations of nutrition assessment, energy balance, indirect calorimetry, nutrition therapy, barriers to nutrient delivery, monitoring during enteral feeding, and the role of nutrition guidelines in critically ill children. Critically ill children are at high risk for energy and protein imbalance. Indirect calorimetry remains the only accurate method to assess energy requirements in this population. Intensive insulin therapy to achieve glycemic control may reduce morbidity and mortality in adults, but risks hypoglycemia in critically ill children. Early enteral nutrition improves nutrition outcomes and adherence to nutrition guidelines can overcome barriers to optimal nutrition therapy. Timely and adequate nutrition therapy is essential to improve nutrition outcomes in critically ill children. Further research is required to determine clinical outcome benefits with indirect calorimetry and enteral nutrition guidelines, and to identify optimal glucose targets.

  20. 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…

  1. 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…

  2. Coping with chronic illness: the mediating role of biographic and illness-related factors.

    Science.gov (United States)

    Viney, L L; Westbrook, M T

    1982-01-01

    The aim of this research was to examine the mediating roles played by a range of biographic and illness-related factors in preferences for strategies for coping with chronic illness. Chronically-ill patients assessed their own coping strategy preference by ranking six clusters of strategies. Information was also obtained about their demographic characteristics, life styles, illness roles, the degree of their disability, their perceived handicaps and their perceived achievement of their rehabilitation goals. Multiple regression analyses of each of these six sets of variables on each coping strategy were carried out to identify patterns of association between them. (1) Preferences for action strategies were found to be associated with patient-related factors (demographic characteristics, life style and illness role). (2) Control strategies were associated with illness-related factors (illness role, degree of disability, perceived handicap and achievement of rehabilitation goals). (3) Escape strategies were ranked higher by women than by men, sex being their only significant predictor. (4) Preferences for fatalism, unlike those for action strategies, were associated with relatively low social status and relatively little interpersonal involvement or social commitment. (5) Preferences for optimism were related only to patients' perceptions of their handicaps. (6) Interpersonal coping was not found to be associated with any of this wide range of biographic illness-related factors.

  3. Measuring illness representations in breast cancer survivors (BCS) prescribed tamoxifen: Modification and validation of the Revised Illness Perceptions Questionnaire (IPQ-BCS).

    Science.gov (United States)

    Moon, Zoe; Moss-Morris, Rona; Hunter, Myra S; Hughes, Lyndsay D

    2017-04-01

    The Revised Illness Perceptions Questionnaire (IPQ-R), widely used to assess illness perceptions, may fail to measure unique characteristics of different illnesses. This study modified and validated the IPQ-R for breast cancer survivors to provide detailed understanding of the specific illness perceptions held by these patients. Initial modifications were made following qualitative interviews and were revised in a think-aloud study. The modified scale was tested in 753 breast cancer survivors prescribed tamoxifen. Modifications included adding a tamoxifen consequences scale and adapting the timeline scales to measure beliefs around risk of recurrence and cure. A confirmatory factor analysis was conducted on the modified questionnaire and an exploratory factor analysis on the causal beliefs scale. Test-retest reliability, internal consistency and construct validity were also examined. The proposed eight-factor structure showed acceptable model fit, with high loadings and good reliability for all subscales. Correlations between subscales were consistent with theory and previous research. The IPQ-BCS is valid and reliable, and provides unique understanding of specific perceptions held by this population, including beliefs surrounding risk of recurrence and consequences of ongoing hormonal treatment. Identifying these perceptions will aid development of interventions targeting depression, fear of recurrence and medication non-adherence.

  4. ACR Appropriateness Criteria on acute respiratory illness.

    Science.gov (United States)

    Washington, Lacey; Khan, Arfa; Mohammed, Tan-Lucien; Batra, Poonam V; Gurney, Jud W; Haramati, Linda B; Jeudy, Jean; Macmahon, Heber; Rozenshtein, Anna; Vydareny, Kay H; Kaiser, Larry; Raoof, Suhail

    2009-10-01

    In a patient with acute respiratory illness (cough, sputum production, chest pain, and/or dyspnea), the need for chest imaging depends on the severity of illness, age of the patient, clinical history, physical and laboratory findings, and other risk factors. Chest radiographs seem warranted when one or more of the following are present: age > or = 40; dementia; a positive physical examination; hemoptysis; associated abnormalities (leukocytosis, hypoxemia); or other risk factors, including coronary artery disease, congestive heart failure, or drug-induced acute respiratory failure. Chest CT may be warranted in complicated cases of severe pneumonia and in febrile neutropenic patients with normal or nonspecific chest radiographic findings. Literature on the indications and usefulness of radiologic studies for acute respiratory illness in different clinical settings is reviewed.

  5. 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.

  6. Antithrombin III for critically ill patients

    DEFF Research Database (Denmark)

    Allingstrup, Mikkel; Wetterslev, Jørn; Ravn, Frederikke B

    2016-01-01

    Background: Critical illness is associated with uncontrolled inflammation and vascular damage which can result in multiple organ failure and death. Antithrombin III (AT III) is an anticoagulant with anti-inflammatory properties but the efficacy and any harmful effects of AT III supplementation...... in critically ill patients are unknown. This review was published in 2008 and updated in 2015.  Objectives: To examine: 1. The effect of AT III on mortality in critically ill participants. 2. The benefits and harms of AT III. We investigated complications specific and not specific to the trial intervention......, bleeding events, the effect on sepsis and disseminated intravascular coagulation (DIC) and the length of stay in the intensive care unit (ICU) and in hospital in general.  Search methods: We searched the following databases from inception to 27 August 2015: Cochrane Central Register of Controlled Trials...

  7. 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.

  8. Morgellons: contested illness, diagnostic compromise and medicalisation.

    Science.gov (United States)

    Fair, Brian

    2010-05-01

    The case of Morgellons illustrates how the emergence of a new medically contested illness intersected with and impacted on the diagnostic processes of an existing uncontested psychiatric condition, Delusional Parasitosis (DP). More specifically, the sociopolitical processes at play in the contested illness, Morgellons, dubiously reflect patient empowerment, as well the resilience and power of medical jurisdiction. This research offers insights into the contested illness and medicalisation literatures, and aims to bridge these two approaches towards the relationship between patient empowerment and medical authority, which I do through the notion of doctor-patient compromise. The data for this research come from a comprehensive qualitative analysis of Morgellons discourse through four key sources: the pro-Morgellons website Morgellons.org; the anti-Morgellons website Morgellonswatch.com; the popular media's portrayal of Morgellons; and the DP and Morgellons articles published in peer-reviewed medical journals, as made available on PubMed.

  9. Review of Critical Illness Myopathy and Neuropathy.

    Science.gov (United States)

    Shepherd, Starane; Batra, Ayush; Lerner, David P

    2017-01-01

    Critical illness myopathy (CIM) and neuropathy are underdiagnosed conditions within the intensive care setting and contribute to prolonged mechanical ventilation and ventilator wean failure and ultimately lead to significant morbidity and mortality. These conditions are often further subdivided into CIM, critical illness polyneuropathy (CIP), or the combination-critical illness polyneuromyopathy (CIPNM). In this review, we discuss the epidemiology and pathophysiology of CIM, CIP, and CIPNM, along with diagnostic considerations such as detailed clinical examination, electrophysiological studies, and histopathological review of muscle biopsy specimens. We also review current available treatments and prognosis. Increased awareness and early recognition of CIM, CIP, and CIPNM in the intensive care unit setting may lead to earlier treatments and rehabilitation, improving patient outcomes.

  10. Stigmatising of persons with a mental illness

    DEFF Research Database (Denmark)

    Vendsborg, Per; Nordentoft, Merete; Lindhardt, Anne

    2011-01-01

    Persons with a mental illness and their relatives experience discrimination and expect to be discriminated. The public regards them as unpredictable and dangerous and do not wish to have any relation with them neither in private nor at work. This opinion is shared by people working in health care...... or social care. The myth of dangerousness is out of proportion and the media is to blame as they most often mention persons with mental illnesses as dangerous. Many countries make a great effort to reduce stigma and this is also under planning in Denmark.......Persons with a mental illness and their relatives experience discrimination and expect to be discriminated. The public regards them as unpredictable and dangerous and do not wish to have any relation with them neither in private nor at work. This opinion is shared by people working in health care...

  11. The Phase of Illness Paradigm: A Checklist Centric Model to Improve Patient Care in the Burn Intensive Care Unit

    Science.gov (United States)

    2015-04-01

    Monitor renal function Obje Objective: Monitor Ventilation Obje Objective: Observe patient Obje Objective: Operate to Achieve a Goal Obje Objective...paradigm (POIP) (Pamplin 2011) and its effect on a variety of measures in three Burn ICUs . This paradigm describes patients with similar illness severity...measures in three Burn ICUs c. Implement the POIP to improve the multidisciplinary burn ICU team’s understanding of patient illness severity, daily care

  12. Mental illness disclosure in Chinese immigrant communities.

    Science.gov (United States)

    Chen, Fang-Pei; Lai, Grace Ying-Chi; Yang, Lawrence

    2013-07-01

    Support from social networks is imperative to mental health recovery of persons with mental illness. However, disclosing mental illness may damage a person's participation in networks due to mental illness stigma, especially in Chinese immigrant communities where social networks (the guanxi network) have specific social-cultural significance. This study focused on mental illness disclosure in Chinese immigrant communities in New York City. Fifty-three Chinese psychiatric patients were recruited consecutively from 2 Chinese bilingual psychiatric inpatient units from 2006 to 2010. Two bilingual psychologists interviewed each participant once in a semistructured interview, including 6 questions on mental illness disclosure. Conventional content analysis was applied to conceptualize the phenomenon. Results showed that participants voluntarily disclosed to a circle of people composed primarily of family and relatives. The decisions and strategies to disclose depended on participants' consideration of 3 critical elements of social relationships. Ganqing, affection associated with relationship building, ultimately determined who had the privilege to know. Renqing, the moral code of reciprocal kindness, further influenced disclosure decisions and what participants anticipated as responses to disclosure. Lastly, concerns over preserving face (lian), a construct representing personal and familial dignity, oftentimes prohibited disclosure. Additionally, in this tight-knit network, involuntary disclosure could happen without participants' permission or knowledge. Participants commonly suffered from stigma after disclosure. However, half of our participants reported situations in which they experienced little discriminatory treatment, and some experienced support and care as a result of cultural dynamics. Recommendations for culturally sensitive practice to facilitate mental illness disclosure among Chinese immigrants were discussed. PsycINFO Database Record (c) 2013 APA, all

  13. The neurological illness of Friedrich Nietzsche.

    Science.gov (United States)

    Hemelsoet, D; Hemelsoet, K; Devreese, D

    2008-03-01

    Friedrich Nietzsche (1844-1900), one of the most profound and influential modern philosophers, suffered since his very childhood from severe migraine. At 44 he had a mental breakdown ending in a dementia with total physical dependence due to stroke. From the very beginning, Nietzsche's dementia was attributed to a neurosyphilitic infection. Recently, this tentative diagnosis has become controversial. To use historical accounts and original materials including correspondence, biographical data and medical papers to document the clinical characteristics of Nietzsche's illness and, by using this pathography, to discuss formerly proposed diagnoses and to provide and support a new diagnostic hypothesis. Original letters from Friedrich Nietzsche, descriptions by relatives and friends, and medical descriptions. Original German sources were investigated. Biographical papers published in medical journals were also consulted. Nietzsche suffered from migraine without aura which started in his childhood. In the second half of his life he suffered from a psychiatric illness with depression. During his last years, a progressive cognitive decline evolved and ended in a profound dementia with stroke. He died from pneumonia in 1900. The family history includes a possible vascular-related mental illness in his father who died from stroke at 36. Friedrich Nietzsche's disease consisted of migraine, psychiatric disturbances, cognitive decline with dementia, and stroke. Despite the prevalent opinion that neurosyphilis caused Nietzsche's illness, there is lack of evidence to support this diagnosis. Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) accounts for all the signs and symptoms of Nietzsche's illness. This study adds new elements to the debate and controversy about Nietzsche's illness. We discuss former diagnoses, comment on the history of a diagnostic mistake, and integrate for the first time Nietzsche's medical problems.

  14. 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...... of diabetes in the social and gendered lives of men, it is explored how diabetes challenges both the domestic and public positions of men and how they in an attempt to avoid this try to resist being ill, which leads to contradictions in their diabetes self-care with dire consequences....

  15. Stigmatising of persons with a mental illness

    DEFF Research Database (Denmark)

    Vendsborg, Per; Nordentoft, Merete; Lindhardt, Anne

    2011-01-01

    Persons with a mental illness and their relatives experience discrimination and expect to be discriminated. The public regards them as unpredictable and dangerous and do not wish to have any relation with them neither in private nor at work. This opinion is shared by people working in health care...... or social care. The myth of dangerousness is out of proportion and the media is to blame as they most often mention persons with mental illnesses as dangerous. Many countries make a great effort to reduce stigma and this is also under planning in Denmark....

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

    Science.gov (United States)

    2017-10-01

    Award Number: W81XWH-10-1-0593 TITLE: Probiotic (VSL#3) for Gulf War Illness PRINCIPAL INVESTIGATOR: Ashok Tuteja, M.D. M.P.H. CONTRACTING...failing to comply with a collection of information if it does not display a currently valid OMB control number. PLEASE DO NOT RETURN YOUR FORM TO... Gulf War Illness 5b. GRANT NUMBER W81XWH-10-1-0593 5c. PROGRAM ELEMENT NUMBER 6 . AUTHOR(S) 5d. PROJECT NUMBER Ashok Tuteja, M.D. 5e. TASK NUMBER

  17. 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.

  18. Promising Practices for Making Recreation Programming Matter for People who Experience Mental Illness.

    Science.gov (United States)

    Hutchinson, Susan L; Fenton, Lara

    2017-08-31

    There is merit in understanding how recreation-oriented programs for adults living with mental illness address barriers to participation and how programming is structured to create safe and inclusive environments, resulting in programming that amplifies the benefits of recreation for mental well-being. Following an environmental scan of programs targeting adults living with mental illness in Canada, ten coordinators in community mental health settings were interviewed. Four themes were constructed to reflect characteristics deemed to be 'promising practices' related to recreation-oriented programming: (a) barriers and solutions to individual participation, (b) characteristics of welcoming and supportive environments, (c) leadership characteristics, and (d) program characteristics.

  19. Categorising Patients Mental Illness by Medical Surgical Nurses in the General Hospital Ward: A Focus Group Study.

    Science.gov (United States)

    Brunero, Scott; Buus, Niels; West, Sandra

    2017-12-01

    To gain insight into medical surgical nurses' process(es) of categorising mental illness in general hospitals. Categorising patients is a daily social practice that helps medical surgical nurses understand their work and actions. Medical surgical nurses' categorising of mentally ill patients in general hospitals is a means in which they articulate their understanding of mental illness and perform their clinical practice. How medical surgical nurses categorise, and the impact that categorising can have on their work practices is poorly understood. A focus group study. Focus group discussions (n=2) of medical surgical nurses' understanding and experience of delivering care to patients with mental illness in a general tertiary referral hospital were conducted in November 2014. Discourse analysis was used to analyse the transcribed data to uncover how participants made discursive evaluations and how this related to their daily clinical practice. The analysis uncovered participant's use of four categories of mentally ill patients: the managed, the unpredictable, the emotional and the dangerous. For participants these categories explained and justified their clinical practice as linked to the challenges and barriers they experienced in providing effective care within the larger healthcare organisation. The language used by medical/surgical reflects the wider discourse of managerialism in healthcare organisations. The recognition of these categories can be used by educators, liaison mental health services and policy makers to reconsider service design and learning opportunities for medical surgical nurses to reduce stigmatisation of patients with mental illness. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. The Illness Experience: Palliative Care Given the impossibility of Healing.

    Science.gov (United States)

    Dantas, Margarida Maria Florêncio; Amazonas, Maria Cristina Lopes de Almeida

    2016-06-01

    This paper presents a reflection about being terminally ill and the various ways that the subject has at its disposal to deal with this event. The objective is to understand the experience of palliation for patients undergoing no therapeutic possibilities of cure. The methodology of this study has the instruments to semi-structured interview, the participant observation and the field diary, and the Descriptive Analysis of Foucault's inspiration how the narratives of the subjects were perceived. The Results of paper there was the possibility of looking at the experience of illness through the eyes of a subject position assumed by the very sick. As conclusion we have than when choosing palliative care, the terminally ill opts for a way to feel more comfortable and resists the impositions of the medical model of prolonging life. O presente trabalho traz uma reflexão a respeito do ser um doente terminal e das várias maneiras que o sujeito tem a seu dispor para lidar com esse acontecimento. Nosso objetivo foi compreender a experiência da paliação por sujeitos doentes sem possibilidades terapêuticas de cura. A metodologia deste estudo teve como instrumentos a Entrevista Narrativa, a Observação Participante e o Diário de Campo, sendo a Análise Descritiva de inspiração foucaultiana o modo como as narrativas dos sujeitos foram percebidas. O resultado do estudo mostrou a possibilidade de olhar a experiência do adoecer através da ótica de uma posição de sujeito assumida pelo próprio enfermo. E concluímos que ao escolher os cuidados paliativos, o doente terminal opta por um modo de se sentir mais confortável e resiste às imposições do modelo médico de prolongamento da vida.