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Avan A, Nucera A, Stranges S, Rocca WA, Logroscino G, Leonardi M, Raggi A, Hachinski V. Risk and sex-specific trends of dementia and stroke in Italy Compared to European and high-income countries and the world: global implications. J Neurol 2024; 271:2745-2757. [PMID: 38388926 DOI: 10.1007/s00415-024-12216-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 12/20/2023] [Accepted: 01/20/2024] [Indexed: 02/24/2024]
Abstract
BACKGROUND Understanding the increasing trends in Italy may inform new prevention strategies and better treatments. We investigated trends and risk factors of dementia, stroke, and ischemic heart disease (IHD) in Italy with the second-oldest population globally, compared to European and high-income countries and the world. METHODS We analyzed the Global Burden of Disease Study (GBD) 2019 estimates on incidence and burden (i.e., disability and death combined) of the three conditions in both sexes. We also analyzed the burden attributable to 12 modifiable risk factors and their changes during 1990-2019. RESULTS In 2019, Italy had 186,108 new dementias (123,885 women) and 94,074 new strokes (53,572 women). Women had 98% higher crude dementia and 24% higher crude stroke burdens than men. The average age-standardized new dementia rate was 114.7 per 100,000 women and 88.4 per 100,000 men, both higher than Western Europe, the European Union, high-income countries, and the world. During 1990-2019, this rate increased in both sexes (4%), despite a decline in stroke (- 45%) and IHD (- 17%) in Italy. Dementia burden attributable to tobacco decreased in both sexes (- 12.7%) during 1990-2019, while high blood glucose and high body mass index combined burden increased (25.4%). Stroke and IHD had similar trends. CONCLUSIONS While decreases in new strokes and IHDs are encouraging, new approaches to their joint prevention are required to reverse the rising dementia trends, especially among women. Life course approaches to promoting holistic brain health should be implemented at the community, national, and international levels before the growing trends become overwhelming.
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Affiliation(s)
- Abolfazl Avan
- Robarts Research Institute, University of Western Ontario, London, ON, Canada
- Department of Clinical Neurological Sciences, University of Western Ontario, London, ON, Canada
- Department of Epidemiology and Biostatistics, University of Western Ontario, London, ON, Canada
| | - Antonia Nucera
- Neurovascular Treatment Unit, Spaziani Hospital, Frosinone, Italy
| | - Saverio Stranges
- Department of Epidemiology and Biostatistics, University of Western Ontario, London, ON, Canada
- Department of Family Medicine and Medicine, University of Western Ontario, London, Canada
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
- The Africa Institute, University of Western Ontario, London, Canada
| | - Walter A Rocca
- Division of Epidemiology, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
- Women's Health Research Center, Mayo Clinic, Rochester, MN, USA
| | - Giancarlo Logroscino
- Department of Translational Biomedicine and Neurosciences (DiBraiN), University of Bari Aldo Moro, Bari, Italy
- Center for Neurodegenerative Diseases, Aging Brain at Pia Fondazione "Card. G. Panico", University of Bari, Tricase (Lecce), Italy
| | - Matilde Leonardi
- Department of Neurology, Public Health, and Disability, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Alberto Raggi
- Department of Neurology, Public Health, and Disability, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Vladimir Hachinski
- Robarts Research Institute, University of Western Ontario, London, ON, Canada.
- Department of Clinical Neurological Sciences, University of Western Ontario, London, ON, Canada.
- Department of Epidemiology and Biostatistics, University of Western Ontario, London, ON, Canada.
- Department of Clinical Neurological Sciences, Robarts Research Institute, University of Western Ontario, 1151 Richmond St. N., London, ON, N6A 5B7, Canada.
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Fowokan A, Giosa JL, Saari M, Holyoke P. Mapping a comprehensive assessment tool to a holistic definition of health for person-centred care planning in home care: a modified eDelphi study. BMC Health Serv Res 2023; 23:1268. [PMID: 37974144 PMCID: PMC10655331 DOI: 10.1186/s12913-023-10203-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 10/23/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND Researchers in the Netherlands proposed the Pillars for Positive Health (PPH) as a broadly encompassing health definition to support more realistic and meaningful care planning for people living with chronic disease and other life-long health conditions. The PPH was subsequently converted to the My Positive Health (MPH) spider web visualization tool. This study sought to identify opportunities for more person-centred care planning at the point of care in home care, using the MPH tool as a framework to link comprehensive assessment and dialogue-based goal-setting. METHODS A modified eDelphi method was used to conduct domain mapping with a purposively sampled expert panel (n = 25). The panel consisted of researchers, health care providers, older adults and caregivers. A two-stage eDelphi process was conducted, with each stage consisting of three survey rounds. In the first stage, participants were asked to map 201 elements of the interRAI Home Care (interRAI HC) comprehensive assessment tool to the six MPH domains or "No pillar of best fit". The second stage focused on identifying opportunities to adapt or expand comprehensive assessment as it relates to the MPH domains. RESULTS In Stage 1, 189 of 201 elements reached consensus in domain mapping. These included: 80 elements for Bodily Functions, 32 for Daily Functioning, 32 for Mental Wellbeing, 24 for Quality of Life, 10 for Participation, and 1 for Meaningfulness. Ten elements were identified to have no pillar of best fit. The 12 elements that did not reach consensus in Stage 1 formed the basis for Stage 2, where expert panel participants proposed four new assessment elements in Meaningfulness and Participation and 11 additional descriptors across the six MPH domains. Of these, two elements and nine of the 11 descriptors reached consensus. CONCLUSION Findings show that elements of the interRAI HC are oriented toward the physical, functional, and mental health domains. Consequently, complementary assessment elements and/or tools may be needed to support comprehensive assessment of 'Meaningfulness' and 'Participation' in person-centred home and community care. Additional descriptors may also be needed to aid communication regarding the understanding and application of MPH domains.
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Affiliation(s)
- A Fowokan
- SE Research Centre, SE Health, 90 Allstate Parkway, Suite 800, Markham, ON, L3R 6H3, Canada
| | - J L Giosa
- SE Research Centre, SE Health, 90 Allstate Parkway, Suite 800, Markham, ON, L3R 6H3, Canada.
- School of Public Health Sciences, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada.
| | - M Saari
- SE Research Centre, SE Health, 90 Allstate Parkway, Suite 800, Markham, ON, L3R 6H3, Canada
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, 155 College Street, Toronto, ON, M5T 1P8, Canada
| | - P Holyoke
- SE Research Centre, SE Health, 90 Allstate Parkway, Suite 800, Markham, ON, L3R 6H3, Canada
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Owen KJ, Cundale K, Hughes JT, McDonald SP, D'Antoine M, Jesudason S. From talk to action: Indigenous Reference Groups drive practice change in kidney transplantation care. Med J Aust 2023; 219 Suppl 8:S15-S18. [PMID: 37839028 DOI: 10.5694/mja2.52102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 08/14/2023] [Indexed: 10/17/2023]
Affiliation(s)
- Kelli J Owen
- Central and Northern Adelaide Renal and Transplantation Service, Royal Adelaide Hospital, Adelaide, SA
- Adelaide Medical School, University of Adelaide, Adelaide, SA
| | - Katie Cundale
- National Indigenous Kidney Transplantation Taskforce, South Australian Health and Medical Research Institute, Adelaide, SA
| | - Jaquelyne T Hughes
- Rural and Remote Health, Flinders University, Darwin, NT
- Royal Darwin Hospital, Darwin, NT
| | - Stephen P McDonald
- Central and Northern Adelaide Renal and Transplantation Service, Royal Adelaide Hospital, Adelaide, SA
- Adelaide Medical School, University of Adelaide, Adelaide, SA
| | - Matilda D'Antoine
- National Indigenous Kidney Transplantation Taskforce, South Australian Health and Medical Research Institute, Adelaide, SA
| | - Shilpanjali Jesudason
- Central and Northern Adelaide Renal and Transplantation Service, Royal Adelaide Hospital, Adelaide, SA
- Adelaide Medical School, University of Adelaide, Adelaide, SA
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Khosla N, Hahn L, Tran C. US South Asian Youths' Perspectives on the Use of Complementary and Alternative Medicine (CAM). J Racial Ethn Health Disparities 2023:10.1007/s40615-023-01672-9. [PMID: 37368189 DOI: 10.1007/s40615-023-01672-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 05/30/2023] [Accepted: 06/05/2023] [Indexed: 06/28/2023]
Abstract
Complementary and alternative medicine (CAM) includes varied medical and healthcare systems, healing practices, and products that are outside of allopathy/biomedicine. The aim of this study was to examine US South Asian youths' beliefs, practices, decision-making, and experiences of using CAM. Ten focus group discussions with 36 participants were conducted. Data were coded deductively and inductively by four coders, working in pairs. Thematic analysis was performed. Disagreements were resolved through consensus. The results showed that CAM was appealing because of its often low cost, ease of access, family traditions to use CAM, and the perception that it was safe to use. Participants exercised pluralistic health choices. Some responses suggested a hierarchy wherein allopathy was used for serious, acute issues, and CAM for much of the remaining issues. The high use of and trust in CAM among young US South Asians raises important issues (e.g., provider support and integration to prevent potential interactions and avoid delaying allopathic treatment). More exploration is needed about the decision-making processes of US South Asian youth, including the perceived benefits/limitations of allopathy and CAM. US healthcare practitioners should familiarize themselves with South Asian social and cultural beliefs about healing to provide culturally-appropriate services and enhance patient care.
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Affiliation(s)
- Nidhi Khosla
- Department of Public Health, California State University East Bay, Hayward, CA, USA.
| | - Lindsay Hahn
- Department of Public Health, California State University East Bay, Hayward, CA, USA
| | - Christine Tran
- Department of General Internal Medicine, University of California, San Francisco, San Francisco, CA, USA
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Adjognon OL, Cohen-Bearak A, Kaitz J, Bokhour BG, Chatelain L, Charns MP, Mohr DC. Factors affecting the implementation of employee whole health in the veterans health administration: a qualitative evaluation. BMC Health Serv Res 2023; 23:600. [PMID: 37291554 DOI: 10.1186/s12913-023-09450-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Accepted: 04/26/2023] [Indexed: 06/10/2023] Open
Abstract
BACKGROUND There is increasing recognition of the need to focus on the health and well-being of healthcare employees given high rates of burnout and turnover. Employee wellness programs are effective at addressing these issues; however, participation in these programs is often a challenge and requires large scale organizational transformation. The Veterans Health Administration (VA) has begun to roll out their own employee wellness program-Employee Whole Health (EWH)-focused on the holistic needs of all employees. This evaluation's goal was to use the Lean Enterprise Transformation (LET) model for organizational transformation to identify key factors-facilitators and barriers-affecting the implementation of VA EWH. METHODS This cross-sectional qualitative evaluation based on the action research model reflects on the organizational implementation of EWH. Semi-structured 60-minute phone interviews were conducted in February-April 2021 with 27 key informants (e.g., EWH coordinator, wellness/occupational health staff) knowledgeable about EWH implementation across 10 VA medical centers. Operational partner provided a list of potential participants, eligible because of their involvement in EWH implementation at their site. The interview guide was informed by the LET model. Interviews were recorded and professionally transcribed. Constant comparative review with a combination of a priori coding based on the model and emergent thematic analysis was used to identify themes from transcripts. Matrix analysis and rapid turnaround qualitative methods were used to identify cross-site factors to EWH implementation. RESULTS Eight common factors in the conceptual model were found to facilitate and/or hinder EWH implementation efforts: [1] EWH initiatives, [2] multilevel leadership support, [3] alignment, [4] integration, [5] employee engagement, [6] communication, [7] staffing, and [8] culture. An emergent factor was [9] the impact of the COVID-19 pandemic on EWH implementation. CONCLUSIONS As VA expands its EWH cultural transformation nationwide, evaluation findings can (a) enable existing programs to address known implementation barriers, and (b) inform new sites to capitalize on known facilitators, anticipate and address barriers, and leverage evaluation recommendations through concerted implementation at the organization, process, and employee levels to jump-start their EWH program implementation.
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Affiliation(s)
- Omonyêlé L Adjognon
- Center for Healthcare Organization and Implementation Research, VA Boston Healthcare System, Boston, MA, USA
- Department of Health Law, Policy & Management, Boston University School of Public Health, Boston, MA, USA
| | - Adena Cohen-Bearak
- Center for Healthcare Organization and Implementation Research, VA Bedford Healthcare System , Bedford, MA, USA
| | | | - Barbara G Bokhour
- Center for Healthcare Organization and Implementation Research, VA Bedford Healthcare System , Bedford, MA, USA
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA
| | - Leslie Chatelain
- Center for Healthcare Organization and Implementation Research, VA Boston Healthcare System, Boston, MA, USA
| | - Martin P Charns
- Center for Healthcare Organization and Implementation Research, VA Boston Healthcare System, Boston, MA, USA
- Department of Health Law, Policy & Management, Boston University School of Public Health, Boston, MA, USA
| | - David C Mohr
- Center for Healthcare Organization and Implementation Research, VA Boston Healthcare System, Boston, MA, USA.
- Department of Health Law, Policy & Management, Boston University School of Public Health, Boston, MA, USA.
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Kushner P, Dalin A. Living with Type 2 Diabetes: Podcast of a Patient-Physician Discussion. Diabetes Ther 2023; 14:621-627. [PMID: 36864368 PMCID: PMC10064352 DOI: 10.1007/s13300-023-01378-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 02/02/2023] [Indexed: 03/04/2023] Open
Abstract
For patients with type 2 diabetes (T2D), the journey to diagnosis may not be straightforward. Patients can present with one of many diabetic complications before a diagnosis of T2D is made. These include heart disease and chronic kidney disease, in addition to cerebrovascular disease, peripheral vascular disease, retinopathy, and neuropathies, all of which can be asymptomatic in the early stages. In their clinical guidelines on standards of care in diabetes, the American Diabetes Association recommends regular screening for conditions such as kidney disease in patients with T2D. Furthermore, the frequent coexistence of diabetes and cardiorenal and/or metabolic conditions often requires a holistic approach to patient management, with specialists from multiple disciplines, including cardiologists, nephrologists, endocrinologists, and primary care physicians, working together. In addition to the use of pharmacological therapies, which can improve prognosis, the management of T2D should include attention to patient self-care, including appropriate dietary changes, consideration of continuous glucose monitoring, and advice on physical exercise. In this podcast, a patient and a clinician discuss a lived experience of the diagnosis of T2D, and the importance of patient education for understanding and managing T2D and its complications. The discussion highlights the central role of the Certified Diabetes Care and Education Specialist, and the role of ongoing emotional support in managing life with T2D, including patient education through reputable online resources and peer support groups. Podcast video with Pamela Kushner (PK) and Anne Dalin (AD) (MP4 92088 KB).
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Affiliation(s)
| | - Anne Dalin
- Patient Author, Co-leader of DiabetesSisters (PODS) Group, Bridgewater, NJ, USA
- National Kidney Foundation - Kidney Advocacy Committee, New York, NY, USA
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Thistlethwayte E. Role of the teenage and young adult blood and marrow stem-cell transplant clinical nurse specialist. Br J Nurs 2022; 31:808-810. [PMID: 35980926 DOI: 10.12968/bjon.2022.31.15.808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
This article explores the role of the teenage and young adult (TYA) blood and marrow stem-cell transplant clinical nurse specialist (CNS) from the author's perspective, and the challenges of developing a novel role. The article aims to provide insight into the role, and review the benefits of the CNS to patient care, thus highlighting the value of developing such a role within other stem-cell transplant centres in the UK.
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Affiliation(s)
- Emma Thistlethwayte
- Teenage and Young Adult Blood and Marrow Stem Cell Transplant Clinical Nurse Specialist, Royal Marsden Hospital, Sutton
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Bulut S, Karakaya J, Oksuz S, Kalyoncu U, Unal E. The reliability, validity, and responsiveness of Cognitive Exercise Therapy Approach: Biopsychosocial Questionnaire for patients with psoriatic arthritis. Rheumatol Int 2022; 42:1973-1981. [PMID: 35831716 DOI: 10.1007/s00296-022-05170-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 07/04/2022] [Indexed: 11/29/2022]
Abstract
Although the importance of the biopsychosocial model that aims the optimum treatment is emphasized in the literature, there is a lack of scales that evaluate individuals with PsA in a multi-dimensional way, including all areas of influence. This study aimed to determine the validity, reliability, and responsiveness of the Cognitive Exercise Therapy Approach-Biopsychosocial Questionnaire (BETY-BQ) in individuals diagnosed with Psoriatic Arthritis (PsA). Psoriatic Arthritis Quality of Life Questionnaire (PsAQoL), Health Assessment Questionnaire, Hospital Anxiety and Depression Scale, and Short Form-36 were used for the validity of the BETY-BQ. For scale reliability, the test-retest method was performed, Intraclass Correlation Coefficient (ICC) was calculated, and Cronbach's alpha (α) coefficient was checked for internal consistency. For the responsiveness of the scale, all scales were re-applied with 3 months intervals. The correlations of BETY-BQ with the other scales were found medium to very high. ICC was analyzed to compare the reliability of the test-retest results and it was found to be excellent. Cronbach's α value was found to be 0.940 which showed an excellent internal consistency. The time-dependent change sensitivity of BETY-BQ was found to be highly correlated with the PsA-specific scale, the PsAQoL questionnaire. BETY-BQ was determined as a valid, reliable, and sensitive assessment tool that health professionals can use in individuals with PsA diagnosis. In this study, a scale that will reveal the biopsychosocial responses of individuals with PsA to pharmacological and non-pharmacological treatments was presented to the literature.
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Affiliation(s)
- Senem Bulut
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Jale Karakaya
- Faculty of Medicine, Department of Biostatistics, Hacettepe University, Ankara, Turkey
| | - Sevim Oksuz
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Eastern Mediterranean University, North Cyprus via Mersin 10, 99628, Famagusta, Turkey
| | - Umut Kalyoncu
- Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology, Hacettepe University, Ankara, Turkey
| | - Edibe Unal
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey.
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Tajudeen YA, Oladunjoye IO, Mustapha MO, Mustapha ST, Ajide-Bamigboye NT. Tackling the global health threat of arboviruses: An appraisal of the three holistic approaches to health. Health Promot Perspect 2021; 11:371-381. [PMID: 35079581 PMCID: PMC8767080 DOI: 10.34172/hpp.2021.48] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 09/03/2021] [Indexed: 12/20/2022] Open
Abstract
Background: The rapid circulation of arboviruses in the human population has been linked with changes in climatic, environmental, and socio-economic conditions. These changes are known to alter the transmission cycles of arboviruses involving the anthropophilic vectors and thus facilitate an extensive geographical distribution of medically important arboviral diseases, thereby posing a significant health threat. Using our current understanding and assessment of relevant literature, this review aimed to understand the underlying factors promoting the spread of arboviruses and how the three most renowned interdisciplinary and holistic approaches to health such as One Health, Eco-Health, and Planetary Health can be a panacea for control of arboviruses. Methods: A comprehensive structured search of relevant databases such as Medline, PubMed, WHO, Scopus, Science Direct, DOAJ, AJOL, and Google Scholar was conducted to identify recent articles on arboviruses and holistic approaches to health using the keywords including "arboviral diseases", "arbovirus vectors", "arboviral infections", "epidemiology of arboviruses", "holistic approaches", "One Health", "Eco-Health", and "Planetary Health". Results: Changes in climatic factors like temperature, humidity, and precipitation support the growth, breeding, and fecundity of arthropod vectors transmitting the arboviral diseases. Increased human migration and urbanization due to socio-economic factors play an important role in population increase leading to the rapid geographical distribution of arthropod vectors and transmission of arboviral diseases. Medical factors like misdiagnosis and misclassification also contribute to the spread of arboviruses. Conclusion: This review highlights two important findings: First, climatic, environmental, socio-economic, and medical factors influence the constant distributions of arthropod vectors. Second, either of the three holistic approaches or a combination of any two can be adopted on arboviral disease control. Our findings underline the need for holistic approaches as the best strategy to mitigating and controlling the emerging and reemerging arboviruses.
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Tamang M, Dorji T. Physiotherapy services in patient care in Bhutan. Hum Resour Health 2021; 19:107. [PMID: 34479592 PMCID: PMC8414470 DOI: 10.1186/s12960-021-00649-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 08/25/2021] [Indexed: 06/13/2023]
Abstract
Physiotherapy and rehabilitative services are an integral part of patient care, but in many developing countries they are not considered a priority and are either not available or not easily accessible to those who need them. Bhutan is one such country where healthcare is provided free of cost to all, but as of 2021 physiotherapy services were available only in 26 of 48 hospitals and 19 of 20 districts. The number of physiotherapy professionals per 10,000 population is 1.4 with significant rates of attrition. There is lack of awareness among patients and other health professionals about physiotherapy and rehabilitation services. The country needs to integrate physiotherapy and rehabilitation services into the overall health policy framework and develop proper planning of human resources and infrastructure to meet the current and future demands.
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Affiliation(s)
- Monu Tamang
- Physiotherapy Unit, Central Regional Referral Hospital, 31101 Gelegphu, Bhutan
| | - Thinley Dorji
- Department of Internal Medicine, Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan
- Kidu Mobile Medical Unit, His Majesty’s People’s Project, Thimphu, Bhutan
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Rhon DI, Fritz JM, Greenlee TA, Dry KE, Mayhew RJ, Laugesen MC, Dragusin E, Teyhen DS. Move to health-a holistic approach to the management of chronic low back pain: an intervention and implementation protocol developed for a pragmatic clinical trial. J Transl Med 2021; 19:357. [PMID: 34407840 PMCID: PMC8371880 DOI: 10.1186/s12967-021-03013-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 07/25/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND The prevalence of chronic pain conditions is growing. Low back pain was the primary cause of disability worldwide out of 156 conditions assessed between 1990 and 2016, according to the Global Burden of Disease Study. Conventional medical approaches have failed to identify effective and long-lasting approaches for the management of chronic pain, and often fail to consider the multiple domains that influence overall health and can contribute to the pain experience. Leading international organizations that focus on pain research have stated the importance of considering these other domains within holistic and multidisciplinary frameworks for treating pain. While the research behind the theoretical link between these domains and chronic pain outcomes has expanded greatly over the last decade, there have been few practical and feasible methods to implement this type of care in normal clinical practice. METHODS The purpose of this manuscript is to describe an implementation protocol that is being used to deliver a complex holistic health intervention at multiple sites within a large government health system, as part of a larger multisite trial for patients with chronic low back pain. The Move to Health program developed by the US Army Medical Command was tailored for specific application to patients with low back pain and begins by providing an empirical link between eight different health domains (that include physical, emotional, social, and psychological constructs) and chronic low back pain. Through a six-step process, a health coach leverages motivational interviewing and information from a personal health inventory to guide the patient through a series of conversations about behavioral lifestyle choices. The patient chooses which domains they want to prioritize, and the health coach helps implement the plan with the use of SMART (Specific, Measurable, Attainable, Realistic, Time-bound) goals and a series of resources for every domain, triaged from self-management to specialist referral. DISCUSSION Complex interventions described in clinical trials are often challenging to implement because they lack sufficient details. Implementation protocols can improve the ability to properly deliver trial interventions into regular clinical practice with increased fidelity. TRIAL REGISTRATION Implementation of this intervention protocol was developed for a clinical trial that was registered a priori (clinicaltrials.gov #NCT04172038).
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Affiliation(s)
- Daniel I Rhon
- Department of Rehabilitation Medicine, Brooke Army Medical Center, JBSA Fort Sam Houston, 3551 Roger Brooke Drive, San Antonio, TX, 78234, USA.
- Department of Rehabilitation Medicine, Uniformed Services University of Health Sciences, Bethesda, MD, USA.
| | | | - Tina A Greenlee
- Department of Rehabilitation Medicine, Brooke Army Medical Center, JBSA Fort Sam Houston, 3551 Roger Brooke Drive, San Antonio, TX, 78234, USA
| | - Katie E Dry
- Department of Rehabilitation Medicine, Brooke Army Medical Center, JBSA Fort Sam Houston, 3551 Roger Brooke Drive, San Antonio, TX, 78234, USA
| | - Rachel J Mayhew
- Department of Rehabilitation Medicine, Brooke Army Medical Center, JBSA Fort Sam Houston, 3551 Roger Brooke Drive, San Antonio, TX, 78234, USA
| | - Mary C Laugesen
- Department of Rehabilitation Medicine, Brooke Army Medical Center, JBSA Fort Sam Houston, 3551 Roger Brooke Drive, San Antonio, TX, 78234, USA
| | - Edita Dragusin
- Department of Rehabilitation Medicine, Brooke Army Medical Center, JBSA Fort Sam Houston, 3551 Roger Brooke Drive, San Antonio, TX, 78234, USA
| | - Deydre S Teyhen
- Walter Reed Army Institute of Research, Silver Spring, MD, USA
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Nahon RL, Silva Lopes JS, Monteiro de Magalhães Neto A. Physical therapy interventions for the treatment of delayed onset muscle soreness (DOMS): Systematic review and meta-analysis. Phys Ther Sport 2021; 52:1-12. [PMID: 34365084 DOI: 10.1016/j.ptsp.2021.07.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 07/17/2021] [Accepted: 07/20/2021] [Indexed: 01/04/2023]
Abstract
OBJECTIVE To evaluate the impact of interventions on pain associated with DOMS. DATA SOURCES PubMed, EMBASE, PEDro, Cochrane, and Scielo databases were searched, from the oldest records until May/2020. Search terms used included combinations of keywords related to "DOMS" and "intervention therapy". ELIGIBILITY CRITERIA Healthy participants (no restrictions were applied, e.g., age, sex, and exercise level). To be included, studies should be: 1) Randomized clinical trial; 2) Having induced muscle damage and subsequently measuring the level of pain; 3) To have applied therapeutic interventions (nonpharmacological or nutritional) and compare with a control group that received no intervention; and 4) The first application of the intervention had to occur immediately after muscle damage had been induced. RESULTS One hundred and twenty-one studies were included. The results revealed that the contrast techniques (p = 0,002 I2 = 60 %), cryotherapy (p = 0,002 I2 = 100 %), phototherapy (p = 0,0001 I2 = 95 %), vibration (p = 0,004 I2 = 96 %), ultrasound (p = 0,02 I2 = 97 %), massage (p < 0,00001 I2 = 94 %), active exercise (p = 0,0004 I2 = 93 %) and compression (p = 0,002 I2 = 93 %) have a better positive effect than the control in the management of DOMS. CONCLUSION Low quality evidence suggests that contrast, cryotherapy, phototherapy, vibration, ultrasound, massage, and active exercise have beneficial effects in the management of DOMS-related pain.
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Affiliation(s)
- Roberto Lohn Nahon
- Universidade Federal do Estado do Rio de Janeiro (UNIRIO), Programa de Pós Graduação em Neurociências, Rio de Janeiro, RJ, Brazil
| | | | - Aníbal Monteiro de Magalhães Neto
- Universidade Federal de Mato Grosso (UFMT), Programa de Pós Graduação em Imunologia e Parasitologia Básicas e Aplicadas (PPGIP), campus do Araguaia, Barra do Garças, MT, Brazil
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Gandhi S, Mohanty K, Sahu M, Naik SS, Pahuja E, Gunasekaran DM, Prasad MK. Profile of recipients of holistic health counselling in a psychiatric OPD in South India. Int J Soc Psychiatry 2021; 67:277-283. [PMID: 32744115 DOI: 10.1177/0020764020946797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND OF THE STUDY Persons with mental illness (PwMI) are prone to weight gain as a side effect of antipsychotics. Health counselling on diet, physical activity, medication adherence, expressed emotions and technology use, by health professionals, can help in managing these side-effects. AIM The aim of this study was to identify the pre-counselling profile of the subjects such as body mass index (BMI), diet, physical activity, medication adherence, expressed emotions and technology use among PwMI; to attend the Holistic Health Clinic as part of follow-up services in the psychiatry Outpatient Department (OPD) as well as to find correlation and association between the study variables. METHODS The study involved a cross-sectional descriptive design based on convenience sampling. The sample consists of 56 patients who are receiving antipsychotics under symptom control (self-reported) and were overweight. Data were collected with a patient assessment proforma and analysed using SPSS-22. RESULTS The patients referred to the holistic health counselling (HHC) had abnormal weight and BMI. The mean and SD of weight was 74.48 ± 14.07 and BMI 29.51 ± 5.15. All the participants received counselling on diet, 87.5% on physical activity, 62.5% on sleep hygiene, 55.4% on medication adherence, 8.9% on family emotional climate and only 5.4% on healthy use of technology. Weight has shown significant relation with gender (male = 80.84 ± 17.71, female = 71.09 ± 10.52, t = -2.52, p = .015) and near to significant relationship (χ2 = 7.685, p = .053) with educational status. CONCLUSION Patients receiving second-generation antipsychotics (SGA) have lesser extra pyramidal side-effects; however, they are more prone to gain weight. Proper screening and counselling during the follow-up visit in the outpatient setting can help in identification, prevention and management of the obesity-related metabolic syndrome and cardiovascular disease (CVD), and motivate them to adopt healthy behaviours.
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Affiliation(s)
- Sailaxmi Gandhi
- Department of Nursing, National Institute of Mental Health and Neurosciences (INI), Bengaluru, India
| | - Krutideepa Mohanty
- Department of Nursing, National Institute of Mental Health and Neurosciences (INI), Bengaluru, India
| | - Maya Sahu
- Department of Nursing, National Institute of Mental Health and Neurosciences (INI), Bengaluru, India
| | - Shalini S Naik
- Department Psychiatry, National Institute of Mental Health and Neurosciences (INI), Bengaluru, India
| | - Erika Pahuja
- Department Psychiatry, National Institute of Mental Health and Neurosciences (INI), Bengaluru, India
| | - Durai Murukan Gunasekaran
- Department of Biostatistics, National Institute of Mental Health and Neurosciences (INI), Bengaluru, India
| | - M Krishna Prasad
- Department Psychiatry, National Institute of Mental Health and Neurosciences (INI), Bengaluru, India
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Kim KS, Kwekkeboom KL, Kim JS. How does art making work? Testing the hypothesized mechanisms of art making on pain experience. Complement Ther Clin Pract 2020; 40:101200. [PMID: 32807729 DOI: 10.1016/j.ctcp.2020.101200] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 05/08/2020] [Accepted: 05/13/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND Pain is a multidimensional experience that requires a holistic pain management approach. Art making, a holistic, mind-body-spirit approach, has been used as a pain management strategy. Although findings of empirical studies point toward several potential mechanisms through which art making activity may affect the pain experience, these mechanisms have not yet been tested. Therefore, the purpose of this study is to evaluate whether perceived control, self-efficacy, spirituality, and mood mediate the effect of art making activity on pain. MATERIALS AND METHODS This study is a secondary analysis of cross-sectional survey data collected in 2014 for the Health and Retirement Study (HRS). Data from a national sample of 731 adults, 50 years of age or older were analyzed for the current study. Participants completed a health survey which included measures of art engagement (representing 'effect of art making' in this study), pain severity and interference, and proposed mediating variables (e.g., perceived control, self-efficacy, spirituality and mood). The joint significance test was used to test hypothesized mediation. RESULT We found that positive mood mediated the effects of art engagement on pain, but perceived control, self-efficacy, spirituality, and negative mood did not. Engagement in art making activity was associated with more positive mood (β = 0.213, p = .001). In turn, greater positive mood was associated with lower pain severity (β = -.147, p = .010) and pain interference (β = -.519, p = .034). CONCLUSION Results of this study provide preliminary evidence that engagement in art making activity impacts pain experience by enhancing positive mood. A large prospective study examining the hypothesized mediating relationship is necessary to confirm our findings.
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Affiliation(s)
- Kyung Soo Kim
- University of Wisconsin - Madison, School of Nursing, Madison, WI, USA.
| | | | - Jee-Seon Kim
- University of Wisconsin - Madison, Educational Psychology, Madison, WI, USA
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15
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Connor MH, Connor CA, Eickhoff J, Schwartz GE. Prospective empirical test suite for energy practitioners. Explore (NY) 2020; 17:60-69. [PMID: 32798173 DOI: 10.1016/j.explore.2020.07.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 07/22/2020] [Accepted: 07/29/2020] [Indexed: 01/19/2023]
Abstract
OBJECTIVE To design a set of measures which were portable and cost-effective that scientists could use to determine competence of Energy Practitioners so that qualified practitioners could be employed in improving ongoing research accuracy. DESIGN This was a prospective study with sample of convenience. SUBJECTS 213 subjects, 185 women and 28 men, were tested in this study. OUTCOME MEASURES Empirical outcome measures included Triaxial Extra Low Frequency Magnetic Field meter, Data Logging Multimeter, RF Field Spectrum Analyzer, Acoustimeter, Broadcast Frequency counter, digital pH meter, digital TDS meter, GDV and physiology suite including heart rate variability, galvanic skin response, respiration, EMG, EKG, temperature and blood volume pulse. Additional questions on ethics and body reading were included in the test. RESULTS Results suggest a range of tests which could be used to determine practitioner competence. Many of the energy practitioners tested consistently produced changes in the areas being measured past the error rate of the devices being used. Across the 13 measures, practitioner success ranged from 56.8% on the Acoustimeter to 100% on the Broadcast Frequency Counter measures with 95% CI. Tri Axial ELF magnetic field meter showed significance with practitioners producing oscillations of amplitude from the L hand at p< 0.01 with and effect size D of 1.5 and R hand p< 0.001 and an effect size D of 1.6. Practitioners demonstrated the ability to produce a change in pH beyond ±.1pH in 10 minutes at a Mean of 0.5 and a SD of 0.4 at a 95% CI of 0.48-0.58 and changes in TDS beyond+/-2% at a Mean of 36.7 and a SD of 35.2 at a 95% CI of 31.9-41.5. Other measures are discussed in detail. CONCLUSIONS This test presents a possible way to demonstrate a level of practitioner competence and improve the selection of energy practitioners for use in scientific studies of energy healing in the areas of full spectrum healing, laying-on-of-hands healing, Reiki, Qi Gong and Tai Chi.
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Affiliation(s)
- Melinda H Connor
- CAM, Akamai University, Hilo Hawaii; Arizona School of Acupuncture and Oriental Medicine, Earthsongs Holistic Consulting, 31907 South Davis Ranch Rd., Marana, AZ 85658, USA.
| | - Caitlin A Connor
- Arizona School of Acupuncture and Oriental Medicine, Earthsongs Holistic Consulting, 31907 South Davis Ranch Rd., Marana, AZ 85658, USA; Health Science Research, Rewley House, University of Oxford, UK
| | - Jens Eickhoff
- Biostatistics & Medical Informatics, University of Wisconsin-Madison
| | - Gary E Schwartz
- Psychology, Medicine, Neurology, Psychiatry, and Surgery, The University of Arizona, USA
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16
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de Campos EA, Narchi NZ, Moreno G. Meanings and perceptions of women regarding the practice of yoga in pregnancy: A qualitative study. Complement Ther Clin Pract 2020; 39:101099. [PMID: 32379641 DOI: 10.1016/j.ctcp.2020.101099] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 12/10/2019] [Accepted: 01/16/2020] [Indexed: 10/25/2022]
Abstract
BACKGROUND AND PURPOSE Considering that pregnancy triggers profound transformations in the life experience of women, among them the need to adapt to a body in a constant process of physiological, psychic, social and emotional change, it is important to identify to what extent yoga can contribute to this process. For this reason, the present study aimed to comprehend the meanings and perceptions of women regarding the practice of yoga during pregnancy. MATERIALS AND METHODS A qualitative and descriptive study was carried out with nine women at different gestational ages who were practicing yoga in places with alternative and integrative therapies for pregnant women located in São Paulo, Brazil. Data collection was performed through semi-structured interviews and the women's statements were transcribed, analysed and grouped into three thematic categories. RESULTS The analysis of the interviews allowed the identification of three categories 'Benefits of practicing yoga', 'Self-knowledge, autonomy and self-care' and 'Empowerment for the moment of the birth'. These findings allowed us to understand how the women perceived the practice of yoga in the pregnancy and considered it fundamental to the recognition that they were competent and skilled to manage and control their bodies during childbirth. CONCLUSION It was concluded that the practice of yoga provided physical and psychosocial benefits for the women of this study, including strengthening of the pelvic floor, pain relief, improvement of breathing, reduction of stress and anxiety, and strengthening of self-confidence, self-esteem and autonomy in the management of the pregnancy and in caring for themselves.
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Affiliation(s)
- Edemilson Antunes de Campos
- Direct-entry Midwifery Program of the School of Arts, Sciences and Humanities of the University of Sao Paulo, Av. Arlindo Bettio, 1000 - Ermelino Matarazzo, 03828-000, São Paulo, São Paulo, Brazil.
| | - Nádia Zanon Narchi
- Direct-entry Midwifery Program of the School of Arts, Sciences and Humanities of the University of Sao Paulo, Av. Arlindo Bettio, 1000 - Ermelino Matarazzo, 03828-000, São Paulo, São Paulo, Brazil.
| | - Gabriela Moreno
- Direct-entry Midwifery Program of the School of Arts, Sciences and Humanities of the University of Sao Paulo, Av. Arlindo Bettio, 1000 - Ermelino Matarazzo, 03828-000, São Paulo, São Paulo, Brazil.
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18
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Speedling BB. Celebrating Sabbath as a Holistic Health Practice: The Transformative Power of a Sanctuary in Time. J Relig Health 2019; 58:1382-1400. [PMID: 30972608 DOI: 10.1007/s10943-019-00799-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Sabbath-keeping has several holistic health benefits when done for intrinsic reasons. Most research on Sabbath-keeping is about individuals where Sabbath-keeping is customary. This organic inquiry describes how a Sabbath promoted transformation for ten women where Sabbath-keeping was not the norm. Six themes emerged: Sabbath-keeping enhanced self-awareness, improved self-care, enriched relationships, developed spirituality, positively affected the rest of a Sabbath-keeper's week, and Sabbath-keeping practices and philosophies also evolved over time. The author argues that reviving the best parts of Sabbath-keeping is an effective, accessible, holistic practice that can contribute to the well-being of individuals, communities, and the earth.
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Affiliation(s)
- Barbara Baker Speedling
- Holistic Health Studies, St. Catherine University, Minneapolis, MN, USA.
- Live Services, RedBrick Health/Virgin Pulse, NBC-HWC, 510 Marquette Avenue, Suite 500, Minneapolis, MN, 55402, USA.
- , 9530 Grand Avenue South, Bloomington, MN, 55420-4221, USA.
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Copeland KJ. Approaches to Multidimensional Health in Representations of Islamic Themes among Black Male Characters in American Film and Television. J Med Humanit 2019; 40:265-275. [PMID: 29204765 DOI: 10.1007/s10912-017-9499-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Historically, representations of Islamic themes in media narratives of Black men have been characterized by personal transformations in the midst of surviving in crime-ridden inner city areas. These young Black men are usually at-risk due to their statuses as Black, economically disadvantaged men. Beginning with Malcolm X and Alex Haley's The Autobiography of Malcolm X, the Black male Islamic redemption narrative has become a common theme in Black popular culture, as it is usually supplemented with unique methods of confronting the various dimensions of health. Throughout this study, the representations of these approaches among Black men in contemporary film and television are examined throughout realms of spiritual, emotional, mental, physical, social, and vocational health.
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Abstract
The human body is well organized, regulated and connected. One of the greatest scientific challenges today is to integrate mind, behaviour and health. Enormous advances in health care have been achieved. However, diseases like cancer still require treatment options beyond therapeutic drugs, namely surgery and radiation. Human being is not only made of cells, tissues and organs, but also feelings and sensations. Linking mental state with physical health is essential to include all elements of disease. For this purpose, halalopathy has been introduced as a new model to integrate mind, behaviour and health, where psychology, spirituality and rationality can be integrated together to generate a well-organized, regulated and connected health system. Halalopathic approaches are based on mind-trust-drug and mind-trust-belief. If the drug and human's belief are compatible, trust in the rationally designed drug will be synergized and placebo effects will be activated to initiate the healing process. Such an organized health system will lower the body's entropy and increase potential energy, which is an important aspect to promote the healing process, with a therapeutic drug toward complete recovery. This study enlightens laws of compatibility to initiate a domino chain effect to activate placebo effects and lower the body's entropy. The healing power of each effect will contribute to the healing process and enhance the total drug effects.
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Affiliation(s)
- Jawad Alzeer
- Department of Chemistry, University of Zurich, Winterthurerstrasse 190, 8057 Zurich, Switzerland.
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21
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Thomas KH, McDaniel JT, Diehr AJ, Hunter K. Mindful Living with Human Immunodeficiency Virus and AIDS: Behavioral Medicine for Patient Resilience and Improved Screening Practices. Nurs Clin North Am 2019; 53:35-46. [PMID: 29362059 DOI: 10.1016/j.cnur.2017.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Complementary techniques are useful in treating adverse symptoms of human immunodeficiency virus (HIV) and AIDS, and in preventing disease spread by encouraging screening. This study indicates that HIV diagnosis rates are higher in states where behavioral medicine is practiced; participation in such activities may influence the extent to which someone might closely monitor personal health. A strong evidence-base exists for the recommendation of mindfulness practices that improve rates of primary preventive practices and self-reported quality of life for participants living with chronic conditions such as HIV and AIDS. Access to such programs is an area for future research and practice.
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Affiliation(s)
- Kate Hendricks Thomas
- Charleston Southern University, CSU College of Health Sciences, 9200 University Boulevard, Charleston, SC 29410, USA.
| | - Justin T McDaniel
- Southern Illinois University, 475 Clocktower Drive Mail Code #4632, Carbondale, IL 62901, USA
| | - Aaron J Diehr
- HIV/AIDS Section, American Public Health Association, Public Health and Recreation Professions, Southern Illinois University, 475 Clocktower Drive Mail Code #4632, Carbondale, IL 62901, USA
| | - Kyleanne Hunter
- Josef Korbel School of International Studies, University of Denver, 2199 S University Boulevard, Denver, CO 80208, USA
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22
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Kiesskalt L, Volland-Schüssel K, Sieber CC, Bollheimer LC. [Hospital pastoral care of people with dementia : A qualitative interview study with professional hospital pastoral carers]. Z Gerontol Geriatr 2018; 51:537-542. [PMID: 29736605 DOI: 10.1007/s00391-018-1396-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2017] [Revised: 03/10/2018] [Accepted: 04/16/2018] [Indexed: 10/17/2022]
Abstract
BACKGROUND Communicating and interacting with persons diagnosed with dementia (PwD) present a challenge to pastoral carers, since most classical pastoral care approaches concentrate on conversation as a medium of relationship formation and do not take limited communication skills into account. This study focuses on the following question: how can hospital-based pastoral carers find appropriate methods of communication and interaction with PwD and provide them with pastoral care? METHODS A total of 10 professional pastoral carers participated in the study. Each of these persons had extensive experience with PwD. Data were collected with the use of guideline-based interviews. The interviews were evaluated using Mayring's method of qualitative content analysis. RESULTS One of the main challenges faced by the pastoral carers in interacting with PwD was to explore communication strategies based on non-verbal communication, in addition to verbal communication. Pastoral carers need to find alternative communicative approaches, such as biographical, non-verbal, and physical sense-related methods. Clinical pastoral education did not adequately equip these professionals for communicating and interacting with PwD. The interviewed pastoral carers acquired this specific knowledge through independent research of the academic literature, observation of other professionals, dementia-specific training courses, and practical experience. CONCLUSION Pastoral carers can make a positive contribution to the holistic care of PwD through their unique communicative and relationship approach to care. It is imperative to develop adequate pastoral care concepts and to integrate methodologies for dealing with PwD into the training curriculum of pastoral carers.
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Affiliation(s)
- L Kiesskalt
- Institut für Psychogerontologie, Friedrich-Alexander-Universität Erlangen-Nürnberg, Kobergerstr. 62, 90408, Nürnberg, Deutschland. .,Alzheimer Gesellschaft München e. V., Josephsburgstr. 92, 81673, München, Deutschland.
| | - K Volland-Schüssel
- Institut für Psychogerontologie, Friedrich-Alexander-Universität Erlangen-Nürnberg, Kobergerstr. 62, 90408, Nürnberg, Deutschland
| | - C C Sieber
- Klinik für Allgemeine Innere Medizin und Geriatrie, Barmherzige Brüder Regensburg, Prüfeninger Str. 86, 93049, Regensburg, Deutschland.,Institut für Biomedizin des Alterns, Friedrich-Alexander-Universität Erlangen-Nürnberg, Kobergerstr. 60, 90408, Nürnberg, Deutschland
| | - L C Bollheimer
- Lehrstuhl für Altersmedizin der Uniklinik RWTH Aachen mit Klinik für Innere Medizin und Geriatrie, Franziskushospital Aachen, Morillenhang 27, 52074, Aachen, Deutschland.
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Jormfeldt H, Doyle L, Ellilä H, Lahti M, Higgins A, Keogh B, Meade O, Stickley T, Sitvast J, Skärsäter I, Kilkku N. Master's level mental health nursing competencies, a prerequisite for equal health among service users in mental health care. Int J Qual Stud Health Well-being 2018; 13:1502013. [PMID: 30067476 PMCID: PMC6084491 DOI: 10.1080/17482631.2018.1502013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/11/2018] [Indexed: 10/28/2022] Open
Abstract
PURPOSE This discussion paper aims to explore the need of a clarified definition of master's level mental health nursing competencies in terms of knowledge, skills and attitudes in a European context. Mental health service users have, in spite of their right to equal overall health, higher rates of physical illness and are more likely to experience premature death than the general population. Implementation of a holistic concept of health comprising mental, physical and social aspects of health in mental health services has previously proved to be challenging. METHODS Master's level mental health nursing competencies in recent literature are discussed and illuminated in terms of knowledge, skills and attitudes in order to enable the promotion of equal overall health among service users in mental health services. RESULTS The discussion show contents, values and utility of master's level mental health nursing competencies in mental health services and contribute to reduced role ambiguity by distinguishing master's level responsibilities from undergraduate nursing tasks and obligations of other professionals in mental health care. CONCLUSION This discussion paper shapes implications for developments in master's level mental health nursing education curricula.
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Affiliation(s)
- Henrika Jormfeldt
- School of Health and Wellfare, Halmstad University, Halmstad, Sweden
| | - Louise Doyle
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Heikki Ellilä
- Health and Well-being, Turku University of Applied Science, Turku, Finland
| | - Mari Lahti
- Health and Well-being, Turku University of Applied Science, Turku, Finland
| | - Agnes Higgins
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Brian Keogh
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Oonagh Meade
- School of Health Sciences, Faculty of Medicine & Health Sciences, University of Nottingham, Nottingham, UK
| | - Theodore Stickley
- School of Health Sciences, Faculty of Medicine & Health Sciences, University of Nottingham, Nottingham, UK
| | - Jan Sitvast
- Advanced Nursing Practice, University of Applied Sciences HU, Utrecht, The Netherlands
| | - Ingela Skärsäter
- School of Health and Wellfare, Halmstad University, Halmstad, Sweden
| | - Nina Kilkku
- Tampere University of Applied Sciences, Tampere, Finland
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Lamb AD, Thompson S, Kinsella N, Gerbitz I, Chapman E, Putt L, Bennett S, Thankappannair V, Geoghegan L, Wright N, Stirton-Croft A, Nixon P, Styling A, Whitney D, Hodgson L, Punt L, Longmore J, Carter M, Petch B, Rimmer Y, Russell S, Hughes-Davies L, Mazhar D, Shah NC, Gnanapragasam VJ, Doble A, Bratt O, Kastner C. Aiming for a holistic integrated service for men diagnosed with prostate cancer - Definitions of standards and skill sets for nurses and allied healthcare professionals. Eur J Oncol Nurs 2017; 29:31-38. [PMID: 28720263 DOI: 10.1016/j.ejon.2017.04.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2016] [Revised: 04/19/2017] [Accepted: 04/20/2017] [Indexed: 11/16/2022]
Abstract
PURPOSE To establish a comprehensive set of recommendations for the service structure and skill set of nurses and allied healthcare professionals in prostate cancer care. METHODS Using components of formal consensus methodology, a 30-member multidisciplinary panel produced 53 items for discussion relating to the provision of care for prostate cancer patients by specialist nurses and allied healthcare professionals. Items were developed by two rounds of email correspondence in which, first, items were generated and, second, items refined to form the basis of a consensus meeting which constituted the third round of review. The fourth and final round was an email review of the consensus output. RESULTS The panel agreed on 33 items that were appropriate for recommendations to be made. These items were grouped under categories of "Environment" and "Patient Pathway" and included comments on training, leadership, communication and quality assessment as well as specific items related to prostate diagnosis clinics, radical treatment clinics and follow-up survivor groups. CONCLUSIONS Specialist nurses and allied healthcare professionals play a vital role alongside urologists and oncologists to provide care to men with prostate cancer and their families. We present a set of standards and consensus recommendations for the roles and skill-set required for these practitioners to provide gold-standard prostate cancer care. These recommendations could form the basis for development of comprehensive integrated prostate cancer pathways in prostate cancer centres as well as providing guidance for any units treating men with prostate cancer.
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Affiliation(s)
- Alastair D Lamb
- CamPARI Clinic, Cancer Directorate, Addenbrooke's Hospital, Cambridge, UK
| | - Sue Thompson
- Peterborough City Hospital, Peterborough, Cambridgeshire, UK
| | | | - Ingmar Gerbitz
- Martini-Klinik, Martinistraße 52, 20246 Hamburg, Germany
| | - Elaine Chapman
- CamPARI Clinic, Cancer Directorate, Addenbrooke's Hospital, Cambridge, UK
| | - Lisa Putt
- CamPARI Clinic, Cancer Directorate, Addenbrooke's Hospital, Cambridge, UK
| | - Sophie Bennett
- CamPARI Clinic, Cancer Directorate, Addenbrooke's Hospital, Cambridge, UK
| | | | - Lisa Geoghegan
- CamPARI Clinic, Cancer Directorate, Addenbrooke's Hospital, Cambridge, UK
| | - Naomi Wright
- CamPARI Clinic, Cancer Directorate, Addenbrooke's Hospital, Cambridge, UK
| | | | - Penny Nixon
- CamPARI Clinic, Cancer Directorate, Addenbrooke's Hospital, Cambridge, UK
| | - Andrew Styling
- CamPARI Clinic, Cancer Directorate, Addenbrooke's Hospital, Cambridge, UK
| | - Diane Whitney
- CamPARI Clinic, Cancer Directorate, Addenbrooke's Hospital, Cambridge, UK
| | - Lindsay Hodgson
- CamPARI Clinic, Cancer Directorate, Addenbrooke's Hospital, Cambridge, UK
| | - Lisa Punt
- Maggies Wallace, Long Road, Cambridge, UK
| | - Jenny Longmore
- CamPARI Clinic, Cancer Directorate, Addenbrooke's Hospital, Cambridge, UK
| | - Mike Carter
- CamPARI Clinic, Cancer Directorate, Addenbrooke's Hospital, Cambridge, UK; Patient representatives
| | - Bill Petch
- CamPARI Clinic, Cancer Directorate, Addenbrooke's Hospital, Cambridge, UK; Patient representatives
| | - Yvonne Rimmer
- CamPARI Clinic, Cancer Directorate, Addenbrooke's Hospital, Cambridge, UK
| | - Simon Russell
- CamPARI Clinic, Cancer Directorate, Addenbrooke's Hospital, Cambridge, UK
| | - Luke Hughes-Davies
- CamPARI Clinic, Cancer Directorate, Addenbrooke's Hospital, Cambridge, UK
| | - Danish Mazhar
- CamPARI Clinic, Cancer Directorate, Addenbrooke's Hospital, Cambridge, UK
| | - Nimish C Shah
- CamPARI Clinic, Cancer Directorate, Addenbrooke's Hospital, Cambridge, UK
| | | | - Andrew Doble
- CamPARI Clinic, Cancer Directorate, Addenbrooke's Hospital, Cambridge, UK
| | - Ola Bratt
- CamPARI Clinic, Cancer Directorate, Addenbrooke's Hospital, Cambridge, UK; Department of Translational Medicine, Division of Urological Cancer, Lund University, Sweden
| | - Christof Kastner
- CamPARI Clinic, Cancer Directorate, Addenbrooke's Hospital, Cambridge, UK.
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Abstract
Background: Importance of community rehabilitation in India has been emphasized in previous research. There is ample research that has been published for different communities in the country. However, the precise role of physiotherapy in community rehabilitation is unclear.The objective of the current brief report is to look into the role of physiotherapy in community rehabilitation. Methods: Relevant literature search was done using databases namely Medline, Scopus, PubMed, PEDro and CINAHL using search terms- India, community rehabilitation, home rehabilitation, home exercises and physiotherapy. Studies that followed the PICO format, published in English,after 2005 and that had specifically mentioned the role of physiotherapy in community projects were included. Results: While there are handful of studies that have mentioned the contribution of physiotherapy in the community, most of the interventions are targeted toward management of chronic health conditions. More work needs to be done to outline the importance and precise role of physiotherapy in the rehabilitation of communities in India, especially in preventive care.A model has been created to emphasize the holistic approach of physiotherapy in the Indian setting. Conclusion: Physiotherapy has a pivotal position in community rehabilitation in India.However, published research for the same is lacking. While physiotherapy interventions have been designed to target chronic health conditions in the community, emphasis on preventive care is lacking.
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Affiliation(s)
- Pavithra Rajan
- Shastri Indo-Canadian Institute, Canada, Fellow, Shastri Indo-Canadian Institute, Calgary, Canada
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26
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Abstract
OBJECTIVE Describe perceptions of persons with SCI on their receipt of holistic care and relational empathy during health care encounters. DESIGN Mailed survey. PARTICIPANTS/SETTING Individuals with SCI who received care from the largest suppliers of SCI care and rehabilitation (Veterans Health Administration and SCI Model Systems). OUTCOME MEASURES Using a survey and administrative databases, we collected demographic and injury characteristics, health status, health conditions, and the main outcome: Consultation and Relational Empathy (CARE) measure. RESULTS The sample included 450 individuals with SCI (124 Veterans and 326 civilians). Response rate was 39% (450/1160). Analyses were conducted on patients with complete data (n = 389). Veterans and civilians with SCI differed across many demographic characteristics, age at injury, and etiology, but mean CARE scores were equivalent. Fewer than half of the full SCI cohort had CARE scores above the normative value of 43. Having a recent pressure ulcer showed a trend for lower odds of having a normative or higher CARE score. Odds of having an above-normative CARE score were nearly 2 times greater for individuals with tetraplegia, and odds were higher for those with higher physical and mental health status. CONCLUSIONS Higher physical and mental health status and tetraplegia were each independently associated with greater perceptions of holistic care and empathy in the therapeutic patient-provider relationship. Limited empathy, communication, and holistic care may arise when providers focus on disease/disease management, rather than on patients as individuals. Frequent health care use and secondary conditions may affect empathy and holistic care in encounters, making it essential to understand and employ efforts to improve the therapeutic relationship between patients with SCI and their providers.
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Affiliation(s)
- Sherri L. LaVela
- Department of Veterans Affairs (VA), Spinal Cord Injury Quality Enhancement Research Initiative (SCI QUERI), Edward Hines Jr. VA Hospital, Hines, IL, USA,Center of Innovation for Complex Chronic Healthcare, Edward Hines Jr. VA Hospital, Hines, IL, USA,Center for Healthcare Studies, Institute for Public Health and Medicine, General Internal Medicine and Geriatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA,Correspondence to: Sherri LaVela, Department of Veterans Affairs, Edward Hines, Jr. VA Hospital (151-H, Building 1, Office D-312), Health Services Research & Development, 5th Avenue & Roosevelt Road, Hines, IL 60141. E-mail:
| | - Allen W. Heinemann
- Center for Rehabilitation Outcomes Research, Rehabilitation Institute of Chicago, Chicago, IL, USA,Department of Physical Medicine & Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Bella Etingen
- Department of Veterans Affairs (VA), Spinal Cord Injury Quality Enhancement Research Initiative (SCI QUERI), Edward Hines Jr. VA Hospital, Hines, IL, USA,Center of Innovation for Complex Chronic Healthcare, Edward Hines Jr. VA Hospital, Hines, IL, USA
| | - Ana Miskovic
- Center for Rehabilitation Outcomes Research, Rehabilitation Institute of Chicago, Chicago, IL, USA
| | - Sara M. Locatelli
- Center of Innovation for Complex Chronic Healthcare, Edward Hines Jr. VA Hospital, Hines, IL, USA
| | - David Chen
- Department of Physical Medicine & Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA,Rehabilitation Institute of Chicago, Chicago, IL, USA
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27
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Thurber KA, Banwell C, Neeman T, Dobbins T, Pescud M, Lovett R, Banks E. Understanding barriers to fruit and vegetable intake in the Australian Longitudinal Study of Indigenous Children: a mixed-methods approach. Public Health Nutr 2017; 20:832-47. [PMID: 27894381 DOI: 10.1017/S1368980016003013] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Objective To identify barriers to fruit and vegetable intake for Indigenous Australian children
and quantify factors related to these barriers, to help understand why children do not
meet recommendations for fruit and vegetable intake. Design We examined factors related to carer-reported barriers using multilevel Poisson models
(robust variance); a key informant focus group guided our interpretation of
findings. Setting Eleven diverse sites across Australia. Subjects Australian Indigenous children and their carers (N 1230) participating
in the Longitudinal Study of Indigenous Children. Results Almost half (45 %; n 555/1230) of carers reported barriers to their
children’s fruit and vegetable intake. Dislike of fruit and vegetables was the most
common barrier, reported by 32·9 % of carers; however, we identified few factors
associated with dislike. Carers were more than ten times less likely to report barriers
to accessing fruit and vegetables if they lived large cities v. very
remote areas. Within urban and inner regional areas, child and carer well-being,
financial security, suitable housing and community cohesion promoted access to fruit and
vegetables. Conclusions In this national Indigenous Australian sample, almost half of carers faced barriers to
providing their children with a healthy diet. Both remote/outer regional carers and
disadvantaged urban/inner regional carers faced problems accessing fruit and vegetables
for their children. Where vegetables were accessible, children’s dislike was a
substantial barrier. Nutrition promotion must address the broader family, community,
environmental and cultural contexts that impact nutrition, and should draw on the
strengths of Indigenous families and communities.
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28
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Moyano-Santiago MA, Rivera-Lirio JM. [Sustainability focus in the health plans of the autonomous communities: sustainable development as an opportunity]. Gac Sanit 2016; 30:172-7. [PMID: 27038802 DOI: 10.1016/j.gaceta.2016.02.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Revised: 02/04/2016] [Accepted: 02/07/2016] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To determine the degree to which the health plans of the autonomous communities focus on the usual three dimensions of sustainability: economic, social and environmental, both in the general level of discourse and in the different areas of intervention. METHOD A qualitative study was conducted through content analysis of a large sample of documents. The specific methodology was analysis of symbolic and operational sensitivity in a sample of eleven health plans of the Spanish state. RESULTS Social aspects, such as social determinants or vulnerable groups, are receiving increasing attention from the health planner, although there is room to strengthen attention to environmental issues and to provide specific interventions in economic terms. CONCLUSIONS The analysis demonstrates the incipient state of health plans as strategic planning documents that integrate economic, social and environmental aspects and contribute to the sustainability of the different health systems of the country.
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29
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Abstract
Sexual health is an important part of an individual's physical and emotional wellbeing. Sexuality and sexual wellbeing are often associated with young people and therefore the needs of the older person can be overlooked. Such discrimination is unjustifiable given that statistics show a rise in sexually transmitted infections (STIs) and new diagnoses of HIV in the older man. These worrying trends emphasise the legitimate need for nurses to address sexuality and sexual wellbeing as an essential component of health care.
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Affiliation(s)
- Wendy Norton
- Senior Lecturer, Faculty of Health and Life Sciences, School of Nursing and Midwifery, De Montfort University, Leicester
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30
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Freysteinson WM, Deutsch AS, Davin K, Lewis C, Sisk A, Sweeney L, Wuest L, Cesario SK. The Mirror Program: Preparing Women for the Postoperative Mastectomy Mirror-Viewing Experience. Nurs Forum 2015; 50:252-257. [PMID: 25130483 DOI: 10.1111/nuf.12108] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
PROBLEM Preparing women for the experiences they will endure during the breast cancer trajectory improves psychological outcomes and quality of life. Women have found that it may be difficult to view themselves in a mirror after having a mastectomy. Supporting women who have had a mastectomy in mirror-viewing and body image is a relatively new yet important intervention in oncology nursing. METHODS The feasibility of a preoperative mirror program given by oncology nurse navigators to women who were scheduled for a mastectomy was examined in this randomized control study. FINDINGS Pre- and postoperative data on anxiety, body image, depression, emotional well-being, and mirror use were collected from intervention participants (n = 10) and control subjects (n = 9). CONCLUSION This article illustrates the development of the mirror program and the results of the feasibility trial, and provides a discussion with implications for future research.
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Affiliation(s)
| | - Amy S Deutsch
- System Cancer Services, Memorial Hermann Health System, Houston, TX
| | - Karen Davin
- Memorial Hermann Memorial City Hospital, Memorial Hermann Health System, Houston, TX
| | - Carol Lewis
- Memorial Hermann the Woodlands Hospital, Formally of Memorial Hermann Health System, Houston, TX
| | - Angela Sisk
- Memorial Hermann Northwest Hospital, Memorial Hermann Health System, Houston, TX
| | - Lilian Sweeney
- Memorial Hermann Southwest Hospital, Memorial Hermann Health Systems, Houston, TX
| | - Linda Wuest
- Memorial Hermann Northeast Hospital, Memorial Hermann Health Services, Houston, TX
| | - Sandra K Cesario
- Nelda C. Stark College of Nursing, Texas Woman's University, Houston, TX
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31
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Kolappa K, Kern DE. One good hand. Patient Educ Couns 2015; 98:1164-1166. [PMID: 26138157 DOI: 10.1016/j.pec.2015.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2014] [Revised: 04/06/2015] [Accepted: 06/15/2015] [Indexed: 06/04/2023]
Affiliation(s)
| | - David E Kern
- Johns Hopkins University School of Medicine, Division of General Internal Medicine, Johns Hopkins Bayview Medical Center, USA.
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32
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Dougall A, Molina GF, Eschevins C, Faulks D. A Global Oral Health Survey of professional opinion using the International Classification of Functioning, Disability and Health. J Dent 2015; 43:683-94. [PMID: 25868878 DOI: 10.1016/j.jdent.2015.04.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2014] [Revised: 03/11/2015] [Accepted: 04/01/2015] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES The concept of oral health is frequently reduced to the absence of disease, despite existing conceptual models exploring the wider determinants of oral health and quality of life. The International Classification of Functioning, Disability and Health (ICF) (WHO) is designed to qualify functional, social and environmental aspects of health. This survey aimed to reach a consensual description of adult oral health, derived from the ICF using international professional opinion. METHODS The Global Oral Health Survey involved a two-round, online survey concerning factors related to oral health including functioning, participation and social environment. Four hundred eighty-six oral health professionals from 74 countries registered online. Professionals were pooled into 18 groups of six WHO world regions and three professional groups. In a randomised stratification process, eight professionals from each pool (n=144) completed the survey. The first round consisted of eight open-ended questions. Open expression replies were analysed for meaningful concepts and linked using established rules to the ICF. In Round 2, items were rated for their relevance to oral health (88% response rate). RESULTS Eighty-nine ICF items and 30 other factors were considered relevant by at least 80% of participants. International professionals reached consensus on a holistic description of oral health, which could be qualified and quantified using the ICF. CONCLUSIONS These results represent the first step towards developing an ICF Core Set in Oral Health, which would provide a practical tool for reporting outcome measures in clinical practice, for research and epidemiology, and for the improvement of interdisciplinary communication regarding oral health. CLINICAL SIGNIFICANCE Professional consensus reached in this survey is the foundation stone for developing an ICF Core Set in Oral Health, allowing the holistic aspects of oral health to be qualified and quantified. This tool is necessary to widen our approach to clinical decision making, measurement of clinical outcomes, research and epidemiology.
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Affiliation(s)
- Alison Dougall
- Dublin Dental University Hospital, Trinity College, Dublin, Ireland.
| | - Gustavo F Molina
- Escuela de Odontología, Universidad Católica de Córdoba, Argentina.
| | - Caroline Eschevins
- Clermont Université, Université d'Auvergne, EA4847, Centre de Recherche on Odontologie Clinique, F-63100 Clermont-Ferrand, France.
| | - Denise Faulks
- Clermont Université, Université d'Auvergne, EA4847, Centre de Recherche on Odontologie Clinique, F-63100 Clermont-Ferrand, France; CHU Clermont-Ferrand, Service d'Odontologie, CH Estaing, F-63100 Clermont-Ferrand, France.
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33
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Abstract
PURPOSE This study aimed to clarify the phenomenon and definition of self-stigma in schizophrenia. CONCLUSION Self-stigma in schizophrenia affects patients' well-being and attitudes to treatment. Although stigma and self-stigma have interactive and different characteristics, theses definitions are not clearly distinguished. Mental illnesses may have different stereotypes but are treated equally in some studies. Lack of awareness of illness is a common feature in schizophrenia but has not been focused in self-stigma studies. PRACTICE IMPLICATION Further studies are needed to clarify the phenomenon of self-stigma in people with schizophrenia and to develop interventions targeted at reducing self-stigma.
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Affiliation(s)
- Yoshimi Omori
- University of Tsukuba, Tsukuba, Ibaraki, Japan; University of Southern Indiana, Evansville, Indiana, USA
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34
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Abstract
International literature and experience suggest that arts-based encounters can be effective in reducing stress and burnout in health care workers. Are these principles universal? Are they as applicable and effective in resource-constrained situations in Africa as in other parts of the world? We describe the impact of creative and arts-based encounters on a group of hospice caregivers at South Coast Hospice in KwaZulu Natal. An experienced facilitator built a caring and trusting relationship with the participants over a three month period through a variety of means, including a singing and songwriting intervention specifically designed to empower and give voice to the hospice caregivers, most of whom were Zulu women. We documented the process through several rounds of interviews, extensive field notes, and audio recordings. This article is a reflection on the experience and draws from the interviews, correspondence among researchers, field notes, and a performance piece written by the facilitator one year after completion of the study. We found that the songwriting and other creative activities of the engagement provided affirmation and acknowledgment of the caregivers as well as an opportunity to release stress, grief, and pain. They experienced changes in terms of hope and freedom both for themselves and their patients. The conceptual themes that emerged from the interviews with the caregivers were interpreted in terms of their inherent cultural assets, a release of agency, a sense of revelation, and transformation. The expressive arts can have a significantly beneficial effect on hospice workers and their patients, and clinical engagement can be enhanced through creative encounters, even in resource-constrained situations. If such creative processes were to be promoted among a wider group of health workers, daily routine work in health care could be not just a repetition of well-rehearsed utilitarian rituals but rather a series of creative and transformative encounters.
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Affiliation(s)
- Patricia Ann Repar
- Departments of Music and Internal Medicine, University of New Mexico, Albuquerque, New Mexico, USA.
| | - Steve Reid
- Primary Health Care Directorate, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
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