Academic literature on the topic 'Chronic illne'

Background: Chronic disease often cause patients feeling anxious in which it give negative consequences on their physical, emotional, social, intelectual and spiritual condition. Nurse can applay complementary therapy such as healing gardens to reduce patient anxiety level. Healing gardens can give comfortable situation, therfore it can improve relaxtation and reduce stress that can make hospitalization shorter. Some researres, results show that healing gardens can improve relaxtation and reduce patients anxiety who are sick. Objective: To identify the relationship between healing gardens toward reducing chronic patients anxiety level in one of Private Hospital in Yogyakarta. Methods: Research design which was done was observation. Population in this research were all chronical hospitalized patient in in one of Private Hospital in Yogyakartaa from August to October 2015. Total sample in this research were 30 respondens who are choosed randomly. Results: The test result of data analysis on the difference of before and after experiencing healing gardens showed p value 0.000 (p value < 0.05), means that healing gardens can reduce chronical panients anxiety level. Conculsion: Healing gardens can reduce anxiety level in chronic illnes patients. Hospital should applay healing gardens toward chronical patients in order to reduce patient anxiety level.

Abstract Johne’s disease (JD) is a chronic enteric disease of ruminants caused by Mycobacterium avium subsp. Paratuberculosis (MAP) but immune and metabolic mechanisms affecting JD progression have not been clearly elucidated. MicroRNAs (miRNA) have been reported to play important roles in numerous biological processes by regulating gene expression. In this study, miRNA expression in ileal lymph nodes (ILLN) from MAP positive (JD subclinical stage) Holstein cows (n = 5) and MAP negative cows (n = 5) were characterized by high throughput sequencing. MiRNA-sequence data was processed using a standard pipeline followed by functional enrichment with ClueGo app in Cytoscape. Among 324 expressed miRNAs, 37 were differently expressed (DE) (18 up-regulated and 19 down-regulated) in MAP infected cows relative to MAP negative cows. Bta-miR-100 (fold change = -2.29), a down-regulated miRNA, has previously been associated with Streptococcus uberis and MAP infections in cows, while bta-miR-330 (fold change = 63.42), the most up-regulated miRNA, was previously reported to be present in the sera of MAP infected calves. Predicted target genes of 37 DE miRNAs were enriched (P &lt; 0.05) in gene ontology terms related to metabolic, cellular and developmental processes, and immune system development, as well as pathways related to cancer and Th17 cell differentiation, and lysosome compartmentalization. This suggests that miRNAs DE following MAP infection may be involved in regulating a wide variety of processes. In addition, 5 DE miRNAs were negatively correlated (P &lt; 0.05) with 39 DE mRNAs (mRNAs expressed in the same tissue), comprising 42 negatively correlated DE miRNA-mRNA pairs. Bta-miR-2447 was negatively correlated with 29 DE mRNAs, suggesting it may be an important hub miRNA in the regulation of MAP infection in ILLN tissue. Our data thus suggest that bta-miR-100, bta-miR-330 and bta-miR-2447, which are implicated in the Th17 cell differentiation pathway, may be key regulators of the host response during MAP infection in ILLN.

Introduction: Chronic disease often cause patients feeling anxious in which it give negative consequences on their physical, emotional, social, intelectual and spiritual condition. Nurse can applay complementary therapy such as healing gardens to reduce patient anxiety level. Healing gardens can give comfortable situation, therfore it can improve relaxtation and reduce stress that can make hospitalization shorter. Some researres, results show that healing gardens can improve relaxtation and reduce patients anxiety who are sick.Purpose: To identify the relationship between healing gardens toward reducing chronic patients anxiety level in one of Private Hospital in Yogyakarta.Methode: Research design which was done was observation. Population in this research were all chronical hospitalized patient in in one of Private Hospital in Yogyakartaa from August to October 2015. Total sample in this research were 30 respondens who are choosed randomly.Result: The test result of data analysis on the difference of before and after experiencing healing gardens showed p value 0.000 (p value < 0.05), means that healing gardens can reduce chronical panients anxiety level.Conculsion and suggestion: Healing gardens can reduce anxiety level in chronic illnes patients. Hospital should applay healing gardens toward chronical patients in order to reduce patient anxiety level. For nurse, they also should give and touch to patients who were doing healing gardens where these can psychologically can improve their safety and comfortable so it can reduce patients anxiety level. Key words: healing gardens, anxiety, chronic disease.

Abstract Johne’s Disease (JD), caused by Mycobacterium avim spp paratuberculosis (MAP), is a chronic and incurable disease of ruminants with devastating consequences to the dairy industry. MAP can alter the expression of genes and biological processes during the progression of JD. While some studies have examined the role of gene expression regulators like microRNA in the pathogenesis of JD, no study has explored the role of DNA methylation. This study therefore examined the effect of MAP on DNA methylation profile in the ileum lymph node (ILLN) of cows with subclinical MAP infection. DNA from ILLN tissues from five cows positive for MAP (MAP positive) and five negative cows (MAP negative) were extracted and subjected to whole genome bisulfite sequencing and bioinformatics analysis. A total of 6,394 differentially methylated cytosines (DMCs) and 3,946 differentially methylated regions (DMRs) (FDR &lt; 0.05) were identified between MAP positive and negative cows. DMRs were annotated to 2,488 genes, including the promoters of 238 genes. Some genes with hypermethylated promoters like GRB10, EIF4E, SLC30A3, SOX30 or hypomethylated promoters like SLC11A1, HOXA4, SLC18A1 have been associated with JD or mycobacterial infections in cattle and/or humans. Functional annotation of DMR genes indicated enrichment in pathways previously associated with JD or human diseases with similar pathological conditions as JD, such as T/B cell receptor signaling pathway, Th17 cell differentiation, Cell adhesion molecules, Leukocyte transendothelial migration, HIF-1 signaling pathway and Chagas disease. Furthermore, enriched gene ontology terms like negative regulation of immune system process, negative regulation of cytokine secretion/production and negative regulation of inflammatory response suggest that MAP prevented or reduced the host immune response. Our data demonstrate that DNA methylation changes contribute to regulation of host immune responses to MAP infection and may be one of the mechanisms that MAP uses to subvert host immune responses for its long-term survival.

AbstractRed blood cell distribution width (RDW) is a hematological parameter usually measured with every complete blood count. Its place in daily practice is mainly in the differential diagnosis of anemia, but nowadays, researchers are focused on different approaches for the erythrocyte’s changes in function and morphology.Sepsis and its most advanced form, septic shock, induces profound disturbances into organ system’s function and morphology. The red blood cells physiology and structure are directly and indirectly altered by these im balances produced in sepsis. RDW was studied in many diseases, like acute heart failure, acute stroke, inflammatory bowel diseases, chronic lung diseases and cancer, but also in sepsis. Its changes are seen to be mainly associated with prognosis. Higher values of RDW are correlated with mortality and severity of illnes in septic and all-cause critically ill patients. RDW was studied also as an independent variable in different predictive scores and some studies suggest it should be introduced in the scores use on a daily basis in critical care settings and emergency departments.In this review we will focus on how RDW was associated with mortality and severity of illness in the recent literature, as an independent prognosis factor and as a component part in different predictive and severity scores.

AbstractThe peripheral arterial obstructive disease (PAOD) is a chronic illnes that has as main symptom intermittent claudication and causes a progressive functional impairment of the patient. The literature is still inconclusive when it addresses the relationship among functional capacity, endurance, muscle contraction speed, and degree of blood flow impairment in patients with PAOD. The objective of this study was to evaluate the physical fitness individuals with bilateral PAOD, claudication and ankle-brachial index between 0.8 and 0.9, to verify the impact of the disease in this outcome and to analyze the association among the tests. Forty individuals, with mean age 56 years were divided in: group PAOD (n=20) and control group (n=20) were subjected to the following tests: Five-Times-Sit-to-Stand Test (FTSST), Heel-rise test (HRT), test of gait speed usual (UV) and maximum (MV), shuttle walking test (SWT). There was a significant difference among the variables obtained through HRT, UV, MV and SWT, showing a worse performance of the group with PAOD compared to the control. The FTSST test showed no differences among the groups. Analyzing the whole sample, the presence of PAOD is an indicator of poor performance in TDBP. This study suggests that people with mild PAOD present reduced performance in functional endurance tests of the lower limbs and that there is a direct relationship between walking speed and patency of local arterial flow, demonstrating in an unprecedented way the need for evaluation of this public, considering the possibility of initial identification of the symptoms and giving greater efficiency in the therapeutic planning of maintenance of the functionality.Keywords: Physical Fitness. Intermittent Claudication. Peripheral Vascular Diseases.ResumoA doença arterial obstrutiva periférica (DAOP) é uma doença crônica que tem como sintoma principal a claudicação intermitente e causa um progressivo comprometimento funcional do paciente. A literatura ainda é inconclusiva quando aborda a relação entre a capacidade funcional, endurance, velocidade de contração muscular e grau de comprometimento de fluxo sanguíneo em pacientes com DAOP. O objetivo deste estudo foi avaliar a aptidão física de indivíduos com DAOP bilateral, claudicantes e Índice tornozelo-braço entre 0,8 e 0,9, verificar o impacto da doença neste desfecho e analisar a associação entre os testes. Quarenta indivíduos, com faixa etária média de 56 anos, divididos em grupo DAOP (n=20) e grupo controle (n=20), foram submetidos aos testes: Teste senta-levanta (TSL), teste ponta de pé (TPP), testes de velocidade usual (VU) e máxima (VM), teste de deslocamento bidirecional progressivo (TDBP). Houve diferença significativa entre as variáveis do TPP, VU, VM e TDBP, mostrando pior performance do grupo com DAOP comparado ao controle. O teste TSL não apresentou diferença entre os grupos. Analisando os grupos em conjunto a presença de DAOP foi indicadora de pior desempenho no TDBP. Este estudo sugere que pacientes com DAOP leve apresentam redução da performance nos testes funcionais de endurance dos membros inferiores e que existe uma relação direta entre a velocidade da marcha e a patência do fluxo arterial local, demonstrando de forma inédita, a necessidade de avaliação deste público, considerando a possibilidade de identificação inicial dos sintomas e conferindo maior eficiência no planejamento terapêutico de manutenção da funcionalidade.Palavras-chave: Aptidão Física. Claudicação Intermitente. Doenças Vasculares Periféricas.

Health related quality of life (HRQoL) is the most desired patient centered outcome of medical care (Leplége et al. 1997). In patients with long term illness, such as Hypertrophic Pachymeningitis (HP) still under diagnosis, therefore no possible to properly cure, it might be the only outcome achievable (Netuveli et al. 2005; Trystuła 2017). The problem becomes even more serious when occurs in young person: starting a family and caring for children becomes hard or even impossible, because of his/her physical and psychical conditions. Most clinicians are aware of the importance for quality of life of this functional limitation, but there are no articles describing this problem in the literature. We aimed to fill this gap in knowledge. 29 year old patient, a car mechanic, married, with 4-year-old son, with the long his- tory of the illnes, and especially persistent, diffuse, non-specific headaches, frequent seizures and cognitive deterioration which have been particularly troublesome recently. He was finalny diagnosed with Hypertrophic Pachymeningitis (HP) associated with Immunoglobulin G4-related (IgG4) with the use of specific diagnostic criteria for HP associated with IgG4-RD (IgG4-HP), which rely on histopathologic analysis (Lindstrom et al. 2010; Lu et al 2014). Computed tomography (CT) of the head showed massive calcifications visible along the cerebellar tentorium on the right side, along the cerebral falx, as well as on dura mater on the cranial vault of both cerebral hemispheres. The patient was diagnosed with common variable immunodeficiency (D 83), thrombocytopenia, chronic EBV hepatitis and epilepsy. IgG4-HP was confirmed by CT, MRI and biopsy (IGg4-RHP antibody was detected). The treatment with steroids, and immunosuppressive therapy (RTX) was introduced (as it was suggested by Levraut et al. (2019). It should be stressed that he had a significantly reduced health-related quality of life (HRQoL), mainly because of long-lasting illness, diverse symptoms, often hospitalization, complex differential diagnosis, and especially biopsy which requires neurosurgical intervention, which affect his physical and mental well-being, especially cognitive control, and not possibility to take care of his family. To help the patient we introduce HBI methodology (Kropotov 2016), that is an evaluation of working brain in milliseconds. Quantitative electroencephalography (qEEG), event-related potentials (ERPs) and low-resolution sLORETA tomography were performed. We did not found any paroxysm of 3 Hz rhythm in Eyes Closed (EO) and in Eyes Open (EO) conditions, however the ERPs deviations from the reference indicate deficit of cognitive control (decrease of P3 NOGO wave in comparison to 100 persons from the normative data base from the Human Brain Index in Chur, Switzerland). Therefore, the patient was offered Transcranial Direct Current Stimulation (atDCS) combined with goal-oriented psychotherapy program. It was found that after 40 days of therapy, cognitive control returned, which was translated into a better quality of life related to the patient's health, measure in the 36-Item Short Form Survey (SF-36). The patient returned to his previous job as a head of car mechanic service. Final diagnosis of IgG4-HP and subsequently, proper farmacotherapy, and introduction of HBI methodology allowing for the selection of an adequate method of neurotherapy, for our patient the transcranial direct current stimulation (atDCS) combined with goal- oriented psychotherapy, was helpful in the improvement of his quality of life.

The COVID-19 pandemics have caused a lot of stressors for parents. Apart from doing daily activities, parents also have to take care of their children and accompany them to study. The number of stressors can lead to toxic behavior in parenting. This study aims to measure the level of toxicity in parenting behavior and coping strategies adopted by parents. This study uses quantitative descriptive methods to measure toxic levels in parenting behavior during the COVID-19 pandemic. A total of 568 parents from Banjarmasin and Yogyakarta participated in this study. The survey results show that several factors can trigger parenting stress during the COVID-19 pandemic, namely worsening economic conditions, delinquent children, excessive anxiety, accumulated daily hassles, growing family demands, and disputes with spouses. However, some of these stressors do not lead to toxic parenting. The results showed that 97.79% of respondents from Banjarmasin and 95.29% from Yogyakarta showed a low toxic level. The remaining 2.21% of respondents in Banjarmasin and 4.71% of respondents in Yogyakarta indicated a moderate toxic level. Coping strategies are crucial for neutralizing stress. There are several strategies applied, namely trying to consider a problem is God's test, and there is a positive side to every problem; trying to address the source of stress and solving it; Withdrawing and finding individual time; looking for social support from the family and others; crying and releasing it by doing favorite things and capitulate and get back the problem. This Research is expected to be a reference for parents in choosing coping strategies to manage the stress they feel in parenting during the pandemic. Keywords: Toxic parenting; stress trigger, coping strategy; COVID-19 References Abidin, R. R. (1990). Parenting Stress Index (PSI) manual. Psychological Assessment Resources, Inc. Anthony, L. G., Anthony, B. J., Glanville, D. N., Naiman, D. Q., Waanders, C., & Shaffer, S. (2005). The Relationships Between Parenting Stress, Parenting Behaviour and Preschoolers’ Social Competence and Behaviour Problems in the Classroom. Infant and Child Development, 14(2), 133–154. https://doi.org/10.1002/icd Arikunto, S. (2010). Prosedur Penelitian Suatu Pendekatan Praktik. Asdi Mahasatya. Badanes, L. S., Dmitrieva, J., & Watamura, S. E. (2012). Understanding cortisol reactivity across the day at child care: The potential buffering role of secure attachments to caregivers. Early Childhood Research Quarterly, 27(1), 156–165. https://doi.org/10.1016/j.ecresq.2011.05.005 Belsky, J. (2005). Social-contextual determinants of parenting. In Encyclopaedia on early childhood development. Berlin, L. ., Appleyard, K., & Dodge, K. . (2011). Intergenerational continuity in child maltreatment: mediating mechanisms and implications for prevention. Child Development, 82, 162–176. https://doi.org/10.1111/j.14678624.2010.01547.x Bethell, C. D., Newacheck, P., Hawes, E., & Halfon, N. (2014). Adverse childhood experiences: assessing the impact on health and school engagement and the mitigating role of resilience. Health Affairs, 33(12), 2106–2115. https://doi.org/10.1377/hlthaff.2014.0914 Branco, M. S. S., & Linhares, M. B. M. (2018). The toxic stress and its impact on development in the Shonkoff’s Ecobiodevelopmental Theorical approach. Estudos de Psicologia (Campinas), 35(1), 89–98. https://doi.org/10.1590/1982-02752018000100009 Braveman, A. P. (2009). Health disparities beginning in childhood: A life-course perspective. Pediatrics, 124. https://doi.org/10.1542 Caldwell, J. ., Shaver, P. ., Li, C., & Minzenberg, M. . (2011). Childhood maltreatment, adult attachment and depression as predictors of parental self-efficacy in at-risk mothers. Journal Aggress Maltreat Trauma, 20, 595–616. https://doi.org/10.1080/10926771.2011.595763 Cohan, S. ., Jang, K. ., & Stein, M. . (2006). Confirmatory factor analysis of a Short Form of the Coping Inventory for Stressful Situations. Journal of Clinical Psychology, 62. Corrigan, P., McCorkle, B., Schell, B., & Kidder, K. (2003). Religion and spirituality in the lives of people with serious mental illnes. Community Mental Health Journal, 39(6). Crnic, K. ., Gaze, C., & Hoffman, C. (2005). Cumulative parenting stress across the preschool period: relations to maternal parenting and child behavior at age 5. Infant and Child Development, 14, 117–132. https://doi.org/10.1002/icd.384 Daulay, N. (2018). Parenting Stress of Mothers in Children with Autism Spectrum Disorder: A Review of the Culture in Indonesia. KnE Social Sciences, 3(5), 453. https://doi.org/10.18502/kss.v3i5.2349 Davis, N. O., & Carter, A. S. (2008). Parenting stress in mothers and fathers of toddlers with autism spectrum disorders: Associations with child characteristics Disorders. Journal of Autism Developmental, 38, 1278–1291. Deater-deckard, K. (1998). Parenting Stress and Child Adjustment : Some Old Hypotheses and New Questions. Clinical Psychology Science and Practice, 5(3). Deckard, K. D.-, & Scarr, S. (1996). Parenting stress among the dual-earner mothers and fathers: are there gender differences? Journal of Family Psychology, 10, 45–59. https://doi.org/10.1037/0893-3200.10.1.45 Dunham, S., & Dermer, H. (2011). Poisonous Parenting : Toxic Relationships Between Parents And Their Adult. Routledge Taylor & Francis Group. Ekas, N., & Whitman, T. L. (2010). Autism symptom topography and maternal socioemotional functioning. American Journal on Intellectual and Developmental Disabilities, 115(3), 234–249. Felitti, V. J., Anda, R. F., Nordenberg, D., Williamson, D. F., Spitz, A. M., Edwards, V., Koss, M. P., & Marks, J. S. (1998). Household Dysfunction to Many of the Leading Causes of Death in Adults The Adverse Childhood Experiences ( ACE ) Study. 14(4), 245–258. Fitzgerald, M. ., Shipman, K. ., Jackson, J. ., McMahon, R. ., & Hanley, H. . (2005). Perceptions of parenting versus parent–child interactions among incest survivors. Child Abuse Negl, 29, 661–681. https://doi.org/10.1016/j.chiabu.2004.10.012 Gottman, J. M., & Silver, N. (1999). The seven principles for making marriage work. Three Rivers Press. Juster, R. P., McEwen, B. S., & Lupien, S. J. (2010). Allostatic load biomarkers of chronic stress and impact on health and cognition. Neuroscience and Biobehavioral Review, 35(1), 2–16. https://doi.org/10.1016 K., J., Margaret, M., & Disiye, A. (2020). Toxic Parenting Adversely Correlates To Students’ Academic Performance In Secondary Schools In Uasin Gishu County, Kenya. International Journal of Scientific and Research Publications (IJSRP),10(7), 249–253. https://doi.org/10.29322/ijsrp.10.07.2020.p10331 Koeske, G. F., & Koeske, R. D. (1990). The Buffering Effect Of Social Support On Parental Stress. American Journal of Orthopsychiatry, 60(3). Kuczynski, L., & Kochanska, G. (1990). Development of children’s non-compliance strategies from toddlerhood to age 5. Developmental Psychology, 26, 8–408. Lazarus, R. S. (1993). Coping theory and research: Past, present, and future. Psychosomatic Medicine, 55, 234–247. Mash, E. J., & Johnston, C. (1990). Determinants of parenting stress: Illustrations from families of hyperactive children and families of physically abused children. Journal of Clinical Child Psychology, 19, 313–328. Mikulincer, M., Shaver, P. R., Bar-on, N., & Ein-dor, T. (2010). The Pushes and Pulls of Close Relationships : Attachment Insecurities and Relational Ambivalence. PS Sozialpsychologie, 98(3), 450–468. Mortensen, J. A., & Barnet, M. A. (2020). The role of child care in supporting the emotion regulatory needs of maltreated infants and toddlers. The University of Arizona. National Academies of Sciences, Engineering, and M. (2016). Parenting Matters: Supporting Parents of Children Ages 0-8. The National Academies Press. https://doi.org/doi:10.17226/21868 National Scientific Council on the Developing Child. (2007). Key concepts: toxic stress. National Scientific Council on the Developing Child. Ostberg, M., & Hagekull, B. (2000). A structural modeling approach to the understanding of parenting stress. Journal of Clinical Child Psychology, 29, 615–625. Pediatrics, A. A. of. (2018). ACEs and toxic stress. American Academy of Pediatrics. Rodenburg, R., Meijer, A. M., Dekovic, M., & Aldenkamp, A. (2007). Parents of children with enduring epilepsy: Predictors of parenting stress and parenting. Epilepsy & Behavior, 11, 197–207. Shonkoff, J. P., Garner, A. S., Siegel, B. S., Dobbins, M. I., Earls, M. F., McGuinn, L., & Wood, D. L. (2012). The lifelong effects of early childhood adversity and toxic stress. Pediatrics, 129(1), 232–246. https://doi.org/10.1542 Shonkoff, J.P. (2012). Leveraging the biology of adversity to address the roots of disparities in health and development. Proceedings of the National Academy of Sciences of the United States of America, 109(SUPPL.2), 17302–17307. https://doi.org/10.1073/pnas.1121259109 Shonkoff, Jack P., & Bales, S. N. (2011). Science Does Not Speak for Itself: Translating Child Development Research for the Public and Its Policymakers. Child Development, 82(1), 17–32. https://doi.org/10.1111/j.1467-8624.2010.01538.x Shonkoff, Jack P., & Levitt, P. (2010). Neuroscience and the Future of Early Childhood Policy: Moving from Why to What and How. Neuron, 67(5), 689–691. https://doi.org/10.1016/j.neuron.2010.08.032 Shonkoff, Jack P. (2010). Building a New Biodevelopmental Framework to Guide the Future of Early Childhood Policy. 81(1), 357–367. Shonkoff, Jack P, & Fisher, P. A. (2013). Rethinking evidence-based practice and two-generation programs to create the future of early childhood policy. 25, 1635–1653. https://doi.org/10.1017/S0954579413000813 Shonkoff, Jack P, Richter, L., Gaag, J. Van Der, Bhutta, Z. A., Shonkoff, A. J. P., & Richter, L. (2012). An Integrated Scienti fi c Framework for Child Survival and Early Childhood Development. Pediatrics. https://doi.org/10.1542/peds.2011-0366 Siegel, B. S., Dobbins, M. I., Earls, M. F., Garner, A. S., Pascoe, J., Wood, D. L., High, P. C., Donoghue, E., Fussell, J. J., Gleason, M. M., Jaudes, P. K., Jones, V. F., Rubin, D. M., Schulte, E. E., Macias, M. M., Bridgemohan, C., Goldson, E., McGuinn, L. J., Weitzman, C., & Wegner, L. M. (2012). Early childhood adversity, toxic stress, and the role of the pediatrician: Translating developmental science into lifelong health. Pediatrics, 129(1). https://doi.org/10.1542/peds.2011-2662 Slopen, N., Mclaughlin, K. A., & Shonkoff, J. P. (2014). Interventions to Improve Cortisol Regulation in Children : A Systematic Review abstract. https://doi.org/10.1542/peds.2013-1632

Actinomycetes israelii is a gram positive bacteria,causing chronic spreading suppurative and granulomatous disease, 1 which forms sulphur granules discharging sinuses. A CASE REPORT : 55 year old female P/W swelling in lower abdomen since 6 months and associated pain, known Diabetic and Hypertensive . O/E - 8x4x2 cms elliptical,rm,mildly tender swelling with illdened margins,smooth surface,skin over the swelling normal , immobile ,becoming prominent on leg raising is palpated in the right iliac fossa , extending partly into the hypogastrium. The clinically palpable mass on TRUCUT biopsy showed collection of acute on chronic inammatory cells and basophilic lamentous bacterial colonies showing Splendore-Hoeppli phenomenon S/O Actinomycosis.Upon Rx with Inj Gentamicin 60mg/IV/TID x 10d and Tab Doxycycline 100mg/BD x 30d ,patient responded with resultant decrease in discharge from the sinus.

National and international epidemiological data show a general male disadvantage in health, and the dominant explanation for men’s poorer health status usually points to men’s belief and behaviours in relation to health and illness: men, it is suggested, disregard health and mismanage illness in order to fulfil social expectations around masculinity. The present research responds to a call for empirical studies that explore men’s health and illness practices not through biomedical or behavioural explanations, which tend to homogenize and oversimplify men’s experiences, rather with a critical approach that would allow to go beyond the idea that “masculinity is dangerous to men’s health.” Masculinity is here intended not as a fixed, universal, biological trait, but rather as a configuration of practices that are accomplished in social action and, therefore, can differ according to the specific gender relations existing in different social settings. This critical perspective allowed studying men’s experiences of health and illness by taking into account also its complex relation with gender construction, but also with structural differences and relational contexts. This research explored, through the conduction of 40 in-depth interviews, the experiences of men living with an intrusive chronic illness, autoimmune diabetes. This condition requires a series of self- management practices in everyday life that could be considered as emasculating (e.g. eating healthy, body discipline and self-monitoring) and that may pose specific challenges to dominant assumptions of masculinity such as bodily strength, control of the body and of emotions, independence and resistance to pain, and for this reason it has been considered as particularly appropriate for exploring the complex intertwining of chronic illness and gender. More specifically, the analysis focused on three areas: namely, the impact of chronic illness in the everyday life; the multiple ways of “doing” masculinity in the context of the “doing” of autoimmune diabetes; and, lastly, the impact of diabetes and of the medicalization of male sexual health on sexuality and intimacy practices. Overall, the empirical material allowed for great insight into men’s experiences of illness and depicted a complex picture, very different from the monolithic description offered by the majority of studies previously conducted on this issue.

A qualitative design was used to explore the use of spirituality and prayer by older adults who have chronic illness and reside in a rural community. Thirteen individuals responded to a flyer soliciting participation in a study of the use of spirituality as part of health care. Participants were at least 60 years of age, had at least one chronic illness and resided in North Central Florida. Twelve participants then responded to six open-ended questions based on an adaption of an instrument used by Dr. Shevon Harvey in her doctoral dissertation. The data was analyzed to identify themes and answer four research questions. The four research questions were 1) how do older adults living with chronic illness describe spirituality? 2) how do older adults use spirituality while living with chronic illness? 3) how can health care providers assist older individuals with chronic illness to meet their spiritual needs?, and 4) do patients feel that their spiritual needs are being addressed during their outpatient health care? The interview responses demonstrated that several different practices, including prayer and scripture readings as well as adherence to medication, diet, and exercise recommendations were used as coping mechanisms by study participants. The majority of participants want their health care providers to address spirituality and/or refer them to spiritual advisors for counseling. The study showed that some participants stated that their spiritual needs were met, but there were some who did not want spirituality addressed in the outpatient setting.; Four themes were identified, which suggest that 1) spiritual practices were frequently used coping measure for these individual with chronic illness, 2) health care providers are supportive of their patients' spirituality, 3) participants with chronic illness consider adherence to medication, diet, and exercise a coping measure, and 4) participants with chronic illness want their health care providers to recognize their spiritual needs. The findings indicated that individuals who self identify as individuals from whom spiritual life is important and who have chronic illnesses and have spiritual needs that can be addressed in the outpatient setting. The findings also demonstrated use of non spiritual coping measures and the importance of health care provider's acceptance of spirituality in this specific population. Recommendations for further research are made.
ID: 029808782; System requirements: World Wide Web browser and PDF reader.; Mode of access: World Wide Web.; Thesis (D.N.P.)--University of Central Florida, 2011.; Includes bibliographical references (p. 68-70).
D.N.P.
Doctorate
Nursing
Nursing Practice

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Fundação Oswaldo Cruz. Instituto Fernandes Figueira. Departamento de Ensino. Programa de Pós-Graduação em Saúde da Criança e da Mulher. Rio de Janeiro, RJ, Brasil
O tema desse trabalho é “A construção da resiliência pelos trabalhadores de enfermagem na atenção a crianças e adolescentes cronicamente adoecidos”. Nesse estudo discutimos resiliência do trabalhador, dialogando com a assistência hospitalar e promoção da saúde. Houve um aumento significativo no número de crianças e adolescentes com doenças crônicas ao longo das décadas que seguiram os anos 60. Esse aumento alterou o perfil epidemiológico e resultou em nova demanda de assistência à saúde causada por maior dependência humana, científica e tecnológica. Questionamos que atributos e competências promotoras de resiliência são desenvolvidos por trabalhadores de enfermagem ao cuidarem dessa clientela. O estudo é relevante por contribuir com a produção de conhecimento sobre o tema e por propor uma interface entre a atenção de média e alta complexidade, a saúde coletiva e os aspectos socioantropológicos. Pressupomos que a vivência da prática assistencial do trabalhador de enfermagem junto a crianças e adolescentes cronicamente adoecidos contribui para a construção da resiliência, onde atributos e competências serão exaustivamente colocados à prova no enfrentamento das dificuldades. O objetivo geral é: analisar o processo de construção de resiliência pelos trabalhadores de enfermagem na atenção hospitalar junto a crianças e adolescentes cronicamente adoecidos. Objetivos específicos: identificar atributos e competências favoráveis à construção da resiliência desses trabalhadores; compreender as estratégias utilizadas pelos trabalhadores de enfermagem no processo de construção de resiliência; verificar quais são as marcas produzidas no trabalhador na assistência a crianças e adolescentes cronicamente adoecidos. É uma pesquisa qualitativa, realizada em unidades pediátricas de um hospital situado no Rio de Janeiro, em cenário de cuidado a crianças e adolescentes em situação de adoecimento crônico. Os sujeitos foram 56 trabalhadores de enfermagem. A produção de dados ocorreu em 3 momentos: aplicação da escala de resiliência, devolução das escalas em grupo e entrevista semi-estruturada. A análise teórica dos dados foi organizada a partir da vertente do interacionismo simbólico em diálogo com as categorias de resiliência e adoecimento crônico, procurando descobrir os núcleos de sentido com significado relacionado ao objeto analítico. A dimensão relacional da análise destacou 3 núcleos temáticos: 1) a relação entre os adultos e crianças; 2) a perspectiva da violência que emerge nas relações; 3) a cronicidade como uma marca que media interações no cuidado. Concluímos que os trabalhadores de enfermagem carecem de uma rede de apoio que os auxiliem no enfrentamento do sofrimento e na ressignificação de sua prática assistencial. O trabalho com criança e adolescente com adoecimento crônico apresenta uma série de peculiaridades que exige do trabalhador mais do que habilidade técnica. Neste campo, a interação humana é intensificada pelas circunstâncias do crescimento,desenvolvimento,sofrimento e morte da clientela.
This is a Master’s Degree in Children and Women Health dissertation of IFF/FIOCRUZ, which theme is The construction of resilience by the nursing staff in the attention to chronically ill children and adolescents. We discuss professional resilience dialoguing with hospital care and health promotion. There has been a significant increase in the number of chronically ill children in the decades past the 60’s, altering the epidemiological profile and entailing new human, scientific and technological dependencies. We question what attributes and skills that promote resilience are developed by nursing professionals in their work with this kind of patient. This study is relevant for contributing with the production of knowledge on this theme e for proposing an interface between the medium and high complexity attention, public health and the inherent socio-anthropological aspects. We start from the presupposition that the continuous labor with chronic illnesses and death during infancy and adolescence contributes to the construction of resilience by the nursing professional., where skills are exhaustively put to test in the coping of hardships. The general goal of this research is to analyse the process of resilience construction by the nursing staff in a situation of hospital care to chronically ill children and adolescents. Specific objectives: identify attributes and skills that favor this construction by these workers, better comprehend the strategies used by nursing professionals in the process of resilience building and verify what are the marks produced in the staff by the assistance to chronically ill children and adolescents. This is a qualitative research that took place at pediatric units of a hospital in the city of Rio de Janeiro, in a scenario of attention to chronically ill children and adolescents. The subjects were 56 nursing workers. Data collection occurred in 3 distinct moments: application of a resilience scale, group discussion for score analysis and semi-structured interview. The theoretical analysis was organized following the precepts of the symbolic interactionism while dialoguing with categories of resilience and chronic illness, trying to uncover possible meanings related to the analytical object. The relational dimension of the analysis highlighted 3 thematic nuclei: 1) the relationship between adults and children; 2) the perspective of violence that emerges in relations; 3) the chronicity as a mark that mediates interactions in health care. We conclude that nursing workers lack a support network capable of assisting them in the coping of hardships and the reframing of their assistancial practice. The work with chronically ill children and adolescents presents peculiarities that demand more from the professional than pure technical skill. In this field, human interaction is intensified by circumstances related to the growth, development, suffering and death of these patients.

This thesis studies the effects of import competition from China and Eastern Europe on the health and fertility decisions of German individuals working in manufacturing. Individuals are matched with separate measures of exposure to competition from China and Eastern Europe, respectively. To isolate exogenous supply shocks from the origin, instrumental variables for competition from each of China and Eastern Europe are constructed. Results in Chapter 1 suggest that higher import competition worsens individual health via job displacement, wage decline, shortened employment duration, increased reliance on welfare and less future orientation, with Chinese import competition affecting individuals twice as much. Health declines as individuals increase their visits to the doctor, exercise less frequently and have a higher probability of developing chronic illness. Also, there is some evidence that individuals do not tend to become disabled but may be slowly pushed into chronic illness. Findings in Chapter 2 show that import competition negatively affects the individual’s probability of having children via reduced earnings, lower satisfaction with personal income and shortened employment duration. The chapter then investigates effects of import exposure by gender. Results show that male and female fertility choices differ upon rising import competition. Higher import exposure lowers female earnings and job autonomy, which in turn generates a lower opportunity cost of work, to the point where having children would become a more rewarding alternative for female workers. By contrast, increased import exposure negatively affects male workers’ fertility through reduced earnings and employment duration.