Care Of Oneself Research Articles

Out-of-Pocket Costs Attributable to Dementia: A Longitudinal Analysis

Alzheimer’s disease and related dementias (ADRD) affects 5.5 million Americans, and is expensive despite the lack of a cure or even treatments effective in managing the disease. The literature thus far has tended to focus on the costs to Medicare, despite the fact that one of the main characteristics of ADRD (the loss of independence and ability to care for oneself) incurs costs not covered by Medicare. In this paper, we use survey data for 2002-2014 from the Health and Retirement Study to estimate the out-of-pocket costs of ADRD for the patient and their family through the first 8 years after onset of symptoms, as defined by a standardized 27-point scale of cognitive ability. A two-part model developed by Basu and Manning (2010) allows us to separate the costs attributable to ADRD into two components, one driven by differences in longevity and one driven by differences in utilization. We consider total out-of-pocket expenditures, as well as out-of-pocket expenditures by category (i.e. hospital, nursing home, doctor, prescription drug, and other). Our results suggest that the out-of-pocket costs of ADRD are quite substantial over the first 8 years after onset. We also find that out-of-pocket spending is decreasing over the first 8 years, similar to the trend seen in Medicare expenditures. The results of this study highlight the financial burden of ADRD, particularly for the population paying out-of-pocket for care.

Efectos del Aislamiento, Social, Preventivo y Obligatorio (ASPO) por Covid19 en la infancia

Los efectos provocados por el COVID en la vida cotidiana requieren particular atención en la infancia por la dependencia de los adultos para acceder a recursos y experiencias que favorezcan el bienestar y la menor autonomía y posibilidades que poseen para proveerse de un entorno apropiado a sus necesidades y potencialidades.
 Para ello, el proyecto aborda los efectos del aislamiento social, preventivo y obligatorio (ASPO) en la alimentación, en el desarrollo psicosocial y socioemocional, en los aprendizajes escolares, en las actividades recreativas, en la socialización con pares, en los afectos y en los vínculos parentales. El interés se centra en cómo se llevan a cabo y perciben los cuidados (cuidarse, ser cuidado y cuidar en el marco de la pandemia) tanto por parte de los adultos como desde la propia experiencia y perspectiva de niños, niñas y adolescentes, teniendo especial preocupación en quienes viven en contextos de vulnerabilidad. 
 En síntesis, el objetivo general es conocer y dimensionar la incidencia del ASPO en las actividades y relaciones cotidianas y dar conocer -y dimensionar- los efectos del aislamiento en niños, niñas y adolescentes, su incidencia en las actividades y relaciones cotidianas y dar cuenta de las estrategias implementadas por los hogares para atenderlos y la presencia de programas sociales y redes comunitarias en el cuidado infantil.
 Los resultados del estudio permiten recuperar de manera integral, los efectos del ASPO en la población de niños niñas y adolescentes, identificando la desigualdad que ellos expresan en distintas dimensiones de la vida cotidiana, cómo se tramitan los cuidados y se manifiestan modalidades de afrontamiento.

Traditional values and domestic violence: an examination of older women’s attitudes and the ability to care for oneself

ABSTRACT Domestic violence (DV) is a worldwide societal problem affecting victims of all ages. While a sizable body of DV literature primarily surrounding young adults exists, research on DV among older individuals has received less attention. Yet, older non-victims and DV victims alike face unique challenges not experienced by younger age groups, such as socialization favoring traditional values, and loved ones who become unable to care for themselves. Less is known, however, about factors that influence older women’s attitudes toward traditional values. Using a sample of women age 50 and older, including both victims and non-victims, the current study addressed this gap in research by examining whether age or the women’s loved one’s ability to care for themselves have an effect on attitudes toward traditional values. A discussion of the findings is provided, as well as policy implications and suggestions for future research.

Activities of Daily Living and Associated Costs in the Most Widespread Neurodegenerative Diseases: A Systematic Review.

Nowadays, the population is rapidly ageing because of increasing life expectancy and decreasing birth rates. Thus, the purpose of this systematic review is to prepare a comprehensive overview which identifies the activities of daily living (ADLs) that are gradually reduced among patients with dementia, as well as explore the therapies applied in relation to dementia and how they effectively improve the quality of life (QoL) of patients and caregivers. Furthermore, we aim to summarise the ADL activities influenced by therapies and examine the treatment costs and care for patients so that recommendations for research and development (R&D) can be made to improve both the QoL of people with dementia and cost-saving measures. The research focuses on four selected neurodegenerative diseases: Alzheimer, Parkinson, vascular dementia, and amyotrophic lateral sclerosis. Therefore, the peer-reviewed English written articles from 2014 to 2019 were searched between September 1 and December 13, 2019. Twenty-seven papers were included in the analysis. The results show that essential assistance occurs in connection with activities: eating, drinking, dressing, bathing, personal hygiene, use of the toilet, and transport. By contrast, shopping or cleaning is not addressed as much. A lower ability to take care of oneself is connected with poor patient health and higher social care costs because the patient requires care from external sources, such as home aid or nurse visits. The challenge that remains is to shift new knowledge from scientific disciplines and connect it with the needs of patients to remove legitimate barriers and increase the acceptance of new solutions by popularisation. Additionally, regarding the burden on caregivers, it would be appropriate to promote this area of education and employment so that family members can use formal caregivers, ensuring them free time and much-needed rest.

Knowledge of Personal Hygiene among Undergraduates

Background: Personal hygiene is the act of taking care of oneself, it is also referring to as an act of maintaining the cleanliness of one's body and clothing to improve overall health and well-being. The purpose of the study was to examine if undergraduates know about personal hygiene, investigate if undergraduates of University of Ilorin differ in personal hygiene knowledge based on age, and assess if there is a difference in knowledge of personal hygiene among undergraduates of University of Ilorin based on gender.
 Methods: A descriptive research design of using surveys was employed for this study. Multi-stage sampling techniques of simple random, proportionate, and convenient sampling techniques were used to select 398 respondents for the study. The researcher developed a questionnaire validated by three experts from the Department of Health Promotion and Environmental Health Education, University of Ilorin was used for the study. ANOVA and Independent t-test was used to test the hypotheses. All hypotheses were tested at 0.05 level of significance.
 Results: The findings from this study revealed that undergraduates of University of Ilorin know about personal hygiene. The mean values of Yes (330/ 82.9%) is greater than the mean value of No (68/17.8%). There is a significant difference in knowledge of personal hygiene among undergraduates of University of Ilorin based on age (p= 0.023). There is a significant difference in knowledge of personal hygiene among undergraduates of University of Ilorin based on gender (p= 0.018).
 Conclusion: The study concluded that undergraduates of University of Ilorin know about personal hygiene.

Improvement in Psychodynamic Psychotherapy for Depression: A Qualitative Study of the Patients' Perspective.

The patient’s perspective on improvement in psychotherapy is crucial for tailoring the therapy he or she is receiving. The present study aimed at exploring the factors aiding and the patients’ experiences of improvement in time-limited psychodynamic psychotherapy for depression. Semi-structured, in-depth interviews were conducted with ten adult patients who received up to 28 sessions of manualized psychodynamic psychotherapy in the Norwegian study “Mechanisms of change in psychotherapy” (the MOP study). The post-therapy interviews addressed the participants’ experiences from therapy. The data were analyzed with thematic content analysis and hermeneutic interpretation. The analysis identified four helpful dimensions: “Therapist activities” comprised supporting and acknowledging, advising and offering tips for everyday life, questioning and pressuring. “Patient activities” included opening up, caring for oneself and showing agency. “Facilitators” for improvement were learning from therapy, learning to receive therapy and agreed goals. “Achievements” comprised new perspectives and understandings, increased self-awareness and mastery and changed thinking and feeling. Improvements from psychodynamic therapy seemed reliant on the degree to which the therapy could activate and be relevant to the patients’ everyday life. Tailoring therapy for patients with depression should link the focus on symptoms and ways of thinking and feeling with their life circumstances.

Становление термина «забота» в контексте педагогической науки

The research objective includes identifying specificity of formation and evolution of the term “care” in the context of pedagogical science. The first stage of the research is devoted to analysing interpretation of care in ancient human-centred philosophy. In the final part of the article, the author analyses interpretation of this term in modern studies where the notion “care” acquires a complicated, well-structured philosophical and pedagogical content. Special attention is paid to defining the term “care for oneself” as a key notion within this subject area. Scientific originality of the study involves a comprehensive analysis of formation and evolution of the term “care” in the context of pedagogical science, from antiquity to modernity. The research findings are as follows: it is proved that the term “care”, from the moment of its origin, has been undergoing permanent transformations acquiring a deeper, multidimensional meaning; this process has a significant impact on development of modern pedagogical thought.

Evaluation of a 12-week allopurinol-lowering therapy in combination with the non-steroidal anti-inflammatory drug meloxicam in patients with gout

To evaluate a 12-week course of combined alloturinol-lowering therapy with a prophylactic anti-inflammatory dose of movalis for the frequency of exacerbations and the quality of life of patients with gout. Allopurinol was administered orally, 1 time per day. Every 3 weeks, the dosage of the drug was increased by 50 mg to 300 mg per day under the control of the level of serum uric acid (sUA). The total daily dose of the drug movalis, used in the form of different dosage forms, was 7.515 mg. The clinical effectiveness of the treatment was evaluated after 3, 6, 9 and 12 weeks according to physical examination, the dynamics of joint pain at rest, during movement and palpation, according to the visual analogue scale (VAS) in millimeters, Likert scale, EuroQol-5D-5L questionnaire, care for oneself, habitual daily activities, the presence of anxiety and depression, assessment of satisfaction with treatment (on a scale of 1 to 5, where 1 is the complete absence of improvement or worsening, and 5 is a very good result); took into account the period of remission, as well as the time before the onset of relapse of gouty arthritis. An adverse event (AE) was recorded. On the background of treatment with movalis 7.5 mg per day more than two-thirds of patients showed no worsening of the articular syndrome with an increase in the dose of allopurinol to 300 mg per day. By the 12th week of observation, a significant difference was found between the severity of gouty arthritis characteristics in the direction of improving mobility, self-care, normal daily activities, reducing soreness, reducing anxiety and depression (p0.05). In addition, the ESR and sUA levels were significantly different initially and at the final observation point (p0.05), which indicates a positive effect on the inflammatory process. A 3-month course of combination therapy was not accompanied by significant increases in blood pressure, changes in creatinine clearance in blood serum. There were no adverse events from the gastrointestinal tract. 90.9% of patients rated the treatment result as very good. AE in the form of a skin allergic rash was observed in one patient; it did not require interruption of treatment and completely stopped without consequences after completion of the course. 12 a week-long combined therapy of the allopurinol-reducing drug with the anti-inflammatory dose movalis prevents the exacerbation of the articular syndrome and improves the quality of life of patients with gout.

«Человек как мера» и «забота о себе» в интерпретациях М. Хайдеггера и В. Бибихина

«Человек как мера» и «забота о себе» в интерпретациях М. Хайдеггера и В. Бибихина

EGOISM AS A WAY OUT OF EXISTENTIAL CRISIS FOR A PERSON IN DISABILITY SITUATION

Purpose of the article is to establish the role of egoism in the life of a person faced with a disability situation, as a moment of self-determination in an existential crisis. I set the task to evaluate the influence of egoism and find out its significance in the prospect of the person’s further existence in the conditions of disability using the philosophical anthropology based on the meta-anthropology principle. Theoretical basis. Based on the fact that the role of egoism is perceived by public opinion as a vice and entails the absorption by a person of the benefits intended for others, I find them inappropriate for a person in a situation of disability. Taking into account the concepts of ego of altruism and altruistic egoism, which partially justify the positive influence of egoism, are only a product of the symbiotic interaction of altruism and egoism. The combination of egoism with altruism cannot reveal the essence of the crisis for a person in a disability situation. In a situation of disability, a person cannot synthesize altruism, as part of the egoism symbiosis. Methodological system in the study of the positive role of egoism, the modern theory of meta-anthropology by Nazip Khamitov is used. The theory that divides the being of a person into various types (ordinary, ultimate, and being beyond the bounds) is able to most fully structure the concept of egoism in the being of a person who has disability. Originality. I made an attempt to prove the positive role of egoism in a situation related to the body transformation into new conditions. The analysis of evidence of the need for the egoism development, as a function capable of actualizing a person in the formed crisis circumstances is carried out. A theory about the need for egoism to get a person out of the existential crisis situation (ultimate being) in which he stays due to a disability situation was proposed. Conclusions. I show that taking care of oneself (egoism) is a balancing factor for a person, as opposing a fatally unfair situation in which a person has received disability. Rational egoism is able to bring a person out of ultimate being and allow him to transform into a new, changed reality.

Transformation of Semantic Dimentions of the Concept of Attention in the Contemporary Information Society

In this article, authors focus on the concept of attention, which is presented in the discourse of history of philosophy, undergoes transformation in the contemporary society under the influence of information technologies. Authors argue that from the Antiquity until the 20th century the philosophical interpretation of attention was presented as care for oneself.

Contracts and Care of Oneself in the Book of Ruth

Abstract This essay utilizes Foucault’s concept of the “technology of the self” to argue the ethical content of Ruth’s actions. In this way, my essay challenges reading the book of Ruth in a way that supports the Western and Christian technology of self and moral principle of self-sacrifice. Paying careful attention to the three episodes of contract-making in the book of Ruth (1:16-17, 3:9-13, 4:1-12), it is evident that Ruth’s actions demonstrate profound resourcefulness and care of oneself rather than self-sacrifice. This hermeneutical lens of “care of oneself” is constituted in the three elements of immanence, vigilant introspection and distance. The character of Ruth possesses the virtue of חֶ֔סֶד, repeatedly and secretly transgresses norms and expectations and creates an ethic that benefits and transforms her self and others.

„… sondern auch das der anderen“ – Beobachtungen zur Deutung und argumentationsstrategischen Funktion der paulinischen Mahnungen in Phil 2,4.12. Zugleich ein Beitrag zur Funktionsbestimmung des Philipperhymnus im Brieftext

AbstractThe text-critical discussion about the originality of καί in Phil 2,4 (ἀλλὰ [καὶ] τὰ ἑτέρων) and the discussion around the understanding of the syntagma ἡ ἑαυτῶν σωτηρία in 2,12 have reached a dead end. In order to bring both discussions forward, the present contribution will link the two issues together more closely. This is in response to the observation that both questions reveal a common vanishing point. This vanishing point consists in the fact that the respective answers have a significant influence on the assessment of an overarching, ethical-parenetic question: To what extent did Paul, in his instructions for action surrounding the Christ Hymn in 1,27–2,18, which are essentially oriented towards the well-being of others, not only presuppose aspects of caring for oneself, but also specifically allude to such aspects in the text of the Epistle itself, thus granting them their own, albeit small, space? If such traces can be found, the argumentation-strategic function of this balancing is to be ascertained for the Pauline way of thinking in 1,27–2,18.

Unpaid Public Work is Not Cost Free: Military Spouses Performing Emotional Labor

Historically, unpaid work was expected of women in many walks of life, privately, in the domestic sphere, and in the public sphere supporting their husband’s career. As women have gained rights of individual recognition and pursued their own careers, the formal expectations of military spouses have diminished. This study explored the meaning and impact of unpaid public work on the health and wellbeing of spouses of senior military Service people. Data are presented from: 12 interviews with spouses from six countries; a group discussion interviewed women; and a workshop with spouses who had not previously participated in the research. A modified grounded approach found that the unpaid public work undertaken involves emotional labor in both private/domestic and public spheres. The impact of unpaid public work is characterized by paradoxes: facilitating care for others while delaying care for oneself; loneliness alongside loss of privacy and control; and valuing the unpaid public work while the general public and military institution may not. This research illuminates the need for support for those continuing to engage in unpaid public work in the future as well as the work that may need to be undertaken by other agencies where spouses no longer provide unpaid work.

Achieving healthy ageing through the perspective of sense of coherence among senior-only households: a qualitative study

Objectives: Explore perceptions towards healthy ageing through the perspective of sense of coherence among older adults residing in senior-only households.Methods: A qualitative study using focus group interviews was conducted and appreciative inquiry was adopted as a strengths-based interviewing approach. 27 older adults who either live alone or with their spouses only were involved in six focus group discussions at a community centre in Singapore. Data saturation was achieved and thematic analysis was performed to analyse the data.Results: The four emerging themes were (1) contending evolving vulnerabilities, (2) intrinsic value of health, (3) taking care of oneself is a personal responsibility, and (4) taking one day at a time: outlook towards later part of life. Older adults’ underlying pathogenic orientation towards health contributed to their perceived unpredictable confrontations with vicissitudes including illness and death. This played a part to their short outlook towards old age. Consequently, this could limit their will and abilities to seek meaningful pursuits or valued aspirations and movement towards the salutogenic health pole.Conclusion: By reframing the definition of health to pursuing and fulfilling valued accomplishments, optimal health can be achieved regardless of physical health state. This study suggested that sense of coherence towards the pursuit of healthy ageing can be addressed by reducing the unpredictability of ageing-related processes and vulnerabilities (comprehensibility), supporting active adoption of actions which promotes physical, mental and social health (manageability) and individual reflection in making sense of old age to seek motivation in living each day purposefully (meaningfulness).

Turnover is Coming: Strategies to Prepare for Impending Retirements

Libraries have long been concerned about aging library professionals. Libraries that have not experienced high rates of retirement and turnover may not be prepared to bring on new personnel using a supportive approach. Onboarding librarians and library staff can increase employee retention. This includes strategies for librarians who are coping with managing high turnover, including learning about the organization’s recruitment procedures, creating an onboarding plan that includes training and documentation, and taking care of oneself.

Positioning of Childlessness: Reflections of Reproductive Age and Older Women

This paper focuses on childless women reflections of their current status. During the qualitative research (2017–2018), 44 interviews have been completed with 28–71 year old women without children. Based on the positioning theory (Harré et al. 2009; Allen, Wiles 2013), the paper reveals how childlessness is being positioned on different levels: personal, interpersonal and cultural. The individualistic values – freedom from the burden, taking care of oneself, recognizing responsibility to raise children – were revealed on the personal level. On the interpersonal level, women of reproductive age expressed positions that were agreed upon with their partners or stated how difficult it is to reach the agreement. Meanwhile, the narratives of women from older generations reveal inert life scenarios. The cultural norms to have children in marriage had a strong influence on both women groups, who were in their reproductive age and who have finished their reproductive career.

Truth worth dying for: parrhesia in Lauren Oliver's novel “Before I Fall”

The post-truth ideology seems to question the possibility of credibility in present-day society; however, the very idea of truth remains potent. In this paper, we adopt the notion of parrhesia, or the mode of telling the uncomfortable truth without deceit and concealment, to analyze how the discourse of truth is presented in contemporary fiction. Avoiding its political aspects, we limit our study to the interpersonal level of parrhesia that shapes individuals as moral subjects and belongs to the domain of ethos. We select Lauren Oliver's novel “Before I Fall” for analysis because it resembles a confession that involves the characters and readers in the practice of truth-telling. Drawing from Foucauldian theory, we examine how the protagonist participates in the parrhesiastic game and how the truth transforms her after she completes the stages of search for the truth, test of the character, and care for oneself and others. We argue that in the novel truth-telling is related to the problems of school bullying, social separateness, and suicide. Through the rhetorical approach to narrative we show how narration reflects psychological and moral changes of the protagonist and examine how narrative judgments reveal the ethical values of the author and the readers. We analyse how the novel describes the problem of violence demonstrating that its source lies within the family and school where abusive adolescent conduct is caused by the inability of adults to create a healthy climate for children. Individuals deprived of emotional support and guidance tend to direct their rage and frustration towards others to reduce inner strain. Lauren Oliver demonstrates the effectiveness of the parrhesiastic practice in renewing social bonds between interlocutors and reducing violent behavior. We conclude that the novel establishes truth as the highest ethical value that includes developing a true self, leading a true life according to the principles and having courage to oppose false opinions of others.

«Технологии себя» в условиях самоизоляции

Introduction. In the context of the COVID-19 pandemic, which spread around the world in early 2020, special attention is paid to external transformations in human life: forced staying at home, using personal protective equipment in public places, social distance, etc. Nevetheless, the inner world of a man is susceptible to serious transformations. Another necessary element that structures the world of self (J. Deleuze’s point of view) is turning into a potential carrier of the virus. Therefore, the problem of human reflection with the goal of taking care of oneself in a crisis situation is of particular relevance. The aim of the study is to substantiate the effectiveness of spiritual practices of the period of Antiquity and the early Middle Ages as forms of caring of the internal in a person in the pandemic. Methods. The author uses general scientific methods: analysis and synthesis, induction, deduction, abstraction. In addition, a comparative historical method, an interpretation method and a systematic approach are applied. With the help of the dialectical approach, the connection between the external and the internal in a person was designated. Scientific novelty of the study. Three scenarios of human responses to self-isolation in the context of an event (external) – meaning (internal) are outlined: orientation to an external event; creating an external event; appeal to the self. Results. In the context of self-isolation, staying alone with himself, a person faced a problem, a crisis of identity (empirical evidence for this problem was provided by psychologists and psychotherapists in Chelyabinsk and the Chelyabinsk region). This problem is due to the fact that the pandemic has reduced many of the person’s connections with the outside world (work, study, relationships with friends and relatives) and / or transferred them to a remote format. Therefore, consciously or optionally, at the level of an unreasonable request, a person has a need to rethink his self. Rethinking is a reflexive procedure when a person re-learns to communicate with his self. M. Foucault analyzed and systematized examples of spiritual work with I, looking into the practices of care of the self in ancient thinkers’ and early Christians’ studies. Conclusion. The COVID-19 virus has made significant adjustments to human life. No less adjustments were made to the events (F. Girenok) that fill the life of a person. A man’s replies to changes in his being can be laid between two poles: event and meaning. Even while at home, many continue to focus on the external, creating something of their own (for example, audiovisual production) or consuming the results of others. At the same time, orientation to meaning involves focusing on oneself. Philosophers and theologians who practiced self-care about two millennia ago, proposed different forms of reflection, pursuing one goal, to learn to talk with oneself.

Linguistic personality of Ivan Franko in the matrimonial directive discourse

The purpose of this article is to reveal specific features of the realization of the linguistic personality of I. Franko in the matrimonial directive discourse. The source base for the analysis was I. Franko’s letters to O. Khoruzhynskaya. The analysis of I. Franko's linguistic personality done within a cognitive-discursive paradigm, using discourse-analysis, intent-analysis, contextual analysis, methods of analysis and synthesis, descriptive method. Іt was established that the intension of directive in the speech of I. Franko was aimed at the expression of advice, requests and questions. The writer seeks a positive settlement at regulating his wife’s health problems, her life and scientific work, financial issues. It also prompts the wife to take care of oneself and children, to perform / not to perform certain actions towards him / other persons, to write a work or to engage in literary activities of family’s acquaintances. I. Franko asks wife to determine his further actions in certain everyday situations. The question is a means of getting new information about the wife's daily affairs, the children’s health state, domestic problems, weather conditions, common friends or the reasons for the absence of letters from his wife. I. Franko uses a question for reconciling family planning. Linguistic means: declarative, imperative and interrogative / interrogative-imperative sentences, verbs of the imperative / conditional mood, imperative verbs together with the infinitive / negative particle not, the verb ask in the 1st person singular, personal pronouns, adverbs, restrictive / emphatic particles and exclamation, etc. Complex sentences provide expressions of incentives and their argumentation. The speech is characterized by obsolete / colloquial words, dialecticisms, polonizms, russisms and chekhisms. The writer uses phraseologisms, metaphors, similes, words in figurative meaning. Terms of endearment and means of expressing courtesy show favor to the addressee. Consequently, the directive discourse ensures the realization of Ivan Franko’s linguistic personality in family communication on the motivational, linguistic-cognitive and lexico-grammatical levels.