Illness Situation Research Articles

Socio-economic and Gender Disparities in Psychological Distress and Marital Adjustment Among Spouses of Hepatitis C Patients: A Quantitative Assessment

The present study examines differences in psychological distress and marital adjustment between spouses of Hepatitis C patients based on socioeconomic and gender status, specifically addressing dissimilarities in emotional and couple functioning due to economic and gender disparities. Hepatitis C is a chronic and progressive disease, and there is a substantial caregiver burden required, which should increase stress and negatively impact marital quality. With the data collected from 200 spouses of Ayub Medical Complex and Combined Military Hospital Abbottabad Pakistan, this research investigates the moderating effects of economic resources and gender roles on psychological distress and other factors pertinent to marital satisfaction, such as affection expressing marital adjustment and dyadic cohesion. Results identified by the study show that compared to spouses with higher SES, participants with lower SES have significantly elevated levels of psychological distress and reduced marital adjustment, indicating the role of economic stress in caregiver stress. The female spouses continue to display higher levels of distress and lower marital satisfaction and cohesiveness than male spouses, replicating the usual female gender role expectations of the traditional caregiver. Also, gender and economic level cross-tabulations show differences in coping and support seeking and, hence, mental health and relationship quality. These results indicate the further imperative of targeting specific psychological and social support for economically disadvantaged and female carers to alleviate their specific known burdens, providing a foundation for developing policies dealing with marital stress in chronic illness situations, among other proposals.

Psicologia institucional na assistência social

The field of social assistance is a promising area for psychologists to work in. The tools and theoretical foundations of this field are under constant self-assessment in order to improve ethical practice in the community. The aim of this study is to reflect on the experience of a one-year extracurricular internship in Basic Social Protection, assessing the practice of psychologists and the challenges of going beyond the role of social technician. The research uses José Bleger’s institutional psychology, normative documents from the Ministry of Social Development and CREPOP’s technical references to carry out a conceptual analysis. This analysis aims to introduce, reflect on and support the training of psychology students to work in the area of social assistance, explaining the possibility of including institutional psychology in this field. The study works with Bleger’s concept of “psycho-hygiene”, applied to the work of social workers and institutional psychologists. It concludes that the work of these professionals can contribute to preventing situations of illness within institutions. Bleger’s work remains relevant and coherent in the ethical training of psychology professionals.

Surveillance of non-communicable diseases: What matters to users? A qualitative interview study.

Surveillance systems for diseases serve as an early warning system and orientation for decision-makers. As part of the National Diabetes Surveillance at the Robert Koch Institute (RKI), existing formats of information transfer were evaluated and an analysis of users' requirements regarding the dissemination of results of surveillance for non-communicable diseases (NCD) was carried out. 13 semi-structured guided interviews were conducted with persons from health politics, healthcare, media and science and analysed in a qualitative content analysis (interview survey period: 10/2022 - 01/2023). For all respondents, the frequency of diseases and their determinants, care and consequences were the focus of NCD surveillance. Wider determinants of health and illness situation were also considered relevant. Requirements regarding the presentation of these contents differed between the user groups. Factors that facilitate and inhibit the use of NCD surveillance information were consistent across the user groups. There is a need for the presentation of options for action, especially for users involved in health politics and healthcare. Diabetes surveillance showed that many requirements are already met by the existing formats. Many of the users also wanted the content to be expanded to include other NCD.

Cross-cultural adaptation and primary approbation of the Russian version of Posttraumatic Growth and Depreciation Inventory — Expanded version

Numerous studies suggest that caring for someone with a chronic disease is often associated with the various negative consequences for the patient’s informal caregivers. At the same time, positive changes caused by the stress influence of patient’s disease can be also noted. For example, the so-called posttraumatic growth. Currently, there is a lack of assessment tools in domestic psychology, that allow to investigate the relation between constructive (developmental) and destructive aspects of the relative’s mental response in a situation of chronic illness of a loved one.The aim of this work was to carry out cross-cultural adaptation and primary approbation of the Posttraumatic Growth and Depreciation Inventory — Expanded version (PTGDI-X). Primary approbation was performed on a focus group of relatives of patients with cerebral pathology (n = 61, mean age 51,2 [SD = 15,3] years). Convergent and discriminant validity of the PTGDI-X assessed using World Assumption Scale (WAS), Symptom Checklist-90-Revised (SCL-90-R), Level of Relatives’ Emotional Burnout Questionnaire (LREB). In addition, a specially adapted for the research Burden questionnaire was used.The analysis revealed good psychometric characteristics of the PTGDI-X Russian version in terms of: internal subscales consistency (Cronbach’s α coefficients varied from 0,73 to 0,86), internal and external construct validity

End-of-life decision-making

The article begins with areflection on the intertwined nature of life and death; this reflection should also serve to sensitize us to the proactive and reactive expressions of aperson's life at the end of life. It will be shown that attachment to life can also manifest itself in the case of depression, fear and exhaustion: One must not lose sight of their potential existence. The existing commitment to life allows us to better understand why the remaining time of life may be perceived as something precious; this may be in contrast to statements made in the living will. Adistinction is made between subjectively, objectively and socially defined criteria for agood life in the borderline situation of aserious illness leading to death; their comparison is central to the end-of-life decision-making process. In addition to physical and neurocognitive illnesses, suicidality is at the centre of the article.

An Increase in the Chemokine Mediators (CCL28 and CCR10) Associated with the Progression of Oral Squamous Cell Carcinoma: A Cross-Sectional Investigation.

Oral cancer ranks as the 16th most prevalent form of cancer worldwide and is a significant concern in Southeast Asia, primarily due to the extensive use of tobacco. Chemokines contribute to a wide range of illness situations. This study aimed to investigate the immunohistochemistry expression of CCL28 and its receptor CCR10 in oral squamous cell carcinoma and examine their relationship with tumor progression. This study retrospectively examined tissues of oral squamous cell carcinoma that were preserved by formalin fixation and paraffin embedding. The study includes two groups: Group I included 50 cases of OSCC with varying histological grades, whereas Group II comprised 50 samples of normal oral mucosa (NOM) obtained from healthy individuals who did not engage in any tobacco use. The cytoplasmic placement of the study groups allowed us to determine the expression patterns of CCL28 and CCR10. The study found a strong link between CCL28 and CCR10 immunohistochemical expression in oral squamous cell carcinoma. There were big differences in the amount of CCR10 staining in the 96 cases that showed positive immunoexpression. This shows that these two molecules have a big impact on how OSCC acts biologically. Various stages of oral squamous cell carcinoma and healthy oral mucosa exhibited simultaneous expression of CCL28 and CCR10. In summary, we can utilize CCR10 and CCL28 co-expression, along with other biomarkers, to aid in the prognosis of oral squamous cell carcinoma (OSCC).

CUIDADOS PALIATIVOS NA UNIDADE DE TERAPIA INTENSIVA: VISANDO A EQUIPE MULTIDISCIPLINAR

Palliative care is essential in the intensive care unit (ICU) to promote patient well-being in situations of serious and terminal illness. The multidisciplinary team plays a fundamental role in the implementation of palliative care in the ICU, as each professional has specific skills that contribute to comprehensive patient care. General objective: Explore palliative care in the intensive care unit and its importance for the multidisciplinary team. This study was a literature review in the Scielo and Google Scholar databases with a time frame from 2020 to 2024, using the following keywords: palliative care, nurse, dental surgeon; intensive care unit and multidisciplinary team. This study was a literature review in the Scielo and Google Scholar databases with a time frame from 2020 to 2024, using the following keywords: palliative care, nurse, dental surgeon; intensive care unit and multidisciplinary team. The inclusion criteria used in this literature review were: complete scientific articles published between 2020 and 2024 and available in databases (Google Scholar and Scielo). Duplicate articles published outside the chosen period and which did not address the topic were excluded. Results and discussions: The nurse and the dental surgeon play important roles as members of the multidisciplinary team in the ICU. The nurse is responsible for coordinating care and ensuring the patient's well-being, while the dental surgeon contributes to the prevention and treatment of oral problems that can affect the patient's quality of life. It is concluded that palliative care in the ICU is effective in improving patients' quality of life, but they still face challenges such as lack of knowledge and difficulties in communication.

Self-Medication: A Response to Illness among Undergraduate Students of Federal University of Lafia, Nasarawa State, Nigeria

This study examined self-medication as a response to illness situations and its implications for healthy living among undergraduate students of the Federal University of Lafia (FULafia), Nasarawa State, Nigeria. The study adopted the Theory of Reasoned Action. A cross sectional research design was used in the study and was carried out at the Federal University of Lafia among undergraduate students of the University. A purposive sampling technique was implemented for the selection of respondents. A sample size of 400 was obtained using Rao (1985) determination formula. Data was collected through questionnaires and in-depth interviews. The analysis was accomplished using descriptive and inferential statistics. The findings of the study indicated a high rate of self-medication among undergraduates of the Federal University of Lafia. Both traditional and orthodox medicines were self-medicated among the undergraduates of FULafia. Self-medication was influenced by availability, accessibility, and affordability of drugs by the undergraduates. It was concluded that, self-medication helps as a response to illness, but it has both negative and positive implications on the healthy living of the students of the Federal University of Lafia, therefore, the school management should situate health facilities on the campus so as to enhance students’ free and easy access to healthcare whenever the need arises.

What Self-Management Skills Do Turkish Caregivers Have in Caring for People with Dementia? Results of a Qualitative Survey.

Family caregivers can be overwhelmed by the care they provide within the family without external support. The development of self-management skills and the associated ability to actively and responsibly manage one's own health or illness situation therefore plays a vital role in the home care of people living with dementia. As part of an individualized intervention for family caregivers of people of Turkish origin with dementia, existing self-management skills were examined through qualitative interviews to gain insight into health literacy and empowerment in caregiving and in interviewees' own practices to maintain their health. Ten caregivers of Turkish origin who were responsible for family members living with dementia were interviewed using problem-centered interviews. We found that the target group has very heterogeneous self-management competencies, which are based, on the one hand, on existing supportive resources and, on the other hand, on diverse care-specific, psychosocial and life-world challenges in intrafamily care that have not been overcome. Self-management skills in family caregivers are influenced by a complex interplay of both available resources that support these skills and challenging caregiving situations. This dynamic combination of resources and challenges results in varying levels of self-management ability among family caregivers. Strengthening resources can help caregivers to meet the challenges resulting from caregiving and to expand their self-management competencies. There is great need for action in promoting self-management skills among Turkish caregivers of people living with dementia in home care. Interventions to promote self-management skills must take into account the individual resources of those affected as well as their social and cultural diversity.

KHULU' AND THE CONTROVERSY IN ISLAMIC LEGAL THOUGHT: THE DIVERGING PERSPECTIVES OF IMAM BAKR AL-MUZANI AND IMAM AL-SYAFI'I ON SERIOUSLY ILL WOMEN

This research aims to explore the differing opinions of Imam Bakr Al-Muzani and Imam al-Syafi'i concerning the permissibility of khulu'—a form of divorce initiated by the wife—particularly in cases where the woman is seriously ill. Given the recent viral phenomenon of khulu' leading to marital dissolution, this study seeks to provide a nuanced understanding of these classical Islamic juristic perspectives. A qualitative research design with a comparative approach was employed to investigate the subject matter. Data sources were obtained through observation, documentation, and an extensive literature review. The collected data were analyzed in a systematic manner involving selection, presentation, and conclusion-drawing phases to ensure the robustness of the findings. The findings revealed a significant divergence in the opinions of the two scholars. Imam Bakr al-Muzani opposed the majority scholarly view that considered the verse related to khulu' to be abrogated (mansukhah). Conversely, Imam al-Syafi'i maintained that khulu', including cases where the woman is seriously ill, is permissible. This difference underscores the broader debate within Islamic jurisprudence regarding the application of khulu' in contemporary contexts. This study contributes to the existing body of knowledge by highlighting the relatively underexplored opinions of Imam Bakr al-Muzani on the issue of khulu'. It also provides a comparative analysis with the more commonly referenced views of Imam al-Syafi'i, thereby enriching the discourse on women's rights in Islamic law, particularly in situations of severe illness. The research suggests that, based on the strongest opinion, women who are seriously ill may be permitted to perform khulu'. This finding has significant implications for contemporary Islamic legal practice, particularly in providing relief and legal options to women in dire health conditions seeking marital dissolution.

Assessment of the epizootic situation of dourine in horses in the North Caucasus and Southern Federal Districts of the Russian Federation from 2020 to 2022

Relevance. Accidental disease is an actual disease of horses in many countries, including Russia, where cases of the disease have been registered in 16 administrative territories. In the Russian Federation, the proportion of accidental illness is about 47% in the general infectious and parasitic pathology of horses. The mortality rate is high, up to 30–50%, sometimes higher. The treatment of sick animals is prohibited.The purpose of the study is to study the epizootic situation of accidental illness in the North Caucasus and Southern Federal Districts, where a high density of horse population is registered.Methods. The epizootic situation of accidental equine disease from 2020 to 2022 was studied based on the materials of annual reports submitted by the state veterinary laboratories of the Russian Federation.The complement binding reaction (CFT) is the main method of lifetime diagnosis of accidental illness.Results. Serological studies for accidental equine disease from 2020 to 2022 were performed in all subjects of the North Caucasus and Southern Federal Districts. It has been established that the epizootic situation of accidental illness in the territory of the Southern Federal District is prosperous, and in a number of regions of the North Caucasus Federal District it is tense. Thus, specific antibodies to the causative agent of accidental disease were detected in the North Caucasus Federal District in 36 cases, including in the Republic of Dagestan — 27, in the Chechen Republic — 4, in the Kabardino-Balkarian Republic — 3, in the Karachay-Cherkess Republic — 2. Thus, the epizootic situation in the South of Russia is different.

The Regulatory Network of hnRNPs Underlying Regulating PKM Alternative Splicing in Tumor Progression.

One of the hallmarks of cancer is metabolic reprogramming in tumor cells, and aerobic glycolysis is the primary mechanism by which glucose is quickly transformed into lactate. As one of the primary rate-limiting enzymes, pyruvate kinase (PK) M is engaged in the last phase of aerobic glycolysis. Alternative splicing is a crucial mechanism for protein diversity, and it promotes PKM precursor mRNA splicing to produce PKM2 dominance, resulting in low PKM1 expression. Specific splicing isoforms are produced in various tissues or illness situations, and the post-translational modifications are linked to numerous disorders, including cancers. hnRNPs are one of the main components of the splicing factor families. However, there have been no comprehensive studies on hnRNPs regulating PKM alternative splicing. Therefore, this review focuses on the regulatory network of hnRNPs on PKM pre-mRNA alternative splicing in tumors and clinical drug research. We elucidate the role of alternative splicing in tumor progression, prognosis, and the potential mechanism of abnormal RNA splicing. We also summarize the drug targets retarding tumorous splicing events, which may be critical to improving the specificity and effectiveness of current therapeutic interventions.

Alzheimer's disease intelligent detection combining XGBOOST and NARX

Due to the current situation of mental health illness, which causing a huge impact on the society. In this paper, an attempt has been made to analyses and predict the data from ANDI using single and composite algorithms. This paper used chi-square test, Spearmans correlation coefficient and maximum mutual information number, cost-sensitive learning, SMOTE, ADASYN, SMOTE+ENN, SMOTE+TOMEK to investigations. Specifically, this paper adopted the random forest to fill the data, and besides, given the fact that the data shows the characteristics of imbalance, this paper identifies the method of SMOTE TOMEK integrated sampling, XGBOOST and Bayesian optimization scheme to give the best performance and the best classification was obtained by XGBOOST combined with SMOTE-TOMEK. Furthermore, this paper used the NARX network to track the changes generated by time-based indicators, providing another insight to refine the study of intelligent diagnosis of Alzheimer.

Interrelation of sociodemographic and clinical factors with burnout and engagement among mothers, who joined online peer support networks for persons raising children with disabilities

BACKGROUND: Parents raising children with disabilities are often exposed to stress and emotional burnout associated not only with the parenting process itself, but also with the need to create special conditions for the development and maintenance of the physical and mental well-being of their children. It is important to reveal factors that determine the parents’ adaptation success in a child’s illness situation. Parents of disabled children often join communities via Internet in order to exchange experiences and competencies in the field of care and interaction with children. This is rapidly developing trend of modern society and requires close attention of psychologists and other specialists working with parents of children with disabilities. This knowledge will allow us to develop appropriate mechanisms for cooperation, treatment and prevention in relevant peer support networks.
 AIM: The aim of the study was to reveal the relationships of sociodemographic and clinical factors with the severity of burnout and engagement in child care in parents who joined online peer support networks for persons raising children with disabilities.
 MATERIALS AND METHODS: The study involved 125 parents (121 mothers and 4 fathers) caring for children with disabilities. Mean [±SD] age, 36,3 ± 6,7 years. The “Level of relatives’ emotional burnout / parent-child version” was used as an assessment tools. Also, semi-structured interview for assessing socio-demographic and clinical characteristics was applied.
 RESULTS: The results of the study showed that age of the mother and child, the education and the work activities of the mother, the child’s kindergarten attendance, the age of onset and duration of the child’s illness, the nature of the relationship with him and the degree of parent’s activity in the treatment and rehabilitation process are the factors associated with engagement and burnout in parents of children with disabilities who joined online peer support networks. In particular, the lesser the age of the mother and the disabled child, the more exhaustion, tendency to devaluate successes and achievements in the process of children’s treatment (inefficacy) and tendency to destructively defuse of stress tension in mothers. The process of exhaustion is most likely at the initial periods of adaptation of the mother to the disease of the child, then the adaptation to the existing situation occurs. Burnout acts as a pathological process that contradicts the general trend and develops in cases when, due to environmental or personal factors, difficulties in adapting the parent to the child’s disease arise.
 CONCLUSIONS: Understanding of parents’ burnout processes is important for moderators of Internet communities, since it allows to route work with information content.

Совладание личности с психологическими последствиями тяжелой болезни при локальной и сосудистой патологии головного мозга

Background. The study of the psychological resources of a person experiencing a life-threatening disease is important due to the increased number of social requests related to improving the quality of a patient's full-fledged adaptation to life. The effectiveness of coping with the psychological consequences of a serious illness is determined by the system of internal conditions of the individual as well as by the age characteristics, due to which a subjective assessment of the psychotraumatic situation, the nature of a person's appeal to potential opportunities are specified. Objective. The study focuses on human resources when coping with the psychological consequences of post-traumatic stress, depending on age and the characteristics of the life-threatening brain disease (local or vascular pathology of the brain). Study Participants. 125 people showing no signs of cognitive deficits and who have given their informed consent were involved in the study. Of those, 64 people had a diagnosis of benign meningioma (30–70 years), and 61 people were diagnosed with cerebrovascular disease (31–69 years). Methods. To assess the level of psychotraumatization in respondents, the “Impact of Event Scale” technique was used, emotional and personal characteristics were studied using the Freiburg Personality Inventory and the “World assumptions scale” technique. Results. It has been established that, regardless of the type of disease, caused by local or vascular pathology of the brain, and the age of a person, a common resource for coping with psychotraumatic experiences is, on the one hand, accepting the situation of the disease and on the other, distancing oneself from experiences that mark it as hopeless, causing despair. For people with symptoms of cerebrovascular disease coping with stress, it is more important to regulate relationships with the outside world and maintain their functionality. While for people with meningioma, a positive self-attitude and the focus on unlocking inner potential, which becomes especially relevant in older age, are more important. Conclusions. The resourcefulness of a person in a situation of severe illness is determined by the rational nature of emotional self-regulation, including through selective appeal to social support. Specific resources associated with the peculiarities of the stressful situation of brain disease become more significant with age and manifest themselves in the specifics of the personality orientation (outward or inward).

Facilitating the creation of compassionate cities in Flanders. The case of Bruges and Herzele.

This paper presents the case studies of Compassionate Bruges and Herzele, as experienced in the role of a project leader/facilitator. Two cities want to grow more solidarity and more carefulness for their citizens as an answer to social bitterness, coldness and isolation. Two PhD students search for an answer to the question ‘how can we develop and foster a civic approach that is complementary to institutional health care, improving the quality of life in situations of severe illness, dying and grieving?’. And to the question ‘how can we invite people to think and act differently to realise this social change?’.
 The uniqueness of this testimonial lies in the top-down approach that was chosen to implement the compassionate city as well as the compassionate community aspect of this project. This is unlike a lot of international examples of compassionate community projects that are rather driven by an individual ‘sponsor’ or grassroots initiatives. In the top-down approach, we bring together partners like schools, employers, life stance groups,… In the bottom-up approach we work with civil society organisations and key figures in local networks. We aim at developing a compassionate community in Bruges Sint-Kruis as well as in Herzele-Centre.
 We will give an overview of how the project was conceived and how both cities evolved in their own way, driven by local differences in policy making, social network dynamics and the people involved. We will present the tensions that emerged and what we did to try and manage these tensions, as well as to manage the complexity of the global context in which these projects deployed. 
 Since some of our interventions proved to be more successful than others, we will conclude with some learnings and reflections and a brief presentation of the ‘Navigation Triangle’ framework. This framework is the synthesis of the levers we experienced to be crucial to understand and use in the process of leading cultural change in a complex environment. This framework might inspire project leaders and facilitators in their navigation processes through the complexity of their own projects, trying to involve people from a top-down as well as a bottom-up point of view.

Review of electrospun microtube array membrane (MTAM)-a novel new class of hollow fiber for encapsulated cell therapy (ECT) in clinical applications.

Encapsulated cell therapy (ECT) shows significant potential for treating neurodegenerative disorders including Alzheimer's and Parkinson's, which currently lack curative medicines and must be managed symptomatically. This novel technique encapsulates functional cells with a semi-permeable membrane, providing protection while enabling critical nutrients and therapeutic substances to pass through. Traditional ECT procedures, on the other hand, pose difficulties in terms of cell survival and retrieval. We introduce the Microtube Array Membrane (MTAM), a revolutionary technology that solves these constraints, in this comprehensive overview. Microtube Array Membrane has distinct microstructures that improve encapsulated cells' long-term viability by combining the advantages of macro and micron scales. Importantly, the MTAM platform improves biosafety by allowing the entire encapsulated unit to be retrieved in the event of an adverse reaction. Our findings show that MTAM-based ECT has a great potential in a variety of illness situations. For cancer treatment, hybridoma cells secreting anti-CEACAM 6 antibodies inhibit triple-negative breast cancer cell lines for an extended period of time. In animal brain models of Alzheimer's disease, hybridoma cells secreting anti-pTau antibodies successfully reduce pTau buildup, accompanied by improvements in memory performance. In mouse models, MTAM-encapsulated primary cardiac mesenchymal stem cells dramatically improve overall survival and heart function. These findings illustrate the efficacy and adaptability of MTAM-based ECT in addressing major issues such as immunological isolation, cell viability, and patient safety. We provide new possibilities for the treatment of neurodegenerative illnesses and other conditions by combining the potential of ECT with MTAM. Continued research and development in this subject has a lot of promise for developing cell therapy and giving hope to people suffering from chronic diseases.

Trust in healthcare professionals of people with chronic cardiovascular disease.

Trust is an essential phenomenon of relationship between patients and healthcare professionals and can be described as an accepted vulnerability to the power of another person over something that one cares about in virtue of goodwill toward the trustor. This characterization of interpersonal trust appears to be adequate for patients suffering from chronic illness. Trust is especially important in the context of chronic cardiovascular diseases as one of the main global health problems. The purpose of the qualitative study was to gain a deeper understanding of how people with chronic cardiovascular disease experience and make sense of trust in healthcare professionals. Eleven semi-structured interviews with participants analysed using interpretative phenomenological analysis to explore in detail their lived experience of trust as a relational phenomenon. Participants with chronic cardiovascular disease were purposively recruited from inpatients on the cardiology ward of the university hospital located in central Slovakia. The study was approved by the faculty ethics committee. Participants gave their written informed consent. Sense of co-existence; Belief in competence; Will to help; Ontological security with eight subthemes were identified. The findings describe the participants' experience with trust in healthcare professionals as a phenomenon of close co-existence, which is rooted in the participants' vulnerability and dependence on the goodwill and competence of health professionals to help with the consequence of (re)establishing a sense of ontological security in the situation of chronic illness. Findings will contribute to an in-depth understanding of trust as an existential dimension of human co-existence and an ethical requirement of healthcare practice, inspire patient empowerment interventions, support adherence to treatment, and person-centred care.

Отношения с матерью и сверстниками у детей предподросткового возраста с сахарным диабетом

<p style="text-align: justify;">The paper examines the relationship of children with insulin-dependent diabetes (type 1 diabetes) with their mother and peers. The study involved 30 children aged 10–12 years (M=11.26; SD=0.69), and their mothers. 14 mother–child pairs formed the experimental group of children with type 1 diabetes; 16 mother–child pairs were included in the control group. The methods used were "Parent-child interaction"; the "Family relationship test"; the "My usual day with a child" essay; the "My usual day with mom" conversation with the child; the "Features of interaction with the parent" questionnaire for teachers; the "Features of communication of the child" questionnaire for teachers and educators; a modified version of the "Unfinished sentences" methodology. The results of the study suggest that control, exactingness, guardianship on the part of the mother can act as a way of coping with the situation of the child's illness. Mothers of children with diabetes are more focused on their own feelings and experiences; the main target of their concern is the health and education of the child. It is noted that children with diabetes, when interacting with peers, more often than healthy peers, demonstrate conformity, a friendly or neutral attitude, preferring to avoid situations of conflict or to solve them with the help of an adult. The links between the low competence of a child with type 1 diabetes in the ability to negotiate with peers, take leadership positions, and a "cooperating" relationship with the mother were revealed. Maternal control and hyper-indulgence in relation to healthy children is associated with a low level of interaction of the child with peers, his ability to solve communicative tasks.</p>

Precautionary planning at the end of life from the perspective of intensive care medicine

In recent years, the number of intensive care treatments has increased significantly. About every fourth patient who dies in hospital receives intensive care. Structured prevention planning is important in order to implement the patient's wishes in situations of serious illness in which patients cannot express their wishes themselves. However, the implementation in practice can be problematic since intensive care situations are complex and rarely correspond to the concrete pre-arranged situations. Communication of the prognosis and the prognostic uncertainty is therefore crucial in order to determine the presumed will of the patient, especially in the context of the process of weighing up the benefits and burdens of intensive care therapies. Hospital treatment can be the reason for targeted preventive planning and avoid unnecessary intensive care treatment during the same stay. Documentation templates can help to record the results of preventive care planning clearly and comprehensibly in the medical file.