Personal Illness Research Articles

Paid Family and Medical Leave: Policy Statement.

Paid family and medical leave (PFML) helps parents balance the competing obligations of work, personal illness, and family. PFML is needed when adding a new member of the family or when a family member or individual becomes acutely or chronically ill. The United States lacks universally available PFML, despite the benefits for child and family health and well-being. Universally available PFML is a key component of improving the health of children and families and is critically needed in the United States.

Psychometric testing of the continence and mobility in older adults knowledge quiz

AbstractWhat are the psychometric properties of the Continence and Mobility in Older Adults Knowledge Quiz? Our previous research revealed gaps in practicing and student nurses' knowledge of mobility and continence in older people. To address this gap, we developed a self‐directed e‐learning module on continence and mobility to enhance student nurses knowledge. The module provided education about continence, mobility, and the links between them. Since we were unable to locate a continence and mobility measure that captured both lower urinary track symptoms and elements of mobility, we developed a continence and mobility knowledge quiz. For researchers and educators to be able to use this quiz with confidence, psychometric testing of our continence and mobility knowledge quiz was required. When caring for older people, two geriatric challenges—continence and mobility—are often linked and viewed as indicators of frailty. Functional changes related to continence and/or mobility can indicate an acute illness in older persons and, if left untreated, can result in permanent changes managing continence needs. Continence care is often viewed negatively and is not prioritized by nurses. We employed stages in development of the Continence and Mobility Knowledge Quiz. In stage one, we developed 18 item true/false items from the literature with the guidance of a continence expert. In stage two, we tested the Quiz with nursing students from three universities in Canada. In stage three, (the current stage) we assessed the validity of the scale using a factor analysis and a reliability analysis (via standardized Cronbach's alpha). From our sample of 420, factor analysis indicated a two‐factor model (as suggested by Kaiser's rule), explained 22% of the variation in responses to the assessment items. We recommend removing item 7 as it does not contribute to the internal consistency of the tool. Cronbach's alpha after removing 7 is 0.65, indicating satisfactory reliability. To our knowledge, this is the first validated tool for measuring nurse knowledge about continence and mobility that addresses both a range of lower urinary tract symptoms and elements of mobility in older adults.

Examining dimensions of help-seeking intentions and associations with personal mental illness stigma among racial and ethnic minority immigrants.

This study examined the factor structure of the General Help-seeking Questionnaire and how personal mental illness stigma was associated with different types of help-seeking intentions among racial and ethnic minority immigrants in the United States. A sample of 202 immigrants aged 18-39 were recruited from a Qualtrics panel and completed the online survey. Confirmatory factor analysis and multiple linear regression were conducted. Results confirmed four dimensions of help-seeking intentions: informal, formal, semi-formal, and traditional sources. Immigrants with higher levels of mental illness stigma are more likely to seek help from traditional sources (e.g., religious leader or other community-based nonfaith resources) and semi-formal sources (e.g., web-based resources). Lack of awareness of service options is a key barrier to formal help-seeking. Results signal the importance of collaboration between mental health service providers. Adopting culturally sensitive care and web-based delivery formats may help address immigrants' concerns about mental health stigma.

Cardiovascular risk in individuals with kidney disease

The worldwide prevalence of chronic kidney disease (CKD) is estimated to exceed 700 million persons, with the incidence steadily increasing due to factors such as an aging population and the growing prevalence of chronic diseases such as diabetes and hypertension. Cardiovascular disease is the primary cause of illness and mortality in persons with nephropathy. Effectively treating nephropathy and cardiovascular risk in individuals with kidney disease is a major challenge in clinical practice. Every patient requires a comprehensive assessment and tailored therapy. In order to reduce the likelihood of cardiovascular events in patients with nephropathy, it is necessary to avoid and rapidly address cardiovascular risk factors. In order to enhance the overall well-being and longevity of individuals with kidney disease, it is essential to identify and address any cardiovascular issues.

ДОСРОЧНОЕ ОСВОБОЖДЕНИЕ ОСУЖДЕННОГО ОТ ОТБЫВАНИЯ НАКАЗАНИЯ В ЭКСТРЕМАЛЬНЫХ УСЛОВИЯХ: НЕКОТОРЫЕ ПРОБЛЕМЫ РЕГУЛИРОВАНИЯ

Based on the analysis of the provisions of the Federal Constitutional Law «On the State of Emergency», the Criminal Code of the Russian Federation, the Penal Code of the Russian Federation and other normative legal acts, a number of shortcomings in the regulation of parole, replacement of the unserved part of the punishment with a milder one and release from punishment due to the illness of the convicted person, accepted by the court in extreme conditions, that is, when natural disasters occur or a state of emergency or martial law is imposed. The article focuses on a number of issues: suspension of the convict’s right to apply for early release, leaving the possibility of such treatment with the administration of the institution or body executing the punishment; attribution of the convict’s participation in emergency rescue and other urgent work to the criteria for parole or replacement of the unserved part of the punishment with a milder one; imputation of post-penitentiary responsibilities related to the elimination of the consequences of extreme conditions; etc.

Introducing patient stories in health sciences education: the learning experiences of students

BackgroundIt has been advocated that the development of medical school curricula must be informed by students, doctors in training, educators, employers, other health and social care professionals and patients, families and carers. Patients are widely employed to teach clinical and interpersonal skills, and while recognised as crucial in health education, they have mostly been offered a passive role. We assessed the impact of patients contributing personal illness narratives in the master curriculum of allied health care professionals on students’ learning experiences.MethodsWe designed a module (Patient and Society) for a master’s degree programme in Health Sciences at the University of Southern Denmark in collaboration with six patients. The patients contributed to the teaching by sharing and discussing their personal illness narrative. At the end of the module, as part of the exam, we asked the students to reflect on the patients’ contribution to the module and how this affected their learning experiences. The 500-word exam responses of 29 students were analysed, in collaboration with six patients, using thematic analysis.ResultsIncluding patients’ illness narratives lifted students’ academic learning, and their personal and professional development. The stories brought theoretical concepts to life; it helped the students to obtain, retain, and apply academic knowledge. Actively and uninterrupted listening to patients’ illness experiences promoted empathy and critical reflection on clinical practice. Faced with the impact of a disease on a person’s life, seeing the healthcare system through a patient’s lens made students reflect critically on the medical positivist model ruling the health care system focused on just fixing the medical problem with very little room for the illness experience.ConclusionOur analyses support previous findings indicating that patient narratives are a powerful tool to achieve academic and professional development. Working with patients in health education has the potential to work towards a more inclusive epistemological stance in the health care system and health research.

Awareness. Interaction. Direction. (A.I.D.): evaluation of a novel mental health awareness training

ABSTRACT Objective The current study evaluates the effectiveness of Awareness. Interaction. Direction. (A.I.D.), a novel Mental Health Awareness Training (MHAT) that was developed to address training limitations of some existing MHATs. Method Between 2022 and 2023, data was collected from 1198 participants who were from a university, working for K-12 schools, or community members in the Mid-Western United States. Participants self-selected or were assigned by their supervisor to complete the A.I.D. training. Prior to and after completing the training, participants answered questions pertaining to mental health knowledge, their confidence in implementing the A.I.D. action plan, and personal stigma. Paired responses for the mental health knowledge questions before and after the A.I.D. training were compared using McNemar’s test. Linear mixed models were used to compare confidence and personal stigma outcomes before and after the A.I.D. training. Results After completion of the A.I.D. training, participants demonstrated a significant increase in mental health knowledge and confidence in implementing the A.I.D. action plan and a significant decrease in personal mental illness stigma. Significant differences by age and gender were identified. Discussion The current study demonstrated the novel A.I.D. training is an effective training. A.I.D. provides a MHAT option that is brief and that can be delivered in different formats (e.g. virtual or in-person) to best accommodate the individuals receiving the training. This presents organisations with another MHAT option.

CAUSES OF TEACHER ABSENTEEISM IN SELECTED SECONDARY SCHOOLS OF KAYUNGA DISTRICT IN UGANDA. A DESCRIPTIVE STUDY.

Background: Teacher absenteeism is when the teacher is out of school either by delaying, leaving before official closing time, not attending school at all, or when the teacher is at school but missing classes. Absenteeism is caused by many factors like personal illness, a relative’s sickness, family conflicts, lack of job satisfaction leading to low morale, lack of personal competence, lack of friendly work group norms, poor leadership at the workplace, in effective supervision and inspection, assignment of other duties outside the workplace, bad weather conditions, union influence, and poor working conditions. The study aims to examine the causes of absenteeism in selected secondary schools of Kayunga District in Uganda. Methodology: This is a descriptive survey design in which quantitative research methods were used on 210 who included the DEO, 10 head teachers, 100 teachers, and 100 Students. Results: 54.0% of the respondents were male while 46.0% were females. According to teacher responses, 67% agreed that female teachers are usually absent due to family responsibilities, and 58% agreed that male teachers are usually absent because of attending their business to substitute for their income. 52% agreed that old teachers are mostly absent because they lost their morale.64% of the teachers agreed that teachers are absent due to illness. 46% of teachers agreed that teachers of low level of education attend further education programs. (46%) agreed that teachers absent themselves because they are not satisfied with their job. Conclusion: Teachers absent themselves because they are unsatisfied with their jobs, family responsibilities, substitute income, undertaking further studies, lost morale, and are tired and some miss due to illness. Recommendation: School employers should ensure that there is constant supervision and remuneration to motivate teachers as a way of curbing teachers’ absenteeism.

Do pregnant persons want influenza vaccines? Knowledge, attitudes, perceptions, and practices toward influenza vaccines in 8 low- and middle-income countries.

While vaccination is the most effective way to prevent influenza infection and adverse outcomes, and despite WHO recommendations to vaccinate pregnant persons, access to seasonal influenza vaccines remains low. We explored knowledge, attitudes, and practices of pregnant persons about seasonal influenza vaccines to inform actions to improve vaccine uptake among this priority population. We pooled individual-level data from cross-sectional surveys assessing pregnant persons' attitudes toward seasonal influenza vaccines in eight low- and middle-income countries during 2018-2019. The eight countries used a standard protocol and questionnaire to measure attitudes and intents toward influenza vaccination. We stratified by country-level (presence/absence of a national influenza vaccination program, country income group, geographic region) and individual-level factors. Our analysis included 8,556 pregnant persons from eight low- and middle-income countries with and without seasonal influenza vaccination programs. Most pregnant persons (6,323, 74%) were willing to receive influenza vaccine if it was offered for free. Willingness differed by presence of an existing influenza vaccination program; acceptance was higher in countries without influenza vaccination programs (2,383, 89%) than in those with such programs (3,940, 67%, p < 0.001). Most pregnant persons in middle-income countries, regardless of influenza vaccination program status, were willing to be vaccinated against influenza if the vaccine was provided free of charge. National investments in influenza vaccination programs may be well-received by pregnant persons, leading to averted illness both in pregnant persons themselves and in their newborn babies. US Centers for Disease Control and Prevention.

Learning from Health Care Counselors' Perspectives on Health Care Worker Distress: A Qualitative Analysis.

Health care provider stress and emotional distress were well documented long before the COVID-19 pandemic, and there is growing data suggesting these have increased in response to the pandemic. The goal of this study was to take advantage of the unique experiences of licensed mental health (MH) clinicians working with health care trainees and clinicians before and during the pandemic to identify how this crisis affected both ongoing as well as new sources of stress. The Healer Education, Assessment and Referral Program (HEAR) provides MH screening, support, and MH referrals to ~19 000 health care students, trainees, staff, and faculty. Since its inception in 2009, the program has been staffed by 4 licensed counseling professionals who have worked both before and since the COVID-19 pandemic. Qualitative data obtained from semi-structured, 1-hour interviews and a follow-up 1-hour focus group with 4 HEAR counselors was analyzed using reflexive thematic analysis. Several preexisting stressors were amplified during the pandemic: financial concerns; long work hours; exposure to the suffering of illness, death, and dying; bullying; discordant values and moral distress; social inequities; individuals' lack of adaptive coping; and individuals' self-concept as a victim. New stressors included: health care demand greater than the workforce numbers and resources; caretaking for ill family/friends; homeschooling of children; social isolation; experiencing the COVID-19 crisis as a war, fire, or storm; fear of personal illness and death, especially before vaccines; and hopes of a cure with vaccines; followed by perceived opportunities for improvement in leadership response to staff concerns. Authentically responding to staff concerns/ideas, a patient and provider-centered health care culture, grief education and support, and attention to actionable stressors affecting providers' well-being are indicated to meet the amplified and new stressors triggered by the COVID-19 pandemic and sequelae.

BRIDGE to liver health: implementation of a group telehealth psychoeducational program through shared medical appointments for MASLD management

BackgroundMetabolic dysfunction-associated steatotic liver disease (MASLD) represents a significantly costly and increasingly prevalent disease, with treatment focused on lifestyle intervention. Integrating education and behavioral health into clinical care offers opportunities to engage and empower patients to prevent progression of liver disease. We describe the design and implementation of Behavioral Resources and Intervention through Digital Group Education (BRIDGE), a 6-session group telehealth program led by advanced practice providers (APPs) in 90-min shared medical appointments (SMAs) with small groups of MASLD patients in an academic outpatient hepatology clinic. The program contains multi-component group interventions, with didactic education and behavioral coaching, while leveraging peer-based learning and support.MethodsA mixed-methods exploratory pilot study was conducted. Feasibility and acceptability of the clinical intervention were assessed by tracking recruitment, attendance, and retention of BRIDGE participants, patient interviews, and debriefing of clinician and staff views of the clinical program. Implementation metrics included program development time, workflow and scheduling logistics, and billing compliance for sustainability. Finally, patient parameters including changes in liver enzymes, FIB-4, weight, and BMI from pre- to post-BRIDGE were retrospectively analyzed.ResultsWe included 57 participants (median age 57, interquartile range (IQR) 50 – 65 years), 38 (67%) female, 38 (67%) white, and 40% had public insurance. Thirty-three (58%) participants completed all six sessions, while 43 (75%) attended at least five sessions. Patients who completed all sessions were older (median age 61 vs 53.5; p = 0.01). Gender, race/ethnicity, and insurance type were not significantly associated with missed sessions, and patients had similar rates of completion regardless of weight, BMI, or stage of liver disease. Barriers to completion included personal illness, family reasons, work commitments, or insurance issues. Prior to BRIDGE, median BMI was 31.9 (SD 29 – 36), with a median weight loss of 2 pounds (IQR -2 – 6) after BRIDGE.ConclusionThe BRIDGE telehealth SMA program was feasible, well-attended, and positively reviewed. This pilot study informs future iterations of program development and evaluation of outcome measures.

Forecasting personal heat strain under extremely hot environments: Utilizing feature importance in machine learning

Since the frequency and intensity of heatwaves are expected to increase due to global warming, it is crucial to establish a simplified approach to preventing personal heat-related illnesses as occupational hazard under extremely hot environments, by taking into account individual differences in heat strain. In light of this, this study proposed a simplified forecast model for personal heat strain under extremely hot environments by utilizing feature importance in machine learning, focused on enhancing its field applicability. Using the 1417 records gathered from the experiments under extremely hot conditions, the simplified model was developed by utilizing four types of machine learning algorithms (i.e., random forest, extreme gradient boosting, support vector regression, and multi-layer perceptron). As a result, the proposed simplified models with four principal features (i.e., dry-bulb temperature, radiant temperature, relative humidity, and percentage body fat) were found to be the most reliable, resulting in a small difference of 0.047 °C compared to the reference model. Since the principal biometric features can be easily measured by a simple and low-cost body composition test (but not with the physical measurement of personal core body temperature) before they are put into the field, the proposed approach will aid in providing more systematic and efficient management system for proactively preventing personal heat-related illnesses. Furthermore, it is expected that the field applicability of the proposed approach can be continuously enhanced by utilizing the accumulated big data gathered from the field-based living-lab projects over a lengthy period.

РЕСОЦИАЛИЗАЦИЯ ОСУЖДЕННЫХ: НЕКОТОРЫЕ ТЕОРЕТИКО-ПРАВОВЫЕ АСПЕКТЫ

When considering various aspects of the re-socialization of convicts, its inadequate theoretical elaboration and insufficient focus on post-penitentiary prevention of the commission of new crimes were established. The article reveals numerous shortcomings of criminal, penal enforcement and other legislation regulating the institution of resocialization of convicts. It is concluded that even with the participation of the court deciding on the early release of a convicted person from serving imprisonment (parole, release from punishment due to a serious illness of the convicted person or replacement of the unserved part of the deprivation of liberty with a milder type of punishment), post- penitentiary issues are not sufficiently taken into account. The article substantiates the provision that when making such a decision, the court should take into account the possibility (not) of achieving the goals of penal enforcement legislation, the forecast of post-penitentiary behavior of a person, the likelihood of committing a new crime or other offense, as well as the need to provide him with appropriate assistance.

Black Latina Passages through Colonial Ecologies of Illness and the Art of Composting Aesthetics

Drawing from Black Latinx and feminist thought to place Latinx Studies and medical/health humanities in conversation, this project asks, what are the medical and colonial histories, personal and collective, that inform patients’ perceptions of illness and Western biomedicine? What happens in cases when Latinx patients have internalized historical forms of medical violence, and what are the means by which Latinx patients construct their healing through narrative? These questions are grounded in material conditions with special concerns for the well-being of Latinx patients, but they are explored via a historically and culturally informed literary analysis of Jasminne Méndez’s Night-Blooming Jasmin(n)e (Night-Blooming), a personal illness narrative composed of poems and lyrical essays that portrays, among other health conditions, Méndez’s life with Scleroderma, Lupus, and Raynaud’s disease. Offering a close reading of Night-Blooming’s biomedical critiques alongside the ecological language, metaphors, and formal structure she employs to describe her illness, the author argues that narratives such as Night-Blooming require us to travel into the colonial ecologies of illness, environmental characteristics, practices, and rhetoric in medical settings that evoke colonial encounters from within and beyond the strict boundaries of healthcare facilities. This essay also follows in the passages of Méndez’s figurative travels to the island of Hispaniola as she works to recover her language, health, and Black roots. Acknowledging the ways Méndez’s chronic illness and biomedicine distort her (textual) body, psychiatric health, and language becomes necessary to appreciate Méndez’s composting aesthetics of illness, healing work that involves a struggle to recover that which is painful and deteriorating for life-affirming and life-sustaining purposes. I suggest that by enacting an aestheticization of illness alongside experiences of pain, Méndez uses Night-Blooming as a conduit to theorize about the potential for transforming human suffering from chronic illness into a means toward cultivating life.

Impact of Immunomodulatory Therapy on COVID-19 Vaccine Response in Patients with Autoimmune Inflammatory Rheumatic Diseases.

Coronavirus disease 2019 (COVID-19) vaccination is essential for patients with autoimmune inflammatory rheumatic diseases (AIIRD) to reduce the risk of morbidity and mortality associated with serious COVID-19 infection. With endemicity, waning of vaccine- and infection-acquired immunity, and development of SARS-CoV-2 variants, the need for additional doses of vaccines against serious illness in high-risk immunocompromised persons remains imperative. This review examines how immunomodulatory therapies affect vaccine-induced immune response in patients with AIIRD. Glucocorticoids, methotrexate, azathioprine, calcineurin inhibitors, mycophenolate mofetil, tumor necrosis factor inhibitors, and abatacept have been shown to variably attenuate both humoral and cellular immune responses to vaccination. Janus kinase inhibitors reduce humoral immune response. In contrast, sulfasalazine, leflunomide, belimumab, interleukin (IL)-17, IL-12/23, IL-6, and IL-1 inhibitors appear favorable, with mild or no impact on vaccine response. Although rituximab is known to profoundly diminish humoral immune response, cellular immunity is relatively preserved. Administering a third and subsequent vaccine dose or temporally coordinating the dosing of immunomodulatory drugs may improve vaccine effectiveness. Further research is needed to personalise vaccination strategies for AIIRD patients, considering their specific immunomodulatory treatments.

Physical and Rehabilitation Medicine: say relational or functional, not holistic.

Modern medicine tends to privilege disciplines promising "objective" laws governing body parts (from molecules to organs). Studies on a person's illness and disability are (apparently) confined to "subjectivity." The Specialty of Physical and Rehabilitation Medicine is often regarded as a humanitarian approach, belonging at best to the family of "soft," "qualitative," or "quasi-experimental" sciences. This specialty often claims specificity by labelling itself as "functional" and "holistic." However, it is shown here that the former term is acceptable, yet redundant, and the second misleading. When human behaviors and perceptions are at stake, "function" indicates a person's relationship with the outer world (already tackled by the definitional term "physical" from the Greek "physis"). The word "holistic" emphasizes mind-body unity and person-environment interdependence but, in current usage, overshadows the complementary need for an analytic, experimental approach to any function. Medicine aims at fighting disease and disability in single persons. This endeavor requires knowing body parts and mechanisms and understanding how interventions on "parts" affect the "whole." This understanding rests on the experimental method. For instance, returning to a given societal role (participation) may require restoration of walking (activity), which may require reinforcement of weakened muscular groups (impairment). Working only on holistic bio-psycho-social "wholes" may miss the therapeutic mission of medicine.

The Legal Regulation of Internet Personal Serious Illness Seeking for Help—Based on the Revision of Charity Law

The Legal Regulation of Internet Personal Serious Illness Seeking for Help—Based on the Revision of Charity Law

Is it time to abandon the concept of treatment-resistant depression?

One of the most used, but poorly defined, terms in the management of clinical depression is that of treatment-resistant depression (TRD) (McIntyre et al., 2023). It implies that persons with major depression have received a range of appropriate psychological, medical or physical treatments (at appropriate doses and for appropriate durations) but have not experienced a significant clinical response. Intrinsically, it does not require consideration as to whether those treatments provided were relevant to their age or developmental stage, clinical phenotype, interpersonal or social context, or personal illness trajectory. These broader clinical considerations often influence initial and subsequent treatment choices.

Coronary artery disease and other cardiovascular disorders among the physicians.

To evaluate the prevalence of cardiovascular disorders (CVDs), specifically coronary artery disease (CAD), among Thai physicians, and the cardiac testing being used. The associated or risk factors of CAD were also studied. Data of Thai physicians who participated in the hospital's corporate social responsibility "Save Doctors' Heart" project conducted between February 14, 2022, and October 31, 2022, were collected: personal illness, family history of CAD, workplace, work hours, dietary habits, exercise, stress, body mass index, laboratory and cardiac testing. Of 1231 physicians, the median age was 48.0 ± 10.34 years, with 55.2% were female; 83.1% reported working <55 h per week, 29.7% exercised ≥3 days a week, and 28.0% were overweight or obese. Hypertension, diabetes mellitus, and dyslipidemia were found in 46.3%, 30.5%, and 75.8%, respectively. Abnormal findings were observed in 29.7% of chest X-rays, 17.7% of electrocardiograms, 33.0% of echocardiograms, 10.6% of exercise stress tests, and 3.8% of stress echocardiograms. Moderate/extensive coronary artery calcium (CAC) scores were present in 12.7%. The prevalence of CVDs or CAD were 51.7% and 11.2%, respectively. Independent risk factors for CAD included older age, male gender, history and/or new findings of DM, and moderate to extensive CAC scores. The prevalence of CVDs and CAD among Thai physicians is 51.7% and 11.2%, respectively. The independent risk for CAD was older age, male, having DM, and moderate to extensive CAC scores. The physicians who are at risk should be cautious, modify their lifestyle, and have appropriate screening/diagnostic testing for cardiac abnormality.

Review of The empathy exams: Essays.

Reviews the book The empathy exams: Essays. Empathy is a universally important aspect of both life and medicine that helps cultivate a therapeutic relationship between healthcare professionals and patients, family and loved ones, community members and friends, and beyond. As the times have evolved, empathy has become increasingly essential in not only elevating the quality of patient-centered care but also nurturing meaningful relationships and compassionate bonds among communities and families. Empathy encompasses an emotional understanding of another's pain and suffering and also invites self-reflection and humility. In The Empathy Exams, the author sheds light on the meaning of empathy through her memoir of experiences and perspectives as a nonhealthcare professional, community member, patient, family member, and friend. Even though the author herself does not practice in the medical setting, from the bond between the physician and patient to the empathetic connection between patients and families, The Empathy Exams explores a thematic and insightful discussion on empathy as a lifelong exploration through multidimensional angles from experiencing personal illness to caring for a loved one. Ultimately, The Empathy Exams encourages all-both medical professionals, nonhealthcare communities and families-to reflect and rethink about empathy in themselves, patients, and loved ones, transforming individual pain and suffering into communal hope and humanity. (PsycInfo Database Record (c) 2024 APA, all rights reserved).