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نتیجه جستجو - Illness

تعداد مقالات یافته شده: 89
ردیف عنوان نوع
1 Knowledge, beliefs and management of childhood fever among nurses and other health professionals: A cross-sectional survey
دانش، باورها و مدیریت تب دوران کودکی در پرستاران و سایر متخصصان بهداشت و درمان: یک مرور مقطعی-2021
Background: Fever phobia, the unfounded fear regarding the potential harms of fever in children, has been internationally documented among parents. This fear causes anxiety in parents and health professionals are regularly consulted for advice. Objectives: This study aimed to investigate the knowledge, beliefs and recommended treatments among Australian nurses, pharmacists, general practitioners and paediatricians in the management of febrile children. Design, setting and participants: This was an online cross-sectional survey of Australian nurses, pharmacists, general practitioners and paediatricians designed to evaluate the knowledge and preferred recommendations in the management of febrile children. Methods: The health professionals were recruited via Facebook. Demographic information, knowledge, beliefs and preferred treatments were collected through the online survey, and responses were compared across professions. Results: Of the 839 health professionals who completed the survey, 52.0% correctly identified a fever as 38 ◦C or above. Overall, 23.6% underestimated the temperature that constitutes a fever. Respondents reported concerns leaving fever untreated in children, with dehydration (65.1%), seizures (65.2%), serious illness (34.4%) and brain damage (29.9%) the most common concerns. Pharmacists were more likely to hold these concerns. The beliefs that reducing a child’s fever with medication will reduce the risk of harm (34.7%) and prevent febrile convulsions (51.1%) were prevalent among respondents. These beliefs were more common among pharmacists. Pharmacists were also more likely to recommend parents monitor a child’s temperature (48.5%) and give medication to reduce fever (64.6%). Conclusions: Australian nurses, pharmacists, general practitioners and paediatricians reported many mis- conceptions surrounding the definition of fever, the potential harms of fever and its management, which may perpetuate parental fears. These misconceptions were most common among pharmacists. Continuing profes- sional development is essential to ease unfounded concerns and ensure the safe and judicious care of febrile children.
keywords: تب | کودک | پرستاران | داروسازان | پزشکان عمومی | مرورها و پرسشنامه ها | Fever | Child | Nurses | Pharmacists | General practitioners | Paediatricans | Surveys and questionnaires
مقاله انگلیسی
2 Development and validation of INTENSS, a need-supportive training for nurses to support patients self-management
توسعه و اعتبار سنجی های آمیز، آموزش نیازمندی برای پرستاران برای حمایت از خود مدیریت بیماران-2021
Background: The growing prevalence of chronic illnesses requires nurses to support self-management and help patients integrate the chronic illness into their life. To our knowledge there are currently no training programs that combine the necessary components to adequately enhance nurses competencies in self-management support. Objective: The systematic development and validation of a need-supportive training in self-management support for nurses. Design: A three-phased study, according to van Meijel et al. (2004), with collection of building blocks, design, and validation of the need-supportive character of the training. Setting and participants: Eight training groups with 30 nurses, 34 nursing students and nine social healthcare workers from different nursing colleges in Flanders, Belgium. Methods: In phase one a literature review, current practice analysis, and problem and needs analysis were per- formed. In phase two, the INTENSS training intervention was developed, framed within the Self-Determination Theory and the 5A’s-Model. The training consisted of a basic training module and a video-interaction guidance module. The intervention was subsequently tested in eight training groups (N = 73). Participants provided feedback during focus group discussions. The intervention was cyclically adapted to trainees experiences and suggestions. In phase three, we evaluated the need-supportive character of the training intervention. Results: Phase one indicated the need for training, since nurses application of self-management support was limited and practiced from a narrow medical point of view. In phase two we developed a theory-driven and multifaceted training, building on attitude, knowledge, skills and reflection in the training. The training was framed within the Self-Determination Theory both at the didactical level as well as on content and format. Overall, participants appreciated the building blocks of the training as supporting their basic needs for auton- omy, relatedness and competence. Conclusions: INTENSS, a multifaceted need-supportive training in self-management support was developed, successfully taking into account participants needs.
keywords: توسعه مداخله | آموزش | تحصیلات | نظریه خود تعیین | پشتیبانی از خود مدیریت | مراقبت های بهداشتی | پرستاری | بیماری مزمن | Intervention development | Training | Education | Self-determination theory | Self-management support | Health care | Nursing | Chronic illness
مقاله انگلیسی
3 Optimization of supply chain networks with inclusion of labor: Applications to COVID-19 pandemic disruptions
بهینه سازی شبکه های زنجیره تامین با گنجاندن نیروی کار: برنامه های کاربردی برای اختلالات همه گیر COVID-19-2021
In this paper, we respond to the COVID-19 pandemic by constructing supply chain network optimization models, which explicitly include labor as an important variable in the network economic activity links, along with associated capacities. Labor is a critical resource in supply chains from production to transportation, storage, and distribution. In a pandemic, the availability of labor for different supply chain network activities may be disrupted due to illness, fear of contagion, morbidity, necessity of social/physical distancing, etc. The modeling framework considers first elastic demands for a product and then fixed demands, coupled with distinct types of labor capacities in order to capture the availability of this valuable resource in a pandemic, as well as possible flexibility. The supply chain network framework, which includes electronic commerce, is relevant to many different supply chain applications including protective personal and medical equipment, as well as to particular food items. Theoretical results as well as computed numerical examples are presented.
Keywords: Pandemic | Supply chains | Labor resources | Disruptions | Network optimization | Healthcare
مقاله انگلیسی
4 PGx in psychiatry: Patients knowledge, interest, and uncertainty management preferences in the context of pharmacogenomic testing
PGX در روانپزشکی: بیماران، سود و عدم اطمینان در زمینه تست های فارماکوژنیوم-2021
Objective: Pharmacogenomic testing (PGx) is expanding into psychiatric care. PGx could potentially offer a unique benefit to psychiatric patients, providing information about patients’ reaction to medications that could reduce the time and financial burdens of drug optimization. The aims of this study were to: (1) examine psychiatry patients’ familiarity and interest in PGx, and (2) explore how Uncertainty Management Theory relates to PGx testing in psychiatry.
Method: We surveyed psychiatric patients, measuring their PGx familiarity and interest, attitudes toward PGx testing, and preference for managing illness uncertainty.
Results: We analyzed data from 598 patients. Patients’ familiarity of PGx was low, but interest was high. Thirty percent of patients were familiar with the test from communication with their healthcare provider or their own online health information seeking. A preference for seeking information was a significant positive predictor of testing interest (p < .001).
Conclusion: Psychiatric patients were interested in PGx testing, regardless of their uncertainty management preferences.
Practice implications: This study is one of the first to examine psychiatric patients’ perspectives on PGx testing in mental health care. Our findings show that psychiatric patients are interested in the test and are familiar enough with PGx to be included in future research on the topic.
keywords: فارماکوژنومیک | عدم قطعیت | روانپزشکی | آزمایش ژنتیک | نظریه مدیریت عدم قطعیت | Pharmacogenomics | Uncertainty | Psychiatry | Genetic testing | Uncertainty Management Theory
مقاله انگلیسی
5 “I didn’t know what I could do”: Behaviors, knowledge and beliefs, and social facilitation after distal radius fracture
"من نمی دانستم چه کاری می توانم انجام دهم": رفتارها، دانش و باورها، و تسهیل اجتماعی پس از شکستگی رادیوس دیستال-2021
Background: Biomedical models have limitations in explaining and predicting recovery after distal radius fracture (DRF). Variation in recovery after DRF may be related to patients’ behaviors and beliefs, factors that can be framed using a lens of self-management. We conceptualized the self-management process using social cognitive theory as reciprocal interactions between behaviors, knowledge and beliefs, and social facilitation. Understanding this process can contribute to needs identification to optimize recovery. Purpose: Describe the components of the self-management process after DRF from the patient’s perspec- tive. Study design: Qualitative descriptive analysis. Methods: Thirty-one adults aged 45-72 with a unilateral DRF were recruited from rehabilitation centers and hand surgeons’ practices. They engaged in one semi-structured interview 2-4 weeks after discon- tinuation of full-time wrist immobilization. Data were analyzed using qualitative descriptive techniques, including codes derived from the data and conceptual framework. Codes and categories were organized using the three components of the self-management process. Results: Participants engaged in medical, role, and emotional management behaviors to address multidi- mensional sequelae of injury, with various degrees of self-direction. They described limited knowledge of their condition and its medical management, naive beliefs about their expected recovery, and uncer- tainty regarding safe movement and use of their extremity. They reported informational, instrumental, and emotional support from health care professionals and a broader circle. Conclusions: Descriptions of multiple domains of behaviors emphasized health-promoting actions beyond adherence to medical recommendations. Engagement in behaviors was reciprocally related to partici- pants’ knowledge and beliefs, including illness and pain-related perceptions. The findings highlight rel- evance of health behavior after DRF, which can be facilitated by hand therapists as part of the social environment. Specifically, hand therapists can assess and address patients’ behaviors and beliefs to sup- port optimal recovery. © 2021 Elsevier Inc. All rights reserved.
keywords: اعتقاد | درمان دست | رفتار بهداشتی | کیفی | محیط اجتماعی | Belief | Hand therapy | Health behavior | Qualitative | Social environment
مقاله انگلیسی
6 Comparing views on civil commitment for drug misuse and for mental illness among persons with opioid use disorder
مقایسه دیدگاه ها در مورد تعهد مدنی برای سو مصرف مواد و بیماری روانی در بین افراد مبتلا به اختلال استفاده از مواد افیونی-2020
Despite the growing use of civil commitment for drug use disorders, little is known about attitudes among individuals who might be subject to civil commitment. This study examined attitudes of persons with opioid use disorder toward civil commitment for drug misuse and for psychiatric illness. Consecutive persons entering a brief, inpatient opioid detoxification (n = 254) were surveyed regarding their attitudes about civil commitment for mental illness and for drug use, and responses were compared by commitment type and by individual history of being civilly committed for opioid misuse. Participants endorsed high support for civil commitment (both psychiatric and drug misuse-related) when used to address risk of harm to self, to others, and of criminal activity. Respondents were more likely to support civil commitment for psychiatric disorders than for drug misuse, expressing higher support for civil commitment in general, higher agreement with the criteria used to justify civil commitment, and greater perceived efficacy of commitment. Individuals previously committed for opioid misuse were less likely to support drug misuserelated commitment on the basis of its perceived efficacy. These results suggest individuals with opioid use disorder hold more favorable views toward civil commitment for mental health disorders than for drug misuse, and reinforce the need for more research on the procedures and outcomes related to civil commitment for drug misuse.
مقاله انگلیسی
7 Reinforcement learning as an intermediate phenotype in psychosis? Deficits sensitive to illness stage but not associated with polygenic risk of schizophrenia in the general population
یادگیری تقویتی به عنوان یک فنوتیپ متوسط در روان پریشی؟ کمبودهای حساس به مرحله بیماری اما با خطر پلی ژنیک اسکیزوفرنی در جمعیت عمومی ارتباط ندارد-2020
Background: Schizophrenia is a complex disorder in which the causal relations between risk genes and observed clinical symptoms are not well understood and the explanatory gap is too wide to be clarified without considering an intermediary level. Thus, we aimed to test the hypothesis of a pathway frommolecular polygenic influence to clinical presentation occurring via deficits in reinforcement learning. Methods: We administered a reinforcement learning task (Go/NoGo) that measures reinforcement learning and the effect of Pavlovian bias on decision making. We modelled the behavioural data with a hierarchical Bayesian approach (hBayesDM) to decompose task performance into its underlying learning mechanisms. Study 1 included controls (n = 29, F|M = 0.81), At Risk Mental State for psychosis (ARMS, n = 23, F|M= 0.35) and FEP (First-episode psychosis, n = 26, F|M = 0.18). Study 2 included healthy adolescents (n = 735, F|M = 1.06), 390 of whom had their polygenic risk scores for schizophrenia (PRSs) calculated. Results: Patients with FEP showed significant impairments in overriding Pavlovian conflict, a lower learning rate and a lower sensitivity to both reward and punishment. Less widespread deficits were observed in ARMS. PRSs did not significantly predict performance on the task in the general population, which only partially correlated with measures of psychopathology. Conclusions: Reinforcement learning deficits are observed in first episode psychosis and, to some extent, in those at clinical risk for psychosis, and were not predicted by molecular genetic risk for schizophrenia in healthy individuals. The study does not support the role of reinforcement learning as an intermediate phenotype in psychosis.
Keywords: Psychosis | Schizophrenia | PRS | Bayesian | Reinforcement learning | Go/NoGo task | Computational psychiatry
مقاله انگلیسی
8 Gender-specific participation and outcomes among jail diversion clients with co-occurring substance use and mental health disorders
مشارکت و نتایج خاص جنسیت در میان انحراف مراجعه کنندگان به زندان با مصرف همزمان مواد و اختلالات سلامت روان-2020
Men and women with co-occurring substance use disorders and mental illness are at relatively high risk for becoming involved in the criminal justice system. Programs, such as post-booking jail diversion, aim to connect these individuals to community-based treatment services in lieu of pursuing criminal prosecution. Gender ap- pears to have an important influence on risk factors and pathways through the criminal justice system, which in turn may influence how interventions like jail diversion work to engage men and women in treatment services and reduce recidivism. Different circumstances, levels of engagement, and outcomes by gender may be related to both person-level characteristics and external factors such as availability of gender-specific services and re- sources. This mixed-methods study identified specific ways in which men and women use services and reoffend after being diverted, and complemented those findings with in-depth insights from program clinicians about how program experiences and resources differ in important ways by gender. We matched and merged administrative records from 2007 to 2009 for 16,233 adults from several state agencies in Connecticut, and included data on demographic characteristics, clinical diagnoses, outpatient and inpatient behavioral health treatment utilization, arrest, and incarceration. Using propensity analysis, the 1693 men and women who participated in the statewide jail diversion program were matched to respective comparison groups of nondiverted men and women. We used longitudinal multivariable regression analyses to estimate the effects of jail diversion participation on treatment utilization, arrest, and incarceration, separately for men and women. We conducted three focus groups with jail diversion clinicians from around the state (n = 21) to gain in-depth insight from them about how circumstances, program experiences, and resources differ by gender in important ways; these subjective clinician insightscomplement the quantitative analyses of diversion outcomes for men and women. For both men and women, diversion was associated with reductions in risk for incarceration and increases in utilization of outpatient treatment services. For men only, diversion was associated with higher utilization of inpatient mental health care. No differences in treatment or criminal justice outcomes were observed in models that compared men and women directly. Major themes from the focus groups included: the existence of too few inpatient and residential resources for women with co-occurring disorders; different challenges to treatment engagement that men and women face; and a need for more effective, gender-specific services for all program participants. Results from this mixed-methods study offer information on gender-specific program outcomes and surrounding circum- stances that can help programs to better understand and address unique risks and needs for men and women with co-occurring substance use and mental health disorders who are involved in the criminal justice system.
Keywords: Substance use disorders | Mental illness | Co-occurring disorders | Jail diversion | Gender
مقاله انگلیسی
9 From working on recovery to working in recovery: Employment status among a nationally representative U.S. sample of individuals who have resolved a significant alcohol or other drug problem
از کار بر روی بهبودی تا کار در بهبودی: وضعیت اشتغال در بین یک نمونه نماینده ملی ایالات متحده از افرادی که مشروبات الکلی یا مشکل دارویی را حل کرده اند-2020
Alcohol and other drug (AOD) use disorders exact a prodigious annual economic toll in the United States (U.S.), driven largely by lost productivity due to illness-related absenteeism, underemployment, and unemployment. While recovery from AOD disorders is associated with improved health and functioning, little is known specifically about increases in productivity due to new or resumed employment and who may continue to struggle. Also, because employment can buffer relapse risk by providing structure, meaning, purpose, and income, greater knowledge in this regard would inform relapse prevention efforts as well as employment-related policy. We conducted a cross-sectional, nationally representative survey of the U.S. adult population assessing persons who reported having resolved an AOD problem (n = 2002). Weighted employment, unemployment, retirement, and disability statistics were compared to the general U.S. population. Logistic and linear regression models tested for differences in employment and unemployment among demographic categories and measures of well-being. Compared to the general U.S. population, individuals who had resolved an AOD problem were less likely to be employed or retired, and more likely to be unemployed and disabled. Certain recovering subgroups, including those identifying as black and those with histories of multiple arrests, were further disadvantaged. Conversely, certain factors, such as a higher level of education and less prior criminal justice involvement were associated with lower unemployment risk. Despite being in recovery from an AOD problem, individuals continue to struggle with obtaining employment, particularly black Americans and those with prior criminal histories. Given the importance of employment in addiction recovery and relapse prevention, more research is needed to identify employment barriers so that they can be effectively addressed.
Keywords: Employment | Unemployment | Under employment | Alcohol and other drugs | Substance use disorder | Addiction recovery | Disparities
مقاله انگلیسی
10 An Updated Systematic Review and Meta-regression Analysis: Mental Disorders Among Adolescents in Juvenile Detention and Correctional Facilities
یک مرور سیستماتیک و تجزیه و تحلیل متا رگرسیون به روز شده: اختلالات روانی در نوجوانان در بازداشتگاههای نوجوانان و زندانهای اصلاح و تربیت-2020
Objective: To synthesize evidence on the prevalence of mental disorders in adolescents in juvenile detention and correctional facilities and examine sources of heterogeneity between studies. Method: Electronic databases and relevant reference lists were searched to identify surveys published from January 1966 to October 2019 that reported on the prevalence of mental disorders in unselected populations of detained adolescents. Data on the prevalence of a range of mental disorders (psychotic illnesses, major depression, attention-deficit/hyperactivity disorder [ADHD], conduct disorder, and posttraumatic stress disorder [PTSD]) along with predetermined study characteristics were extracted from the eligible studies. Analyses were reported separately for male and female adolescents, and findings were synthesized using random-effects models. Potential sources of heterogeneity were examined by meta-regression and subgroup analyses. Results: Forty-seven studies from 19 countries comprising 28,033 male and 4,754 female adolescents were identified. The mean age of adolescents assessed was 16 years (range, 10–19 years). In male adolescents, 2.7% (95% CI 2.0%–3.4%) had a diagnosis of psychotic illness; 10.1% (95% CI 8.1%–12.2%) major depression; 17.3% (95% CI 13.9%–20.7%) ADHD; 61.7% (95% CI 55.4%–67.9%) conduct disorder; and 8.6% (95% CI 6.4%–10.7%) PTSD. In female adolescents, 2.9% (95% CI 2.4%–3.5%) had a psychotic illness; 25.8% (95% CI 20.3%–31.3%) major depression; 17.5% (95% CI 12.1%–22.9%) ADHD; 59.0% (95% CI 44.9%–73.1%) conduct disorder; and 18.2% (95% CI 13.1%–23.2%) PTSD. Metaregression found higher prevalences of ADHD and conduct disorder in investigations published after 2006. Female adolescents had higher prevalences of major depression and PTSD than male adolescents. Conclusion: Consideration should be given to reviewing whether health care services in juvenile detention can address these levels of psychiatric morbidit
Key words: criminal justice | detention | mental disorders | PTSD | systematic review
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