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Raak, Ragnhild, Ingrid Hurtig, and Lis Karin Wahren. "Coping Strategies and Life Satisfaction in Subgrouped Fibromyalgia Patients." Biological Research For Nursing 4, no. 3 (January 2003): 193–202. http://dx.doi.org/10.1177/1099800402239622.
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The present study describes pain- and stress-coping strategies and life satisfaction in subgroups of fibromyalgia patients. Thirty-two females with fibromyalgia syndrome (FMS) and 21 healthy pain-free women were studied. Those with FMS were classified as thermal (both heat and cold) pain sensitive or slightly cold pain sensitive based on pain thresholds determined using a Thermotest device. Global stress-coping styles, life satisfaction, and specific pain-coping strategies were measured. Patients classified as thermal pain sensitive were affected by physical symptoms to a greater extent than were those classified as slightly cold pain sensitive. The thermal pain sensitive group used more diverting attention coping strategies than the slightly cold pain sensitive group did. Separating fibromyalgia patients into subgroups might increase the potential for improving nursing care of these patients. Through the use of effective coping strategies in dealing with stress and pain, life satisfaction may also be enhanced.
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Wong, W., P. Chen, Y. Chow, H. Lim, S. Wong, L. McCracken, and R. Fielding. "The relationship between pain coping variability and committed action in chronic pain adjustment." European Psychiatry 33, S1 (March 2016): S209. http://dx.doi.org/10.1016/j.eurpsy.2016.01.499.
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IntroductionResearch evidenced the association of pain coping strategies with short-term and long-term adjustments to chronic pain. Yet, previous studies mainly assessed the frequency of coping strategies when pain occurs whilst no data is available on one's flexibility/rigidity in using different pain coping strategies, i.e., pain coping variability, in dealing with different situations.ObjectivesThis study aimed to examine the multivariate association between pain coping variability and committed action in predicting concurrent pain-related disability. Specifically, we examined the independent effects of pain coping variability and committed action in predicting concurrent pain-related disability in a sample of Chinese patients with chronic pain.MethodsChronic pain patients (n = 287) completed a test battery assessing pain intensity/disability, pain coping strategies and variability, committed action, and pain catastrophizing. Multiple regression modeling compared the association of individual pain coping strategies and pain coping variability with disability (Models 1–2), and examined the independent effects of committed action and pain coping variability on disability (Model 3).ResultsOf the 8 coping strategies assessed, only guarding (std β = 0.17) was emerged as significant independent predictor of disability (Model 1). Pain coping variability (std β = −0.10) was associated with disability after controlling for guarding and other covariates (Model 2) and was emerged as independent predictor of disability (Model 3: std β = −0.11) (all P < 0.05) (Tables 1 and 2).ConclusionsOur data offers preliminary support for the multivariate association between pain coping variability and committed action in predicting concurrent pain-related disability, which supplements the existing pain coping data that are largely based on assessing frequency of coping.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Esteve, Rosa, Alicia E. López-Martínez, Madelon L. Peters, Elena R. Serrano-Ibáñez, Gema T. Ruiz-Párraga, and Carmen Ramírez-Maestre. "Optimism, Positive and Negative Affect, and Goal Adjustment Strategies: Their Relationship to Activity Patterns in Patients with Chronic Musculoskeletal Pain." Pain Research and Management 2018 (2018): 1–12. http://dx.doi.org/10.1155/2018/6291719.
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Objective. Activity patterns are the product of pain and of the self-regulation of current goals in the context of pain. The aim of this study was to investigate the association between goal management strategies and activity patterns while taking into account the role of optimism/pessimism and positive/negative affect. Methods. Two hundred and thirty-seven patients with chronic musculoskeletal pain filled out questionnaires on optimism, positive and negative affect, pain intensity, and the activity patterns they employed in dealing with their pain. Questionnaires were also administered to assess their general goal management strategies: goal persistence, flexible goal adjustment, and disengagement and reengagement with goals. Results. Structural equation modelling showed that higher levels of optimism were related to persistence, flexible goal management, and commitment to new goals. These strategies were associated with higher positive affect, persistence in finishing tasks despite pain, and infrequent avoidance behaviour in the presence or anticipation of pain. Conclusions. The strategies used by the patients with chronic musculoskeletal pain to manage their life goals are related to their activity patterns.
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Sanders, Matthew R., Geoffrey Cleghorn, Ross W. Shepherd, and Mark Patrick. "Predictors of Clinical Improvement in Children with Recurrent Abdominal Pain." Behavioural and Cognitive Psychotherapy 24, no. 1 (January 1996): 27–38. http://dx.doi.org/10.1017/s1352465800016817.
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Forty-three children with recurrent abdominal pain who had received treatment from a paediatric gastroenterology clinic were reassessed 6 and 12 months after initial presentation. Measures of children's pain included a pain diary (PD) which measured pain intensity, a parent observation record (POR) which assessed pain behaviour and a structured interview to assess the degree to which pain interferes with the child's activities. Pretreatment measures of the child's history of pain, coping strategies in dealing with pain, and their mother's caregiving strategies were examined as predictors of two indices of clinical improvement: the extent of change in pain on the child's pain diary from pre-test to 6 months follow-up, and the degree of interference to the child's activities. All children had shown significant improvement in the level of pain at follow up, with 74.4% being pain free at 12 month follow-up on the PD and 83.7% being pain free on the POR. The amount of change they showed varied, with some showing residual impairment even though they were significantly improved. Regression analyses showed that children with greatest reductions on the child's pain diary at the 6 month follow-up were those with a stress-related mode of onset, whose mothers used more adaptive caregiving strategies, and who received cognitive behavioural family intervention. There was also a non significant trend for younger children to fare better. These data suggest the importance of early diagnosis and routinely assessing parental caregiving behaviour and beliefs about the origins of pain in planning treatment for children with RAP.
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Gandolfi, Marialuisa, Valeria Donisi, Simone Battista, Alessandro Picelli, Nicola Valè, Lidia Del Piccolo, and Nicola Smania. "Health-Related Quality of Life and Psychological Features in Post-Stroke Patients with Chronic Pain: A Cross-Sectional Study in the Neuro-Rehabilitation Context of Care." International Journal of Environmental Research and Public Health 18, no. 6 (March 17, 2021): 3089. http://dx.doi.org/10.3390/ijerph18063089.
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This study aims at exploring disability, health-related quality of life (HrQoL), psychological distress, and psychological features in post-stroke patients with chronic pain. An observational cross-sectional study involving 50 post-stroke patients (25 with chronic pain and 25 without pain) was conducted. The primary outcome was the self-reported level of disability and HrQoL which were both assessed through the Stroke Impact Scale 3.0. Both psychological distress and specific psychological features (i.e., self-efficacy, coping strategies, psychological flexibility, perceived social support) were examined. Post-stroke patients with chronic pain reported statistically significant higher levels of disability and worse HrQoL, higher psychological distress and inflexibility, as well as a lower level of self-efficacy and problem-oriented coping strategies than patients without pain (p < 0.001). Finally, correlation analysis in the group of stroke survivors with pain showed that higher levels of disability were significantly related to higher psychological distress. This study confirms the negative influence of chronic pain on disability and HrQoL in post-stroke patients and presents preliminary insights on the association between chronic pain, disability, HrQoL, psychosocial distress, and the patient’s approach in dealing with personal difficulties and emotions. These findings carry further implications for multidisciplinary management of post-stroke patients with chronic pain.
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Klich, Urszula. "A Case Study in the Use of Mindfulness-Based Biofeedback for Anxiety Reduction in a Chronic Pain Patient with a Spinal Cord Injury Preparing for Decannulation." Biofeedback 47, no. 3 (November 1, 2019): 63–70. http://dx.doi.org/10.5298/1081-5937-47.3.04.
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A clinical approach centered on teaching self-regulation and compassion can assist patients dealing with pain and anxiety to feel more control over their environment. Compassion, found to be a critical variable in the therapeutic benefit of mindfulness-based techniques, can be combined with biofeedback to maximize the advantageous psychological and physical changes that are seen with both. This article will present treatment considerations in a case in which compassion-based strategies within mindfulness-based biofeedback treatment were used with a patient experiencing anxiety related to pain and fear of undergoing a medical procedure for decannulation.
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Morden, Andrew, Clare Jinks, and Bie Nio Ong. "Temporally divergent significant meanings, biographical disruption and self-management for chronic joint pain." Health: An Interdisciplinary Journal for the Social Study of Health, Illness and Medicine 21, no. 4 (August 19, 2015): 357–74. http://dx.doi.org/10.1177/1363459315600773.
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Self-management is recommended by policy and clinical guidelines as a way to contend with the growing incidence of osteoarthritis-related joint pain in an ageing population. Sociologists assert that self-management is as much about lay strategies for dealing with the biographically disruptive qualities of chronic illness as opposed to solely complying with medical regimens. The original concept of biographical disruption coined by Bury is not uncontested. Chronic joint pain has been characterised as featuring ‘co-existing meanings’ of significance and consequence. The former conferring no biographical disruption due to osteoarthritis being associated with ‘normal ageing’ and the latter causing biographical disruption due to the corporeal limitations joint pain imparts, which, in turn, can influence whether, why and how self-management is undertaken. This article reports findings from repeat interviews and a diary study completed by 22 participants with chronic knee pain. We explore the co-existing but temporally divergent ‘meanings as significance’ associated with knee pain. Participants describe the onset and current experience of the pain in terms of biographical normality (retrospective or contemporaneous meanings). Future meanings as significance are mediated by cultural beliefs about ageing and current physical consequences of the condition, and also have a distinct character of their own. Knee pain is associated with the possibility of disability and harbours a distinct risk; potential disruption to everyday social relationships, notably relating to care and dependency. In turn, future meanings of significance influence the preventative self-management strategies that people utilise. We argue for a more cogent theoretical understanding of temporal dimensions of biographical disruption, biographical work and subsequent self-management by utilising and extending the thought of Bury, and Corbin and Strauss. Doing so helps to understand patient self-management strategies and facilitates self-management support in clinical settings for osteoarthritis and potentially other chronic conditions.
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Wong, W., Y. Chow, S. Wong, P. Chen, H. Lim, L. McCracken, and R. Fielding. "The role of coping flexibility in chronic pain adjustment: Preliminary analysis." European Psychiatry 33, S1 (March 2016): S208—S209. http://dx.doi.org/10.1016/j.eurpsy.2016.01.498.
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IntroductionWhile a body of research has evidenced the role of pain coping in chronic pain adjustment, the role of coping flexibility in chronic pain adjustment has received little research attention. Coping flexibility can be conceptualized with two dimensions, cognitive and behavioral. The cognitive dimension of coping flexibility (or coping appraisal flexibility) refers to one's appraisal of pain experience when changing coping strategies whereas the behavioral dimension of coping flexibility denotes the variety of coping responses individuals use in dealing with stressful demands.ObjectiveThe aim of this paper is to present preliminary findings on the role of coping flexibility in chronic pain adjustment by assessing 3 competing models of pain coping flexibility (see Figs. 1–3).MethodsPatients with chronic pain (n = 300) completed a battery of questionnaire assessing pain disability, discriminative facility, need for closure, pain coping behavior, coping flexibility, and pain catastrophizing. The 3 hypothesized models were tested using structural equation modeling (SEM). In all models tested, need for closure and discriminative facility were fitted as the dispositional cognitive and motivational factors respectively underlying the coping mechanism, whereas pain catastrophizing and pain intensity were included as covariates.ResultsResults of SEM showed that the hierarchical model obtained the best data-model fit (CFI = 0.96) whereas the other two models did not attain an accept fit (CFI ranging from 0.70–0.72).ConclusionOur results lend tentative support for the hierarchical model of pain coping flexibility that coping variability mediated the effects of coping appraisal flexibility on disability.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Liu, Yiran. "Targeting Cystic Fibrosis: A review from Pathogenesis to Innovative Clinical Strategies." E3S Web of Conferences 245 (2021): 03053. http://dx.doi.org/10.1051/e3sconf/202124503053.
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Cystic fibrosis is a hereditary disease caused by mutation in cystic fibrosis transmembrane conductance regulator (CFTR) gene, which controls CFTR proteins. Many are or have been threatened by this rare but life-threating disease, therefore, more attention should be paid to better solve this public health issue. Here we provide a thorough review about cystic fibrosis in the aspects of disease pathogenesis, clinical manifestation as well as clinical therapeutics to achieve a deeper understanding of this disease. Among the demand of innovative clinical strategies, appearance of the combination drug trikafta is a promising sign of better dealing with cystic fibrosis.
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Savage, David W., David L. Martell, and B. Mike Wotton. "Forest management strategies for dealing with fire-related uncertainty when managing two forest seral stages." Canadian Journal of Forest Research 41, no. 2 (February 2011): 309–20. http://dx.doi.org/10.1139/x10-212.
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Ecological values are an important aspect of sustainable forest management, but little attention has been paid to maintaining these values when using traditional linear programming (LP) forest management planning models in uncertain planning environments. We embedded an LP planning model that specifies when and how much to harvest in a simulation model of a “managed” flammable forest landscape. The simulation model was used to evaluate two strategies for dealing with fire-related uncertainty when managing mature and old forest areas. The two seral stage areas were constrained in the LP planning model to a minimum of 10% of the total forest area and the strategies were evaluated under four representative fire regimes. We also developed a risk analysis tool that can be used by forest managers that wish to incorporate fire-related uncertainty in their decision-making. We found that use of the LP model would reduce the areas of the mature and old forest to their lower bound and fire would further reduce the seral areas below those levels, particularly when the mean annual burn fraction exceeds 0.45% per annum. Increasing the minimum area required (i.e., the right-hand side of the constraint) would increase the likelihood of satisfying the minimum area requirements.
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Bedard, Geneviève Bianca V., Graham J. Reid, Patrick J. McGrath, and Christine T. Chambers. "Coping and Self-Medication in a Community Sample of Junior High School Students." Pain Research and Management 2, no. 3 (1997): 151–56. http://dx.doi.org/10.1155/1997/254142.
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OBJECTIVE: To examine differences between high and low catastrophizers in terms of pain, self-medication, coping, age and sex.DESIGN: Data were collected from 651 junior high students. Coping was assessed in response to pain in general. Pain (intensity and frequency) and self-medication were assessed in response to five types of pain: headache, stomach, muscle and/or joint and/or back, ear and/or throat, and menstrual pains.RESULTS: Catastrophizing groups were formed based on scores from the upper and lower thirds of a catastrophizing scale. The high catastrophizing group had higher levels of pain intensity and frequency for all five types of pain, and self-medicated more for headache, and ear and/or throat pain, compared with the low catastrophizing group. High catastrophizers reported taking over-the-counter (OTC) medication more frequently than low catastrophizers. High catastrophizers used information seeking, problem solving, social support seeking, positive self-statements and externalization more often than low catastrophizers. Low catastrophizers used behavioural and cognitive distraction more often than high catastrophizers. High catastrophizers perceived themselves to have more difficulty in dealing with pain and less control over their emotions when in pain than low catastrophizers. There were no significant differences between high and low catastrophizers in terms of controllability of pain. There was a higher percentage of catastrophizers in grade 9 than in grades 7 or 8 and a higher percentage of girls catastrophizing than boys.CONCLUSIONS: More frequent use of coping strategies while experiencing greater pain intensity and frequency may reflect catastrophizers' general inability to reduce pain. Greater use of OTC medications by catastrophizers is likely due to their experiences of more frequent and intense pain.
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Kucmanski, Luciane Salete, Leoni Zenevicz, Daniela Savi Geremia, Valeria Silvana Faganello Madureira, Tatiana Gaffuri da Silva, and Sílvia Silva de Souza. "Alzheimer’s desease: challenges faced by family caregivers." Revista Brasileira de Geriatria e Gerontologia 19, no. 6 (December 2016): 1022–29. http://dx.doi.org/10.1590/1981-22562016019.150162.
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Abstract Gaps identified in Brazilian health policies and the need to develop and implement strategies for the empowerment and monitoring of family caregivers support the development of care proposals aimed at the family. The present study aimed to analyze the challenges faced by family members providing day to day care of patients with Alzheimer's disease in the city of Chapecó, Santa Catarina. The method employed was the qualitative approach through semi-structured interviews. The speeches were grouped, categorized and analyzed using the hermeneutic method. The results showed that during the period of Alzheimer's disease, caregivers experience a range of situations, including: a need to learn about the disease; dealing with guilt; and handling situations of pain, addiction and physical and psychological suffering. In conclusion the study described the challenges of the daily lives of these families, explaining the importance of and highlighting the need to adopt tools and strategies that provide physical, emotional, psychological and financial support to family caregivers of patients with Alzheimer's disease.
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Pellico, Linda H., Wesley P. Gilliam, Allison W. Lee, and Robert D. Kerns. "Hearing New Voices: Registered Nurses and Health Technicians Experience Caring for Chronic Pain Patients in Primary Care Clinics." Open Nursing Journal 8, no. 1 (September 9, 2014): 25–33. http://dx.doi.org/10.2174/1874434601408010025.
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Recent national estimates from the U.S. reveal that as many as one-third of all Americans experience chronic pain resulting in high prevalence rates of visits to primary care clinics (PCC). Indeed, chronic pain appears to be an emerging global health problem. Research has largely ignored the perspective of PCC staff other than physicians in providing care for patients with chronic pain. We wanted to gain insights from the experiences of Registered Nurses (RNs) and Health Technicians (HTs) who care for this patient population. Krippendorff’s method for content analysis was used to analyze comments written in an open-ended survey from fifty-seven primary care clinic staff (RNs-N=27 and HTs-N=30) respondents. This represented an overall response rate of 75%. Five themes emerged related to the experience of RNs and HTs caring for patients with chronic pain: 1) Primacy of Medications and Accompanying Clinical Quandaries; 2) System Barriers; 3) Dealing with Failure; 4) Primacy of Patient Centered Care; and 5) Importance of Team Based Care. This study demonstrates that nursing staff provide patient-centered care, recognize the importance of their role within an interdisciplinary team and can offer valuable insight about the care of patients with chronic pain. This study provides insight into strategies that can mitigate barriers to chronic pain management while sustaining those aspects that RNs and HTs view as essential for improving patient care for this vulnerable population in PCCs.
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Bailly, F., V. Foltz, S. Rozenberg, B. Fautrel, and L. Gossec. "SAT0403 Patients with Chronic Low Back Pain Develop Over Time Positive Coping Strategies Include Striving for Normality, Dealing with Pain, Having High Levels of Physical Activity and Maintaining Social Connections: A Qualitative Study." Annals of the Rheumatic Diseases 72, Suppl 3 (June 2013): A719.3—A719. http://dx.doi.org/10.1136/annrheumdis-2013-eular.2127.
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Delgado-Pérez, Esther, Isabel Rodríguez-Costa, Fernando Vergara-Pérez, María Blanco-Morales, and María Torres-Lacomba. "Recovering Sexuality after Childbirth. What Strategies Do Women Adopt? A Qualitative Study." International Journal of Environmental Research and Public Health 19, no. 2 (January 15, 2022): 950. http://dx.doi.org/10.3390/ijerph19020950.
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This study aimed to determine the strategies used by women to adapt to the changes that affect the first sexual relations after childbirth. A qualitative study with a phenomenological approach used three data collection techniques (in-depth interviews, discussion groups, and online forums). Thirty-six women in the first six months postpartum participated in the study, from physiotherapy centers with maternal child specialties in several locations in Spain. Women with different types of delivery, presence or absence of perineal trauma during delivery, previous deliveries, and different types of breastfeeding were included. Among the strategies, closeness support and understanding were the ones that women used to adjust to the new situation, in order to improve the couple’s relationship, intimacy, and cope with the significant changes that appear in the first six months postpartum. Changes and adaptations in sexual practices become a tool for coping with a new sexuality, especially if it is affected by the presence of pain or discomfort associated with physical changes. Personal time facilitates emotional management and improvement of emotional changes related to the demands of motherhood. Accepting the changes that motherhood brings is critical to dealing with the new situation. Strategies used by postpartum women focus on acceptance, self-care, partner, couple time, personal time, and adapting encounters. The findings of this study are of interest to health professionals as they provide insight into how women cope with the changes that appear in the first six months postpartum. In this way, the findings will be able to transmit to couples the alternatives they can adopt before the resumption of sexual relations to improve satisfaction both as a couple and in terms of sexuality after childbirth.
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Michaut, Alexia, Lucie Planche, Lucie Auzanneau, and Grégoire Cormier. "Management of acromioclavicular joint disease by manual therapy versus corticosteroid injections: the protocol of a non-inferiority study." BMJ Open 10, no. 12 (December 2020): e034439. http://dx.doi.org/10.1136/bmjopen-2019-034439.
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IntroductionDegenerative acromioclavicular joint pain accounts for about 4% of shoulder pain. Various medical and non-medical treatment strategies are available for acromioclavicular joint disease but it is difficult to conduct a comparative evaluation of these treatments. The few studies dealing with the medical management of the disease have conducted no comparative assessment of drug therapies, physiotherapy, joint manipulation and corticosteroid injections. The primary goal of this study is to determine whether manual therapy is not inferior to ultrasound-guided injection of a corticosteroid preparation to decrease acromiocalvicular joint pain at 3 months.Methods and analysisThe acromioclavicular arthropathy managed by manual therapy is a monocentric, comparative, randomised, controlled, non-inferiority study conducted in the Rheumatology Department of Vendée Departmental Hospital, involving two parallel groups receiving either corticosteroid injections or manual therapy. The inclusion criteria are patients who suffer from pain in the shoulder or the proximal part of the arm, with pain located on palpation of the acromioclavicular joint associated with a positive cross-arm test and a positive O’Brien test. Randomisation will be at a 1:1 ratio. The injection group will receive a single ultrasound-guided injection of 1 mL of Diprostène and the manual therapy group will receive between one and three sessions at intervals of one per week. The primary outcome will be to compare the Visual Analogue Scale for pain-activity-related score at 3 months for both groups.Ethics and disseminationThe study project has been approved by the appropriate ethics committee (Committee for the Protection of Patients Ouest II in Angers, 30 April 2019, with the registration number of 2019/22). In agreement with current French regulations, signed informed written consent will be obtained from each patient. Results of the main trial and of the secondary endpoints will be submitted for publication in a peer-reviewed journal.Trial registration numberNCT03951480.
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Novysedláková, Mária, Katarína Zrubáková, Mariana Magerčiaková, and Eva Moraučíková. "COPING AND EMOTIONAL COMFORT OF CAREGIVERS." CBU International Conference Proceedings 6 (September 25, 2018): 944–51. http://dx.doi.org/10.12955/cbup.v6.1276.
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Introduction: The aim of this research is to find coping strategies for dealing with stress among caregivers who look after a chronically ill family member and to assess which of the most common emotions they are experiencing.Methods: We used a standard 28-item questionnaire Brief COPE (Carver, 1997) with Likert scale with values of 6-1 and standardized Variety habitual emotional, subjective well-being in this study (Džuka, Dalbert, 2002). The questionnaire was distributed by nurses who care for ill relatives in the Home Care Agency. We used descriptive statistical methods.Results: Exploratory data includes answers from 30 respondents, who were caregivers of a patient with chronic illness at home. The average age of respondents was 66.3 years + 4,5, ranged between 56 and 71 years old. Concerning the custodies, these were the most often the life partners - husband / wife (63 %). The average length of treatment was half a year - year (27 %). Top active strategies for coping with stress were: planning, instrumental social support, acceptance, religiosity, emotional support, with the average from 4,65 to 4,27. The least used coping strategies were humor and drug use. Respondents experienced more frequent negative than positive emotions - pain with average 4,30, sadness 4,24, fear 4.23,Conclusion: The study shows that the caregivers can select an active strategy to help them overcome difficulties while taking care of the sick. When assessing emotional survival, we found out that respondents had negative emotions.
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Swain, Santosh Kumar, and Pragnya Paramita Jena. "Clinical implications and future perspective of COVID-19 pandemic-a review." International Journal of Advances in Medicine 8, no. 2 (January 27, 2021): 334. http://dx.doi.org/10.18203/2349-3933.ijam20210287.
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Current COVID-19 pandemic poses unprecedented challenges for human being and still waiting for effective treatment strategies. The impact of the COVID-19 pandemic is truly devastating and raised several concerns among the people because of the worries and fear of catching an infection. Rapid spread of this pandemic is also causing crisis of the certain useful existing medications. The clinical presentations of the COVID-19 infections are mainly associated with otorhinolaryngological and respiratory manifestations which include throat pain, dry cough, fever, loss of smell, loss of taste and breathlessness. The use of the personal protective equipment (PPE) is an important preventive measure for a health care professional during dealing of the COVID-19 patients. Other than PPE, frequent hand washing, use of face mask and social distancing are important measures against COVID-19 infection. This review article focuses on the clinical aspects of the disease, diagnosis, preventive measures, future outlook and challenges faced by the developing and developing countries particularly for managing the ear, nose, throat, head and neck patients.
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Ware, Hannah, Avi Madan-Swain, Thomas H. Howard, Christina J. Bemrich-Stolz, Lee Hilliard, and Jeffrey D. Lebensburger. "Coping and Adjustment Among Adolescents with Sickle Cell Disease." Blood 124, no. 21 (December 6, 2014): 440. http://dx.doi.org/10.1182/blood.v124.21.440.440.
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Abstract Introduction: Living with sickle cell disease (SCD) and its associated complications and treatment can impact adolescent coping and adjustment, including peer relationships, participating in physical activities, and academic performance. Understanding the adolescent perspective on SCD and its impact on life activities will enable healthcare professionals to develop focused interventions to improve quality of life for adolescents and young adults (AYA) living with SCD. Objectives: To examine adolescent understanding of SCD and its impact on psychosocial functioning using exploratory qualitative research methodology. Methods: Twenty-one participants (ages 12-21 years old, median: 17 years, 12 female) with a diagnosis of sickle cell anemia (any variant) participated in IRB approved semi-structured interviews. Participants were recruited at routine sickle cell clinic visits and were on various treatment regimens such as chronic transfusions or Hydroxyurea. The interview protocol was piloted with AYA patients for content, understandability, and face validity. All interviews were recorded and transcribed by a single interviewer. All interview transcripts were independently coded by two researchers (In Vivo coding: codes are direct quotes) and required 100% agreement for a code to be included in the final codebook. Using the constant comparative method, codes were placed into categories and themes. A final construct of codes, categories, and themes was agreed upon by three researchers with expertise in psychology and SCD. Interviews did not continue past 21 participants since no new categories or themes were identified during the final interviews. Results: The overarching theme that emerged was the impact of SCD on psychosocial functioning of AYA as it related to coping and adjustment strategies. Three main subthemes relating to coping and adjustment were noted: social support, pain, and transition to adult care. Participants (20/21) reported sharing information about SCD with peers with and without SCD, with several expressing benefits to disclosure; “felt good to talk about it and get it off my chest,” “[friends] they help me out too. They get me water and take care of me.” All participants described benefits of developing relationships with other AYA with SCD and expressed a desire to meet peers with SCD; “it helps because they really know how you feel and what you go through,” “it would be helpful to hear about other people’s experiences and tips for dealing with things.” Participants (18/21) described their disease in terms of pain. Unpredictable pain events negatively impacted relationships with peers; “if I’m out and start feeling bad…it just reminds me that I’m not like everybody else.” Participants (2/21) described balancing taking medication to relieve pain and avoiding becoming dependent on pain medication. Primary concerns about transitioning to adult care included being viewed as drug-seeking by adult emergency department personnel and trusting an unfamiliar doctor’s judgment about their care and willingness to learn how their disease affected them as an individual. Surprisingly, 7/21 participants expressed some positive experiences from living with SCD including feeling “special,” “stronger and better,” and having a different perspective on life than peers without SCD. Conclusion: During adolescence, peer interactions play a major role in social and emotional development. Our findings strongly support the need for AYA with SCD to have opportunities to interact with healthy peers as well as those experiencing similar struggles related to SCD (SCD summer camps, social networking, teen support groups or mentoring). Participants identified pain as a defining characteristic of living with SCD and commented only on pharmacologic pain management. Participants expressed anxiety related to transitioning to adult care with particular focus on inadequate pain management at adult institutions. Our results suggest: 1) medical centers should focus on educating teens about pain and developing pain protocols that highlight teaching non-pharmacologic pain management strategies 2) improved pain management will positively impact quality of life and reduce anxiety about transition. Additionally, participants identified benefits to living with SCD, and future research should identify strategies to promote benefit finding behaviors in AYA with SCD. Disclosures No relevant conflicts of interest to declare.
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Beales, Darren, David Carolan, Joshua Chuah-Choong, Sarah Hammond, Eimear O’Brien, Eileen Boyle, Sonia Ranelli, David Holthouse, Tim Mitchell, and Helen Slater. "Exploring peoples’ lived experience of complex regional pain syndrome in Australia: a qualitative study." Scandinavian Journal of Pain 21, no. 2 (January 6, 2021): 393–405. http://dx.doi.org/10.1515/sjpain-2020-0142.
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Abstract Objectives Complex regional pain syndrome (CRPS) is a persistent pain condition which is often misunderstood and poorly managed. Qualitative studies are needed to explore the lived experience of the condition and to better understand patient perspectives on their management experiences and needs. The aim of this study was to explore the lived experience of CRPS in Australia, including exploration of their perceptions of care and advice received from healthcare professionals. Methods A qualitative study with individual in-depth semi-structured, face-to-face interviews was performed (n=15, 80% female, average time elapsed since diagnosis 3.8 years). Qualitative data were analysed using an inductive thematic analysis approach. Results Four main themes with associated subthemes were identified, representing the participants’ journey: (1) Life Changing Impact of CRPS (Subthemes: Impact on self, Impact on others); (2) Variable Experiences of Care (Subthemes: Helpful experiences of care, Unhelpful experiences of care); (3) Making Sense of CRPS (Subthemes: Knowledge and understanding, Dealing with unpredictability); and (4) Perceptions on Lessons Learned from Living with CRPS (Subthemes: Acceptance was an important part of the journey, Trial and error was necessary to find an individual way forward, Coping strategies). Conclusions The themes identified align to and expand on prior qualitative research findings in people with CRPS. It highlights the challenges people face related to their personal self, their close relationships and their social and work roles. It highlights the difficulties these people have in finding reliable, trust-worthy information. These findings suggest that healthcare professionals may benefit from education about how to better support people with CRPS, including helping people to navigate to the right care. Engaging people with CRPS in the development of educational resources should be a future research goal. It is recommended that patient perspectives are incorporated into the development of care pathways for CRPS.
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Matczak, P., J. Lewandowski, A. Choryński, M. Szwed, and Z. W. Kundzewicz. "Flood risk governance arrangements in Europe." Proceedings of the International Association of Hydrological Sciences 369 (June 11, 2015): 195–99. http://dx.doi.org/10.5194/piahs-369-195-2015.
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Abstract. The STAR-FLOOD (Strengthening and Redesigning European Flood Risk Practices Towards Appropriate and Resilient Flood Risk Governance Arrangements) project, funded by the European Commission, investigates strategies for dealing with flood risk in six European countries: Belgium, the UK, France, the Netherlands, Poland and Sweden and in 18 vulnerable urban regions in these countries. The project aims to describe, analyse, explain, and evaluate the main similarities and differences between the selected EU Member States in terms of development and performance of flood risk governance arrangements. It also discusses the scientific and societal importance of these similarities and differences. Attention is paid to identification and characterization of shifts in flood risk governance arrangements and in flood risk management strategies and to determination of triggering factors and restraining factors. An assessment of a change of resilience and appropriateness (legitimacy, effectiveness, efficiency) of flood risk governance arrangements in Poland is presented and comparison with other European countries is offered.
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Wójtowicz, Mirosław. "Wpływ światowego kryzysu gospodarczego na brazylijski i meksykański przemysł samochodowy." Studies of the Industrial Geography Commission of the Polish Geographical Society 17 (January 1, 2011): 129–43. http://dx.doi.org/10.24917/20801653.17.11.
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The aim of the study is to analyze the process of economic growth and changes of Brazilian and Mexican automobile industry in years 2000–2010. Special attention was paid to the situation of those industries in the years of global economic crisis and to strategies of dealing with the production and sales slump at the turn of years 2008–2009.The analysis confirmed disparities between Brazilian and Mexican automobile industries’ response to global economic crisis. The Mexican automobile sector was strongly affected by the slump in demand for new cars on the USA market whereas the Brazilian automobile sector experienced only a small production slowdown as the national demand for new cars soared.
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De Santis, Maria, Berardo Di Matteo, Emanuele Chisari, Gilberto Cincinelli, Peter Angele, Christian Lattermann, Giuseppe Filardo, Nicolò Danilo Vitale, Carlo Selmi, and Elizaveta Kon. "The Role of Wnt Pathway in the Pathogenesis of OA and Its Potential Therapeutic Implications in the Field of Regenerative Medicine." BioMed Research International 2018 (October 15, 2018): 1–8. http://dx.doi.org/10.1155/2018/7402947.
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Introduction. Osteoarthritis (OA) is a degenerative joint disease characterized by articular cartilage degradation, subchondral damage, and bone remodelling, affecting most commonly weight-bearing joints, such as the knee and hip. The loss of cartilage leads to joint space narrowing, pain, and loss of function which could ultimately require total joint replacement. The Wnt/β catenin pathway is involved in the pathophysiology of OA and has been proposed as a therapeutic target. Endogenous and pharmacological inhibitors of this pathway were recently investigated within innovative therapies including the use of platelet-rich plasma (PRP) and mesenchymal stem cells (MSCs). Methods. A review of the literature was performed on the PubMed database based on the following inclusion criteria: article written in English language in the last 20 years and dealing with (1) the role of Wnt-β catenin pathway in the pathogenesis of osteoarthritis and (2) pharmacologic or biologic strategies modulating the Wnt-β catenin pathway in the OA setting. Results. Evidences support that Wnt signalling pathway is likely linked to OA progression and severity. Its inhibition through natural antagonists and new synthetic or biological drugs shares the potential to improve the clinical condition of the patients by affecting the pathological activity of Wnt/β-catenin signalling. Conclusions. While further research is needed to better understand the mechanisms regulating the molecular interaction between OA regenerative therapies and Wnt, it seems that biologic therapies for OA exert modulation on Wnt/β catenin pathway that might be relevant in achieving the beneficial clinical effect of those therapeutic strategies.
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Potgieter, Nicoline, and Günther Streit. "Predictable sedation: Safe administration of oral Midazolam and nitrous oxide gas for paediatric patients in the general dental practice." South African Dental Journal 76, no. 08 (October 26, 2021): 471–76. http://dx.doi.org/10.17159/2519-0105/2021/v76no8a4.
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Behaviour management for anxious paediatric dental patients is challenging. Solutions include education and sedation. Various drugs have been used to effectively sedate paediatric patients during treatment. The aim of this study was to review literature on the sedation of paediatric patients. The study specifically looked at those reviews covering the combination of two sedation methods in case of more challenging paediatric patients. The study undertook a literature review focused on studies using nitrous oxide, Midazolam, or a combination of the two substances. An electronic search was done on EBSCOhost to source articles published from 1979 to 2019. A deeper form of sedation can be achieved for paediatric patients when using a combination of nitrous oxide, oxygen and a hypnotic agent such as Midazolam. Dealing with the anxiety levels of paediatric patients is a challenge for dental health providers. Two of the main strategies used to deal with anxious children are behaviour management and sedation. A critical review of journal articles on the use of nitrous oxide and oxygen in combination with Midazolam was therefore undertaken. The findings suggest that, in order to achieve a deeper form of sedation, the combination of nitrous oxide, oxygen and Midazolam works well to reduce discomfort, anxiety and/or pain in paediatric patients.
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Di Battista, Diego, David Merino, Giannis Zacharakis, Pablo Loza-Alvarez, and Omar E. Olarte. "Enhanced Light Sheet Elastic Scattering Microscopy by Using a Supercontinuum Laser." Methods and Protocols 2, no. 3 (July 5, 2019): 57. http://dx.doi.org/10.3390/mps2030057.
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Light sheet fluorescence microscopy techniques have revolutionized biological microscopy enabling low-phototoxic long-term 3D imaging of living samples. Although there exist many light sheet microscopy (LSM) implementations relying on fluorescence, just a few works have paid attention to the laser elastic scattering source of contrast available in every light sheet microscope. Interestingly, elastic scattering can potentially disclose valuable information from the structure and composition of the sample at different spatial scales. However, when coherent scattered light is detected with a camera sensor, a speckled intensity is generated on top of the native imaged features, compromising their visibility. In this work, we propose a novel light sheet based optical setup which implements three strategies for dealing with speckles of elastic scattering images: (i) polarization filtering; (ii) reducing the temporal coherence of the excitation laser light; and, (iii) reducing the spatial coherence of the light sheet. Finally, we show how these strategies enable pristine light-sheet elastic-scattering imaging of structural features in challenging biological samples avoiding the deleterious effects of speckle, and without relying on, but complementing, fluorescent labelling.
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د. عبد اللطيف السلمي, د. عبد اللطيف السلمي. "Semantics of Saudi Political Discourse: A Significations Study of Prince Saud Al-Faicel Speeches." journal of King Abdulaziz University Arts And Humanities 28, no. 14 (May 17, 2020): 245–73. http://dx.doi.org/10.4197/art.28-14.7.
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the present study p urports to shed light on the problematics of the relationship between language and politics in general and on the semiotic formulation, in particular, of Prince Saud Al-Faicel political discourse. It attempts to explain how this discourse succeeded to formulate a political model capable, thanks to its argumentative and rhetorical tools, to decode or unlock regional crises and international transformations in order to make historical decisions. Such problematics reflect our particular perception of political discourse in its relationship with textual linguistics, along with the powerful semiotic discursive strategies and practices ever present in the analysis and interpretation of the political discourse of Prince Saud Al-Faicel. The Present study relied on an analytic frame following Norman Fairclough's model and other semiotic studies structured around lexicon and language construction. It also paid attention to analyzing the intricacies characterizing relations and strategies within power relations. The originality of the present study can be seen in its combination of the textual approach with the analytical one when dealing with political discourse.
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KOROLOVA, Tetiana, Oleksandra POPOVA, and Natalya ZHMAYEVA. "Interpretation of the Chinese Press and Features of Its Translation into Ukrainian." WISDOM 17, no. 1 (March 21, 2021): 14–34. http://dx.doi.org/10.24234/wisdom.v17i1.422.
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The paper develops a methodology for interpreting and analysing translation features (including strategies, tactics, and operations) of the Chinese press within the language pair “Chinese – Ukrainian”. Special attention is paid to the lexical and grammatical characteristics of the Chinese press as manipulative instruments. The philosophical background of the Chinese newspaper lexicon is considered, which stipulates a diverse use of common and specific vocabulary (including terms) from modern Chinese (?? / báihuà), idiomatic expressions (?? / chéngy?), neologisms and literary words from old Chinese (?? / wény?), and emotionally coloured vocabulary. The grammatical level is represented by a fixed word order in a sentence; complex, compound, and two-member simple sentences; all communicative types of sentences; lack of elliptical structures; a large number of particles. The research offers an integrated approach to the study of the strategy of communicatively equivalent translation, translation tactics, and operations when dealing with the Chinese press. Some translation regularities are illustrated.
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Woertgen, Chris, Ralf Dirk Rothoerl, Carsten Englert, and Carsten Neumann. "Pyogenic spinal infections and outcome according to the 36-Item Short Form Health Survey." Journal of Neurosurgery: Spine 4, no. 6 (June 2006): 441–46. http://dx.doi.org/10.3171/spi.2006.4.6.441.
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Object Pyogenic vertebral infections are rare. In most papers investigators have focused on risk factors, clinical characteristics, and diagnostic findings, and discussed different management strategies. The optimal strategy for dealing with spinal infections, however, remains controversial. Additionally, outcome data regarding quality of life (QOL) after pyogenic spinal infections are sparse. The aim of this study was to provide further data in this field. Methods The authors retrospectively investigated 62 patients suffering from pyogenic spinal infections. In 37 patients (59%), lumbar lesions were observed; thoracic and thoracolumbar infections were documented in 19 (31%) and a cervical infection was demonstrated in six patients (10%). Overall 28 patients (45%) underwent conservative treatment, and 34 (55%) underwent surgery with or without the placement of instrumentation. At follow-up examination the authors recorded each patient’s satisfaction as well as QOL according to the 36-Item Short Form Health Survey. Quality of life after treatment of pyogenic spine infections did not reach the level of the normative sample. Most patients continued to suffer some sort of pain. Despite different indications, the surgically treated patients experienced a slightly better QOL and self-reported satisfaction levels, as well as a statistically significant better outcome, than patients treated conservatively. Conclusions The results obtained in the present study suggest that surgery, especially in conjunction with the placement of instrumentation, may be more beneficial than conservative treatment in patients with a spinal infection.
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Keck, Wolfgang, and Chiara Saraceno. "Caring for a parent while working for pay in the German welfare regime." International Journal of Ageing and Later Life 5, no. 1 (October 13, 2010): 107–38. http://dx.doi.org/10.3384/ijal.1652-8670.1051107.
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This article presents the results of a study that addresses the strategies adopted by adult children in employment who bear the main care responsibility for a frail parent. The context of the study is the resources and constraints offered and imposed, respectively, by long-term care policies in Germany. The empirical part is based on 34 in-depth interviews conducted in winter 2007-2008 in Berlin and Brandenburg. Five different care arrangements emerge at the interfaces of family resources and constraints, paid work demands, other family demands and policy options. These represent different ways of dealing with the interference that can occur between work and care, and other dimensions of personal and family life. In the conclusion, against the background of the research findings, the authors discuss the role of the German policy framework for long-term care in terms of its efficacy in providing adequate care and in easing work amily tensions in a context characterised by unequal private resources.
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Jabłonka, Martyna. "Translational Problems in Audio Description. The Case Study of “Django Unchained” by Quentin Tarantino." Transfer. Reception Studies 6 (December 30, 2021): 175–88. http://dx.doi.org/10.16926/10.16926/trs.2021.06.04.
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The main purpose of this paper is to discuss the most common translational problems which occur during the production of audio description (AD), which is one of the modes of audiovisual translation (AVT). The article analyses selected translational problems encountered while scrutinizing the film entitled Django Unchained (2012) by Quentin Tarantino. The analysis is chiefly focused on issues which occur most frequently in the film and seem to be most difficult to solve by audio describers, both in English and in Polish versions of the film. The study compares notions of character description, facial expressions and gestures; these phenomena constitute in fact the core of audio description and particular attention should be paid to accurate rendering of them into the target language. Nonetheless, the article suggests possible strategies of dealing with the above-mentioned obstacles. Proceeding from these considerations, the study proposes conclusions concerning the type of audio description that would probably be the most successful and beneficent to the target audience.
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Koscheyev, Victor S., Gloria R. Leon, and Ian A. Greaves. "Lessons Learned and Unsolved Public Health Problems After Large-Scale Disasters." Prehospital and Disaster Medicine 12, no. 2 (June 1997): 49–60. http://dx.doi.org/10.1017/s1049023x00037407.
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AbstractBackground:This paper examines the considerable medical and psychological problems that ensue after disasters in which massive populations are affected for extended and sometimes unknown time periods. The organization of disaster response teams after large-scale disasters is based on experiences as a medical specialist at Chernobyl immediately after this catastrophe. Optimal ways of dealing with the immediate medical and logistical demands as well as long-term public health problems are explored with a particular focus on radiation disasters. Other lessons learned from Chernobyl are explained.Issues:Current concerns involve the constant threat of a disaster posed by aging nuclear facilities and nuclear and chemical disarmament activities. The strategies that have been used by various groups in responding to a disaster and dealing with medical and psychological health effects at different disaster stages are evaluated. The emergence of specialized centers in the former Soviet Union to study long-term health effects after radiation accidents are described. Worldwide, there has been relatively little attention paid to mid- and long-term health effects, particularly the psychological stress effects. Problems in conducting longitudinal health research are explored.Recommendations:The use of a mobile diagnostic and continuously operating prehospital triage system for rapid health screening of large populations at different stages after a large-scale disaster is advisable. The functional systems of the body to be observed at different stages after a radiation disaster are specified. There is a particularly strong need for continued medical and psychosocial evaluation of radiation exposed populations over an extended time and a need for international collaboration among investigators.
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Martin-Sanchez, Fernando, Riccardo Bellazzi, Vittorio Casella, William Dixon, Guillermo Lopez-Campos, and Niels Peek. "Progress in Characterizing the Human Exposome: a Key Step for Precision Medicine." Yearbook of Medical Informatics 29, no. 01 (April 17, 2020): 115–20. http://dx.doi.org/10.1055/s-0040-1701975.
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Summary Objective: Most diseases result from the complex interplay between genetic and environmental factors. The exposome can be defined as a systematic approach to acquire large data sets corresponding to environmental exposures of an individual along her/ his life. The objective of this contribution is to raise awareness within the health informatics community about the importance of dealing with data related to the contribution of environmental factors to individual health, particularly in the context of precision medicine informatics. Methods: This article summarizes the main findings after a panel organized by the International Medical Informatics Association - Exposome Informatics Working Group held during the last MEDINFO, in Lyon (France) in August 2019. Results: The members of our community presented four initiatives (PULSE, Digital exposome, Cloudy with a chance of pain, Wearable clinics), providing a detailed view of current challenges and accomplishments in processing environmental and social data from a health research perspective. Projects illustrate a wide range of research methods, digital data collection technologies, and analytics and visualization tools. This reinforces the idea that this area is now ready for health informaticians to step in and contribute their expertise, leading the application of informatics strategies to understand environmental health problems. Conclusions: The featured projects illustrate applications that use exposome data for the investigation of the causes of diseases, health care, patient empowerment, and public health. They offer a rich overview of the expanding range of applications that informatics is finding in the field of environmental health, with potential impact in precision medicine.
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Ibrahim, Sarhang. "Lived Experiences of Patients with COVID-19 in the Kurdistan Region, Iraq: A Qualitative Study." Erbil Journal of Nursing and Midwifery 4, no. 1 (May 30, 2021): 32–40. http://dx.doi.org/10.15218/ejnm.2021.04.
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Background and objective: COVID-19 has adverse effects on physical and mental health and threatens the quality of life significantly; therefore, it is necessary to help COVID-19 patients with their lifestyle, which is tightly bound to the quality of their lives. The present study aims to develop plans to improve the quality of life among COVID-19 patients by an-alyzing their lived experiences. Methods and patients: The present qualitative study was conducted from August to Sep-tember 2020 on twelve COVID-19 patients hospitalized in Erbil’s Emirates Hospital, the Kurdistan Region of Iraq. In-depth semi-structured interviews (12) were utilized to collect data. Trustworthiness was ensured by making an excellent prolonged relationship with the patients, peer-checking, member-checking, and implementing experts’ suggestion at every stage. Four main themes were extracted from the interviews, which were transcribed ver-batim and analyzed using the six methodological activities proposed by Van Manen. Results: The present study results indicated that COVID-19 patients have a difficult time dealing with the disease and getting adapted to their new situation, leading to a remarka-ble decrease in the quality of their lives. Analyzing the transcribed interviews led to emer-gence of four main themes: “disbelief in being really ill,” “fear and stress,” “changes in lifestyle,” and “seriously adhering to health guidelines.” Conclusion: Our results showed that COVID-19 patients suffer from physical pain and un-dergo poor mental health due to fear and stress resulting in worsening quality of life. A deep understanding of COVID-19 patients’ states and situations is highly significant to help nurses and nursing managers plan effective strategies for caring for patients with COVID-19.
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Tuominen, Tiina, and Mervi Hasu. "Public servants coping with competing demands on their agency in client relationships." International Journal of Public Sector Management 33, no. 5 (June 4, 2020): 595–611. http://dx.doi.org/10.1108/ijpsm-05-2019-0120.
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PurposeThis paper analyzes how public servants who work with young people discursively cope with competing demands on their agency, defined as their orientation toward and capabilities to influence their clients. Previous studies revealed how public servants treat their clients when facing competing demands but paid less attention to how public servants define their agency.Design/methodology/approachMicro-level discourse analysis is applied to analyze how public servants represent their agency in client relationships, drawing on interviews with nine individuals in a Finnish city who work with young people lacking jobs or school placements.FindingsInstead of describing their agency coherently, the interviewees applied several discourses to represent their agency differently in relation to different demands. This ability to navigate contradictory discourses is discussed as reflexive discursive coping strategy, which enables public servants to maintain a positive image of their agency despite tensions at work.Research limitations/implicationsAlthough the method does not allow direct generalizations, it reveals discursive strategies likely to be found in many contemporary public organizations.Practical implicationsThe study indicates a need to better acknowledge and nurture the multifaceted nature of agency to improve service quality.Originality/valueThe findings deepen the view on tensions in public servants' work and show that diverse discourses not only create anxiety but also help individuals dealing with contradictory work.
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Lee, Yomee. "From Forever Foreigners to Model Minority: Asian American Men in Sports." Physical Culture and Sport. Studies and Research 72, no. 1 (December 1, 2016): 23–32. http://dx.doi.org/10.1515/pcssr-2016-0025.
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AbstractDespite their long history in the United States, relatively little scholarly attention has been paid to Asian Americans and their lived experience in sports. The purpose of this study was to give voices to Asian American men by focusing on their experiences in sports. In particular, this study examined the experiences of East Asian and Southeast Asian American male college students who were often perceived as “foreign” and “pejoratively feminine” racialized minority yet participated in sports that were associated with dominant masculinity in the U.S. The setting of the study was as a predominately White institution located in Upstate New York where Asian Americans make up about one percent of the total student population. Qualitative research method was employed for the study. Six Asian American male students were recruited through snowball and purposeful sampling methods. In-depth interviews were conducted to reveal the rich stories of these Asian American men. The research showed that the stories of Asian American male college students were much nuanced and complicated. Specifically, this study revealed that Asian American men were constantly otherized as “forever foreigners” who did not have a legitimate citizenship in the United States. Also, Asian Americans faced unique ideas about their manhood that either highlighted emasculated and feminized masculinity or hyper-masculinity. In dealing with these situations, Asian American men employed unique cultural strategies to challenge and resist racial stereotypes through sports.
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Sørensen, Benny, Yesim Dargaud, Gili Kenet, Jeanne M. Lusher, Andrew Mumford, Steven W. Pipe, and Andreas Tiede. "Strategies for Securing and Maintaining Predictable Efficacy with Recombinant Activated Factor VII in On-Demand Treatment of Haemophilia Patients with Inhibitors." Blood 114, no. 22 (November 20, 2009): 4443. http://dx.doi.org/10.1182/blood.v114.22.4443.4443.
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Abstract Abstract 4443 Introduction Practical strategies for securing and maintaining predictable efficacy with recombinant activated factor VII (rFVIIa) remain to be fully described. We intend to document such strategies as applicable to on-demand treatment of haemophilia patients with inhibitors. In a minority of patients who appear refractory to bypassing-agent therapy, effective strategies may help to optimise treatment — inappropriate therapy can delay bleed cessation and waste valuable resources. Methods At a recent Novo Nordisk-sponsored meeting held in San Francisco in December 2008, an expert panel of physicians discussed strategies for securing and maintaining predictable efficacy with rFVIIa for on-demand treatment of spontaneous bleeds in haemophilia patients with inhibitors. Some of the strategies discussed (choice of rFVIIa dose according to patient age, site of bleed, and bleed severity, as well as timing of therapy, use of home treatment, treatment monitoring and dealing with severe or difficult-to-treat bleeds) were included in a questionnaire, which was sent to a selected international group of physicians who are involved in the treatment of inhibitor patients. An honorarium (of ≤50, Euro 50 or $50 for physicians in the UK, Europe and the United States respectively) was offered by Novo Nordisk in recognition of the time taken to complete the survey. Questionnaires varied slightly according to variations in licensed use of rFVIIa in these countries. The aim of the survey was to obtain insight into the ways in which on-demand treatment of spontaneous bleeds in haemophilia patients with inhibitors is managed in real-life clinical practice and to find strategies to ensure predictable efficacy with rFVIIa. Results Data were analysed from 28 completed questionnaires. Most respondents (59%) recommend 1×270μg/kg as the initial dose of rFVIIa in both children (aged <15 years) and adults (aged >15 years) and repeated doses (2-3) of 90μg/kg were also widely used (33-41%). In case further haemostatic support is needed, 55% suggest 1×90μg/kg every 2-3 hours whereas another 40% suggest 1×270μg/kg until haemostasis is achieved. Treatment strategies for target joints, muscle and mucocutaneous bleeds were recommended to be adjusted by increasing the initial dosage of rFVIIa or shortening the dosage interval. In the case of mucocutaneous bleeds, respondents also recommend adjuvant antifibrinolytic therapy. All respondents recommended administration of rFVIIa within 1 hour following the first sign of bleeding; in 70% of cases, the first dose of rFVIIa was stated to be given within 2 hours. In total, 76% of respondents advocated home therapy. Most (93%) encouraged patients to keep a diary of bleeds. The haemostatic effect was predominantly monitored by observing: decreased pain, decreased swelling, and improved mobility. In cases of abnormal bleeds, all severe bleeds, as well as bleeds that do not respond to 2-3 doses of rFVIIa, clinicians recommended that patients contact the haemophilia centre. The interval of rFVIIa dosing was reported to be shortened in 21.8-48.4% of such cases. In cases of unexpected efficacy, 57-60% of respondents reported that they perform detailed laboratory investigation of coagulation factors and platelet function (including a detailed history of drugs/agents that may affect primary haemostasis). From 55 to 76% of respondents reported the use of physiotherapy, in particular in target joints and post surgery. Conclusions Although variations exist in how on-demand rFVIIa is used in different bleeding scenarios in inhibitor patients, many clinicians follow similar strategies. Treatment strategies, which focus on securing and maintaining predictable efficacy, will be developed both from expert panel recommendations and from clinicians' real-life experiences. Such strategies will benefit inhibitor patients, expediting bleed cessation and providing effective use of resources. Disclosures: Sørensen: Novo Nordisk: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding, Speakers Bureau; Baxter: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; CSL Behring: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding, Speakers Bureau; Wyeth: Research Funding; Bayer: Speakers Bureau; Grifols: Research Funding. Kenet:Novo Nordisk: Honoraria, Membership on an entity's Board of Directors or advisory committees; Bayer: Honoraria, Membership on an entity's Board of Directors or advisory committees; Sanofi- Aventis- Daichii: Membership on an entity's Board of Directors or advisory committees. Lusher:Novo Nordisk: Consultancy. Mumford:Novo Nordisk: Consultancy. Pipe:Baxter: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Novo Nordisk: Membership on an entity's Board of Directors or advisory committees; Wyeth: Speakers Bureau; Inspiration Biopharmaceuticals: Research Funding; CSL Behring: Honoraria. Tiede:Novo Nordisk: Consultancy, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau.
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Haley, Janice. "Dealing with children’s pain." American Journal of Hospice Care 2, no. 3 (May 1985): 34–40. http://dx.doi.org/10.1177/104990918500200306.
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Mickleburgh, Sue. "Dealing with Chronic Pain." Physiotherapy 85, no. 10 (October 1999): 572–73. http://dx.doi.org/10.1016/s0031-9406(05)61254-0.
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York, Ashley. "Dealing with the pain." Nature Reviews Microbiology 16, no. 7 (May 22, 2018): 395. http://dx.doi.org/10.1038/s41579-018-0032-1.
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Mark, Anita M. "Dealing with tooth pain." Journal of the American Dental Association 150, no. 9 (September 2019): 812. http://dx.doi.org/10.1016/j.adaj.2019.07.001.
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Bhattarai, Gaurav. "Rediscovering the Contemporary Relevance of National Security Strategies in Divya Upadesh: A History-Policy Relationship." Unity Journal 3, no. 01 (March 6, 2022): 165–82. http://dx.doi.org/10.3126/unityj.v3i01.43323.
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Rediscovering the past to build a secure future is better realized by understanding the role of history in policy making. Today, while Nepal’s national security policies remain silent about the geopolitical threats, it is timely to rediscover the guidelines on national security strategies introduced in Divya Upadesh, a Divine Counsel of the Great King Prithivi Narayan Shah. Currently, Nepal inability in escaping the geostrategic challenge of accommodating the interest of major powers is explicitly visible in the fiasco created by the Nepali political parties in the context of Nepal’s uncertainty over US-sponsored MCC project, which is today perceived in Nepal as hostile to China-led BRI. Historically, Nepal has successfully balanced its two Gulliverian neighbors. But, today, Nepal is not in a position to evade the repercussions triggered by Sino-Indian rivalry at the regional front and Sino-US strategic competition at the global level. On the backdrop of their conflicting interest—strategic, security, economic—Kathmandu faces the geostrategic challenges of accommodating the interest of major powers. Although Nepal’s integrated foreign policy of 2020 mentions of the changed geopolitical context, pragmatic policy recommendations, as indicated by foreign policy behavior, are missing. Constitutional guidelines on Nepal’s foreign policy and national security alone are not sufficient. Thus, drawing lessons from history could be of help to formulate the national security strategies in order to better cope with the external threats. The rationale behind considering Divya Upadesh is to make Nepali policy makers realize that the national security strategies and policies that Nepal adopted in a usual/normal context won’t be able to fulfill the requirements of the uncertain strategic milieu against the backdrop of a ‘new Cold War’ brewing between the United States and China. In the late 18th century when P.N Shah was introducing a comprehensive national security policy for the first time, the external environment wasn’t much favorable. After his death, however, instead of paying heed to his guidelines, expansionism ended up to territorial loss, adventurism led to Himalayan wars, appeasement led to increasing British influence in Nepal. After 1950, guidelines in Divya Upadesh have been more confined to history books and classrooms lectures. While Nepal lionizes its act of balancing India and China though the policy of non-alignment and equidistance, foreign and security policy makers never paid attention to reinvent the lesson for the same. Thus, this qualitative study recuperates the relevance of effective balancing as advocated by PN Shah in addressing the challenges surfaced while accommodating the interests of major powers. Most of the available literature on Divya Upadesh are either translated English versions, or limited to the analysis of the unification process. The relevance of an intersection of foreign policy and national security in Divya Upadesh is not unveiled by any of the available literature. Apprehending the same research gap, this study explores the contemporary significance of Divya Upadesh while devising the national security policies and strategies. Firstly, the contemporary challenges to Nepal’s national security prompted by Kathmandu’s struggle in accommodation of the interest of major powers is discussed; secondly, the policy of ‘balancing’ counseled by Prithivi Narayan Shah is emphasized as an apt and relevant in dealing with the contemporary challenges emanating from the neighborhood and beyond. Thirdly, “meticulous diplomacy,” is highlighted to offer economic shape to the act of balancing. Finally, it has been realized how studying history means studying causes, and as such, turning the pages of Divya Upadesh, policy makers discover the causes of Nepal’s failure in accommodating the interest of major powers.
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CLARKE, AMANDA, and LORNA WARREN. "Hopes, fears and expectations about the future: what do older people's stories tell us about active ageing?" Ageing and Society 27, no. 4 (June 18, 2007): 465–88. http://dx.doi.org/10.1017/s0144686x06005824.
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ABSTRACT‘Active ageing’ is a key concept in current policy and research on ageing and yet is under-analysed or interpreted largely within an economic framework. This paper explores active ageing in the broader context of older people's lives. Drawing on a series of biographical interviews with 23 people aged 60–96 years, the discussion focuses on the theme of future hopes and concerns. Exhortations for ‘active ageing’ may be challenged by a lifelong unwillingness to look forward or plan ahead. Nevertheless, the findings show that fears for a future of limited resources, decline and dependency can exist alongside not only the desire to live longer but also the positive anticipation of forthcoming events and strong inter-generational relations. ‘Living for now’ and ‘taking a day at a time’ – and by extension the accomplishment of everyday activities rather than the activity-driven goals of earlier years – are common strategies for dealing with the unpredictability of later life. In this respect, even stopping paid work and entering residential care may be actively chosen and empowering even though they are steps towards disengagement and dependency. Similarly, planning for death, such as writing (living) wills and making funeral arrangements, may be positive and proactive responses to beliefs and concerns about dying. ‘Active ageing’ therefore needs to offer choices for life to be lived at all stages whilst recognising that much of the focus for older people is on ordinary needs, deeds and relationships.
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Musa, Alessia, Michele Pipicelli, Matteo Spano, Francesco Tufano, Francesco De Nola, Gabriele Di Blasio, Alfredo Gimelli, Daniela Anna Misul, and Gianluca Toscano. "A Review of Model Predictive Controls Applied to Advanced Driver-Assistance Systems." Energies 14, no. 23 (November 29, 2021): 7974. http://dx.doi.org/10.3390/en14237974.
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Advanced Driver-Assistance Systems (ADASs) are currently gaining particular attention in the automotive field, as enablers for vehicle energy consumption, safety, and comfort enhancement. Compelling evidence is in fact provided by the variety of related studies that are to be found in the literature. Moreover, considering the actual technology readiness, larger opportunities might stem from the combination of ADASs and vehicle connectivity. Nevertheless, the definition of a suitable control system is not often trivial, especially when dealing with multiple-objective problems and dynamics complexity. In this scenario, even though diverse strategies are possible (e.g., Equivalent Consumption Minimization Strategy, Rule-based strategy, etc.), the Model Predictive Control (MPC) turned out to be among the most effective ones in fulfilling the aforementioned tasks. Hence, the proposed study is meant to produce a comprehensive review of MPCs applied to scenarios where ADASs are exploited and aims at providing the guidelines to select the appropriate strategy. More precisely, particular attention is paid to the prediction phase, the objective function formulation and the constraints. Subsequently, the interest is shifted to the combination of ADASs and vehicle connectivity to assess for how such information is handled by the MPC. The main results from the literature are presented and discussed, along with the integration of MPC in the optimal management of higher level connection and automation. Current gaps and challenges are addressed to, so as to possibly provide hints on future developments.
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Blair, Lorrie. "Strategies for Dealing with Censorship." Art Education 49, no. 5 (September 1996): 57. http://dx.doi.org/10.2307/3193612.
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Colbert, Janet L., and Brian S. Turner. "Strategies for dealing with fraud." Journal of Corporate Accounting & Finance 11, no. 4 (2000): 43–49. http://dx.doi.org/10.1002/1097-0053(200005/06)11:4<43::aid-jcaf7>3.0.co;2-z.
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BOSCHERT, SHERRY. "Dealing With Functional GI Pain." Family Practice News 42, no. 13 (August 2012): 16. http://dx.doi.org/10.1016/s0300-7073(12)70534-0.
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BOSCHERT, SHERRY. "Dealing With Functional Abdominal Pain." Pediatric News 46, no. 6 (June 2012): 16. http://dx.doi.org/10.1016/s0031-398x(12)70145-5.
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Gairín Sallán, Joaquín. "Organizational strategies in dealing with diversity." Educar 22 (February 1, 1998): 239. http://dx.doi.org/10.5565/rev/educar.360.
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Lawler, Andrew. "Two Strategies for Dealing With Dissent." Science 276, no. 5314 (May 9, 1997): 901. http://dx.doi.org/10.1126/science.276.5314.901.
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Morgan, Terry D. "Takings Law: Strategies for Dealing withLucas." Land Use Law & Zoning Digest 45, no. 1 (January 1993): 3–10. http://dx.doi.org/10.1080/00947598.1993.10395783.
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