Quality of Life Research - The COVID-19 pandemic might add to the stressors experienced by people living with rheumatic diseases. This study aimed to examine rheumatic patients’ functional... 相似文献
Objectives: Currently in Ghana, there is an on-going task-shifting strategy in which nurses are trained in hypertension management. While this study will provide useful information on the viability of this approach, it is not clear how patients in the intervention perceive hypertension, the task-shifting strategy, and its effects on blood pressure management. The objective of this paper is to examine patients’ perceptions of hypertension and hypertension management in the context of an on-going task-shifting intervention to manage blood pressure control in Ghana.
Design: Forty-two patients participating in the Task Shifting Strategy for Hypertension program (23 males, 19 females, and mean age 61. 7 years) completed in-depth, qualitative interviews. Interviews were transcribed, and key words and phrases were extracted and coded using the PEN-3 Cultural Model as a guide through open and axial coding techniques, thus allowing rich exploration of the data.
Results: Emergent themes included patients’ perceptions of hypertension, which encompassed misperceptions of hypertension and blood pressure control. Additional themes included enablers and barriers to hypertension management, and how the intervention nurtured lifestyle change associated with blood pressure control. Primary enabling factors included the supportive nature of TASSH nurses, while notable barriers were financial constraints and difficulty accessing medication. Nurturing factors included the motivational interviewing and patient counseling which instilled confidence in the patients that they could make lasting behavior changes.
Conclusions: This study offers a unique perspective of blood pressure control by examining how patients view an on-going task-shifting initiative for hypertension management. The results of this study shed light on factors that can help and hinder individuals in low-resource settings with long-term blood pressure management. 相似文献
There are well-established relationships between health and homelessness, and shelters can facilitate the transmission of diseases and contribute to their prevention. Adequate environmental health conditions and hygiene behaviors in homeless shelters are fundamental to the health of their clients, a marginalized population. We report the status of environmental health conditions and hygiene behaviors in homeless shelters and associated health outcomes; interventions to improve these conditions, behaviors, and outcomes; and obstacles to improvement.
Methods
PubMed, Web of Science, Scopus, and EBSCOhost were searched for peer-reviewed studies, and additional sources for grey literature. Studies were included if they reported primary data on one or more environmental health condition or hygiene behavior in homeless shelters.
Results
Twenty-eight studies were included in the review. Insufficient ventilation systems, unhygienic bedding, and overcrowding were the most documented environmental health and hygiene deficiencies in homeless shelters, and tuberculosis infections and skin diseases were the most documented associated health outcomes among clients. Studies frequently recommended or described implementation of behavioral and administrative controls, ventilation system improvements, and ultraviolet germicidal irradiation fixtures.
Discussion
Most studies addressed airborne transmission of tuberculosis and were conducted in high-income countries, revealing an imbalance in the literature. Insufficient resources and the transience of clients are barriers to improving hygiene behaviors and environmental conditions in homeless shelters. Further investment and research into ensuring adequate hygiene and environmental health in this setting can protect and promote the health and well-being of people experiencing homelessness. 相似文献
ABSTRACTA longstanding trope in Indian psychiatry, and in popular representations of it, involves the efficacy of incantations and exorcism in healing afflictions of the mind, notably hysteria. In many accounts, from nineteenth century medical journals to twenty-first century popular films, a medicine deemed at once ‘Western’ and universal is granted the ability to diagnose neurotic afflictions, but rendered incapable of curing them, while bodily techniques referred to as ‘Indian’ are granted efficacy. In this article, I explore the subtleties and implications of this recurrent knowledge paradigm. I argue that a particular arrangement—one in which difference is established through equivalence—undergirds the terms by which medicine comes to be viewed as a cultural encounter. As these progressive formulations are often founded on stories about women’s madness, I ask, what are the implications of an arguably pragmatic ethos founded on an uneven—and deeply gendered—resolution to postcolonial knowledge problems? 相似文献
Refractory acute myeloid leukemia (AML) includes AML includes failure of disease to respond to standard induction chemotherapy, relapse within 6 months after first CR, and 2 or more relapses. The outcome of these patients is usually very poor; only a small proportion can be rescued by allogenic hematopoietic stem-cell transplantation (allo-HSCT). The aim of this study was to evaluate the efficacy and feasibility of allo-HSCT in patients with refractory AML.
Patients and Methods
We retrospectively analyzed the clinical outcome of 91 patients who were diagnosed with treatment-refractory AML at Hacettepe University Hospital between January 2002 and June 2018. Patients' disease status included refractory AML, defined as failure to respond to standard induction chemotherapy and relapse within 6 months after first complete remission.
Results
The median follow-up was 12 months (range, 0.5-184 months) for the entire group. Kaplan-Meier estimates of the 3-year overall survival for patients who underwent allo-HSCT and patients who received only salvage chemotherapy were 67% and 12%, respectively. Additionally, the Kaplan-Meier estimates of 5-year overall survival for patients who underwent allo-HSCT and patients who received only salvage chemotherapy were 44% and 4%, respectively (P < .001). Complete remission was obtained in 25 patients (83.3%) who underwent allo-HSCT; however, the disease of only 3 patients (3.8%) exhibited complete response after salvage chemotherapy.
Conclusion
Allo-HSCT is still the best-known treatment option with curative potential in patients with treatment-refractory AML. Therefore, all efforts should be made in an attempt to find a suitable matched donor in order to perform allo-HSCT. 相似文献
Biomedicine fosters particular styles of interaction and behaviors, with the therapeutic relationship seen as occurring between a doctor and patient. In contrast, where alternative modalities of healing are practiced, relationships go beyond a dyadic interaction and include wider social networks. In this article, we propose the existence of a ‘therapeutic unit’ in Maya healing practices in Guatemala that binds healer, wellness seeker, family, and community members, along with the spiritual and natural realms, into a coherent system requiring all of these elements to achieve success. Drawing on interviews with 67 Maya healers, we describe healers’ understanding of raxnaq’il nuk’aslemal (well-being), and show how these interactions activate wider networks that play crucial roles during treatments. We highlight how holism is expressed in relationships typical of indigenous healing systems, and how an appreciation of this is important for developing culturally appropriate health care provision systems. 相似文献