The ‘disabilitization’ of medicine: The emergence of Quality of Life as a space to interrogate the concept of the medical model

2019 ◽  
Vol 32 (5) ◽  
pp. 164-190
Author(s):  
Arseli Dokumacı
Keyword(s):  
Quality Of Life ◽  
Heart Diseases ◽  
Medical Model ◽  
The Body ◽  
Karnofsky Performance Scale ◽  
Medical Model Of Disability ◽  
Diagnostic Criterion ◽  
Clinical Gaze

This article presents an archaeological inquiry into the early histories of Quality of Life (QoL) measures, and takes this as an occasion to rethink the concept of the ‘medical model of disability’. Focusing on three instruments that set the ground for the emergence of QoL measures, namely, the Karnofsky Performance Scale (KPS, 1948), and the classification of functional capacity as a diagnostic criterion for heart diseases (Bainton, 1928) and as a supplementary aid to therapeutic criteria in rheumatoid arthritis ( Steinbrocker, Traeger, and Batterman, 1949 ) – I discuss how medicine, throughout the emergence of QoL, began to expand its gaze beyond the confines of the body to what that body does in daily life. Building upon Armstrong et al.’s notion of ‘distal symptoms’ (2007) and Wahlberg’s idea of ‘knowledge of living’ (2018), I propose the notion of disabilitization to encapsulate this expansion of the clinical gaze, through which medicine has come to articulate diseases and their treatments in new ways, and in so doing, has inadvertently created disability as a new kind of knowledge category in itself – a category that is defined not through its reduction to mere pathology, but through its dispersal into everyday life. I present this concept not as a periodization, but as a provocative discontinuity with the totalizing history assumed within the medical model of disability, and in so doing, ask what, in fact, holds ‘the medical model’ together, and whether there might be other ways of understanding medicine’s complex relationship to disability than what the concept of the medical model allows us to envisage.

Experience in the use of double broncholytic therapy in occupational practice

2019 ◽  
pp. 303-307
Author(s):  
Elena A. Beigel ◽  
Natalya G. Kuptsova ◽  
Elena V. Katamanova ◽  
Oksana V. Ushakova ◽  
Oleg L. Lakhman
Keyword(s):  
Quality Of Life ◽  
Personal Data ◽  
The Body ◽  
Step Test ◽  
Aluminum Production ◽  
Chronic Obstructive ◽  
Body Plethysmography ◽  
Occupational Copd ◽  
The Impact

Introduction. Occupational chronic obstructive pulmonary disease (COPD) is one of the leading nosological forms of occupational respiratory disease. Numerous studies have shown high effectiveness of the combination of indacaterol/glycopyrronium (Ultibro®breezhaler®) on the impact on clinical and functional indicators in the treatment of COPD in General practice.The aim of the investigation the case of occupational COPD with the analysis of the dynamics of functional indicators, tolerance to physical load and evaluation of the quality of life of workers engaged in aluminum production by using combination of indacaterol/glycopyrronium.Materials and methods. The random sampling method included 20 men, workers of aluminum production, with the established diagnosis of professional COPD at the age of 40 to 60 years. The survey was conducted (Borg scale, medical Research Council scale (mMRC) and COPD Assessment Test (CAT). Functional methods of studies were conducted: spirometry, body plethysmography, electrocardiography (ECG) and the six-minute stepper test (6-MST).Results. Against the background of 8 weeks of therapy, the volume of forced exhalation for 1 minute (FEV1) increased by 14.7% and amounted to 67.90% of the due values, the forced vital capacity of the lungs (FVC) increased by 11.3% and amounted to 76.95% of the due. According to the body plethysmography (BPG) is set to decrease in residual lung volume on average by 13.4% and static hyperinflation, confirmed by the decrease in functional residual volume (FRV) of 18.8%. During the study period increased physical activity of patients. The average difference between the distance traveled in the six-minute step test before and after treatment was 58.8 m. The analysis of personal data showed that the quality of life of patients improved, the total score in the questionnaire CAT at the beginning of the study was 16.9 points, and after 8 weeks decreased by 63% and amounted to 10.7 points.Conclusions: The Results indicate a positive effect of combination therapy with indacaterol/glycopyrronium on the course and progression of occupational COPD.

scholarly journals Differences in exercise capacity and health-related quality of life according to the body mass index in patients with COPD

Pulmonology ◽  
2021 ◽  
Author(s):  
Jhonatan Betancourt-Peña ◽  
Juan Carlos Ávila-Valencia ◽  
Diana Milena Diaz-Vidal ◽  
Vicente Benavides-Córdoba
Keyword(s):  
Quality Of Life ◽  
Body Mass Index ◽  
Exercise Capacity ◽  
Body Mass ◽  
The Body ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related

scholarly journals The Analysis of Nutritional Habits of the Third Age Students in Poznań

2020 ◽  
Vol 5 (1) ◽  
pp. 21-29
Author(s):  
Magdalena Pracka ◽  
Marcin Dziedziński ◽  
Przemysław Łukasz Kowalczewski
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Eating Habits ◽  
The Elderly ◽  
The Body ◽  
Nutritional Habits ◽  
Third Age ◽  
Waist To Hip Ratio ◽  
The Third

AbstractIn recent years have seen increasing percentage of the elderly in the overall population. This has driven the attention to the lifestyle factors that influence the health and quality of life of this social group, including their nutrition and physical activity. Universities of the Third Age (U3A) are a valuable platform for the dissemination and broadening of the knowledge related to these topics. The nutritional habits of 61 U3A students in Poznań were evaluated on the basis of a modified KomPAN questionnaire. Their nutritional status was determined using the body mass index (BMI) and waist to hip ratio (WHR) indices. Nearly half of the respondents were overweight and 16% had first degree obesity. The WHR index in women was on average 0.8, while in men it was 1.01. Only 13% of the students declared regular eating, with 60% consuming 4-5 meals a day. Women were found to eat snacks between meals more often than men. It was also found that the majority of the elderly do not add salt to ready meals or sweeten beverages with sugars. Taking into account the observed nutritional problems and the occurrence of improper eating habits of the elderly, it is recommended to continue the education on the prevention of common diet-related diseased.

scholarly journals Classification of endonasal HHT lesions using digital microscopy

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
F. Haubner ◽  
A. Schneider ◽  
H. Schinke ◽  
M. Bertlich ◽  
B. G. Weiss ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Treatment Modalities ◽  
Hereditary Haemorrhagic Telangiectasia ◽  
Digital Microscopy ◽  
Digital Microscope ◽  
Lower Severity ◽  
Gender Specific Differences ◽  
Vegf Level

Abstract Background Recurrent spontaneous epistaxis is the most common clinical manifestation and the most debilitating symptom in hereditary haemorrhagic telangiectasia (HHT) patients. To this date, there exist only a classification of HHT patients by different genetic mutations. There is no standard classification for the mucocutaneous endonasal manifestations of HHT. The aim of the present study was to document the variety of endonasal HHT lesions using digital microscopy and to propose a clinical classification. Methods We recorded the endonasal HHT lesions of 28 patients using a digital microscope. We reconstructed the 3D images und videos recorded by digital microscope afterwards and classified the endonasal lesions of HHT in two classes: Grade A, presence of only flat telangiectasias in the mucosa level and Grade B, (additional) presence of raised berry or wart-like telangiectasia spots. We investigated also Haemoglobin level by routine laboratory procedures, plasma VEGF level by ELISA, Severity of epistaxis by epistaxis severity score (ESS) and quality of life by a linear visual analogue scale (VAS). Results We found a higher quality of life and a lower severity of epistaxis in Grade A patients in comparison to Grade B patients. No difference in plasma VEGF level and in Haemoglobin between Grad A patients and Grade B patients could be detected. Plasma VEGF levels showed no gender specific differences. It could also not be correlated to the extranasal manifestation. Conclusion The classification for endonasal manifestation of HHT proposed in this study indicates severity of epistaxis und quality of life. Digital microscopy with the ability of 3D reconstruction of images presents a useful tool for such classifications. The classification of endonasal HHT lesions using digital microscopy allows to evaluate the dynamic of HHT lesions in the course of time independent of examiner. This allows also to evaluate the efficacy of the different treatment modalities by dynamic of HHT lesions. Moreover digital microscopy is very beneficial in academic teaching of rare diseases.

scholarly journals Mindfulness Research Update: 2008

2009 ◽  
Vol 14 (1) ◽  
pp. 10-18 ◽  
Author(s):  
Jeffrey M. Greeson
Keyword(s):  
Quality Of Life ◽  
Stress Reduction ◽  
Mindfulness Meditation ◽  
Stress Hormones ◽  
Theoretical Work ◽  
The Body ◽  
Mindfulness Practice ◽  
Optimal Health ◽  
The Brain

Objective: To briefly review the effects of mindfulness on the mind, the brain, the body, and behavior. Methods: Selective review of MEDLINE, PsycINFO, and Google Scholar databases (2003—2008) using the terms ``mindfulness,'' ``meditation,'' ``mental health,'' ``physical health,'' ``quality of life,'' and ``stress reduction.'' A total of 52 exemplars of empirical and theoretical work were selected for review. Results: Both basic and clinical research indicate that cultivating a more mindful way of being is associated with less emotional distress, more positive states of mind, and better quality of life. In addition, mindfulness practice can influence the brain, the autonomic nervous system, stress hormones, the immune system, and health behaviors, including eating, sleeping, and substance use, in salutary ways. Conclusion: The application of cutting-edge technology toward understanding mindfulness— an ``inner technology''—is elucidating new ways in which attention, awareness, acceptance, and compassion may promote optimal health—in mind, body, relationships, and spirit.

scholarly journals AB0300 LUPUS DISEASE ACTIVITY CORRELATES WITH QUALITY OF LIFE BUT NOT WITH HEALTH LITERACY STATUS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1176.2-1176
Author(s):  
E. Eraslan ◽  
R. Bilici Salman ◽  
H. Satiş ◽  
A. Avanoglu Guler ◽  
H. Karadeniz ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Health Literacy ◽  
Disease Activity ◽  
Lupus Erythematosus ◽  
Patient Reported Outcome ◽  
The Body ◽  
Limited Health Literacy ◽  
Patient Reported ◽  
Limited Health

Background:Systemic lupus erythematosus (SLE) is a chronic autoimmune disease of unknown etiology that can affect any organ of the body. SLE is associated with adverse effects on both health and non-health-related quality of life (HRQOL and non-HRQOL). Lupus PRO is a patient reported outcome measure that has been validated in many languages. It has 44 items that cover both HRQOL and non-HRQOL (1). Health literacy is defined as the degree to which individuals have the capacity to obtain, process and understand basic health information and services needed to make appropriate health decisions. Multiple studies indicate that people with limited health literacy have worse health status and higher rates of hospitalization (2).Objectives:We aimed to evaluate the relationship between the LLDAS (Lupus Low Disease Activity State) criteria and the Lupus PRO test, as well as the health literacy status of lupus patients.Methods:83 SLE patients (94% women) were included in the study. We performed Lupus PRO and the European Health Literacy Survey tests during the routine follow-up visits of lupus patients to our rheumatology outpatient clinic and admissions to rheumatology inpatient clinic. Available clinical data on medical records were obtained, physician global assessments (PGA) were recorded by the attending physician.Results:LLDAS criteria strongly and inversely correlated with the total score, as well as the mood subunit of the Lupus PRO. Similarly, it also significantly inversely correlated with the body appearence and goals subunits. Health literacy status of the patients did not correlate with their LLDAS scores, ie their disease activities.Conclusion:Our results suggest that lupus disease activity, assessed by LLDAS criteria, significantly correlates with measures of quality of life, spesicifically Lupus PRO test, but not with health literacy status. Further studies are needed to evaluate if health literacy is related with damage, hospitalization or mortality associated with lupus.References:[1]Jolly M, Pickard AS, Block JA, Kumar RB, Mikolaitis RA, Wilke CT, et al., editors. Disease-specific patient reported outcome tools for systemic lupus erythematosus. Seminars in arthritis and rheumatism; 2012: Elsevier.[2]Paasche-Orlow MK, Parker RM, Gazmararian JA, Nielsen-Bohlman LT, Rudd RR. The prevalence of limited health literacy. Journal of general internal medicine. 2005;20(2):175-84.Disclosure of Interests:None declared

Body image and quality of life in women with breast cancer: Appreciating the body and its functionality

Body Image ◽  
2022 ◽  
Vol 40 ◽  
pp. 92-102
Author(s):  
Kerry Ettridge ◽  
Katrine Scharling-Gamba ◽  
Caroline Miller ◽  
David Roder ◽  
Ivanka Prichard
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Body Image ◽  
The Body

scholarly journals EVALUATION OF THE QUALITY OF LIFE IN CHRONIC OBSTRUCTIVE PULMONARY DISEASE IN OVERWEIGHT PATIENTS

2020 ◽  
Vol 73 (8) ◽  
pp. 1668-1670
Author(s):  
Mykola M. Ostrovskyy ◽  
Nadiia V. Korzh
Keyword(s):  
Quality Of Life ◽  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Body Mass ◽  
Pathological Process ◽  
The Body ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients

The aim: To evaluate the effect of overweight on the quality of life of chronic obstructive pulmonary disease (COPD) patients GOLD III. Materials and methods: 65 patients with chronic obstructive pulmonary disease (COPD GOLD III) were examined in different phases of pathological process. The pulmonary function (PF) test was performed by means of “SPIROKOM” device (Ukraine). The degree of overweight was determined by calculating the body mass index (BMI) using the formula І = m/h² (m – body mass in kilograms, h – height, square of the height in meters (kg/m²). Patients’ quality of life was evaluated with the help of standardized St.George’s Respiratory Questionnaire (SGRQ). Results: The study revealed changes in the PF indices and the decrease in quality of life in overweight patients, especially in case of destabilization of the pathological process. Conclusions: The obtained results show that overweight is the underlying condition for more severe course of the pathology and requires further study of its impact on the health and quality of life of patients in order to improve the effectiveness of treatment.

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