scholarly journals Ear acupuncture as an adjunct in a treatment protocol for anorexia nervosa: utilization rate and nurses’ experience

2021 ◽  
pp. 096452842110569
Author(s):  
Kajsa Landgren
Keyword(s):  
Anorexia Nervosa ◽  
Usual Care ◽  
Clinical Care ◽  
Treatment Protocol ◽  
Depression Scale ◽  
Acupuncture Point ◽  
Subjective Health ◽  
Ear Acupuncture ◽  
The Body ◽  
Utilization Rate

Background: Anorexia nervosa (AN) is a life-threatening illness. Sometimes long inpatient treatment is necessary, increasing the anxiety that comes with hospitalization and the necessary weight gain. Safe, non-pharmacological adjunctive therapies that improve subjective health are called for. Objective: The aim of this non-randomized, mixed-methods observational study was to describe the utilization rate and nurses’ experiences of ear acupuncture in a highly specialized clinic for eating disorders in Sweden, in which acupuncture had been implemented as part of routine clinical care. Twenty-five patients with AN-treated voluntarily or by law were included. The semi-standardized National Acupuncture Detoxification Association (NADA) ear acupuncture protocol, sometimes combined with needling at 2 traditional acupuncture point locations on the body, had been implemented as a voluntary adjunct to usual care, twice weekly. To evaluate the acceptance of acupuncture, the study examined how often patients chose acupuncture when offered on schedule, and how often they asked for extra acupuncture sessions. Patients rated their subjective health using the hospital anxiety and depression scale (HADS) and visual analogue scale (VAS), treatment satisfaction with usual care and acupuncture, and health-related quality of life with the RAND36 instrument. A credibility/expectancy questionnaire (CEQ) was used to measure confidence in treatment. Body mass index (BMI) was calculated to follow the patients’ recovery. Nurses’ experiences of giving acupuncture as a part of routine care were captured in interviews, and analysed with content analysis. Ethical approval was obtained. Results: Despite an initially moderate level of trust in acupuncture, the utilization rate of the scheduled acupuncture was 89% and patients asked for extra acupuncture sessions on 28 occasions. No serious side effects were reported. Nurses’ experiences of providing acupuncture were positive. They were generally enthusiastic, although they reported finding it difficult to organize group treatments and to find time for acupuncture sessions if they were not scheduled. Conclusion: Further research into the effectiveness and costs of acupuncture in psychiatric care is needed. This study provides relevant information for clinicians as well as researchers planning future randomized controlled trials.

Interpersonal Psychotherapy for the Treatment of Eating Disorders

2010 ◽  
pp. 347-372 ◽  
Author(s):  
Marian Tanofsky-Kraff ◽  
Denise E. Wilfley
Keyword(s):  
Anorexia Nervosa ◽  
Clinical Care ◽  
Interpersonal Psychotherapy ◽  
Future Research ◽  
Cognitive Behavior ◽  
Research Directions ◽  
Routine Clinical Care ◽  
Interpersonal Factors ◽  
Future Research Directions

Interpersonal psychotherapy (IPT) is a focused, time-limited treatment that targets interpersonal problem(s) associated with the onset and/or maintenance of EDs. IPT is supported by substantial empirical evidence documenting the role of interpersonal factors in the onset and maintenance of EDs. IPT is a viable alternative to cognitive behavior therapy for the treatment of bulimia nervosa and binge eating disorder. The effectiveness of IPT for the treatment of anorexia nervosa requires further investigation. The utility of IPT for the prevention of obesity is currently being explored. Future research directions include enhancing the delivery of IPT for EDs, increasing the availability of IPT in routine clinical care settings, exploring IPT adolescent and parent–child adaptations, and developing IPT for the prevention of eating and weight-related problems that may promote full-syndrome EDs or obesity.

Anorexia Nervosa and Depression in a Woman Blind since the Age of Nine Months

1993 ◽  
Vol 38 (7) ◽  
pp. 469-471 ◽  
Author(s):  
Clifford W. Sharp
Keyword(s):  
Eating Disorders ◽  
Body Image ◽  
Anorexia Nervosa ◽  
Eating Disorder ◽  
Major Depression ◽  
Food Intake ◽  
Older Women ◽  
The Body ◽  
Atypical Presentation ◽  
History Of

A woman aged 58 who has been blind since the age of nine months presented with major depression and a 40 year history of an eating disorder characterized by a restriction of food intake and body disparagement. The case is additional evidence that a specifically visual body image is not essential for the development of anorexia nervosa and supports the view that the concept of body image is unnecessary and unproductive in eating disorders. Greater emphasis should be placed on attitudes and feelings toward the body, and the possibility of an eating disorder should be considered in cases of older women with an atypical presentation.

Body Image in Anorexia Nervosa

1981 ◽  
Vol 26 (4) ◽  
pp. 224-227 ◽  
Author(s):  
David M. Garner
Keyword(s):  
Body Image ◽  
Anorexia Nervosa ◽  
Body Satisfaction ◽  
Body Part ◽  
The Body ◽  
Size Perception ◽  
Whole Body ◽  
Size Estimation ◽  
Psychological Disturbance ◽  
Body Image Disturbances

Despite much recent interest in the objective measurement of body image in anorexia nervosa, many questions remain regarding basic mechanisms responsible for the findings as well as their meaning in the disorder. It is unclear if “whole body” measures assess the same underlying phenomena as the “body part” method, and it is unclear if body image disturbances are etiologic or a byproduct of anorexia nervosa. The possible association between self-esteem and body satisfaction and the relationship of the latter variable to actual size estimation supports the hypothesis that size perception may be closely tied to satisfaction with non-physical aspects of self. Finally it must be determined if over estimation is a function of a general psychological disturbance or of a deficit of specific interest in this disorder. Despite these questions, the way in which anorexic patients see themselves as well as the cognitive and affective responses to this perception remains an interesting and potentially fruitful area of study with this disorder.

Management of complicated shunt infections: a clinical report

2008 ◽  
Vol 1 (3) ◽  
pp. 223-228 ◽  
Author(s):  
Hector E. James ◽  
John S. Bradley
Keyword(s):  
Antibiotic Therapy ◽  
Treatment Protocol ◽  
Shunt Infection ◽  
The Body ◽  
Clinical Report ◽  
Intravenous Antibiotic ◽  
Once Daily ◽  
Intravenous Antibiotic Therapy ◽  
Shunt Infections

Object The authors present their experience with a protocol for the treatment of patients with complicated shunt infections. Methods Complicated shunt infections are defined for the purpose of this protocol as multiple compartment hydrocephalus, multiple organism shunt infection, severe peritonitis, or infections in other sites of the body. The initial treatment protocol for these patients was 3 weeks of intravenous antibiotic therapy and 2 weeks of twice daily intraventricular/intrashunt antibiotic therapy. Cerebrospinal fluid (CSF) cultures were monitored during therapy and obtained again 48 hours after completion. The shunt was completely replaced. Additionally, follow-up cultures were obtained in all patients 3–6 months after therapy was completed. Results A cure of the infection was achieved in all patients as defined by negative cultures obtained at completion of antibiotic therapy and in follow-up studies. The follow-up period was 2–11 years (mean 4.4 ± 2.5 years). The treatment protocol was modified in the patients treated after 1991, and 18 patients were treated with this modified treatment regime. In these patients, intraventricular antibiotics were administered only once daily for 14 days, and the CSF was cultured 24 hours after antibiotic therapy had been stopped instead of after 48 hours. The results were similar to those obtained with the initial protocol. Conclusions Based on their prospective nonrandomized series, the authors believe that patients with complicated shunt infections can be successfully treated with 2 weeks of intraventricular antibiotic therapy administered once daily, concurrent with 3 weeks of intravenous antibiotic therapy. This protocol reduces length of treatment and hospital stay, and avoids recurrence of infection.

Statement on Pediatric Fellowship Training

PEDIATRICS ◽  
1991 ◽  
Vol 87 (2) ◽  
pp. 265-265
Author(s):  
Keyword(s):  
Research Training ◽  
Clinical Care ◽  
Fellowship Training ◽  
The Body ◽  
Pediatric Residents ◽  
Pediatric Society ◽  
Research Fellowship ◽  
Research Activities ◽  
Fellowship Programs ◽  
Interest In Research

The following statement was adopted by the Federation of Pediatric Organizations in February, 1990. The Federation consists of the following pediatric organizations: Ambulatory Pediatric Association, American Academy of Pediatrics, American Board of Pediatrics, American Pediatric Society, Association of Medical School Pediatric Department Chairmen, Association of Pediatric Program Directors, Society for Pediatric Research. The Federation supports the concept that "the principal goal of fellowship training should be the development of future academic pediatricians." Graduates of pediatric fellowship programs usually work in academic centers with significant time set aside for research. Some fellowship-trained pediatricians, particularly neonatologists, allergists, and neurologists, may not work in hospitals or ambulatory settings that are associated closely with academic programs. Fellowship-trained pediatricians in all settings should be encouraged to continue their interest in research to add to the body of pediatric knowledge. To achieve the goal of training pediatric scientists, the following guidelines for fellowship education are recommended: 1. Upon completion of a pediatric fellowship, the trainee should be proficient in clinical care, teaching, and research. Fellowship training should prepare a pediatrician to care for children with complex illnesses within his/her area of special expertise and to serve as a consultant for the general pediatrician. In addition, the fellowship-trained pediatrician should be responsible for the education of pediatric residents and the continuing education of practicing pediatricians. For this reason, fellowship training should include interpersonal skills and pedagogical techniques. 2. Research training should begin as soon as possible; premedical students, medical students, and pediatric residents should be encouraged strongly to participate in meaningful research, and research activities should be carried out throughout fellowship training.

STATEMENT OF PEDIATRIC FELLOWSHIP TRAINING

PEDIATRICS ◽  
1996 ◽  
Vol 98 (2) ◽  
pp. A8-A8
Keyword(s):  
Clinical Care ◽  
Fellowship Training ◽  
The Body ◽  
Current Position ◽  
Pediatric Residents ◽  
Body Of Knowledge ◽  
Area Of Interest ◽  
Fellowship Programs ◽  
Special Expertise ◽  
Research Mentor

In 1990, the Federation of Pediatric Organizations adopted a statement on pediatric fellowship training.1 This revised statement represents the current position of the federation regarding the purpose and objectives of fellowship training. The federation continues to support the concept that "the principal goal of fellowship training should be the development of future academic pediatricians." Within academic and teaching centers, there is a need for master clinicians, skilled teachers, and productive investigators who conduct research with varied interests. Graduates of pediatric fellowship programs should be proficient in both direct and consultative clinical care, teaching, and a selected area of research. Thereafter, differentiation of interests and activities should be expected and encouraged, but graduates of the fellowship programs in all settings should continue their involvement in research, whether collaborative or direct, to add to the body of knowledge in their area of interest. The following guidelines for fellowships are recommended: 1. Fellowship training should prepare pediatricians to care for children with complex problems within their areas of special expertise and to serve as consultants. Fellows should participate directly in the care of patients and should serve as consultants, with guidance and supervision provided by senior clinical mentors. 2. Fellowship training should include the development of skills as an educator, including presentation skills, curriculum development, and evaluation. Fellows should participate in the education of pediatric residents and the continuing education of practicing pediatricians. 3. Each fellow should have a mutually agreed on research mentor(s). It is essential for the fellow to have mentor(s) capable of fostering the trainee's career development.

scholarly journals Wealth Inequality as a Predictor of Subjective Health, Happiness and Life Satisfaction among Nepalese Women

2018 ◽  
Vol 15 (12) ◽  
pp. 2836 ◽  
Author(s):  
Zhifei He ◽  
Zhaohui Cheng ◽  
Ghose Bishwajit ◽  
Dongsheng Zou
Keyword(s):  
Economic Status ◽  
Wealth Inequality ◽  
Well Being ◽  
Developed Countries ◽  
Subjective Health ◽  
Household Wealth ◽  
The Body ◽  
Status Report ◽  
Wealth Status ◽  
Cross Sectional

Socioeconomic status has shown to be associated with subjective health, well-being, satisfaction with overall life and estimation of happiness. The body of research concerning the question of whether higher economic status leads to better health and well-being are mostly from developed countries. The present study was therefore conducted among women in Nepal with an aim to investigate whether household wealth status is associated with satisfaction about (1) self-reported health, (2) happiness, and (3) life overall. Methods: Subjects were 5226 Nepalese women aged between 15 and 24 years. Cross-sectional data were extracted from round 5 of the Nepal Multiple Indicator Cluster Survey (NMICS), conducted in 2014, and analyzed using chi-square tests of association, bivariate and multivariable regression methods. Results: Wealth status was significantly associated with satisfaction about health, estimation of happiness and satisfaction. Compared with women in the poorest households, the odds of positive estimation about overall happiness were respectively 30% higher for poorer (p < 0.0001; 95% CI = 1.653–3.190), 80% higher for middle (p = 0.001; 95% CI = 1.294–2.522), 64% higher for richer (p = 0.006; 95% CI = 1.155–2.326), and 40% higher for richest households. The odds of reporting satisfaction about life were respectively 97% higher for poorer (p < 0.0001; 95% CI = 1.680–2.317), 41% higher for middle (p < 0.0001; 95% CI = 1.165–1.715), 62% higher for richer (p < 0.0001; 95% CI = 1.313–2.003), and 31% higher for richest households (p = 0.043; 95% CI = 1.008–1.700). Conclusion: Our results conclude that women in households with lower wealth status report poorer subjective health, quality of life and happiness. However, the findings need to be interpreted in light of the existing sociocultural conditions mediating the role of household wealth status on women’s lives.

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