scholarly journals Emotional experience of people with advanced liver disease: Secondary data analysis

2018 ◽  
Vol 16 (4) ◽  
pp. 284-295
Author(s):  
Alexandra Gray-Renfrew ◽  
Barbara Kimbell ◽  
Anne Finucane
Keyword(s):  
Liver Disease ◽  
Emotional Experience ◽  
Secondary Analysis ◽  
Emotional Responses ◽  
Secondary Data ◽  
Coordinated Care ◽  
Advanced Liver Disease ◽  
Care Gaps ◽  
Disease Experience ◽  
Depth Interviews

Introduction Patients with advanced liver disease live mainly in the community with treatment of complications provided for in-hospital. The illness trajectory of advanced liver disease is uncertain and most do not have access to end of life care. Gaps in knowledge and understanding of the patient experience of this condition have been identified. Methods Secondary analysis of 15 transcripts from in-depth interviews with people with advanced liver disease collected as part of a previous longitudinal study on the experience of liver disease. Transcripts were thematically analysed for emotional content. Results Fear, anger, sadness and guilt clearly featured in the person’s experience of advanced liver disease. Certain causal factors were identified as provoking these emotional responses, including shock of diagnosis, uncertainty concerning illness, lack of coordinated care, worrying symptoms and sudden death. Humour emerged as a coping mechanism. Conclusion People living with advanced liver disease experience distressing emotions. It is helpful for clinicians, nurses and other healthcare support staff to have an appreciation of the person’s emotional concerns in order to provide holistic care typical of a palliative approach.

The Spectrum of Disease Severity in Cirrhosis and Its Implications for Hemostasis

2020 ◽  
Vol 46 (06) ◽  
pp. 716-723
Author(s):  
Matthew J. Stotts ◽  
Ton Lisman ◽  
Nicolas M. Intagliata
Keyword(s):  
Liver Disease ◽  
Bleeding Risk ◽  
Decompensated Cirrhosis ◽  
Advanced Liver Disease ◽  
Critical Knowledge ◽  
Compensated Cirrhosis ◽  
Thrombotic Complications ◽  
Disease Experience ◽  
The Many ◽  
Shed Light

AbstractBleeding and thrombosis are both common complications that patients with advanced liver disease experience. While hemostatic pathways remain largely intact with cirrhosis, this balance can quickly shift in the direction of bleeding or clotting in an unpredictable manner. A growing body of literature is attempting to shed light on difficult scenarios that clinicians often face, ranging from predicting and mitigating bleeding risk in those who need invasive procedures to determining the best strategies to manage both bleeding and thrombotic complications when they occur. Studies examining hemostasis in those with advanced liver disease, however, often include heterogeneous cohorts with varied methodology. While these studies often select a cohort of all types and degrees of cirrhosis, emerging evidence suggests significant differences in underlying systemic inflammation and hemostatic abnormalities among specific phenotypes of liver disease, ranging from compensated cirrhosis to decompensated cirrhosis and acute-on-chronic liver failure. It is paramount that future studies account for these differing disease severities if we hope to address the many critical knowledge gaps in this field.

Serum CYFRA 21 – 1 levels are elevated in advanced liver disease and associate with poor survival

2019 ◽  
Author(s):  
K Hamesch ◽  
N Guldiken ◽  
M Aly ◽  
N Hueser ◽  
D Hartmann ◽  
...  
Keyword(s):  
Liver Disease ◽  
Poor Survival ◽  
Advanced Liver Disease

Sarcopenia in Patients with Advanced Liver Disease

2018 ◽  
Vol 19 (7) ◽  
pp. 681-691 ◽  
Author(s):  
Francesca Romana Ponziani ◽  
Antonio Gasbarrini
Keyword(s):  
Liver Disease ◽  
Advanced Liver Disease

Co-workers’ perceptions of and reactions to employee’s involuntary demotion

2019 ◽  
Vol 41 (4) ◽  
pp. 740-757 ◽  
Author(s):  
Sophie Hennekam ◽  
Subramaniam Ananthram ◽  
Steve McKenna
Keyword(s):  
Design Methodology ◽  
Emotional Responses ◽  
Emotional Reaction ◽  
Content Type ◽  
Informational Justice ◽  
Behavioural Responses ◽  
Behavioural Reaction ◽  
Three Stages ◽  
Depth Interviews ◽  
The Way

Purpose The purpose of this paper is to investigate how individuals perceive and react to the involuntary demotion of a co-worker in their organisation. Design/methodology/approach The authors draw on 46 semi-structured in-depth interviews (23 dyads) with co-workers of demoted individuals. Findings The findings suggest that an individual’s observation of the demotion of a co-worker has three stages: their perception of fairness, their emotional reaction and their behavioural reaction. The perception of fairness concerned issues of distributive, procedural, interpersonal and informational justice. The emotional responses identified were feelings of disappointment/disillusion, uncertainty, vulnerability and anger. Finally, the behavioural reactions triggered by their emotional responses included expressions of voice, loyalty, exit and adaptation. Originality/value Perceptions of (in)justice perpetrated on others stimulate emotional and behavioural responses, which impacts organisational functioning. Managers should therefore pay attention to the way a demotion is perceived, not only by those directly concerned, but also by co-workers as observers.

scholarly journals Fifteen-year trends in self-reported racism and link with health and well-being of African Canadian adolescents: a secondary data analysis

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Helen U. Okoye ◽  
Elizabeth Saewyc
Keyword(s):  
British Columbia ◽  
Health Outcomes ◽  
Racial Discrimination ◽  
Secondary Analysis ◽  
Secondary Data ◽  
Well Being ◽  
Public Health Action ◽  
Extreme Stress ◽  
Self Rated Health ◽  
African Canadian

Abstract Background We assessed the prevalence and trends in racial discrimination among African Canadian adolescents in British Columbia. The association between racial discrimination and self-rated health, access to mental health services, substance use, suicidal thoughts and attempts, experience of extreme stress, among others were examined within the 2018 dataset. Methods Secondary analysis used the data collected from African Canadian adolescents (n = 2448) as part of the British Columbia Adolescent Health Surveys (2003–2018). We examined whether racial discrimination increased, decreased, or remained stable over time. We evaluated experiences of racial discrimination for all adolescents, and then disaggregated analyses for boys, girls, immigrant, and Canadian-born African adolescents. We used Rao-Scott’s adjusted chi-square to test differences in racial discrimination and adjusted logistic regressions to test trends across survey years, widening or narrowing gaps in racial discrimination, as well as the link to health outcomes. Results Racial discrimination was significantly different across the survey years (Adjusted F = 4.60, p < .01), with the highest percentage of adolescents reporting past year racial discrimination in 2018 (29.9%) and the lowest percentage in 2013 (21.3%). Girls and immigrant African Canadian adolescents were more likely to have experienced racial discrimination. However, girls and Canadian-born adolescents had the highest odds of reporting racial discrimination in 2018 compared to 2003, AOR = 1.85, and 1.58, respectively. The findings reveal significant differences in the experiences of racial discrimination for boys and girls, as well as for immigrant and Canadian-born African adolescents. Significant differences were noted in the link between racial discrimination and self-rated health and engaging in behaviours that might expose them to health risks. The worst negative health outcomes were found for boys and immigrant African Canadian adolescents. Conclusion The study suggests that more than 1 in 4 African Canadian adolescents in British Columbia report racial discrimination, which is an increasing trend in recent years. Those who reported racial discrimination also had the worst adverse health outcomes. There is a need for more public health action to reduce racism, create awareness about the negative health impacts, and provide better support for African Canadian adolescents.

scholarly journals ‘We have become prisoners of our own age’: from a continuing care retirement community to a total institution in the midst of the COVID-19 outbreak

2021 ◽  
Author(s):  
Liat Ayalon ◽  
Sharon Avidor
Keyword(s):  
Emotional Responses ◽  
Retirement Community ◽  
Retirement Communities ◽  
Continuing Care ◽  
Total Institution ◽  
Continuing Care Retirement Communities ◽  
Personal Experiences ◽  
Total Institutions ◽  
Design And Methods ◽  
Depth Interviews

Abstract Background and objectives during the coronavirus disease 2019 pandemic in Israel, people residing in continuing care retirement communities (CCRC) found themselves under strict instructions to self-isolate, imposed by the CCRC managements before, during and after the nationwide lockdown. The present study explored the personal experiences of CCRC residents during the lockdown. Research design and methods in-depth interviews were conducted with 24 CCRC residents from 13 different CCRCs. Authors performed a thematic analysis of interview transcripts, using constant comparisons and contrasts. Results three major themes were identified: (i) ‘Us vs. them: Others are worse off’. Older residents engaged in constant attempts to compare their situation to that of others. The overall message behind these downward comparisons was that the situation is not so bad, as others are in a worse predicament; (ii) ‘Us vs. them: Power imbalance’. This comparison emphasised the unbalanced power-relations between older adults and the staff and management in the setting and (iii) ‘We have become prisoners of our own age’. Interviewees described strong emotions of despair, depression and anger, which were intensified when the rest of society returned back to a new routine, whilst they were still under lockdown. Discussion and implications the measures imposed on residents by managements of CCRCs during the lockdown, and the emotional responses of distress among some of the residents, revealed that CCRCs have components of total institutions, not normally evident. This underscores the hidden emotional costs of the lockdown among those whose autonomy was compromised.

scholarly journals Patterns of dendritic cell and monocyte subsets are associated with disease severity and mortality in liver cirrhosis patients

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Chandra Chiappin Cardoso ◽  
Camila Matiollo ◽  
Carolina Hilgert Jacobsen Pereira ◽  
Janaina Santana Fonseca ◽  
Helder Emmanuel Leite Alves ◽  
...  
Keyword(s):  
Dendritic Cells ◽  
Liver Cirrhosis ◽  
Liver Disease ◽  
Dendritic Cell ◽  
Disease Severity ◽  
Advanced Liver Disease ◽  
Hla Dr ◽  
Acute Decompensation ◽  
Cirrhotic Patients ◽  
Classical Monocytes

AbstractLiver cirrhosis is often complicated by an immunological imbalance known as cirrhosis-associated immune dysfunction. This study aimed to investigate disturbances in circulating monocytes and dendritic cells in patients with acute decompensation (AD) of cirrhosis. The sample included 39 adult cirrhotic patients hospitalized for AD, 29 patients with stable cirrhosis (SC), and 30 healthy controls (CTR). Flow cytometry was used to analyze monocyte and dendritic cell subsets in whole blood and quantify cytokines in plasma samples. Cirrhotic groups showed higher frequencies of intermediate monocytes (iMo) than CTR. AD patients had lower percentages of nonclassical monocytes than CTR and SC. Cirrhotic patients had a profound reduction in absolute and relative dendritic cell numbers compared with CTR and showed higher plasmacytoid/classical dendritic cell ratios. Increased plasma levels of IL-6, IL-10, and IL-17A, elevated percentages of CD62L+ monocytes, and reduced HLA-DR expression on classical monocytes (cMo) were also observed in cirrhotic patients. Patients with more advanced liver disease showed increased cMo and reduced tissue macrophages (TiMas) frequencies. It was found that cMo percentages greater than 90.0% within the monocyte compartment and iMo and TiMas percentages lower than 5.7% and 8.6%, respectively, were associated with increased 90-day mortality. Monocytes and dendritic cells are deeply altered in cirrhotic patients, and subset profiles differ between stable and advanced liver disease. High cMo and low TiMas frequencies may be useful biomarkers of disease severity and mortality in liver cirrhosis.

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