scholarly journals Retomando los caminos de vida: Psicoterapia ericksoniana en combinación con el drama ritual de la terapia sistémica de Bert Hellinger (Constelaciones Familiares) para pacientes con duelo complicado

2019 ◽  
Author(s):  
Oleg Gorfinkel
Keyword(s):  
Systemic Therapy ◽  
Treatment Options ◽  
Complicated Grief ◽  
Patient Treatment ◽  
Treatment Model ◽  
Single Session ◽  
Efficient Treatment ◽  
The Public ◽  
Group Format ◽  
Salud Mental

El duelo complicado apenas está siendo reconocido en el campo de salud mental como un trastorno con un perfil y una etiología muy propios, que por lo tanto requiere de estrategias e intervenciones psicoterapéuticas especialmente adaptadas a sus factores particulares. La experiencia clínica en la psicoterapia ericksoniana, así como en la terapia sistémica de Bert Hellinger (Constelaciones Familiares), advierte la posibilidad de desarrollar, a partir de una integración de estos dos enfoques, un tratamiento eficiente que pueda ser impartido en forma grupal y en una sola sesión. Las ventajas de tal modelo de intervención son evidentes, ya que permitirá reducir de manera muy significativa tanto el tiempo como el costo del tratamiento por paciente, así ampliando su accesibilidad y disponibilidad para el público que lo necesite. Por lo tanto, la presente investigación se abocó a (1) desarrollar un modelo de tratamiento para duelo complicado, basado en una integración de la psicoterapia ericksoniana y de la terapia sistémica de Bert Hellinger (Constelaciones Familiares), para ser aplicado en forma grupal y en una sola sesión, y (2) aplicar dicho tratamiento en pacientes diagnosticados con duelo complicado y evaluar su eficacia para disminuir los síntomas del trastorno. Se espera que al alcanzar dichos objetivos, este trabajo sirva para mejorar las opciones de tratamiento disponibles para las personas que sufren del duelo complicado. ENGLISH: Complicated grief is only now gaining recognition in the mental health field as a disorder with its own distinct profile and etiology, and one that requires psychotherapeutic strategies and interventions specially adapted to its peculiar features. Clinical experience in both Ericksonian psychotherapy and Bert Hellinger's systemic therapy (Family Constellations), suggests that through an integration of these two methods, it is possible to develop an efficient treatment to be administered in a group format and in a single session. The advantages of such a treatment model are evident, as it provides a significant reduction in both the time and the per-patient treatment cost, thus making treatment more available and accessible for the public that needs it. For this reason, the present research has aimed at (1) developing a treatment model for complicated grief, based on an integration of Ericksonian psychotherapy and Bert Hellinger's systemic therapy (Family Constellations) and suitable for being administered in a group format and in a single session; (2) applying said treatment in patients diagnosed with complicated grief and evaluating its effectiveness in reducing the symptoms of the disorder. It is hoped that through meeting the above goals, this research will serve to improve the treatment options available to individuals suffering from complicated grief.

scholarly journals Exploring Unmet Needs from an Online Metastatic Breast Cancer Support Group: A Qualitative Study

Medicina ◽  
2021 ◽  
Vol 57 (7) ◽  
pp. 693
Author(s):  
Aravinthan Kadravello ◽  
Seng-Beng Tan ◽  
Gwo-Fuang Ho ◽  
Ranjit Kaur ◽  
Cheng-Har Yip
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Support Group ◽  
Unmet Needs ◽  
Treatment Options ◽  
Metastatic Breast ◽  
Public Hospitals ◽  
Online Support ◽  
Online Support Group ◽  
The Public

Background and Objective: Despite the increasing treatment options for patients with metastatic breast cancer (MBC), unmet needs remain common, especially in low and middle-income countries where resources are limited and MBC patients face many challenges. They often join support groups to cope with their unmet needs. Currently, many MBC patients connect with each other via online support group in view of the constant availability of support and rapid information exchange. The objective of this study is to determine the unmet needs of women with MBC from an online support group. Material and Methods: Messages in an online support group of twenty-two MBC patients over a period of three years from August 2016 till August 2019 were thematically analyzed. Results: Three themes were generated, (1) unmet information needs (2) unmet financial needs (3) unmet support needs. Women needed information on side effects of treatment, new treatment options and availability of clinical trials. Although Malaysia has universal health care coverage, access to treatment remains a major challenge. When treatment was not available in the public hospitals, or waiting lists were too long, women were forced to seek treatment in private hospitals, incurring financial catastrophe. Insufficient private insurance and inadequate social security payments force many women to consider stopping treatment. Women felt that they were not getting support from their clinicians in the public sector, who were quick to stop active treatment and advise palliation. On the other hand, clinicians in the private sector advise expensive treatment beyond the financial capability of the patients. Women with families also face the challenge of managing their family and household in addition to coping with their illness. Conclusions: There is a need for healthcare professionals, policy makers, and civil society to better address the needs of MBC patients through patient-centered, multidisciplinary and multi-organizational collaboration.

scholarly journals Treatment of Anterior Cruciate Ligament Injury in Skeletally Immature Patients

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Joshua L. Hudgens ◽  
Diane L. Dahm
Keyword(s):  
Cruciate Ligament ◽  
Treatment Options ◽  
Cartilage Damage ◽  
Functional Results ◽  
Patient Treatment ◽  
Ligament Injury ◽  
Minimal Risk ◽  
Skeletally Immature ◽  
Increased Risk ◽  
Skeletally Immature Patient

The incidence of ACL tears is rising in the pediatric and adolescent populations as these individuals succumb to traumatic and nontraumatic athletic injuries. Management of this condition in the skeletally immature patient poses a challenge and is controversial. Operative reconstruction carries the concern for damage to the physis with resultant limb length inequality and angular joint deformity but provides stability to the knee and allows return of function in most patients. On the other hand, nonoperative treatment has been shown to carry an increased risk of meniscal and articular cartilage damage and is difficult from a compliance standpoint in this demographic. For the majority of skeletally immature patients, operative treatment is recommended as it has shown good clinical and functional results with minimal risk of growth disturbance. This paper aims to address the natural course of ACL injuries in the skeletally immature patient, treatment options with associated complications, and current preventative strategies.

scholarly journals Pharmacologic treatment of osteoporosis – 2011

2011 ◽  
Vol 152 (33) ◽  
pp. 1320-1326 ◽  
Author(s):  
Péter Lakatos
Keyword(s):  
Bone Loss ◽  
Fracture Risk ◽  
Hormone Replacement ◽  
Treatment Options ◽  
Osteoporotic Fractures ◽  
Cost Effective ◽  
Similar Efficacy ◽  
High Fracture ◽  
Efficient Treatment ◽  
Treatment Of Osteoporosis

Osteoporosis affects approximately 9% of the population in Hungary resulting in about 100 000 osteoporotic fractures annually. Thirty-five percent of patients with hip fractures due to osteoporosis will die within 1 year. Direct costs of osteoporosis exceed 25 billion forints per year. Apparently, cost-effective reduction of bone loss and consequent fracture risk will add up to not only financial savings but improvement in quality of life, as well. A number of pharmacological modalities are available for this purpose. The mainstay of the treatment of osteoporosis is the bisphosphonate group that includes effective anti-resorptive compounds mitigating bone loss and fragility. The recently registered denosumab exhibits similar efficacy by neutralizing RANK ligand, however, marked differences can be observed between the two drug classes. Strontium has a unique mechanism of action by rebalancing bone turnover, and thus, providing an efficient treatment option for the not fast bone losers who are at high fracture risk. The purely anabolic teriparatide is available for the extremely severe osteoporotic patients and for those who do not respond to other types of therapy. Older treatment options such as hormone replacement therapy, raloxifene, tibolone or calcitonin may also have a restricted place in the management of osteoporosis. Orv. Hetil., 2011, 152, 1320–1326.

scholarly journals The emergence of novel coronavirus disease, global treatment update and its containment strategies in overpopulated countries: A Review

Coronaviruses ◽  
2020 ◽  
Vol 01 ◽  
Author(s):  
Fazli Azim ◽  
Md Shahidul Islam ◽  
Hedaeytullah Saju ◽  
Kaniz Fatema ◽  
Aneela Hayat ◽  
...  
Keyword(s):  
Cell Attachment ◽  
Antiviral Treatment ◽  
Treatment Options ◽  
Supportive Therapy ◽  
The Public ◽  
Drug Candidates ◽  
Cell Based Therapy ◽  
Research Activities ◽  
Host Cell Attachment ◽  
Novel Coronavirus

: The ongoing pandemic of the novel coronavirus SARS-CoV-2 (COVID-19), has created a major challenge for the public health worldwide. The reported cases indicate the outbreak is more widespread than initially assumed. Around 18 million people have been infected with 689,000 reported deaths (August 2020; number is increasing daily) by this novel coronavirus, with a high mutation rate this poses even more serious threat worldwide. The actual source of COVID-19 is still unclear, even if the initial reports links it to the Chinese seafood wet markets in Wuhan, other animals such as birds, snakes, and many small mammals including bats are also linked with this novel coronavirus. Structure of the COVID-19 shows distinctive proteins among which, spike proteins have a pivotal role in host cell attachment and virus-cell membrane fusion in order to facilitate virus infection. Currently, no specific antiviral treatment or vaccine is available. Various drug candidates including SARS‐CoV and MERS‐CoV protease inhibitors, neuraminidase inhibitors, RNA synthesis inhibitors, ACE2 inhibitors and lungs supportive therapy are on the trail. Cell-based therapy also appeared with remarkable treatment possibilities. In this article, we endeavored to succinctly cover the current and available treatment options including pharmaceuticals, cell-based therapy, and traditional medicine. We also focused on the extent of damages by this novel coronavirus in India, Pakistan, and Bangladesh, the strategies adopted and the research activities initiated so far by these densely populated countries (neighboring China) are explained in this review.

scholarly journals Budgetary restrictions and ethical behaviours in a hospital context – evidence from general surgeons

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Cristina Piedade Silva ◽  
Rita Martins de Sousa
Keyword(s):  
Medical Profession ◽  
Participant Observation ◽  
Methodological Approach ◽  
Treatment Options ◽  
Patient Treatment ◽  
Ethical Behaviour ◽  
Content Type ◽  
Ethical Implications ◽  
General Surgeons ◽  
The Impact

Purpose The purpose of this paper is to study how budgetary constraints can have ethical implications on patient treatment options. Design/methodology/approach By applying a qualitative methodological approach (interviews) and participant observation, this paper studies the behaviour of surgeons in scenarios of financial restriction. Findings The empirical findings show that despite the conflict between the economy and the leges artis, surgeons maintain the ethical and deontological principles of their profession with fair rules of orientation. Practical implications The importance of this study can be realised by its continuity. One of the authors is already implicated on a wider research to investigate the influence of the economic scarcity of resources on general surgeons’ ethical behaviours. Social implications This paper is a contribution to understanding the rules that restrain the activities of surgeons. Politicians sometimes do not have a full understanding of the pressures that the medical profession faces in their day-to-day activities. Currently, with the addition of problems relate to COVID-19, politicians and populations seem to better understand the importance of the Serviço Nacional de Saúde (SNS), This paper hopes that this understanding will be not only a conjectural moment. Originality/value In conjunction with the economic recession that began in the first decade of this century, health institutions have long faced budgetary constraints that condition their material and human resources and correspondingly shape the scope of health professional activities. Until now, it has not been studied the impact of economic crises on the ethical behaviour of Portuguese surgeons. Therefore, this research is a first step and a useful contribution to understanding the rules that can restrain (or not) the ethical conduct of these health professionals.

Identifying stakeholder opinion regarding access to “high-cost medicines”: A systematic review of the literature

Open Medicine ◽  
2014 ◽  
Vol 9 (3) ◽  
pp. 513-527 ◽  
Author(s):  
Philip Wahlster ◽  
Shane Scahill ◽  
Sanjay Garg ◽  
Zaheer-Ud-Din Babar
Keyword(s):  
Systematic Review ◽  
Ethical Issues ◽  
Treatment Options ◽  
System Level ◽  
Research Articles ◽  
Original Research ◽  
Review Of The Literature ◽  
Moral Issues ◽  
The Public ◽  
Patient Groups

AbstractObjective: To identify the viewpoints and perceptions of different stakeholders regarding high cost medicines (HCMs). Methods: A systematic review of the literature was performed to identify original research articles. Using predefined categories, data related to the viewpoints of different stakeholders was systematically extracted and analyzed. Results: Thirty seven original research articles matched the criteria. The main stakeholders identified include physicians, patients, public and health funding authorities. The influence of media and other economic and ethical issues were also identified in the literature. A large number of stakeholders were concerned about lack of access to HCMs. Physicians have difficulty balancing the the rational use of expensive drugs while at the same time acting as “patients’ advocate”. Patients would like to know about all treatment options, even if they may not be able to afford them. The process and criteria for reimbursement should be transparent and access has to be equitable across patient groups. Conclusion: Access to HCMs could be improved through transparency and involvement of all stakeholders, especially patients and the public. Moral issues and the “rule of rescue” could influence decision-making process significantly. At system level, objectivity is important to ensure that the system is equitable and transparent.

scholarly journals Boarding Injuries: The Long and the Short of It

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Leslie A. Fabian ◽  
Steven M. Thygerson ◽  
Ray M. Merrill
Keyword(s):  
Brain Injuries ◽  
Injury Severity ◽  
Treatment Options ◽  
Head Injuries ◽  
Patient Treatment ◽  
Injury Patterns ◽  
Population Demographics ◽  
Icu Length Of Stay ◽  
Level Ii ◽  
Prospective Investigation

As the popularity of longboarding increases, trauma centers are treating an increased number of high severity injuries. Current literature lacks descriptions of the types of injuries experienced by longboarders, a distinct subset of the skateboarding culture. A retrospective review of longboarding and skateboarding injury cases was conducted at a level II trauma center from January 1, 2006, through December 31, 2011. Specific injuries in addition to high injury severity factors (hospital and intensive care unit (ICU) length of stay (LOS), Injury Severity Score (ISS), patient treatment options, disposition, and outcome) were calculated to compare longboarder to skateboarder injuries. A total of 824 patients met the inclusion criteria. Skull fractures, traumatic brain injuries (TBI), and intracranial hemorrhage (ICH) were significantly more common among longboard patients than skateboarders (P<0.0001). All patients with an ISS above 15 were longboarders. Hospital and ICU LOS in days was also significantly greater for longboarders compared with skateboarders (P<0.0001). Of the three patients that died, each was a longboarder and each experienced a head injury. Longboard injuries account for a higher incidence rate of severe head injuries compared to skateboard injuries. Our data show that further, prospective investigation into the longboarding population demographics and injury patterns is necessary to contribute to effective injury prevention in this population.

INNV-22. FACTORS GUIDING THE INITIATION OF TUMOR TREATING FIELDS (TTFIELDS; 200 KHZ) THERAPY FOR GLIOBLASTOMA: SELF-REPORTED PATIENT AND ONCOLOGIST PERSPECTIVES

2021 ◽  
Vol 23 (Supplement_6) ◽  
pp. vi109-vi110
Author(s):  
Peggy Frongillo ◽  
P Gage Gwyn ◽  
Connie Wagenknecht ◽  
Nichelle Renae Adams
Keyword(s):  
Support Groups ◽  
Treatment Options ◽  
Progression Free Survival ◽  
Standard Of Care ◽  
Tumor Location ◽  
Survey Study ◽  
Patient Treatment ◽  
Survey Analysis ◽  
Tumor Treating Fields ◽  
Post Surgery

Abstract BACKGROUND The standard-of-care for newly-diagnosed glioblastoma (ndGBM) has been the standard Stupp protocol. In ndGBM, approved TTFields (200 KHz) concomitant with maintenance temozolomide significantly improved progression-free survival and overall survival. TTFields-therapy selectively disrupts cancer cell division, requiring array-application to the shaved-scalp to non-invasively deliver TTFields to tumor location and confer clinical benefit. This survey-study assessed factors impacting decision of oncologist/patient/caregiver to initiate TTFields-therapy. METHODS A clinical-market research group administered double-blinded, online-questionnaires (30-min) to oncologists/ndGBM-patients/caregivers. Survey questions, an amalgamate of closed-/open-ended questions, were designed to track awareness, perceptions, and acceptance of ndGBM treatments in a representative United States (US) oncologist and adult patient/caregiver population (semi-annually; 2018-2020). The present survey-analysis focuses on results related to initiation of TTFields-therapy for ndGBM. RESULTS Four separate patient/caregiver surveys (Q1/2018-Q3/2020; (n=50-51/wave) and 4 separate oncologist surveys (Q2/2019-Q4/2020; n=130/wave) were conducted. Results suggest majority of patients with ndGBM research treatment options, including TTFields-therapy, immediately after surgery and before radiation/initial temozolomide; and initiate TTFields-therapy after radiation/initial temozolomide (ie, before maintenance temozolomide). Patients-reported initially learning about TTFields post-surgery via oncologists, nurses, support groups, social-media, and TTFields web-based resources. Among 97% of current/previous TTFields-users, the key patient-driver for selecting TTFields, mirroring oncologist-driver to recommend, was efficacy/survival benefit. Other highly-rated selection-drivers were anti-mitotic mechanism (93%), improved long-term 5-year survival (87%), sustained quality-of-life (87%), and no travel requirement to start (87%). In latest study wave, reported patient usage-barrier was the inability to subsequently enroll in clinical trials (64%), while the top-reported oncologist prescribing-barrier was concern with patient treatment usage (60%). Also, survey suggests oncologists discuss TTFields with most patients with ndGBM, citing efficacy and National Comprehensive Cancer Network® inclusion as key treatment-initiation drivers. CONCLUSIONS Overall, survey data suggests awareness (100%, aided; 61%-68%, unaided) by US oncologists/patients/caregivers of TTFields (200 kHz) as a viable treatment option for adults with ndGBM.

Falling Out of Performance: Pragmatic Breakdown in Veterans’ Storytelling

2015 ◽  
Author(s):  
Kristiana Willsey
Keyword(s):  
Traumatic Stress ◽  
Combat Veterans ◽  
Treatment Options ◽  
Military Veterans ◽  
Post Traumatic Stress ◽  
The Public ◽  
Post Traumatic ◽  
The Military ◽  
War Stories ◽  
Careful Management

Unfortunately, coming to terms with disability and trauma are all too familiar foes for American combat veterans, many of whom receive inadequate, delayed, or nonexistent treatment options upon returning home. We conclude this volume with chapter 10, “Falling Out of Performance: Pragmatic Breakdown in Veterans’ Storytelling,” in which Kristiana Willsey provides new insights into the ways in which U.S. military veterans of Iraq and Afghanistan make meaning and process trauma through the sharing of narratives. She argues that naturalizing the labor of narrative—by assuming stories are inherently transformative, redemptive, or unifying—obscures the responsibilities of the audience as co-authors, putting the burden on veterans to both share their experiences of war, and simultaneously scaffold those experiences for an American public that (with the ongoing privatization of the military and the ever-shifting fronts of global warfare) is increasingly alienated from its military. Importantly, Willsey asserts that the public exhortations in which veterans tell their stories in an effort to cultivate a kind of cultural catharsis can put them in an impossible position: urged to tell their war stories; necessitating the careful management of those stories for audiences uniquely historically disassociated from their wars; and then conflating the visible management of those stories with the “spoiled identity” of post-traumatic stress disorder (PTSD).

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