Living with long term disease or impairment.
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Qurʾān
القرآن6 shownVerses named for this subject by hand come first. The rest are found by the subject’s own Arabic and English senses and are shown as lexical matches, not as anchors anyone has confirmed.
Qur'ān 48:17English sense: sick | Arabic sense: المريض, مريض
لَّيۡسَ عَلَى ٱلۡأَعۡمَىٰ حَرَجࣱ وَلَا عَلَى ٱلۡأَعۡرَجِ حَرَجࣱ وَلَا عَلَى ٱلۡمَرِيضِ حَرَجࣱۗ وَمَن يُطِعِ ٱللَّهَ وَرَسُولَهُۥ يُدۡخِلۡهُ جَنَّٰتࣲ تَجۡرِي مِن تَحۡتِهَا ٱلۡأَنۡهَٰرُۖ وَمَن يَتَوَلَّ يُعَذِّبۡهُ عَذَابًا أَلِيمࣰ ا
the blind, the lame, and the sick will not be blamed.’ God will admit anyone who obeys Him and His Messenger to Gardens graced with flowing streams; He will painfully punish anyone who turns away
Qur'ān 9:91English sense: sick | Arabic sense: المرض, مرض
لَّيۡسَ عَلَى ٱلضُّعَفَآءِ وَلَا عَلَى ٱلۡمَرۡضَىٰ وَلَا عَلَى ٱلَّذِينَ لَا يَجِدُونَ مَا يُنفِقُونَ حَرَجٌ إِذَا نَصَحُواْ لِلَّهِ وَرَسُولِهِۦۚ مَا عَلَى ٱلۡمُحۡسِنِينَ مِن سَبِيلࣲۚ وَٱللَّهُ غَفُورࣱ رَّحِيمࣱ
but there is no blame attached to the weak, the sick, and those who have no means to spend, provided they are true to God and His Messenger- there is no reason to reproach those who do good: God is most forgiving and merciful
Qur'ān 24:61Arabic sense: المريض, مريض
لَّيۡسَ عَلَى ٱلۡأَعۡمَىٰ حَرَجࣱ وَلَا عَلَى ٱلۡأَعۡرَجِ حَرَجࣱ وَلَا عَلَى ٱلۡمَرِيضِ حَرَجࣱ وَلَا عَلَىٰٓ أَنفُسِكُمۡ أَن تَأۡكُلُواْ مِنۢ بُيُوتِكُمۡ أَوۡ بُيُوتِ ءَابَآئِكُمۡ أَوۡ بُيُوتِ أُمَّهَٰتِكُمۡ أَوۡ بُيُوتِ إِخۡوَٰنِكُمۡ أَوۡ بُيُوتِ أَخَوَٰتِكُمۡ أَوۡ بُيُوتِ أَعۡمَٰمِكُمۡ أَوۡ بُيُوتِ عَمَّٰتِكُمۡ أَوۡ بُيُوتِ أَخۡوَٰلِكُمۡ أَوۡ بُيُوتِ خَٰلَٰتِكُمۡ أَوۡ مَا مَلَكۡتُم مَّفَاتِحَهُۥٓ أَوۡ صَدِيقِكُمۡۚ لَيۡسَ عَلَيۡكُمۡ جُنَاحٌ أَن تَأۡكُلُواْ جَمِيعًا أَوۡ أَشۡتَاتࣰ اۚ فَإِذَا دَخَلۡتُم بُيُوتࣰ ا فَسَلِّمُواْ عَلَىٰٓ أَنفُسِكُمۡ تَحِيَّةࣰ مِّنۡ عِندِ ٱللَّهِ مُبَٰرَكَةࣰ طَيِّبَةࣰۚ كَذَٰلِكَ يُبَيِّنُ ٱللَّهُ لَكُمُ ٱلۡأٓيَٰتِ لَعَلَّكُمۡ تَعۡقِلُونَ
No blame will be attached to the blind, the lame, the sick.Whether you eat in your own houses, or those of your fathers, your mothers, your brothers, your sisters, your paternal uncles, your paternal aunts, your maternal uncles, your maternal aunts, houses you have the keys for, or any of your friends’ houses, you will not be blamed: you will not be blamed whether you eat in company or separately. When you enter any house, greet one another with a greeting of blessing and goodness as enjoined by God. This is how God makes His messages clear to you so that you may understand
Qur'ān 4:102English sense: illness | Arabic sense: مرض
وَإِذَا كُنتَ فِيهِمۡ فَأَقَمۡتَ لَهُمُ ٱلصَّلَوٰةَ فَلۡتَقُمۡ طَآئِفَةࣱ مِّنۡهُم مَّعَكَ وَلۡيَأۡخُذُوٓاْ أَسۡلِحَتَهُمۡۖ فَإِذَا سَجَدُواْ فَلۡيَكُونُواْ مِن وَرَآئِكُمۡ وَلۡتَأۡتِ طَآئِفَةٌ أُخۡرَىٰ لَمۡ يُصَلُّواْ فَلۡيُصَلُّواْ مَعَكَ وَلۡيَأۡخُذُواْ حِذۡرَهُمۡ وَأَسۡلِحَتَهُمۡۗ وَدَّ ٱلَّذِينَ كَفَرُواْ لَوۡ تَغۡفُلُونَ عَنۡ أَسۡلِحَتِكُمۡ وَأَمۡتِعَتِكُمۡ فَيَمِيلُونَ عَلَيۡكُم مَّيۡلَةࣰ وَٰحِدَةࣰۚ وَلَا جُنَاحَ عَلَيۡكُمۡ إِن كَانَ بِكُمۡ أَذࣰ ى مِّن مَّطَرٍ أَوۡ كُنتُم مَّرۡضَىٰٓ أَن تَضَعُوٓاْ أَسۡلِحَتَكُمۡۖ وَخُذُواْ حِذۡرَكُمۡۗ إِنَّ ٱللَّهَ أَعَدَّ لِلۡكَٰفِرِينَ عَذَابࣰ ا مُّهِينࣰ ا
When you [Prophet] are with the believers, leading them in prayer, let a group of them stand up in prayer with you, taking their weapons with them, and when they have finished their prostration, let them take up their positions at the back. Then let the other group, who have not yet prayed, pray with you, also on their guard and armed with their weapons: the disbelievers would dearly like you to be heedless of your weapons and baggage, in order for them to take you in a single assault. You will not be blamed if you lay aside your arms when you are overtaken by heavy rain or illness, but be on your guard. Indeed, God has prepared a humiliating punishment for the disbelievers
Qur'ān 4:43Arabic sense: مرض | English sense: illness
يَٰٓأَيُّهَا ٱلَّذِينَ ءَامَنُواْ لَا تَقۡرَبُواْ ٱلصَّلَوٰةَ وَأَنتُمۡ سُكَٰرَىٰ حَتَّىٰ تَعۡلَمُواْ مَا تَقُولُونَ وَلَا جُنُبًا إِلَّا عَابِرِي سَبِيلٍ حَتَّىٰ تَغۡتَسِلُواْۚ وَإِن كُنتُم مَّرۡضَىٰٓ أَوۡ عَلَىٰ سَفَرٍ أَوۡ جَآءَ أَحَدࣱ مِّنكُم مِّنَ ٱلۡغَآئِطِ أَوۡ لَٰمَسۡتُمُ ٱلنِّسَآءَ فَلَمۡ تَجِدُواْ مَآءࣰ فَتَيَمَّمُواْ صَعِيدࣰ ا طَيِّبࣰ ا فَٱمۡسَحُواْ بِوُجُوهِكُمۡ وَأَيۡدِيكُمۡۗ إِنَّ ٱللَّهَ كَانَ عَفُوًّا غَفُورًا
You who believe, do not come anywhere near the prayer if you are intoxicated, not until you know what you are saying; nor if you are in a state of major ritual impurity- though you may pass through the mosque- not until you have bathed; if you are ill, on a journey, have relieved yourselves, or had intercourse, and cannot find any water, then find some clean sand and wipe your faces and hands with it. God is always ready to pardon and forgive
Qur'ān 5:6Arabic sense: مرض | English sense: sick
يَٰٓأَيُّهَا ٱلَّذِينَ ءَامَنُوٓاْ إِذَا قُمۡتُمۡ إِلَى ٱلصَّلَوٰةِ فَٱغۡسِلُواْ وُجُوهَكُمۡ وَأَيۡدِيَكُمۡ إِلَى ٱلۡمَرَافِقِ وَٱمۡسَحُواْ بِرُءُوسِكُمۡ وَأَرۡجُلَكُمۡ إِلَى ٱلۡكَعۡبَيۡنِۚ وَإِن كُنتُمۡ جُنُبࣰ ا فَٱطَّهَّرُواْۚ وَإِن كُنتُم مَّرۡضَىٰٓ أَوۡ عَلَىٰ سَفَرٍ أَوۡ جَآءَ أَحَدࣱ مِّنكُم مِّنَ ٱلۡغَآئِطِ أَوۡ لَٰمَسۡتُمُ ٱلنِّسَآءَ فَلَمۡ تَجِدُواْ مَآءࣰ فَتَيَمَّمُواْ صَعِيدࣰ ا طَيِّبࣰ ا فَٱمۡسَحُواْ بِوُجُوهِكُمۡ وَأَيۡدِيكُم مِّنۡهُۚ مَا يُرِيدُ ٱللَّهُ لِيَجۡعَلَ عَلَيۡكُم مِّنۡ حَرَجࣲ وَلَٰكِن يُرِيدُ لِيُطَهِّرَكُمۡ وَلِيُتِمَّ نِعۡمَتَهُۥ عَلَيۡكُمۡ لَعَلَّكُمۡ تَشۡكُرُونَ
You who believe, when you are about to pray, wash your faces and your hands up to the elbows, wipe your heads, wash your feet up to the ankles and, if required, wash your whole body. If any of you is sick or on a journey, or has just relieved himself, or had intimate contact with a woman, and can find no water, then take some clean sand and wipe your face and hands with it. God does not wish to place any burden on you: He only wishes to cleanse you and perfect His blessing on you, so that you may be thankful
Tafsīr
التفسير6 shownCommentary on the verses above, at most two editions per verse.
en-al-jalalayn on 48:17en-al-jalalayncommentary on an ayah this subject surfaced
There is no blame on the blind nor is there blame on the lame nor is there blame on the sick to refrain from participating in the struggle. And whoever obeys God and His Messenger He will admit him read yudkhilhu or nudkhilhu ‘We will admit him’ into gardens underneath which rivers flow; and whoever turns away him He will chastise read yu‘adhdhibhu or nu‘adhdhibhu ‘him We will chastise’ with a painful chastisement.
en-tafisr-ibn-kathir on 48:17en-tafisr-ibn-kathircommentary on an ayah this subject surfaced
Say to the bedouins who lagged behind: "You shall be called to fight against a people given to great warfare, then you shall fight them, or they shall surrender. Then if you obey, Allah will give you a fair reward; but if you turn away as you did turn away before, He will punish you with a painful torment. (16)No blame or sin is there upon the blind, nor is there sin upon the lame, nor is there sin upon the sick. And whosoever obeys Allah and His Messenger, He will admit him to Gardens beneath which rivers flow; and whosoever turns back, He will punish him with a painful torment (17)
Allah conveys the News that there will be Many Cases of Jihad, and that Jihad distinguishes the Ranks of the Believers and exposes the Hypocrites
Scholars of Tafsir differ over who the people mentioned here are. They are people experienced at warfare who will be called to fight. There are many opinions, fi
en-al-jalalayn on 9:91en-al-jalalayncommentary on an ayah this subject surfaced
As for the weak such as the old and the sick the blind and the chronically ill and those who find nothing to expend for the struggle no blame no sin falls upon them should they stay away from it if they remain true to God and to His Messenger when they stay behind by not spreading false rumours or impeding others from joining the struggle but by adhering to obedience. There is no way of blame no way of reproach against those who are virtuous through such behaviour. And God is Forgiving Merciful to them by granting them such leeway in this matter.
en-tafisr-ibn-kathir on 9:91en-tafisr-ibn-kathircommentary on an ayah this subject surfaced
There is no blame on those who are weak or ill or who find no resources to spend, if they are sincere and true (in duty) to Allah and His Messenger. No means (of complaint) can there be against the doers of good. And Allah is Oft-Forgiving, Most Merciful (91)Nor (is there blame) on those who came to you to be provided with mounts, when you said: "I can find no mounts for you," they turned back, with their eyes overflowing with tears of grief that they could not find anything to spend (92)The means (of complaint) is only against those who are rich, and yet ask exemption. They are content to be with (the women) who sit behind (at home) and Allah has sealed up their hearts so that they know not (what they are losing)(93)
Legitimate Excuses for staying away from Jihad
Allah mentions here the valid excuses that permit one to stay away from fighting. He first mentions the excuses that remain
en-asbab-al-nuzul-by-al-wahidi on 24:61en-asbab-al-nuzul-by-al-wahidicommentary on an ayah this subject surfaced
(No blame is there upon the blind�) [24:61]. Said ibn �Abbas: �When Allah, glorious and exalted is He, revealed (O ye who believe! Squander not your wealth among yourselves in vanity�) [4:29], the Muslims felt vexed to eat with the sick, the old, the blind and the lame. They said: �Food is the best part of one�s wealth, and Allah, exalted is He, has warned against squandering wealth in vanity. The blind cannot see where wholesome food is, the lame cannot compete over food and the sick cannot eat properly�. As a response, Allah, exalted is He, revealed this verse�. Sa�id ibn Jubayr and al-Dahhak said: �The lame and the blind used to feel vexed at eating with healthy people because the latter found them despicable and disliked eating with them. The people of Medina did not allow the blind, lame or sick person to share their food because they considered them dirty. For this reason, Allah, e
en-asbab-al-nuzul-by-al-wahidi on 4:43en-asbab-al-nuzul-by-al-wahidicommentary on an ayah this subject surfaced
O you who have faith! Do not approach the prayer when you are intoxicated until you know what you are saying, or defiled-except for travelers on the road-until you have made the full ablution.... Surely God is pardoning, forgiving. Intoxication is drunkenness. Drunkenness is disparate, and the drunkards diverse. One is drunk with the wine of the grape, another with the wine of heedlessness, another with love for this world, another with the frivolity of the soul and self-love. This last is the most difficult, for self-love is the basis of idol-worship, the seed of estrangement, the curtain of ill fortune, and the root of every darkness. If you are martyred a hundred times a day in the path of God you will still be an idol-worshiper if you see yourself in the midst. When will you be the man to want the heart without caprice? When you will have the pain to see the body with contempt? [DS 7
Research library, full list
776 to 800 of 828Peng P, Stinson JN, Choiniere M, Dion D, Intrater H, Lefort S, Lynch M, Ong M, Rashiq S, Tkachuk G, Veillette Y, STOPPAIN Investigators Group (2007)MEDLINE-indexed journal, not yet read by usCanadian journal of anaesthesia = Journal canadien d'anesthesie76 citations Dedicated multidisciplinary pain management centres for children in Canada: the current status.
Purpose: The objective of this study was to examine the services currently offered by multidisciplinary pain treatment facilities (MPTFs) dedicated for pediatric chronic pain management across Canada.
Methods: A MPTF was defined as a clinic that advertised specialized multidisciplinary services for the diagnosis and management of chronic pain and had a minimum of three different health care disciplines (including at least one medical speciality) available and integrated within the facility. The search method was previously described in an accompanying article. Designated investigators were responsible for confirming and supplementing MPTFs from the preliminary list in their respective provinces. Administrative leads at each eligible MPTF were asked to complete a detailed questionnaire on their infrastructure, clinical, research, teaching and administrative activities. Only MPTFs dedicate…
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Repeated sleep restriction in rats leads to homeostatic and allostatic responses during recovery sleep.
Recent studies indicate that chronic sleep restriction can have negative consequences for brain function and peripheral physiology and can contribute to the allostatic load throughout the body. Interestingly, few studies have examined how the sleep-wake system itself responds to repeated sleep restriction. In this study, rats were subjected to a sleep-restriction protocol consisting of 20 h of sleep deprivation (SD) followed by a 4-h sleep opportunity each day for 5 consecutive days. In response to the first 20-h SD block on day 1, animals responded during the 4-h sleep opportunity with enhanced sleep intensity [i.e., nonrapid eye movement (NREM) delta power] and increased rapid eye movement sleep time compared with baseline. This sleep pattern is indicative of a homeostatic response to acute sleep loss. Remarkably, after the 20-h SD blocks on days 2-5, animals failed to exhibit a compen…
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Spousal bereavement in older adults: common, resilient, and chronic grief with defining characteristics.
The purpose of this study was to identify empirically patterns of grief among 141 older bereaved spouses. A longitudinal hierarchical cluster procedure with the Ward agglomeration method was used to identify distinct clusters based on grief scores. Three clusters were identified: common (49%), resilient (34%), and chronic (17%) grief. Members of the common grief cluster experienced elevated levels of grief and depressive symptoms that decreased over time. Members of the resilient cluster experienced the lowest levels of grief and depression and the highest quality of life. The chronic grief cluster experienced the highest levels of grief and depression, more sudden deaths, the lowest self-esteem, and the highest marital dependency. The majority in this chronic cluster also met proposed criteria for a diagnosis of complicated grief. Five out of every six bereaved spouses adjusted well ove…
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The role of mindfulness in a contextual cognitive-behavioral analysis of chronic pain-related suffering and disability.
An increasing number of studies consider the specific processes by which distressing sensations, thoughts, and emotional experiences exert their influence on the daily functioning of those who suffer with chronic pain. Clinical methods of mindfulness and the processes that underlie them appear to have clear implications in this area, but have not been systematically investigated to this point in time. The purpose of the present study was to examine mindfulness in relation to the pain, emotional, physical, and social functioning of individuals with chronic pain. The present study included 105 consecutive patients attending a clinical assessment for treatment of chronic pain. Each completed a standardized battery of questionnaires, including a measure of mindfulness, the Mindful Attention Awareness Scale [Brown KW, Ryan RM. The benefits of being present: mindfulness and its role in psychol…
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Factors underlying tiredness in older adults.
Background and aims: The purpose of the present study was to examine for factors related to tiredness, cross-sectionally at the age of 75 years, and factors related to subsequent onset of tiredness, from age 75 to 80 in a non-disabled community-living population.
Methods: The study is part of the prospective Nordic Research on Aging Study (NORA) on the 1914 cohort in Jyväskylä, Finland and Glostrup, Denmark. In total, 546 non-disabled older men and women participated in the cross-sectional study at age 75, and 299 persons without tiredness and disability at baseline took part in the follow-up study, from age 75 to 80. Tiredness was measured by a validated scale based on the following items: using the toilet, washing and dressing lower body, and cutting toenails. Independent variables were: social position measured by housing tenure and income, chronic diseases, use of medicine, pain, mus…
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Processes of change in treatment for chronic pain: the contributions of pain, acceptance, and catastrophizing.
Cognitive-behavioral therapy has a substantial evidence base with regard to its effectiveness for individuals with chronic pain. Historically, although there has been some investigation in to the processes by which treatment succeeds or fails, few data are available regarding the unique contributions of processes from distinct cognitive behavioral approaches and how these processes may interact to affect patient functioning. The present investigation sought to evaluate three proposed process variables that have garnered empirical support within chronic pain settings, namely: pain intensity, catastrophizing, and acceptance. Participants were 252 consecutive patients who completed treatment on an interdisciplinary pain management unit. Using multiple regression, the contributions of changes in process variables to changes in treatment outcomes were assessed. In general, changes in both acc…
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The relationship between pain, neuropsychological performance, and physical function in community-dwelling older adults with chronic low back pain.
Objective: Chronic pain and cognitive impairment are prevalent and disabling in older adults (OA), but their interrelationship has not been rigorously tested. We did so in OA with chronic low back pain (CLBP).
Design: A total of 323 OA (160 pain-free, 163 CLBP; mean age 73.5 years, 45% female) had neuropsychological (NP) testing with the Repeatable Battery for the Assessment of Neuropsychological Status, Trail Making Test, and the Grooved Pegboard Test. Pain intensity was measured with the McGill Pain Questionnaire Short Form. Physical performance (gait speed, functional reach, chair rise, trunk rotation, and static/dynamic lifting), psychosocial disruption (Geriatric Depression Scale, the Short Form-36 Mental Health and Role Limitations-Emotional Composite scale), and self-reported disability (Functional Status Index, the Short From-36 Physical Functioning/Role-Physical Composite scale)…
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Recovery as an explanatory mechanism in the relation between acute stress reactions and chronic health impairment.
This contribution aims at shedding light on the mechanisms that may underlie the relationship between acute reactions to stressful work characteristics and employee health in the long run. Recovery, a process of psychophysiological unwinding after effort expenditure, is considered a vital link in this relationship. This link is explained on the basis of assumptions from theories on effort, recovery, and sustained activation. It is argued that recovery after work (external recovery) is particularly necessitated when recovery opportunities during worktime (internal recovery) are insufficient. It is further argued that two conditions may impede the recovery process by sustaining physiological activation, prolonged exposure to work demands (working long hours) and cognitive stress-related processes (such as rumination). These theoretical assumptions are substantiated by empirical support fro…
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Popkin BM (2006)MEDLINE-indexed journal, not yet read by usThe American journal of clinical nutrition870 citations Global nutrition dynamics: the world is shifting rapidly toward a diet linked with noncommunicable diseases.
Global energy imbalances and related obesity levels are rapidly increasing. The world is rapidly shifting from a dietary period in which the higher-income countries are dominated by patterns of degenerative diseases (whereas the lower- and middle-income countries are dominated by receding famine) to one in which the world is increasingly being dominated by degenerative diseases. This article documents the high levels of overweight and obesity found across higher- and lower-income countries and the global shift of this burden toward the poor and toward urban and rural populations. Dietary changes appear to be shifting universally toward a diet dominated by higher intakes of animal and partially hydrogenated fats and lower intakes of fiber. Activity patterns at work, at leisure, during travel, and in the home are equally shifting rapidly toward reduced energy expenditure. Large-scale decre…
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Schulz KH, Gold S (2006)MEDLINE-indexed journal, not yet read by usBundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz6 citations [Psychological stress, immune function and disease development. The psychoneuroimmunologic perspective].
Interdisciplinary psychoneuroimmunological (PNI) research increasingly demonstrates clinically relevant interrelations between psychological stressors and the onset or progression of chronic diseases. Disturbances of the bi-directional interaction between the nervous system, the immune system and the endocrine system have been hypothesized to be implicated in several diseases. Here, we review evidence from psychoneuroimmunology within the theoretical framework of allostatic load to conceptualize some of these associations. Interdisciplinary PNI research investigating the importance of psychological stress for the higher incidence of infections, decreased responses to vaccinations and delayed wound healing is reviewed. Furthermore, the literature supporting similar associations with regard to progression of oncological diseases and autoimmune disorders is reviewed with a focus on breast c…
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Paternal involvement in the management of pediatric chronic diseases: associations with adherence, quality of life, and health status.
Objectives: This article reports associations among paternal involvement in pediatric chronic disease management and child outcomes.
Methods: The Dads' Active Disease Support scale (DADS) and measures of treatment adherence, quality of life, health status, and health care utilization were obtained for youths with six chronic diseases, with complete data sets obtained from 190 couples.
Results: Paternal involvement was not associated with these outcomes among younger children. Among adolescents, mother-reported and father-reported DADS scores indicating more paternal involvement were associated with maintenance, rather than deterioration, of treatment adherence and more favorable quality of life. Youths' health status and health care utilization were not related significantly to paternal involvement.
Conclusions: More paternal involvement was associated with more favorable adherence and q…
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Depression in patients with chronic venous ulceration.
As leg ulcer research has generally focused on aspects of treatment, the psychosocial impact of leg ulceration remains understudied. This article reports the findings of a study exploring the prevalence of anxiety and depression in 190 patients with chronic venous ulceration across 9 Trusts in the northwest of England. The hospital anxiety and depression scale (HADS) was used to screen patients for the presence of anxiety and depression using a cut-off point of 9 for level of "caseness". A total of 52 (27%) people scored as depressed while 50 (26%) scored as anxious. The two symptoms which appeared to be associated with anxiety and depression were pain and odour, while there was no association found between living alone, mobility and exudate. These findings suggest that the focus of care needs to be redirected for many patients for whom cure is not an option, but who are left to live wit…
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Chronic stress induces adrenal hyperplasia and hypertrophy in a subregion-specific manner.
The adrenal gland is an essential stress-responsive organ that is part of both the hypothalamic-pituitary-adrenal axis and the sympatho-adrenomedullary system. Chronic stress exposure commonly increases adrenal weight, but it is not known to what extent this growth is due to cellular hyperplasia or hypertrophy and whether it is subregion specific. Moreover, it is not clear whether increased production of adrenal glucocorticoid after chronic stress is due to increased sensitivity to adrenocorticotropic hormone (ACTH) vs. increased maximal output. The present studies use a 14-day chronic variable stress (CVS) paradigm in adult male rats to assess the effects of chronic stress on adrenal growth and corticosterone steroidogenesis. Exogenous ACTH administration (0-895 ng/100 g body wt) to dexamethasone-blocked rats demonstrated that CVS increased maximal plasma and adrenal corticosterone resp…
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Twelve-year course and outcome predictors of anorexia nervosa.
Objective: The current study presents the long-term course of anorexia nervosa (AN) over 12 years in a large sample of 103 patients diagnosed according to criteria in the 4th ed. of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV).
Method: Assessments were made at the beginning of therapy, at the end of therapy, at the 2-year follow-up, at the 6-year follow-up, and at the 12-year follow-up. Self-rating and an expert-rating interview data were obtained.
Results: The participation rate at the 12-year follow-up was 88% of those alive. There was substantial improvement during therapy, a moderate (in many instances nonsignificant) decline during the first 2 years posttreatment, and further improvement from 3 to 12 years posttreatment. Based on a global 12-year outcome score, 27.5% had a good outcome, 25.3% an intermediate outcome, 39.6% had a poor outcome, and 7 (7.7%) were …
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Chronic pain couples: perceived marital interactions and pain behaviours.
Patient adjustment to chronic pain is well known to be influenced by the spouse and his or her response to patient expressions of pain. However, these responses do not occur in a vacuum, and the aim of the present study was to investigate patient-spouse interactions in chronic pain in detail. Ninety-five patient-spouse dyads completed questionnaires relating to mood, marital satisfaction and communication, and 80 couples also took part in semi-structured interviews. Data were analysed using quantitative and qualitative methods. Results showed that spouses of chronic pain patients reported engaging in a far wider repertoire of responses to pain behaviours than has been recognised to date. New response categories of 'hostile-solicitous' and 'observe only' were identified. Patients generally interpreted solicitous responses less favourably than spouse responses which encouraged task persist…
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Arnow BA, Hunkeler EM, Blasey CM, Lee J, Constantino MJ, Fireman B, Kraemer HC, Dea R, Robinson R, Hayward C (2006)MEDLINE-indexed journal, not yet read by usPsychosomatic medicine346 citations Comorbid depression, chronic pain, and disability in primary care.
Objectives: The objectives of this study were to provide estimates of the prevalence and strength of association between major depression and chronic pain in a primary care population and to examine the clinical burden associated with the two conditions, singly and together.
Methods: A random sample of Kaiser Permanente patients who visited a primary care clinic was mailed a questionnaire assessing major depressive disorder (MDD), chronic pain, pain-related disability, somatic symptom severity, panic disorder, other anxiety, probable alcohol abuse, and health-related quality of life (HRQL). Instruments included the Patient Health Questionnaire, SF-8, and Graded Chronic Pain Questionnaire. A total of 5808 patients responded (54% of those eligible to participate).
Results: Among those with MDD, a significantly higher proportion reported chronic (i.e., nondisabling or disabling) pain than t…
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Relationship between multimorbidity and health-related quality of life of patients in primary care.
Previous studies about the association of multimorbidity and the health-related quality of life (HRQOL) in primary-care patients are limited because of their reliance on simple counts of diseases from a limited list of diseases and their failure to assess the severity of disease. We evaluated the association while taking into account the severity of the medical conditions based on the Cumulative Illness Rating Scale (CIRS) score, and controlling for potential confounders (age, sex, household income, education, self-perception of economic status, number of people living in the same dwelling, and perceived social support). We randomly selected 238 patients to construct quintiles of increasing multimorbidity (CIRS). Patients completed the 36-item Medical Outcomes study questionnaire (SF-36) to evaluate their HRQOL. Applying bivariate and multivariate linear regression analyses, we used the …
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Health anxiety levels in chronic pain clinic attenders.
Objective: An application of the cognitive-behavioural model of health anxiety (hypochondriasis) to chronic pain depends on the extent to which high levels of health anxiety occur in chronic pain, which has yet to be established.
Methods: The occurrence of health anxiety in consecutively recruited chronic pain patients (n=161) and nonclinical controls with (n=34) and without pain (n=70) was investigated using a questionnaire measure of health anxiety.
Results: Conservative figures estimated a frequency of 36.7% for hypochondriasis and 51.1% of severe and disabling health anxiety in the chronic pain sample.
Conclusion: The current finding that high levels of health anxiety are indeed very common in chronic pain indicates the potential value of an application of the cognitive-behavioural health anxiety model to at least the subgroup of highly health-anxious chronic pain patients.
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The nutrition and health transition in the North West Province of South Africa: a review of the THUSA (Transition and Health during Urbanisation of South Africans) study.
Objective: To describe how urbanisation influences the nutrition and health transition in South Africa by using data from the THUSA (Transition and Health during Urbanisation of South Africans) study.
Design: The THUSA study was a cross-sectional, comparative, population-based survey.
Setting: The North West Province of South Africa.
Subjects: In total, 1854 apparently healthy volunteers, men and women aged 15 years and older, from 37 randomly selected sites. Pregnant and lactating women, those with diagnosed chronic diseases and taking medication, with acute infections or inebriated were excluded but screened for hypertension and diabetes mellitus. Subjects were stratified into five groups representing different levels of urbanisation in rural and urban areas: namely, deep rural, farms, squatter camps, townships and towns/cities. OUTCOME MEASURES AND METHODS: Socio-economic and educatio…
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Barnett M (2005)MEDLINE-indexed journal, not yet read by usJournal of clinical nursing125 citations Chronic obstructive pulmonary disease: a phenomenological study of patients' experiences.
Aim: The purpose of this study is to explore the experience of living with chronic obstructive pulmonary disease by investigating the subjective phenomenon as described by the patient.
Background: Chronic obstructive pulmonary disease is now recognized as one of the most common chronic respiratory diseases in the United Kingdom, with a high prevalence of morbidity and mortality. As the disease progresses, symptoms increase which gradually influence all aspects of the lives of those affected by it.
Method: A phenomenological approach was identified as the most appropriate method to gain an understanding of living with chronic obstructive pulmonary disease. The data were obtained from 10 participants using unstructured interviews to capture detailed experiences verbatim. Analysis, based on the framework of Diekelmann et al. (The NLN Criteria for Appraisal of Baccalaureate Programs: A Criti…
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Improved estimates of the benefits of breastfeeding using sibling comparisons to reduce selection bias.
Objective: Better measurement of the health and cognitive benefits of breastfeeding by using sibling comparisons to reduce sample selection bias.
Data: We use data on the breastfeeding history, physical and emotional health, academic performance, cognitive ability, and demographic characteristics of 16,903 adolescents from the first (1994) wave of the National Longitudinal Study of Adolescent Health. The sample includes 2,734 sibling pairs.
Study design: We examine the relationship between breastfeeding history and 15 indicators of physical health, emotional health, and cognitive ability, using ordinary least squares and logit regression. For each indicator, we estimate, in addition to the usual between-family model, a within-family model to see whether differences in siblings' outcomes are associated with differences in the siblings' breastfeeding histories.
Principal findings: Nearly a…
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Cognitive complaints are associated with depression, fatigue, female sex, and pain catastrophizing in patients with chronic pain.
Objective: To examine the relation between demographic, pain-related, psychosocial, affective, and treatment factors and complaints of cognitive dysfunction among patients with chronic pain.
Design: Cross-sectional survey.
Setting: A university hospital outpatient multidisciplinary chronic pain program.
Participants: Chronic pain patients (N=222; 135 women, 87 men) completed a battery of psychometric questionnaires as part of an initial evaluation on referral to the program.
Interventions: Not applicable.
Main outcome measures: Cognitive impairment was assessed with items from the Brief Symptom Inventory; measures of depressive symptoms, pain intensity, posttraumatic stress disorder (PTSD), and pain catastrophizing were obtained from the Beck Depression Inventory (negative affect, negative self, somatic/physical function), McGill Pain Questionnaire, Modified Posttraumatic Chronic Pain Te…
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Chronic mild stress impact: are females more vulnerable?
Despite the knowledge that women are more susceptible than men to stress-related mental illness, such as major depression, there is no comprehensive estimation of the role of gender in the detrimental effects of chronic stress that might cause depression. Sex differences regarding the association of behavioral parameters with serotonergic and hypothalamic-pituitary-adrenal axis activities were investigated in the chronic mild stress model of depression. Additionally, the impact of chronic mild stress exposure on an additional/novel short-term stressful procedure, such as the forced swim test was examined in male and female rats. Female rats were found to be more vulnerable to chronic mild stress and that was depicted with disruption of sucrose intake, decreases in open field activity, increased corticosterone levels, alteration in estrous cycle and decreased serotonergic activity in hipp…
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Parenting stress and impact of illness in parents of children with coeliac disease.
Coeliac disease (CD) is a chronic disease which could stress patients and their family. Although, poor attention has been paid to the quality of life in CD children and to the functioning of families with CD children. The study aims to evaluate the parenting perception of the CD impact and the parenting distress level. A group of 74 parents of CD children compiled the Impact Childhood Illness Scale and the Parenting Stress Index which is also compiled by 74 parents of health children. The assessment does not reveal a significant impact of CD on patient's personal life although some critical areas emerged. Results evidenced an higher level of parenting stress in parents of CD children than parents of healthy children. CD, if suitably managed, has not a critical impact on parenting perception. Although, CD certainly put parents through an higher risk of a distress related to parenting role…
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A Mixed-Methods Evaluation of a Nurse-Led Community-Based Health Home for Ethnically Diverse Older Adults With Multimorbidity in the Adult Day Health Setting.
Multimorbidity affects 75% of older adults (aged 65 years and older) in the United States and increases risk of poor medical outcomes, especially among the poor and underserved. The creation of a Medicaid option allowing states to establish health homes under the Affordable Care Act was intended to enhance coordinated care for Medicaid beneficiaries with multimorbidity. The Community-Based Health Home (CBHH) model uses the infrastructure of the Adult Day Health Center (ADHC) to serve as a health home to improve outcomes for medically complex vulnerable adults. Between 2017 and 2018, we used a sequential explanatory mixed-methods approach to (a) quantitatively examine changes in depression, fall risk, loneliness, cognitive function, nutritional risk, pain classification, and health care utilization over the course of 12 months in the program and (b) qualitatively explore the perspectives …
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