258 research outputs found
Manifestations of cardiotoxicity in patients after radiation therapy
Cardiotoxic effects of antitumor treatment are diverse and develop both after chemotherapeutic treatment and after the application of radiation therapy. In recent decades, the problem of heart lesions due to the use of radiotherapy has acquired new significance, primarily due to a significant increase in the number of patients exposed to radiation in the modern world. The frequency of radiation damage to the cardiovascular system is quite high and, according to various data, can reach 54%. The structure of radiation-induced disease describes the development of pericarditis, cardiomyopathy, coronary and valvular pathology, rhythm and conduction disorders, post-radiation heart disease is one of the most difficult in treatment and early diagnosis is the most important task of the modern trend - cardiooncology. The need for long-term follow-up of patients after antitumor treatment with radiation therapy is one of the topical issues of practical public health.ΠΠ°ΡΠ΄ΠΈΠΎΡΠΎΠΊΡΠΈΡΠ΅ΡΠΊΠΈΠ΅ ΡΡΡΠ΅ΠΊΡΡ ΠΏΡΠΎΡΠΈΠ²ΠΎΠΎΠΏΡΡ
ΠΎΠ»Π΅Π²ΠΎΠ³ΠΎ Π»Π΅ΡΠ΅Π½ΠΈΡ ΡΠ°Π·Π½ΠΎΠΎΠ±ΡΠ°Π·Π½Ρ ΠΈ ΡΠ°Π·Π²ΠΈΠ²Π°ΡΡΡΡ ΠΊΠ°ΠΊ ΠΏΠΎΡΠ»Π΅ Ρ
ΠΈΠΌΠΈΠΎΡΠ΅ΡΠ°ΠΏΠ΅Π²ΡΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ Π»Π΅ΡΠ΅Π½ΠΈΡ, ΡΠ°ΠΊ ΠΈ ΠΏΠΎΡΠ»Π΅ ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΡ Π»ΡΡΠ΅Π²ΠΎΠΉ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ. Π ΠΏΠΎΡΠ»Π΅Π΄Π½ΠΈΠ΅ Π΄Π΅ΡΡΡΠΈΠ»Π΅ΡΠΈΡ ΠΏΡΠΎΠ±Π»Π΅ΠΌΠ° ΠΏΠΎΡΠ°ΠΆΠ΅Π½ΠΈΠΉ ΡΠ΅ΡΠ΄ΡΠ° Π²ΡΠ»Π΅Π΄ΡΡΠ²ΠΈΠ΅ ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΡ Π»ΡΡΠ΅Π²ΠΎΠΉ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ ΠΏΡΠΈΠΎΠ±ΡΠ΅Π»Π° Π½ΠΎΠ²ΠΎΠ΅ Π·Π½Π°ΡΠ΅Π½ΠΈΠ΅, ΠΏΡΠ΅ΠΆΠ΄Π΅ Π²ΡΠ΅Π³ΠΎ Π² ΡΠ²ΡΠ·ΠΈ Ρ ΡΡΡΠ΅ΡΡΠ²Π΅Π½Π½ΡΠΌ ΡΠ²Π΅Π»ΠΈΡΠ΅Π½ΠΈΠ΅ΠΌ Π² ΡΠΎΠ²ΡΠ΅ΠΌΠ΅Π½Π½ΠΎΠΌ ΠΌΠΈΡΠ΅ ΡΠΈΡΠ»Π° ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ², ΠΏΠΎΠ΄Π²Π΅ΡΠ³ΡΠΈΡ
ΡΡ Π»ΡΡΠ΅Π²ΠΎΠΌΡ Π²ΠΎΠ·Π΄Π΅ΠΉΡΡΠ²ΠΈΡ. Π§Π°ΡΡΠΎΡΠ° ΡΠ°Π·Π²ΠΈΡΠΈΡ Π»ΡΡΠ΅Π²ΡΡ
ΠΏΠΎΠ²ΡΠ΅ΠΆΠ΄Π΅Π½ΠΈΠΉ ΡΠ΅ΡΠ΄Π΅ΡΠ½ΠΎ-ΡΠΎΡΡΠ΄ΠΈΡΡΠΎΠΉ ΡΠΈΡΡΠ΅ΠΌΡ Π΄ΠΎΡΡΠ°ΡΠΎΡΠ½ΠΎ Π²ΡΡΠΎΠΊΠ° ΠΈ, ΠΏΠΎ ΡΠ°Π·Π»ΠΈΡΠ½ΡΠΌ Π΄Π°Π½Π½ΡΠΌ, ΠΌΠΎΠΆΠ΅Ρ Π΄ΠΎΡΡΠΈΠ³Π°ΡΡ 54%. Π ΡΡΡΡΠΊΡΡΡΠ΅ ΡΠ°Π΄ΠΈΠ°ΡΠΈΠΎΠ½Π½ΠΎ-ΠΈΠ½Π΄ΡΡΠΈΡΠΎΠ²Π°Π½Π½ΠΎΠΉ Π±ΠΎΠ»Π΅Π·Π½ΠΈ ΠΎΠΏΠΈΡΠ°Π½Ρ ΡΠ°Π·Π²ΠΈΡΠΈΠ΅ ΠΏΠ΅ΡΠΈΠΊΠ°ΡΠ΄ΠΈΡΠΎΠ², ΠΊΠ°ΡΠ΄ΠΈΠΎΠΌΠΈΠΎΠΏΠ°ΡΠΈΠΈ, ΠΊΠΎΡΠΎΠ½Π°ΡΠ½Π°Ρ ΠΈ ΠΊΠ»Π°ΠΏΠ°Π½Π½Π°Ρ ΠΏΠ°ΡΠΎΠ»ΠΎΠ³ΠΈΠΈ, Π½Π°ΡΡΡΠ΅Π½ΠΈΡ ΡΠΈΡΠΌΠ° ΠΈ ΠΏΡΠΎΠ²ΠΎΠ΄ΠΈΠΌΠΎΡΡΠΈ, ΠΏΠΎΡΡΠ»ΡΡΠ΅Π²ΠΎΠ΅ ΠΏΠΎΡΠ°ΠΆΠ΅Π½ΠΈΠ΅ ΡΠ΅ΡΠ΄ΡΠ° ΡΠ²Π»ΡΠ΅ΡΡΡ ΠΎΠ΄Π½ΠΈΠΌ ΠΈΠ· ΡΠ°ΠΌΡΡ
ΡΡΡΠ΄Π½ΡΡ
Π² Π²ΠΎΠΏΡΠΎΡΠ°Ρ
Π»Π΅ΡΠ΅Π½ΠΈΡ ΠΈ ΡΠ°Π½Π½ΡΡ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠ° ΡΠ²Π»ΡΠ΅ΡΡΡ Π²Π°ΠΆΠ½Π΅ΠΉΡΠ΅ΠΉ Π·Π°Π΄Π°ΡΠ΅ΠΉ ΡΠΎΠ²ΡΠ΅ΠΌΠ΅Π½Π½ΠΎΠ³ΠΎ Π½Π°ΠΏΡΠ°Π²Π»Π΅Π½ΠΈΡ - ΠΊΠ°ΡΠ΄ΠΈΠΎΠΎΠ½ΠΊΠΎΠ»ΠΎΠ³ΠΈΠΈ. ΠΠ΅ΠΎΠ±Ρ
ΠΎΠ΄ΠΈΠΌΠΎΡΡΡ Π΄Π»ΠΈΡΠ΅Π»ΡΠ½ΠΎΠ³ΠΎ Π½Π°Π±Π»ΡΠ΄Π΅Π½ΠΈΡ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² ΠΏΠΎΡΠ»Π΅ ΠΏΡΠΎΡΠΈΠ²ΠΎΠΎΠΏΡΡ
ΠΎΠ»Π΅Π²ΠΎΠ³ΠΎ Π»Π΅ΡΠ΅Π½ΠΈΡ Ρ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½ΠΈΠ΅ΠΌ Π»ΡΡΠ΅Π²ΠΎΠΉ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ ΡΠ²Π»ΡΠ΅ΡΡΡ ΠΎΠ΄Π½ΠΈΠΌ ΠΈΠ· Π°ΠΊΡΡΠ°Π»ΡΠ½ΡΡ
Π²ΠΎΠΏΡΠΎΡΠΎΠ² ΠΏΡΠ°ΠΊΡΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ Π·Π΄ΡΠ°Π²ΠΎΠΎΡ
ΡΠ°Π½Π΅Π½ΠΈΡ
The composite first person narrative: Texture, structure, and meaning in writing phenomenological descriptions
This paper illustrates the use of composite first person narrative interpretive methods, as described by Todres, across a range of phenomena. This methodology introduces texture into the presently understood structures of phenomena and thereby creates new understandings of the phenomenon, bringing about a form of understanding that is relationally alive that contributes to improved caring practices. The method is influenced by the work of Gendlin, Heidegger, van Manen, Gadamer, and Merleau-Ponty. The method's applicability to different research topics is demonstrated through the composite narratives of nursing students learning nursing practice in an accelerated and condensed program, obese female adolescents attempting weight control, chronically ill male parolees, and midlife women experiencing distress during menopause. Within current research, these four phenomena have been predominantly described and understood through quantified articulations that give the reader a structural understanding of the phenomena, but the more embodied or βcontextualβ human qualities of the phenomena are often not visible. The βwhat is it likeβ or the βunsaidβ aspects of such human phenomena are not clear to the reader when proxies are used to βaccount forβ a variety of situated conditions. This novel method is employed to re-present narrative data and findings from research through first person accounts that blend the voices of the participants with those of the researcher, emphasizing the connectedness, the βweβ among all participants, researchers, and listeners. These re-presentations allow readers to develop more embodied understandings of both the texture and structure of each of the phenomena and illustrate the use of the composite account as a way for researchers to better understand and convey the wholeness of the experience of any phenomenon under inquiry
Prevention of stroke in atrial fibrillation: desired and real
The analysis of the data ot the register of patients with atrial fibrillation (retrospective part -1860 patients, prospective observation - 498 patients), which were observed in the period 2009-2017 in outpatient facilities and hospitals in Moscow, is presented. The dynamics of the appointment of antithrombotic drugs of various groups in routine clinical practice and in conditions of observation in an anticoagulant room on the basis of a day hospital were studied. The results are compared with data from other domestic observational studies of patients with atrial fibrillation. Other ways to improve the quality of antithrombotic prophylaxis are discussed.ΠΡΠ΅Π΄ΡΡΠ°Π²Π»Π΅Π½ Π°Π½Π°Π»ΠΈΠ· Π΄Π°Π½Π½ΡΡ
ΡΠ΅Π³ΠΈΡΡΡΠ° ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ ΡΠΈΠ±ΡΠΈΠ»Π»ΡΡΠΈΠ΅ΠΉ ΠΏΡΠ΅Π΄ΡΠ΅ΡΠ΄ΠΈΠΉ (ΡΠ΅ΡΡΠΎΡΠΏΠ΅ΠΊΡΠΈΠ²Π½Π°Ρ ΡΠ°ΡΡΡ -1860 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ², ΠΏΡΠΎΡΠΏΠ΅ΠΊΡΠΈΠ²Π½ΠΎΠ΅ Π½Π°Π±Π»ΡΠ΄Π΅Π½ΠΈΠ΅ - 498 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ²), Π½Π°Π±Π»ΡΠ΄Π°Π²ΡΠΈΡ
ΡΡ Π² ΠΏΠ΅ΡΠΈΠΎΠ΄ 2009-2017Π³ΠΎΠ΄Ρ Π² Π°ΠΌΠ±ΡΠ»Π°ΡΠΎΡΠ½ΡΡ
ΡΡΡΠ΅ΠΆΠ΄Π΅Π½ΠΈΡΡ
ΠΈ ΡΡΠ°ΡΠΈΠΎΠ½Π°ΡΠ°Ρ
Π³. ΠΠΎΡΠΊΠ²Ρ. ΠΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½Π° Π΄ΠΈΠ½Π°ΠΌΠΈΠΊΠ° Π½Π°Π·Π½Π°ΡΠ΅Π½ΠΈΡ Π°Π½ΡΠΈΡΡΠΎΠΌΠ±ΠΎΡΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΏΡΠ΅ΠΏΠ°ΡΠ°ΡΠΎΠ² ΡΠ°Π·Π»ΠΈΡΠ½ΡΡ
Π³ΡΡΠΏΠΏ Π² ΡΡΡΠΈΠ½Π½ΠΎΠΉ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΏΡΠ°ΠΊΡΠΈΠΊΠ΅ ΠΈ Π² ΡΡΠ»ΠΎΠ²ΠΈΡΡ
Π½Π°Π±Π»ΡΠ΄Π΅Π½ΠΈΡ Π² Π°Π½ΡΠΈΠΊΠΎΠ°Π³ΡΠ»ΡΠ½ΡΠ½ΠΎΠΌ ΠΊΠ°Π±ΠΈΠ½Π΅ΡΠ΅ Π½Π° Π±Π°Π·Π΅ Π΄Π½Π΅Π²Π½ΠΎΠ³ΠΎ ΡΡΠ°ΡΠΈΠΎΠ½Π°ΡΠ°. Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ ΡΠΎΠΏΠΎΡΡΠ°Π²Π»Π΅Π½Ρ Ρ Π΄Π°Π½Π½ΡΠΌΠΈ Π΄ΡΡΠ³ΠΈΡ
ΠΎΡΠ΅ΡΠ΅ΡΡΠ²Π΅Π½Π½ΡΡ
Π½Π°Π±Π»ΡΠ΄Π°ΡΠ΅Π»ΡΠ½ΡΡ
ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠΉ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ ΡΠΈΠ±ΡΠΈΠ»Π»ΡΡΠΈΠ΅ΠΉ ΠΏΡΠ΅Π΄ΡΠ΅ΡΠ΄ΠΈΠΉ. ΠΠ±ΡΡΠΆΠ΄Π°ΡΡΡΡ Π΄ΡΡΠ³ΠΈΠ΅ ΡΠΏΠΎΡΠΎΠ±Ρ ΠΏΠΎΠ²ΡΡΠ΅Π½ΠΈΡ ΠΊΠ°ΡΠ΅ΡΡΠ²Π° Π°Π½ΡΠΈΡΡΠΎΠΌΠ±ΠΎΡΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΏΡΠΎΡΠΈΠ»Π°ΠΊΡΠΈΠΊΠΈ
Resoundings of the flesh: Caring for others by way of βsecond personβ perspectivity
In bringing ourselves to the encounter with the experience of others, we bring our bodies with usβand, in doing so, we are able to resonate not only intellectually but also empathically with the other's experiences and expressions (which are given to us both verbally and nonverbally). In remaining faithful to our foundations in phenomenology (Husserl, Heidegger, Merleau-Ponty, and Levinas), we shall talk about taking notice of others from within the relational βexchangeβ and reflect upon what, precisely, are the experientially given βaffairsβ to which Husserl invited us to return. Our interest begins with the other's βfirst personβ experience, but since we cannot access this directly, we must rely on the resonance we find within ourselves, within our own lived bodies, when we are addressed by the other, whether in word or in gesture. I am wondering what the other is experiencing and all my powers of perception are driven toward this other, whose first person experience remains just out of reach and accessible only insofar as I have this capacity for a deeper βbodily feltβ awareness in which the other's experience takes possession of me. Merleau-Ponty's notion of bearing βwitnessβ to behavior is useful in illuminating this βsecond personβ perspective, which takes its point of departure from Husserl's (1910β1911) intersubjective reduction, by means of which we βparticipate in the other's positingβ (1952/1989, emphasis added) and thereby grasp the meaning of the other's expression. Ultimately, the intuitive talent of the caring professional will be shown to reside in his or her being able to move beyond what the other is able to say to a more deeply felt attunement to what is being revealed to us in the other's presence. Applications to patient care are discussed
The functional condition of left atrium during the endovascular treatment of atrial fibrillation
The atrial fibrillation causes structural and functional changes of atriums. In this case, the remodeling of left atrium increases the risk of AF. One of the treatment strategy is catheter isolation of the pulmonary veins. However, the effectiveness of these operations does not exceed 70% in most of the cases that may be due to remodeling of left atrium. In this regard, the assessment of the condition of left atrium is actual for the optimization of treatment tactics and improvement of effectiveness rate.Π€ΠΈΠ±ΡΠΈΠ»Π»ΡΡΠΈΡ ΠΏΡΠ΅Π΄ΡΠ΅ΡΠ΄ΠΈΠΉ Π²ΡΠ·ΡΠ²Π°Π΅Ρ ΡΡΡΡΠΊΡΡΡΠ½ΡΠ΅ ΠΈ ΡΡΠ½ΠΊΡΠΈΠΎΠ½Π°Π»ΡΠ½ΡΠ΅ ΠΈΠ·ΠΌΠ΅Π½Π΅Π½ΠΈΡ ΠΏΡΠ΅Π΄ΡΠ΅ΡΠ΄ΠΈΠΉ. ΠΡΠΈ ΡΡΠΎΠΌ ΡΠ΅ΠΌΠΎΠ΄Π΅Π»ΠΈΡΠΎΠ²Π°Π½ΠΈΠ΅ Π»Π΅Π²ΠΎΠ³ΠΎ ΠΏΡΠ΅Π΄ΡΠ΅ΡΠ΄ΠΈΡ ΡΠ²Π΅Π»ΠΈΡΠΈΠ²Π°Π΅Ρ ΡΠΈΡΠΊ Π²ΠΎΠ·Π½ΠΈΠΊΠ½ΠΎΠ²Π΅Π½ΠΈΡ Π€Π. ΠΠ΄Π½Π° ΠΈΠ· ΡΡΡΠ°ΡΠ΅Π³ΠΈΠΉ Π»Π΅ΡΠ΅Π½ΠΈΡ - ΠΊΠ°ΡΠ΅ΡΠ΅ΡΠ½Π°Ρ ΠΈΠ·ΠΎΠ»ΡΡΠΈΡ Π»Π΅Π³ΠΎΡΠ½ΡΡ
Π²Π΅Π½. ΠΠ΄Π½Π°ΠΊΠΎ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΡ Π΄Π°Π½Π½ΡΡ
ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΉ Π² Π±ΠΎΠ»ΡΡΠΈΠ½ΡΡΠ²Π΅ ΡΠ»ΡΡΠ°Π΅Π² Π½Π΅ ΠΏΡΠ΅Π²ΡΡΠ°Π΅Ρ 70%, ΡΡΠΎ ΠΌΠΎΠΆΠ΅Ρ Π±ΡΡΡ ΠΎΠ±ΡΡΠ»ΠΎΠ²Π»Π΅Π½ΠΎ, Π² ΡΠΎΠΌ ΡΠΈΡΠ»Π΅, ΡΠ΅ΠΌΠΎΠ΄Π΅Π»ΠΈΡΠΎΠ²Π°Π½ΠΈΠ΅ΠΌ Π»Π΅Π²ΠΎΠ³ΠΎ ΠΏΡΠ΅Π΄ΡΠ΅ΡΠ΄ΠΈΡ. Π ΡΠ²ΡΠ·ΠΈ Ρ ΡΡΠΈΠΌ, Π°ΠΊΡΡΠ°Π»ΡΠ½Π° ΠΎΡΠ΅Π½ΠΊΠ° ΡΠΎΡΡΠΎΡΠ½ΠΈΡ Π»Π΅Π²ΠΎΠ³ΠΎ ΠΏΡΠ΅Π΄ΡΠ΅ΡΠ΄ΠΈΡ Π΄Π»Ρ ΠΎΠΏΡΠΈΠΌΠΈΠ·Π°ΡΠΈΠΈ ΡΠ°ΠΊΡΠΈΠΊΠΈ Π»Π΅ΡΠ΅Π½ΠΈΡ ΠΈ ΡΠ»ΡΡΡΠ΅Π½ΠΈΡ ΠΏΠΎΠΊΠ°Π·Π°ΡΠ΅Π»Π΅ΠΉ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΠΈ
Predictors of acute cerebrovascular events in patients with essential hypertension and sinus rhythm of the heart
The predictive value of left ventricular myocardium diastolic dysfunction regarding under aspect of cerebral vascular events development and stability of this disorder was determined in examination of 71 patients with arterial hypertension and normal sinus heart rhythm, who were in acute period of ischemic stroke, and retrospective analysis of survival and arterial hypertension current in 91 patients, who were kept under observation for a long time period.ΠΡΠΈ ΠΎΠ±ΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠΈ 71 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠ° Ρ Π³ΠΈΠΏΠ΅ΡΡΠΎΠ½ΠΈΡΠ΅ΡΠΊΠΎΠΉ Π±ΠΎΠ»Π΅Π·Π½ΡΡ ΠΈ ΡΠΈΠ½ΡΡΠΎΠ²ΡΠΌ ΡΠΈΡΠΌΠΎΠΌ ΡΠ΅ΡΠ΄ΡΠ°, Π½Π°Ρ
ΠΎΠ΄ΠΈΠ²ΡΠΈΡ
ΡΡ Π² ΠΎΡΡΡΠΎΠΌ ΠΏΠ΅ΡΠΈΠΎΠ΄Π΅ ΠΈΡΠ΅ΠΌΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΠΈΠ½ΡΡΠ»ΡΡΠ°, ΠΈ ΡΠ΅ΡΡΠΎΡΠΏΠ΅ΠΊΡΠΈΠ²Π½ΠΎΠΌ ΠΈΠ·ΡΡΠ΅Π½ΠΈΠΈ Π²ΡΠΆΠΈΠ²Π°Π΅ΠΌΠΎΡΡΠΈ ΠΈ ΡΠ΅ΡΠ΅Π½ΠΈΡ Π°ΡΡΠ΅ΡΠΈΠ°Π»ΡΠ½ΠΎΠΉ Π³ΠΈΠΏΠ΅ΡΡΠ΅Π½Π·ΠΈΠΈ Ρ 91 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠ° Π² ΡΠ΅ΡΠ΅Π½ΠΈΠ΅ Π΄Π»ΠΈΡΠ΅Π»ΡΠ½ΠΎΠ³ΠΎ ΠΏΠ΅ΡΠΈΠΎΠ΄Π° Π½Π°Π±Π»ΡΠ΄Π΅Π½ΠΈΡ, Π²ΡΡΠ²Π»Π΅Π½Π° ΠΏΡΠ΅Π΄ΡΠΊΠ°Π·Π°ΡΠ΅Π»ΡΠ½Π°Ρ ΡΠ΅Π½Π½ΠΎΡΡΡ Π² ΠΎΡΠ½ΠΎΡΠ΅Π½ΠΈΠΈ ΡΠ°Π·Π²ΠΈΡΠΈΡ ΡΠΎΡΡΠ΄ΠΈΡΡΡΡ
ΠΌΠΎΠ·Π³ΠΎΠ²ΡΡ
ΠΎΡΠ»ΠΎΠΆΠ½Π΅Π½ΠΈΠΉ Π½Π°ΡΡΡΠ΅Π½ΠΈΡ Π΄ΠΈΠ°ΡΡΠΎΠ»ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΡΡΠ½ΠΊΡΠΈΠΈ ΠΌΠΈΠΎΠΊΠ°ΡΠ΄Π° Π»Π΅Π²ΠΎΠ³ΠΎ ΠΆΠ΅Π»ΡΠ΄ΠΎΡΠΊΠ° ΠΈ ΠΏΡΠΎΠ΄Π΅ΠΌΠΎΠ½ΡΡΡΠΈΡΠΎΠ²Π°Π½Π° ΡΡΠΎΠΉΠΊΠΎΡΡΡ ΡΠΊΠ°Π·Π°Π½Π½ΡΡ
ΠΈΠ·ΠΌΠ΅Π½Π΅Π½ΠΈΠΉ
Homeopathy β what are the active ingredients? An exploratory study using the UK Medical Research Council's framework for the evaluation of complex interventions
BACKGROUND: Research in homeopathy has traditionally addressed itself to defining the effectiveness of homeopathic potencies in comparison to placebo medication. There is now increasing awareness that the homeopathic consultation is in itself a therapeutic intervention working independently or synergistically with the prescribed remedy. Our objective was to identify and evalute potential "active ingredients" of the homeopathic approach as a whole, in a prospective formal case series, which draws on actual consultation data, and is based on the MRC framework for the evaluation of complex interventions. METHODS: Following on from a theoretical review of how homeopathic care might mediate its effects, 18 patients were prospectively recruited to a case series based at Bristol Homeopathic Hospital. Patients, who lived with one of three index conditions, were interviewed before and after a five visit "package of care". All consultations were recorded and transcribed verbatim. Additional data, including generic and condition-specific questionnaires, artwork and "significant other" reports were collected. Textual data was subject to thematic analysis and triangulated with other sources. RESULTS: We judged that around one third of patients had experienced a major improvement in their health over the study period, a third had some improvement and a third had no improvement. Putative active ingredients included the patients' "openness to the mind-body connection", consultational empathy, in-depth enquiry into bodily complaints, disclosure, the remedy matching process and, potentially, the homeopathic remedies themselves. CONCLUSION: This study has has identified, using primary consultation and other data, a range of factors that might account for the effectiveness of homeopathic care. Some of these, such as empathy, are non-specific. Others, such as the remedy matching process, are specific to homeopathy. These findings counsel against the use of placebo-controlled RCT designs in which both arms would potentially be receiving specific active ingredients. Future research in homeopathy should focus on pragmatic trials and seek to confirm or refute the therapeutic role of constructs such as patient "openness", disclosure and homeopathicity
Experiencing mindfulness meditationβa client narrative perspective
The study was based on the non-participant involvement of the researcher in four six-to-eight weeks' mindfulness meditation training courses led by chartered psychologists. The participants suffered from stress/sleeplessness, depression or agoraphobia in the presented cases. They were selected on the basis of recommendations by the psychologist who was the course instructor, who described them as positive and suitable. The participants wrote diaries on a weekly basis, and they were interviewed at the beginning, middle and end of the course. An in-depth analysis of three individual cases will be presented in the form of narratives constructed from their own words. The narratives demonstrate the unique and embodied changes of the individual participant's experiences during the training course. The purpose was to illustrate richly what happens and how changes happen during these weeks of learning and practicing mindfulness meditation. It is not the intention to give evidence about the effectiveness of mindfulness meditation in general, but to present the whats and hows of cases where mindfulness meditation appears to improve quality of life, health and well-being
Affecting qualitative health psychology
The βaffective turnβ is a contemporary movement within the humanities, social science
and psychology to investigate affect, emotion and feeling as hybrid phenomena jointly
constituted from both biological and social influences. Health and illness are themselves
jointly constituted in this way, and many of the topics, concerns and methods of health
psychology are strongly permeated by affective phenomena. Qualitative research in
health psychology might therefore benefit by engaging with this work. This paper
describes some features of the affective turn, and suggests theories, terminology and
methods that might be useful
- β¦