Age-related disgust responses to signs of disease.

Previous studies found similarities in adults' disgust responses to benign (e.g. obesity) and actual disease signs (e.g. influenza). However, limited research has compared visual (i.e. benign and actual) to cognitive (i.e. disease label) disease cues in different age groups. The current study investigated disgust responses across middle childhood (7-9 years), late childhood (10-12 years), adolescence (13-17 years), and adulthood (18+ years). Participants viewed individuals representing a benign visual disease (obese), sick-looking (staphylococcus), sick-label (cold/flu), and healthy condition. Disgust-related outcomes were: (1) avoidance, or contact level with apparel the individual was said to have worn, (2) disgust facial reactions, and (3) a combination of (1) and (2). Avoidance was greater for the sick-looking and sick-label than the healthy and obese conditions. For facial reaction and combination outcomes, middle childhood participants responded with greater disgust to the sick-looking than the healthy condition, while late childhood participants expressed stronger disgust towards the sick-looking and obese conditions than the healthy condition. Adolescents and adults exhibited stronger disgust towards sick-label and sick-looking than obese and healthy conditions. Results suggest visual cues are central to children's disgust responses whereas adolescents and adult responses considered cognitive cues.

The Saturated Phenomenon of Flesh and Mineness and Otherness of the Body in Illness.

A key topic within the field of the phenomenology of medicine has been the relationship between body and self in illness, including discussions about the otherness and mineness of the body. The aim of this article is to distinguish between different meanings of bodily otherness and mineness in illness with reference to the interpretation of the body as "saturated phenomenon," inspired by the phenomenology of Jean-Luc Marion. With the help of Marion's ideas it is possible to distinguish between two meanings of bodily otherness and of mineness (objective and non-objective forms). These distinctions support and elaborate on ideas already found in the phenomenology of medicine and offer further insights into the nature of the experience of illness.

A competência emocional dos enfermeiros na prestação de cuidados à pessoa com doença mental / The emotional competence of nurses in providing care to people with mental illness

Introdução: As emoções ocupam um papel fundamental e determinante no desenvolvimento pessoal e profissional dos enfermeiros, assim como na prestação de cuidados que realizam. Objetivos: Conhecer as variáveis sociodemográficas que caraterizam a população em estudo e quais as correlações existentes entre a competência emocional e as suas dimensões. Métodos: Estudo descritivo, exploratório, abordagem quantitativa, desenvolvido num hospital psiquiátrico da Região Norte de Portugal. Para recolha de informação foi utilizada: Escala Veiga da Competência Emocional. A colheita de dados foi realizada durante o mês de dezembro 2021. Foram cumpridos os pressupostos da Comissão de Ética de acordo com Declaração Helsínquia. A população em estudo foi constituída por 40 enfermeiros, sendo os critérios de inclusão: enfermeiros em situação laboral ativa no cuidado à pessoa com doença mental internada. Resultados: Verificou-se que na sua maioria os participantes eram do sexo feminino (58,76%), com idades compreendidas entre 26-55 anos. Quanto às habilitações académicas, a maioria dos participantes (53,4%) apresentava licenciatura, sendo que 38,9% apresentava a especialidade. Relativamente ao grau de importância, atribuído às questões situação profissional, foi considerado numa escala de Likert: 1 “sem importância”, 5 “muito importante”, como sendo, muito importante “relação interpessoal com os outros”, “estabilidade emocional na relação com os outros” e “estabilidade emocional na prestação de cuidados”, 79% (n=31). Conclusão: Verificou-se correlações entre as variáveis sexo/habilitações académicas. No sexo feminino, foi possível verificar que este perceciona-se, “frequentemente”, empático na prestação de cuidados. Enfermeiros com título especialista também se percecionam como profissionais empáticos, quando comparados com enfermeiros de cuidados gerais. (AU)

Introduction: Emotions play a fundamental and decisive role in the personal and professional development of nurses and the provision of care. Objectives: To explore the sociodemographic variables that characterize the sample under study and the correlations between emotional competence and its dimensions. Methods: Descriptive, exploratory study, quantitative approach, developed in a psychiatric hospital in the Northern Region of Portugal. The collection of information was performed using the Veiga Scale of Emotional Competence. Data collection was carried out in December 2021. The Ethics Committee followed the Helsinki Declaration guidelines. The sample consisted of 40 nurses, and the inclusion criteria were: nurses working with hospitalized people with mental illness. Results: Most participants were female (58.76%), aged between 26 and 55. Regarding academic qualifications, most participants (53.4%) had a degree, and 38.9% had a speciality. Concerning the degree of importance attributed to the professional situation issues, a Likert scale was used: 1 «unimportant», 5 «very important», as being very important, «interpersonal relationship with others», «emotional stability in the relationship with others» and «emotional stability in care delivery», 79% (n=31). Conclusion: Correlations were found between gender and academic qualifications. It was possible to verify that women nurses “often” perceive themselves as empathetic in the provision of care. Nurses with a specialist title also perceive themselves as empathetic professionals compared to general care nurses. (AU)

Self-loving in the epidemic years: Carmen Machado's rhetoric of woundedness.

This article explores Carmen Machado's Her Body and Other Parties (2017) as articulating generative unmaking of bodies. Mobilizing that which I examine as rhetoric of woundedness, a thread of Latina rhetoric wherein wounds are strategically positioned to emphasize flesh as space of conflict, Machado writes body horrors to provoke dis-ease in audiences. Specifically, Machado highlights pervasive discursive discomforts that decentralize narratives about women's body (un)wellness. It is important to note, however, that Machado's attention to the corporal becomes, in part, rejection of body, a de-composition of physicality-sometimes reached through sexual ecstasy, other times through violence and epidemics-to re-compose self. Such a tactic recalls conversations advanced in Cherríe Moraga's writings and Yvonne Yarbro-Bejarano's embodied theories, both included in Carla Trujillo's landmark anthology, Chicana Lesbians: The Girls Our Mothers Warned Us About (1991). Moraga and Yarbro-Bejarano investigate textual dismemberment of female physique to re-imagine and reclaim body for enactments of Chicana desire. What marks Machado as distinct is her resistance to reclaim body. Often, Machado's characters manifest phantom states that quarantine body from toxic physical and social spaces. Concurrently, characters lose rights to body due to self-hate within that toxicity. Machado's characters find clarity only when freed from physicality, at which point they may re-compose themselves according to their testified truths. I see this distinction as a progression of works contained in Trujillo's anthology as Machado envisions a worldmaking process that one composes through autonomous self-love and self-partnership to nurture female narrative and solidarity.

Domestic work, occupational stress and depression in nurses at a public hospital in Mexico City

AIM: To identify the effect of the domestic on the depression of nurses in a public hospital in Mexico City. BACKGROUND: Domestic work performed mainly by women coupled with the demands of work is associated with the possibility of developing mental disorders, especially depression. INTRODUCTION: Working conditions have an impact on the physical and mental health of nurses. Participation in domestic activities adds to wear and tear on workers. METHODS: The research had a cross-sectional design with a random sample of 329 nurses from a third-level hospital in Mexico City. Occupational stress and domestic work were evaluated with nursing Stress Scale questionnaires and the Individual Worker Health Survey (PROESSAT). The DASS-21 subscale was used for depression. The associations were analyzed using logistic regression models. RESULTS: The probability of suffering from depression was 7 times higher for women engaged in domestic work. Experiencing death, lack of support and having an additional job increased their association. DISCUSSION: The work-family conflict, as well as lack of support, is associated with depressive symptoms in nurses. CONCLUSION: There is a need to implement strategic programs that provide nurses with tools to deal with work-family conflict reconciliation. It is necessary to offer more favorable working conditions in the practice of nursing.

Preparation and Practice of the Necessary Documents in Hospital for the "Act on Decision of Life-Sustaining Treatment for Patients at the End-of-Life".

PURPOSE: Six forms relating to decisions on life-sustaining treatment (LST) for patients at the end-of-life (EOL) in hospital are required by the "Act on Decision of LST for Patients at the EOL." We investigated the preparation and creation status of these documents from the database of the National Agency for Management of LST. MATERIALS AND METHODS: We analyzed the contents and details of each document necessary for decisions on LST, and the creation status of forms. We defined patients completing form 1 as "self-determined" of LST, and those whose family members had completed form 11/12 as "family decision" of LST. According to the determination subject, we compared the four items of LST on form 13 (the paper of implementation of LST) and the documentation time interval between forms. RESULTS: The six forms require information about the patient, doctor, specialized doctor, family members, institution, decision for LST, and intention to use hospice services. Of 44,381 who had completed at least one document, 36,693 patients had form 13. Among them, 11,531, 10,976, and 12,551 people completed forms 1, 11, and 12, respectively. The documentation time interval from forms 1, 11, or 12 to form 13 was 8.6±13.6 days, 1.0±9.5 days, and 1.5±9.7 days, respectively. CONCLUSION: The self-determination rate of LST was 31% and the mean time interval from self-determination to implementation of LST was 8.6 days. The creation of these forms still takes place when the patients are close to death.

Sickness and sleep health predict frustration and affective responses to a frustrating trigger.

Fluctuations in health and sleep are common, but we know surprisingly little about how these daily life stressors affect one's level of frustration and sensitivity to becoming frustrated. In this pre-registered study, 517 participants (Mage = 30.4, SD = 10.4) reported their current sickness symptoms, health status, sleepiness, and sleep duration and quality the previous night. They also rated their general frustration and mood before and after a mild frustration-eliciting task. In the task, participants were instructed to copy geometric shapes onto a piece of paper, without lifting the pen from the paper. Participants were given three minutes to copy the eight shapes, but in order to induce frustration half of them were unsolvable. The study was subsequently repeated in an independent sample (N = 113). Frustration increased in response to the task; however, those with the worst sickness symptoms or sleep health reduced or did not change their frustration levels. Instead, across both studies, frustration was already high at baseline for these individuals. These findings indicate that being sick or having poor sleep is related to high general frustration, but resilience to further frustration due to mild frustrating situations.

Complex PTSD symptoms mediate the association between childhood trauma and physical health problems.

The ICD-11 reconceptualized Posttraumatic Stress Disorder (PTSD) as a narrowly defined fear-based disorder, and introduced Complex PTSD (CPTSD) as a new diagnosis comprised of PTSD symptoms and symptoms of 'Disturbances in Self-Organization' (DSO) that are more reflective of general dysphoria. Previous research suggests that PTSD symptoms mediate the association between childhood trauma and physical health problems, including cardiovascular disease. No study has yet assessed how posttraumatic stress symptoms, as outlined in the ICD-11, influence the association between childhood trauma and somatic problems in adulthood. OBJECTIVE: This cross-sectional descriptive study examined whether PTSD and DSO symptoms mediated the associations between childhood physical and sexual abuse and childhood emotional abuse and neglect and somatic problems and cardiovascular diseases (CVD) load in adulthood. METHODS: General adult population samples from Ireland (N = 1020) and the United Kingdom (N = 1051) completed self-report questionnaires online. RESULTS: Structural equation modelling results indicated that PTSD and DSO symptoms fully mediated the association between both forms of childhood trauma and somatic problems, and that PTSD symptoms but not DSO symptoms fully mediated the association between childhood trauma and CVD load. CONCLUSION: Psychological interventions that effectively treat CPTSD symptoms may have the added benefit of reducing risk of physical health problems.

Illness and disgust. Compensation strategies of patients and healthcare professionals

In this article, we carry out a review of disgust in healthcare contexts (healthcare staff and patients), a topic not studied enough yet. To this end, we first accomplish a brief presentation of disgust biological and socio-moral elements, which allow us to understand the role of disgust in patients' rejection of their own wounds and self-healing. Disgust can lead patients to refuse self-care treatments after surgery or refuse to carry out diagnostic tests. On the other hand, health professionals are not exempt from feeling disgust because they are in con-tact with factors that cause it, which may conflict with professional ethics and the duty of care. In addition, we present the preliminary results of a pilot study in which we show what causes dis-gust in doctors and nurses and how they deal with it. The results point to compensation strategies that could affect the quality of care. In this sense, it is necessary to highlight the differences between the factors that cause disgust, since on many occasions they are not due to the disease, but to the lack of hygiene on patient's side. In short, due to disgust, the patients could refuse to heal their wounds on their own and due to this same emotion doctors may feel discomfort in at-tending the patients

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Colonialism, science, and health.

In addition to genocide, slavery, and the dispossession of indigenous people, colonialism, as a form of control, meant the suppression of traditional knowledge. The imposition of Christianity, the modern Western paradigm, and modern science that followed perpetrated this suppression. The universal role held by modern science is supported neither by epistemic nor social aspects. It is ineffective and complicit in the collapse of civilization, and it is worsened by comprehensive and unifying ideas to be reduced to an input-process of technological innovation for the benefit of social control industries such as the military, information technology, communication, or health. Furthermore, it suppresses ancestral knowledge related to health and medicine that may be beneficial and must be researched (stimulant medicines). Coupled with the health industry, it promotes the medicalization of life, spreading uncertainty, anxiety, and unease. Therefore, it is an instrument of neocolonialism that imposes its priorities, supplanting problems in subordinated countries, and extracts substantial resources, which is detrimental to social policies and programs. The biggest objection to the universality of modern science is derived from its empiricist and reductionist nature. Through the practically impossible idea of a unifying and explanatory knowledge, it impedes researchers the understanding of the complexity of the world and their historical moment and to act accordingly. It transforms great creative and liberating potential to submissiveness for the interests of capital and its representatives.

El colonialismo, como forma de dominación, significó, además de genocidio, esclavitud o despojo de pueblos originarios, la supresión de saberes tradicionales perpetrada por la imposición del cristianismo, del paradigma moderno occidental y de la ciencia moderna que le siguió. El carácter universal detentado por la ciencia moderna no se sostiene en lo epistémico ni en lo social; es inoperante con y cómplice del colapso civilizatorio; se empobrece de ideas comprensivas e integradoras para reducirse al insumo-proceso de la innovación tecnológica en provecho de las industrias del control social (militar, informática, de comunicación o de la salud); y suprime saberes ancestrales de la esfera de la salud que encierran beneficios y posibilidades que es preciso investigar (medicina estimulante). Aunada a la industria de la salud, impulsa la medicalización de la vida, preñándola de incertidumbre, angustia y desasosiego. Es instrumento del neocolonialismo al imponer sus prioridades, que suplantan las propias de los países subordinados y sustraen cuantiosos recursos en detrimento de políticas y programas sociales. La mayor objeción a la universalidad de la ciencia moderna deriva de su carácter empirista y reduccionista que, al condicionar la imposibilidad práctica de un conocimiento integrador y explicativo, aleja a los investigadores del entendimiento de la complejidad del mundo, de su momento histórico y de actuar en consecuencia, y transforma la gran potencialidad creativa y liberadora de este enorme contingente en docilidad a los designios de los intereses del capital y sus agentes.

Brief psychological interventions for psychiatric disorders in young people with long term physical health conditions: A systematic review and meta-analysis.

OBJECTIVES: Rates of psychiatric disorders are considerably elevated in young people with long term physical health conditions. Currently few children obtain effective mental health treatments in the context of long term physical health conditions, and ways to improve access to evidence-based mental health interventions are urgently needed. One approach is to deploy briefer, more economical, yet still evidence-based, treatments. The objective of this review was to evaluate the efficacy of brief interventions targeting psychiatric disorders in children and young people with long term physical health conditions. METHODS: Predefined terms relating to brief psychological interventions for psychiatric disorders in children with long term physical health conditions were used to search relevant databases. A systematic review and meta-analysis was carried out in accordance with the Cochrane guidelines. Two reviewers independently screened titles and abstracts, extracted the data and conducted risk of bias assessments. RESULTS: A total of 12 randomised controlled trials were found to meet the inclusion criteria of the review. Of those, three studies were suitable for meta-analysis. A large effect size in favour of brief cognitive behavioural therapy for anxiety was found (g = - 0.95, CI -1.49 to -0.041; p < .001) with non-significant moderate-substantial heterogeneity (I2 = 58%; p = .09). CONCLUSION: This review suggests there is preliminary evidence that brief interventions, based on cognitive behavioural principles, may benefit young people with an anxiety disorder in the context of a long term physical health condition. There was insufficient evidence to assess whether this held true for depression and disruptive behaviour.

[Falling ill as a migrant, psychological and cultural aspects]. / Être malade dans la migration, aspects psychologiques et culturels.

When the body fails a person's foundations are damaged. The wait for a diagnosis, the physical pain, the chronic disease weaken the patient who may be overwhelmed by fears and anxiety. For patients from another country, this distressing experience adds to their vulnerability inherent to the separation from the home country the effects of which are intensified when illness strikes.

¿Tiene el médico enfermo imagen de su propia enfermedad?: un dilema bioético / Does the sick physician have an accurate picture of his own disease?: a bioethical dilemma

Se refiere aquí una experiencia vivida en la convalecencia de una enfermedad por un cirujano cardíaco en un hospital con clientela cerrada, en una época en que no existían otros servicios en la ciudad y habiendo sido él mismo el "fundador" del Servicio, debiendo practicar cirugía de revascularización coronaria. La enfermedad, definitivamente, constituye una nueva dimensión de la sensibilidad, a veces carente de razonamiento según Broeckman, o al decir de Lolas Strepke "falla la teorización del rol de estar enfermo", y eso es lo que introduce a los médicos en el laberinto. Nos preguntamos finalmente: ¿Quién se ocupa del "cuidado del médico", o sea, del "cuidado del cuidador"? Se concluye que, por lo general, el médico, estando enfermo, no tiene imagen real de su propia enfermedad. Falta analizar los aspectos narcisistas psicológicos de los cirujanos. (AU)

What is reported here is an experience lived in the convalescence of a disease by a cardiac surgeon within a hospital of closed clientele, at a time when there were no other services in the city and having been himself the "founder" of that same service, having to practice coronary revascularization. Illness definitely constitutes a new dimension of sensitivity, sometimes lacking in reasoning according to Broeckman, or as Lolas Strepke says "the theorization on the role of being sick fails", and that is what makes physicians end up in a labyrinth. So finally, we ask ourselves, who deals with the "care of the doctor" or the "care of the caregiver"? It is concluded that generally the doctor, being sick, has no realistic image of his own illness. We lack an analysis of the psychological narcissistic aspects of surgeons. (AU)

The Irrelevance of Harm for a Theory of Disease.

Normativism holds that there is a close conceptual link between disease and disvalue. We challenge normativism by advancing an argument against a popular normativist theory, Jerome Wakefield's harmful dysfunction account. Wakefield maintains that medical disorders are breakdowns (dysfunctions) in evolved mechanisms that cause significant harm to the organism. We argue that Wakefield's account is not a promising way to distinguish between disease and health because being harmful is neither necessary nor sufficient for a dysfunction to be a disorder. Counterexamples to the harmful dysfunction account are considered, such as mild infections, perceptual deficits, and beneficial illnesses. Then we consider two ways of amending the harmful dysfunction account to address these cases and argue that the proposed amendments raise even more serious problems for this account. These problems apply generally to any normativist theory and raise doubts about the entire normative approach to the philosophy of health and disease.

Harm as a Necessary Component of the Concept of Medical Disorder: Reply to Muckler and Taylor.

Wakefield's harmful dysfunction analysis asserts that the concept of medical disorder includes a naturalistic component of dysfunction (failure of biologically designed functioning) and a value (harm) component, both of which are required for disorder attributions. Muckler and Taylor, defending a purely naturalist, value-free understanding of disorder, argue that harm is not necessary for disorder. They provide three examples of dysfunctions that, they claim, are considered disorders but are entirely harmless: mild mononucleosis, cowpox that prevents smallpox, and minor perceptual deficits. They also reject the proposal that dysfunctions need only be typically harmful to qualify as disorders. We argue that the proposed counterexamples are, in fact, considered harmful; thus, they fail to disconfirm the harm requirement: incapacity for exertion is inherently harmful, whether or not exertion occurs, cowpox is directly harmful irrespective of indirect benefits, and colorblindness and anosmia are considered harmful by those who consider them disorders. We also defend the typicality qualifier as viably addressing some apparently harmless disorders and argue that a dysfunction's harmfulness is best understood in dispositional terms.

People expressing olfactory and visual cues of disease are less liked.

For humans, like other social animals, behaviour acts as a first line of defence against pathogens. A key component is the ability to detect subtle perceptual cues of sick conspecifics. The present study assessed the effects of endotoxin-induced olfactory and visual sickness cues on liking, as well as potential involved mechanisms. Seventy-seven participants were exposed to sick and healthy facial pictures and body odours from the same individual in a 2 × 2 factorial design while disgust-related facial electromyography (EMG) was recorded. Following exposure, participants rated their liking of the person presented. In another session, participants also answered questionnaires on perceived vulnerability to disease, disgust sensitivity and health anxiety. Lower ratings of liking were linked to both facial and body odour disease cues as main effects. Disgust, as measured by EMG, did not seem to be the mediating mechanism, but participants who perceived themselves as more prone to disgust, and as more vulnerable to disease, liked presented persons less irrespectively of their health status. Concluding, olfactory and visual sickness cues that appear already a few hours after the experimental induction of systemic inflammation have implications for human sociality and may as such be a part of a behavioural defence against disease. This article is part of the Theo Murphy meeting issue 'Olfactory communication in humans'.

Adverse childhood experiences: Assessing the impact on physical and psychosocial health in adulthood and the mitigating role of resilience.

BACKGROUND: More than 2000 studies demonstrate adverse childhood experiences ACEs are universal and that experiencing multiple ACEs increases risk for developing physical and psychosocial health problems in adulthood. A challenge faced by clinicians is identifying those most at risk. Recent evidence suggests socio-ecological resilience may mitigate the consequences ACEs. We hypothesize that integrated assessment of ACEs and resilience might improve identification of those at highest risk. OBJECTIVES: We examined ACEs among adults attending a rural family practice clinic and explored associations between ACE, socio-ecological resilience and health. METHODS: A cross-sectional survey measured ACEs, resilience, and health in adult patients attending a collaborative family health care centre in Lunenburg, Nova Scotia, Canada. Correlation analyses were used to determine associations between the measures. The impact of socio-economic status, level of education and gender was considered. RESULTS: Two hundred and twenty-six persons participated in this study. Approximately 73 % of participants had experienced at least one ACEs and 31 % experienced 4 or more. Overall with increasing numbers of ACEs prevalence of health problems increased. However, individuals with high resilience scores had lower prevalence of health problems. Regression analyses indicated that the number of ACEs were slightly more important predictor of health issues than level of resilience, though both were important. Social economic status, education level and gender were not significant predictors of the impact of ACEs on person's health. CONCLUSION: The results suggest integrated assessment for resilience and ACEs may facilitate identification of those at higher risk and in need of preventative intervention.

Disease burden of adverse childhood experiences across 14 states.

OBJECTIVE: To examine whether the relationship between Adverse Childhood Experiences (ACEs) and health outcomes is similar across states and persists net of ACEs associations with smoking, heavy drinking, and obesity. METHODS: We use data from the Behavioral Risk Factor Surveillance System for 14 states. Logistic regressions yield estimates of the direct associations of ACEs exposure with health outcomes net of health risk factors, and indirect ACEs-health associations via health risk factors. Models were estimated for California (N = 22,475) and pooled data from 13 states (N = 110,076), and also separately by state. RESULTS: Exposure to ACEs is associated with significantly higher odds of smoking, heavy drinking, and obesity. Net of these health risk factors, there was a significant and graded relationship in California and the pooled 13-state data between greater ACEs exposure and odds of depression, asthma, COPD, arthritis, and cardiovascular disease. Four or more ACEs were less consistently associated across states with cancer and diabetes and a dose-response relationship was also not present. There was a wide range across individual states in the percentage change in health outcomes predicted for exposure to 4+ ACEs. ACEs-related smoking, heavy drinking, and obesity explain a large and significant proportion of 4+ ACEs associations with COPD and cardiovascular disease, however some effect, absent of risk behavior, remained. CONCLUSIONS: ACE's associations with most of the health conditions persist independent of behavioral pathways but only asthma, arthritis, COPD, cardiovascular disease, and depression consistently exhibit a dose-response relationship. Our results suggest that attention to child maltreatment and household dysfunction, mental health treatment, substance abuse prevention and promotion of physical activity and healthy weight outcomes might mitigate some adverse health consequences of ACEs. Differences across states in the pattern of ACEs-health associations may also indicate fruitful areas for prevention.