Chronic pain sufferers are frequently misunderstood and stigmatised. The aim of this investigation was to provide a description of the lifewor1d of people with chronic low back pain, using the phenomenological method. Themes which emerged were that the persistent nature of chronic pain makes it particularly difficult to endure, arousing a profound fear of the future. It causes a disruption in the relationship between the person and the body, in which the person is forced to function within the constraints of pain. Sufferers are unable to fulfil social roles as expected and are forced to revise their goals and activities. The distress of their experience is mediated by the ability to make sense of their condition, finding meaning in the pain itself. The study highlights the value of the phenomenological method in health psychology. Recommendations are made which may be of benefit to people with chronic pain and their families. / Psychology / M. Sc. (Psychology)

Die gesin is die sentrum waarbinne die kind se vorming tot volwaardige volwassenheid plaasvind. Indien een van die ouers met 'n chroniese fisieke siektetoestand gediagnoseer word, mag dit moontlike implikasies inhou vir die ouer, die kind, maar ook ander gesinslede. Die chroniese siektetoestand en die implikasies wat dit vir die siek persoon inhou is bestudeer. Daarbenewens is die dinamiek van die gesin, waarbinne die ouer en die kind met mekaar in interaksie is, ontleed. Om te bepaal wat die effek van die chroniese fisieke siektetoestand van die ouer op die kind is, is 'n literatuurstudie onderneem. Dit is daarna geverifieer met gevallestudies wat ondemeem is. Die gevallestudies het die bevindinge van die literatuurstudie bevestig. Dit blyk dat die chroniese siektetoestand van die ouer 'n invloed op die wording van die kind het. Die siektetoestand is 'n voortdurende stressor binne die gesin, wat veroorsaak dat kind(ers) affektiewe-, kognitiewe-, gedrags- en sosiale probleme manifesteer. Daar moet aanpassings gemaak word om die stres binne die gesin te minimaliseer. Riglyne is saamgestel om die terapeut, wat hierdie kind(ers) en gesinne begelei, te help. / The family is the system within which the child develops and eventually attains maturity. When a patient is diagnosed with chronic disease, it has certain implications not only for the parent, but also for children and other members of that family. A liteature study was undertaken to determine the impact of the chronically ill parent on the child. This study was then verified with specific case studies done by the author. These case studies confinned the findings of the literature study. It would seem that the chronic illness of a parent has a definite impact on the development of a child. The parent's illness is a constant stressor within the family, causing children to manifest affective, cognitive, behavioral as well as social problems. Certain adjustments have to be made to minimize stress within such a family. Guidelines are provided to assist the therapist in dealing with these children and families. / Psychology of Education / M. Ed. (Voorligting)

Alterações gastrointestinais em pacientes com doença renal crônica são queixas comuns, sendo a constipação considerada um dos sintomas mais prevalentes. O tratamento deste sintoma é limitado nesta população, devido às modificações dietéticas impostas pela perda da função renal e métodos dialíticos, especialmente na hemodiálise. Dados locais sobre a prevalência e fatores associados à constipação são pouco conhecidos em nosso meio. Neste estudo transversal, foram incluídos 57 participantes que realizam hemodiálise há pelo menos 3 meses no Hospital Moinhos de Vento em Porto Alegre, Brasil. Um questionário foi utilizado para avaliar dados sociodemográficos e clínicos potencialmente associados à constipação, a qual foi definida utilizando os critérios de ROMA III. Foi diagnosticada constipação em 28 pacientes nesta amostra (49,1%). Do total da amostra, 34 indivíduos (59,6%) relataram estar utilizando ou já terem utilizado laxantes em algum momento. Entre os constipados, 23 (82%) relataram esse uso. Outros 11 indivíduos usam laxativos cronicamente, ainda que não tenham sido classificados como constipados pelos critérios de ROMA III. Considerando a autopercepção, relataram “dificuldade para evacuar” 21/57 (36,8%). A concordância entre a autopercepção de “dificuldade para evacuar” e constipação pelos critérios de ROMA III ocorreu em 34 (59,6%) dos indivíduos. Entre os 28 pacientes constipados, 17 (77,3%) referem que sintomas gastrointestinais interferem no seu bem-estar, enquanto que entre os 29 pacientes não constipados, somente 5 (22,7%) referem esta interferência (p = 0,01) Quando investigado os fatores potencialmente associados à constipação,a inatividade física (Razão de prevalência 53,4; Teste exato de Fisher p = 0,052) e o sexo feminino (Razão de Prevalência 1,6; Pearson X2 p = 0,07) apresentaram tendênciaà associação significativa. No entanto, não foi encontrada associação significativa entre constipação e escolaridade, faixa etária, utilização de carbonato de cálcio, presença de 8 diabetes, estado nutricional e consumo de fibras atual. Conclusões: A constipação intestinal é um sintoma frequente em pacientes em hemodiálise no nosso meio. A utilização dos critérios de ROMA III para o diagnóstico de constipação permite diagnosticar um maior número de casos quando comparado apenas à autopercepção. A maior parte dos pacientes da amostra faz ou já fez uso crônico de laxantes, ainda que boa parte destes não se considere constipado, ou seja, classificados como constipados pelos critérios de ROMA III. Considerando-se a alta prevalência e interferência no bem-estar, a abordagem sobre a presença de constipação deve ser rotineira nessa população, a fim de alcançar-se um diagnóstico e manejo corretos. / Seventeen (77.3%) of the 28 constipated patients reported that their gastrointestinal symptoms interfered with their wellbeing, whereas just 5 (22.7%) of the 29 patients without constipation reported the same interference (p = 0.01). Investigation of factors potentially associated with constipation detected that inactivity (Prevalence ratio 53.4; Fisher’s exact test p = 0.052) and female sex (Prevalence ratio 1.6; PearsonX2 p = 0.07) exhibited tendencies towards a significant association. However, there were no significant associations between constipation and educational level, age group, use of calcium carbonate, presence of diabetes, nutritional status, or current fiber consumption. 10 Conclusions: Constipation is a common symptom among patients on hemodialysis in our country. Use of the ROMA III criteria diagnoses a higher number of cases of constipation than patients’ own perception alone. The majority of patients in the sample have used or were still using laxatives chronically, even though a considerable proportion of these patients were not considered constipated,they were not classified as constipated according to the ROMA III criteria. Considering its high prevalence and its impact on wellbeing, whether patients have constipation should be routinely investigated in this population, to enable correct diagnosis and management.

Alterações gastrointestinais em pacientes com doença renal crônica são queixas comuns, sendo a constipação considerada um dos sintomas mais prevalentes. O tratamento deste sintoma é limitado nesta população, devido às modificações dietéticas impostas pela perda da função renal e métodos dialíticos, especialmente na hemodiálise. Dados locais sobre a prevalência e fatores associados à constipação são pouco conhecidos em nosso meio. Neste estudo transversal, foram incluídos 57 participantes que realizam hemodiálise há pelo menos 3 meses no Hospital Moinhos de Vento em Porto Alegre, Brasil. Um questionário foi utilizado para avaliar dados sociodemográficos e clínicos potencialmente associados à constipação, a qual foi definida utilizando os critérios de ROMA III. Foi diagnosticada constipação em 28 pacientes nesta amostra (49,1%). Do total da amostra, 34 indivíduos (59,6%) relataram estar utilizando ou já terem utilizado laxantes em algum momento. Entre os constipados, 23 (82%) relataram esse uso. Outros 11 indivíduos usam laxativos cronicamente, ainda que não tenham sido classificados como constipados pelos critérios de ROMA III. Considerando a autopercepção, relataram “dificuldade para evacuar” 21/57 (36,8%). A concordância entre a autopercepção de “dificuldade para evacuar” e constipação pelos critérios de ROMA III ocorreu em 34 (59,6%) dos indivíduos. Entre os 28 pacientes constipados, 17 (77,3%) referem que sintomas gastrointestinais interferem no seu bem-estar, enquanto que entre os 29 pacientes não constipados, somente 5 (22,7%) referem esta interferência (p = 0,01) Quando investigado os fatores potencialmente associados à constipação,a inatividade física (Razão de prevalência 53,4; Teste exato de Fisher p = 0,052) e o sexo feminino (Razão de Prevalência 1,6; Pearson X2 p = 0,07) apresentaram tendênciaà associação significativa. No entanto, não foi encontrada associação significativa entre constipação e escolaridade, faixa etária, utilização de carbonato de cálcio, presença de 8 diabetes, estado nutricional e consumo de fibras atual. Conclusões: A constipação intestinal é um sintoma frequente em pacientes em hemodiálise no nosso meio. A utilização dos critérios de ROMA III para o diagnóstico de constipação permite diagnosticar um maior número de casos quando comparado apenas à autopercepção. A maior parte dos pacientes da amostra faz ou já fez uso crônico de laxantes, ainda que boa parte destes não se considere constipado, ou seja, classificados como constipados pelos critérios de ROMA III. Considerando-se a alta prevalência e interferência no bem-estar, a abordagem sobre a presença de constipação deve ser rotineira nessa população, a fim de alcançar-se um diagnóstico e manejo corretos. / Seventeen (77.3%) of the 28 constipated patients reported that their gastrointestinal symptoms interfered with their wellbeing, whereas just 5 (22.7%) of the 29 patients without constipation reported the same interference (p = 0.01). Investigation of factors potentially associated with constipation detected that inactivity (Prevalence ratio 53.4; Fisher’s exact test p = 0.052) and female sex (Prevalence ratio 1.6; PearsonX2 p = 0.07) exhibited tendencies towards a significant association. However, there were no significant associations between constipation and educational level, age group, use of calcium carbonate, presence of diabetes, nutritional status, or current fiber consumption. 10 Conclusions: Constipation is a common symptom among patients on hemodialysis in our country. Use of the ROMA III criteria diagnoses a higher number of cases of constipation than patients’ own perception alone. The majority of patients in the sample have used or were still using laxatives chronically, even though a considerable proportion of these patients were not considered constipated,they were not classified as constipated according to the ROMA III criteria. Considering its high prevalence and its impact on wellbeing, whether patients have constipation should be routinely investigated in this population, to enable correct diagnosis and management.

Abstract The principal aim of a population-based cross-sectional survey was to generate information on the lifetime occurrence of prostatitis in Finnish men and their exposure to the disease, and also on the influence of prostatitis-related fears and disturbances on their sexual life. A second aim was to develop and clinically validate a new diagnostic tool for differential diagnosis between the forms of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), especially between patients belonging to categories IIIA and IIIB in the new NIH (National Institutes of Health) clinical classification. Altogether 1832 men out of 2500 aged 20–59 years chosen randomly from the two most northerly provinces of Finland (Oulu and Lapland) participated in the epidemiological study, a response rate of 75%. The overall lifetime prevalence of prostatitis was 14.2%. The risk of having had the disease increased with age, being 1.7 times greater in the men aged 40–49 years than in those aged 20–39 years, and 3.1 times greater in those aged 50–59 years. More than a quarter of the 261 men who had or had had prostatitis symptoms (27%) suffered from them at least once a year, while 16% suffered from chronic prostatitis symptoms throughout the year. 63% of the men with prostatitis had their worst symptoms during the wintertime (November–march). 17% of the men with chronic prostatitis reported a constant fear of undetected prostate cancer. Erectile dysfunction was reported by 43% of the symptomatic men and decreased libido by 24%. Self-assessment of personality showed that the men with prostatitis were more often busy and nervous and had a meticulous attitude to life and problems than were the non-symptomatic men. 197 patients with chronic prostatitis/chronic pelvic pain syndrome participated in three clinical case-control studies during the years 1995–2000, at Oulu University Hospital, the District Hospital of Oulainen and Seinäjoki Central Hospital. The first prostatic tissue pressure measurement (PTPM) study included 34 patients and 9 controls. A novel method was developed to measure intraprostatic tissue pressure with a Stryker® intracompartmental pressure monitor. The PTPM showed a clear increase (p < 0.001) in the patients with symptoms of prostatitis and benign prostatic enlargement (BPE) relative to the controls and the patients with BPE but without pain symptoms. The second PTPM study included 42 patients with chronic prostatitis symptoms without significant BPE and 12 new controls. Significantly higher pressure readings (p < 0.001) were recorded at all three measurement points in the patients than in the controls. 48 new patients and 12 new controls were enrolled for the third PTPM study, the purpose of which was to confirm the results of the previous ones and to compare the prostatic tissue pressures of two clinical groups (IIIA and IIIB). The prostatic tissue pressure was again significantly higher in the patients with chronic prostatitis symptoms than in the controls (p < 0.001). An interesting finding was that prostatitis patients belonging to clinical category IIIA had significantly higher tissue pressures (p < 0.01) than those in category IIIB, probably reflecting more severe inflammation in the prostatic tissue. This new PTPM method provides a more precise and/or exact tool for differential diagnosis between the forms of pelvic pain and CP/CPPS.

Background: The buprenorphine transdermal system (BTDS) is approved in the US for the management of chronic pain. Due to its high affinity for mu-opioid receptors with a slow dissociation profile, buprenorphine may potentially displace or prevent the binding of competing mu-opioid-receptor agonists, including immediate-release (IR) opioids, in a dose-dependent manner. Health care professionals may assume that the use of IR opioids for supplemental analgesia during BTDS therapy is not acceptable. Materials and methods: This post hoc analysis evaluated the use of IR opioids as supplemental analgesia during the management of moderate-severe chronic pain with BTDS at 52 US sites (BUP3015S, NCT01125917). Patients were categorized into IR-opioid and no-IR-opioid groups. At each visit of the extension phase, adverse events, concomitant medications, and information from the Brief Pain Inventory (BPI) were recorded. Results: The most common supplemental IR opioids prescribed during BTDS treatment (n=354) were hydrocodone-acetaminophen and oxycodone-acetaminophen. The mean daily dose of IR opioids (morphine equivalents) for supplemental analgesia was 22 mg. At baseline, BPI pain intensity and BPI - interference scores were higher for patients in the IR-opioid group. In both treatment groups, scores improved by week 4, and then were maintained throughout 6 months of the open-label extension trial. The incidence of treatment-emergent adverse events was similar in both groups. Conclusion: Patients who were prescribed IR opioids reported lower scores for BPI pain intensity and pain interference to levels similar to patients receiving BTDS without IR opioids, without increasing the rate or severity of treatment-emergent adverse events. Patients prescribed concomitant use of IR opioids with BTDS had greater treatment persistence. The results of this post hoc analysis provide support for the concomitant use of IR opioids for supplemental analgesia during the management of moderate-severe chronic pain with BTDS.

No description available.

The scope of this project is an examination of medical compliance for the Hispanic patient with End State Renal Disease.

The intake of sodium, potassium, and phosphorus has important implications for chronic disease risk. Excess sodium intake is shown to be associated with elevated blood pressure, which in turn is a risk factor for cardiovascular disease (CVD) and chronic kidney disease (CKD). Potassium intake, on the other hand, is shown to be beneficial for lowering blood pressure and reducing the risk of CVD and CKD. Once an individual develops CKD, they experience alterations in mineral metabolism, especially phosphorus, and must closely monitor mineral intake and biochemical laboratory values in order to avoid complications. Thus, monitoring mineral intake is important in both healthy and CKD individuals in both research as well as clinical practice settings. It is therefore also important to have a method for estimating mineral intake that is both accurate as well as easy to administer. Two commonly used methods are self-report and 24-hour urinary mineral excretion. however, both methods have pros and cons. An alternative option that has been explored for all three minerals of interest is to collect a spot urine sample, then use one of several published equations to calculate an estimate of 24-hour urinary mineral excretion. While this method is relatively easy to administer, much remains unexplored regarding the accuracy of estimated 24-hour mineral excretion. My aim for my dissertation was to explore how estimated 24-hour sodium (e24hUNa), potassium (e24hUK) and phosphorus (e24hUP) compared to true mineral intake in healthy participants as well as those with CKD. We conducted secondary analyses from two controlled feeding studies, in which true mineral intake was known. Our results show that e24hUNa and e24hUK are not reliable indicators of true sodium and potassium intake, respectively, in healthy participants nor those with CKD, and e24hUP is not a reliable indicator of phosphorus intake in CKD participants. Though these findings should be confirmed by larger studies, these findings suggest that currently available equations may need to be revised and estimated 24-hour mineral excretion from spot urine samples should be interpreted with caution.

Thesis (Ph. D. (Social Work)) -- University of Limpopo, 2016 / Refer to document / University of Limpopo