holistic

整体
  • 文章类型: Journal Article
    原发性进行性失语(PPA)是一种神经退行性脑疾病,其特征是语言能力下降。这是一种罕见的,通常是年轻的痴呆症,对受影响者的工作和个人活动产生破坏性影响。目前,没有针对PPA的治愈或疾病改善疗法,也没有任何方法可以阻止或减缓潜在的进行性脑变性。因此,在整个疾病过程中,任何治疗都必须进行姑息治疗,以控制症状并改善受影响者的生活质量。大多数受影响的人在诊断后很少或没有接受后续护理,特别是在疾病的早期。医学文献中关于以人为中心的护理的信息很少,这些护理旨在改善从患有这种疾病的人的角度撰写的PPA患者的生活质量。我接受了PPA的非流利/农艺变体的早期和准确的临床诊断,由成像支持。我很幸运,从语言困难开始,我就从多学科医疗团队的示范性个性化护理中受益。在本文中,我讨论了这种个性化和以人为中心的护理的各个方面的生活经验,描述它是如何建立在共同决策和整体的基础上的,包含痴呆症的方法包括身体,心理,情感,生活在无法治愈的神经退行性疾病中的社会心理和精神层面。
    Primary progressive aphasia (PPA) is a neurodegenerative brain disorder characterized by declining language ability. It is a rare, often young-onset dementia with a devastating impact on the work and personal activities of those affected. At present there is no cure or disease-modifying therapy for PPA nor any way to arrest or slow the underlying progressive brain degeneration. Throughout the course of the condition any treatment must therefore be palliative-designed to manage symptoms and improve the quality of life of the affected person. The majority of those affected receive little or no follow-up care after diagnosis, particularly in the early stage of the disease. There is very little information in the medical literature about person-centered care designed to improve the quality of life of people with PPA written from the perspective of those living with this condition. I received an early and accurate clinical diagnosis of the nonfluent/agrammatic variant of PPA, supported by imaging. I am fortunate to have benefited from exemplary individualized care from a multidisciplinary medical team from the onset of my difficulties with language. In this paper, I discuss my lived experience of all aspects of this personalized and person-centered care, describing how it was founded on shared decision-making and a holistic, dementia-inclusive approach encompassing the physical, mental, emotional, psychosocial and spiritual dimensions of living with an incurable neurodegenerative disease.
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  • 文章类型: Journal Article
    暂无摘要。
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  • 文章类型: Published Erratum
    [这更正了文章DOI:10.3389/freur.2024.1382196。].
    [This corrects the article DOI: 10.3389/fneur.2024.1382196.].
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  • 文章类型: Journal Article
    背景:肿瘤科护士支持癌症患者满足其自我护理需求,往往忽视自己的情绪和自我照顾的需要。这项研究旨在调查意大利肿瘤科护士基于性别的整体正念的五个方面的变化,肿瘤学工作经验,和轮班工作。
    方法:2023年对所有在肿瘤科工作并在意大利工作的注册护士进行了横断面研究。
    结果:根据性别,整体正念的所有五个方面都没有显着差异(p≥0.05),肿瘤学领域的工作经验,和轮班工作。
    结论:整体正念可以定义为一种内在的个体特征吗?当然,需要更多的见解来更好地定义肿瘤护理的整体趋势.
    BACKGROUND: Oncology nurses support cancer patients in meeting their self-care needs, often neglecting their own emotions and self-care needs. This study aims to investigate the variations in the five facets of holistic mindfulness among Italian oncology nurses based on gender, work experience in oncology, and shift work.
    METHODS: A cross-sectional study was carried out in 2023 amongst all registered nurses who were employed in an oncology setting and working in Italy.
    RESULTS: There were no significant differences in all five facets of holistic mindfulness (p ≥ 0.05) according to gender, work experience in the oncology field, and shift work.
    CONCLUSIONS: Could holistic mindfulness be defined as an intrinsic individual characteristic? Surely, more insights will be necessary to better define the holistic trend in oncology nursing.
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  • 文章类型: Journal Article
    描述太多,律师,时间太少了?我们想通过自制传单的镜头提出关于生活方式医学咨询的独特而创新的观点,旨在弥合传统医疗保健实践和个性化之间的差距,整体福祉。在有前途的医疗保健人文领域,自制生活方式医学传单是个人机构促进健康和活力的有形体现。传单包含了各种各样的自我护理实践,饮食见解,和正念技术,强调心灵之间的内在联系,身体,和精神在一个人的健康旅程。这份双面文件强调了赋予个人在自己的健康旅程中发挥积极作用的重要性。包括建立坚实的健康和福祉基础的广泛提示,以及带有资源的QR码,以使这些更改发生。患者可能明白他们需要吃健康的食物,花时间在户外,但可能不知道如何最好地在他们所在的地区实施这些变化。尽管平均访问办公室的时间有限,像视觉辅助一样简单的东西可以在诊所之外产生变化的涟漪。作为一份带回家的文件,它可以成为一个机会,分享和赋予他人在病人自己的影响范围以及。传单充当有形的神器,成为培养社区参与感的渠道,鼓励对话,并促进追求福祉的共同经验。
    Description Too much to counsel on, too little time? We would like to present a unique and innovative perspective on lifestyle medicine counseling through the lens of a homemade flyer, designed to bridge the gap between conventional health care practices and personalized, holistic well-being. In the promising field of health care humanities, the homemade lifestyle medicine flyer serves as a tangible manifestation of individual agency in promoting health and vitality. The flyer encapsulates a diverse range of self-care practices, dietary insights, and mindfulness techniques, emphasizing the inherent connection between mind, body, and spirit in one\'s health journey. This double-sided document highlights the significance of empowering individuals to take an active role in their own health journey. Included are a broad range of tips for building a solid health and well-being foundation, as well as a QR code with resources to make those changes happen. Patients may understand that they need to eat healthy foods and spend time outdoors but may not know how best to implement those changes in their area. Although there is limited time for the average office visit, something as simple as a visual aid can go quite far in creating ripples of change beyond the clinic. As a take-home document, it can become an opportunity to share and empower others in the patient\'s own sphere of influence as well. The flyer acts as a tangible artifact, becoming a conduit for fostering a sense of community engagement, encouraging dialogue, and promoting shared experiences in the pursuit of well-being.
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  • 文章类型: Journal Article
    成瘾及其辅助行为的性质和起源,以及它们的长期性,呼吁将它们概念化并视为长期和复杂的过程的治疗方法。成瘾通常与人格问题和创伤史并存。患有这些疾病的患者通常表现出不良的治疗参与度和高复发率,可能是因为可用的治疗方法尚未以更综合或整体的方式解决患有成瘾的患者。特别是,成瘾性障碍的综合治疗模式-类似于人格障碍或创伤的治疗-可能需要行为整合,认知,以及促进治疗关系中的以情绪为中心的干预措施。然而,目前大多数的治疗模式,包括那些在稳定或行为改变方面非常有效的,缺乏一种或多种可以维持长期康复的治疗成分,健康,以及更高比例的患者的健康。在这篇文章中,我建议从图式疗法的角度来处理成瘾及其治疗,一个综合的,发展模式在处理人格障碍症状和长期创伤史方面具有良好的积极成果记录,通常与成瘾性疾病并存。在推进这一提议的过程中,我首先提供一些将成瘾联系在一起的背景,附件,和个性,建议同时治疗以改善结果。然后,在简要回顾了治疗成瘾的主要方法之后,我介绍了图式疗法在理论上和实践上都处于有利地位的想法,以解决现有治疗方案的许多缺点。特别是,我注意到上瘾和共同发生的勾结行为与核心发展需求的早期和持续挫败感紧密交织在一起。我说明了成瘾循环如何通过模式强化过程和模式操作得以延续。然后,我演示这些关键术语(即,需要,schemas,和模式)告知患者的评估和病例制定,从注重整合康复行为改变的强大治疗关系中指导治疗干预措施,治疗功能失调的模式和模式,防止复发。
    The nature and origins of addictions and of their adjunctive behaviors, as well as their chronicity, call for treatments that conceptualize and treat them as the long-term and complex processes that they are. Addictions are often comorbid with personality problems and with trauma histories. Patients suffering from these disorders often show poor engagement with treatment and high rates of relapse, possibly because available treatments have yet to address the patient suffering from addiction in a more integrated or holistic manner. In particular, comprehensive treatment models for addictive disorders - like treatments for personality disorders or trauma - are likely to require the integration of behavioral, cognitive, and emotion-focused interventions within a facilitative therapeutic relationship. However, most current treatment models, including ones which are highly effective in stabilization or behavioral change, lack one or more components of treatment that could sustain longer term recovery, wellness, and health for a higher percentage of patients. In this article, I propose approaching addictions and their treatment from the perspective of schema therapy, an integrative, developmental model with a strong track record of positive outcomes in addressing personality disorder symptoms and long-standing trauma histories, commonly comorbid with addictive disorders. In advancing this proposal, I begin by providing some background tying together addictions, attachment, and personality, suggesting they be treated simultaneously to achieve improved outcomes. Then, after briefly reviewing the leading approaches to the treatment of addictions, I introduce the idea that schema therapy is well-situated - both theoretically and practically - to address many of the shortcomings of existing treatment options. In particular, I note how addictive and co-occurring colluding behaviors are deeply intertwined with both early and continued frustration of core developmental needs. I illustrate how the addictive cycle is perpetuated through the process of schema reinforcement and through the operation of schema modes. I then demonstrate how these key terms (i.e., needs, schemas, and modes) inform the patient\'s assessment and case formulation, guiding treatment interventions from a strong therapeutic relationship that focuses on integrating recovery behavior change, healing dysfunctional schemas and modes, and preventing relapse.
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  • 文章类型: Journal Article
    慢性肌肉骨骼痛(CMP),定义为持续超过3个月的肌肉骨骼组织持续不适,全球约有17.1亿人口,导致严重的功能障碍和心理困扰,从而不利地影响个人的生活质量。这篇叙述性综述的目的是阐明饮食习惯之间的复杂关系,少肌症,和肠道菌群组成,着眼于加强患者管理和治疗效果。鉴于人们对饮食对CMP的影响越来越感兴趣,有必要对当前文献进行详细研究。营养摄入是肠道微生物群分布的关键决定因素,which,反过来,与肌肉组织的完整性和性能有关,有可能导致肌肉减少症.由于肌肉力量和功能的减弱,肌肉减少症的发展会加重CMP。此外,肠道微生物群的破坏可能直接调节伤害感受,加剧CMP的表现。因此,营养优化已成为CMP管理的可行方法。强调有利于健康肠道微生物组的饮食可以预防或减轻肌肉减少症,从而衰减CMP强度。然而,该领域需要进一步的实证探索,以解开这些相互作用的细微差别,并为CMP患者制定有效的饮食策略。除了单纯的镇痛,CMP的全面患者护理需要承认疼痛的复杂性和多因素性质及其基本要素。采用综合治疗模式使医疗保健从业者能够承诺更好的患者预后,丰富的生活质量,以及与CMP相关的持续医疗保健成本下降。
    慢性肌肉骨骼疼痛(CMP)是骨骼的长期疼痛,肌肉,和关节,这是一个普遍的问题,影响着全世界超过17亿人。这种痛苦真的会扰乱一个人的日常生活,使日常工作变得困难,并造成很大的压力。这篇评论就像是对饮食习惯的深入研究,肌肉损失,生活在我们内脏中的微小生物都与这种疼痛有关。随着我们对食物如何影响CMP越来越好奇,仔细观察我们已经知道的东西很重要。我们吃的东西可以改变我们肠道中的小虫子,这对我们的肌肉有很大的影响。如果我们的肌肉变得虚弱和萎缩(一种称为肌少症的疾病),它会使CMP变得更糟,因为虚弱的肌肉不能很好地支撑我们的身体。此外,如果我们肠道中的虫子平衡失调,它甚至可能使我们感到更强烈的疼痛。所以,改变我们的饮食可能是解决CMP的好方法。吃让我们的肠道细菌快乐的食物可能有助于防止肌肉损失和减轻疼痛。但是我们仍然需要做更多的研究来更好地了解这一点,并找出为此目的吃的最佳食物。治疗CMP不仅仅是摆脱疼痛;它是关于查看整个情况以及所有导致疼痛的事情。通过考虑一切-从我们的饮食到我们的肌肉到我们的肠道细菌-医生可以帮助改善CMP患者的生活,让他们更舒适,从长远来看可能会降低医疗成本。
    Chronic musculoskeletal pain (CMP), defined as persistent discomfort in musculoskeletal tissues persisting for over 3 months, afflicts an estimated 1.71 billion people globally, leading to significant functional impairments and psychological distress, thereby detrimentally affecting individuals\' quality of life. The objective of this narrative review is to elucidate the complex relationship among dietary habits, sarcopenia, and gut microbiota composition, with an eye toward enhancing patient management and outcomes. Given the burgeoning interest in the influence of diet on CMP, a detailed examination of the current literature is warranted. Nutritional intake is a critical determinant of the gut microbiota profile, which, in turn, is linked to musculature integrity and performance, potentially leading to sarcopenia. The development of sarcopenia can aggravate CMP owing to diminished muscular strength and functionality. Additionally, disruptions in the gut microbiota may directly modulate nociception, intensifying CMP manifestations. Thus, nutritional optimization emerges as a viable approach to CMP management. Emphasizing a diet conducive to a healthy gut microbiome could forestall or mitigate sarcopenia, thereby attenuating CMP intensity. Nevertheless, the domain calls for further empirical exploration to unravel the nuances of these interactions and to forge efficacious dietary strategies for individuals with CMP. Beyond mere analgesia, comprehensive patient care for CMP requires acknowledgment of the complex and multifactorial nature of pain and its foundational elements. Embracing an integrative treatment model allows healthcare practitioners to promise better patient prognoses, enriched life quality, and a decrease in the sustained healthcare costs associated with CMP.
    Chronic musculoskeletal pain (CMP) is long-lasting pain in the bones, muscles, and joints, and it’s a common problem affecting over 1.7 billion people worldwide. This kind of pain can really disrupt someone’s daily life, making it hard to do everyday things and causing a lot of stress. This review is like a deep dive into how eating habits, muscle loss, and the tiny organisms living in our guts all connect to this pain. As we are becoming more curious about how food affects CMP, it’s important to look closely at what we already know. What we eat can change the tiny bugs in our guts, which has a big impact on our muscles. If our muscles get weak and shrink (a condition called sarcopenia), it can make CMP worse because weak muscles cannot support our bodies well. Also, if the balance of bugs in our gut is off, it might even make us feel pain more intensely. So, changing what we eat might be a good way to tackle CMP. Eating foods that keep our gut bugs happy might help prevent muscle loss and reduce pain. But we still need to do more research to understand this better and to figure out the best foods to eat for this purpose. Treating CMP is not just about getting rid of the pain; it’s about looking at the whole picture and all the things that contribute to the pain. By considering everything — from our diet to our muscles to our gut bugs — doctors can help improve the lives of people with CMP, making them more comfortable and possibly reducing medical costs in the long run.
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  • 文章类型: Journal Article
    胸腺上皮肿瘤(TET)是一种相对罕见的胸部肿瘤,在亚洲人中发病率较高。诊断和治疗模式长期以来主要基于临床经验和专家共识。近年来,随着体检中检测到的TET数量的增加,迫切需要制定适用于中国人口的指导方针。因此,我们打算为TET制定一个整体综合指南。
    在中国抗癌协会(CACA)纵隔肿瘤委员会的领导下,成立了一个多学科指南制定小组。进行了系统文献回顾和两轮有关关键临床问题的问卷调查。建议评估的分级,使用开发和评估(GRADE)方法对证据质量和建议强度进行评分。
    CACA指南为前纵隔病变的临床鉴别诊断提供了建议,无症状的前纵隔小结节的处理,TET的病理分类和分期系统,以及手术原理,新辅助和辅助治疗,先进的TETS系统治疗,以及手术切除后的随访策略。
    该指南为TET提供了全面的综合管理策略,并将成为临床医生决策的有用工具。
    UNASSIGNED: Thymic epithelial tumors (TETs) are a relatively rare type of thoracic tumors with higher incidence in Asians. The diagnosis and treatment pattern has long been based mainly on clinical experience and expert consensus. In recent years, with an increasing number of TETs detected in physical examinations, there is an urgent need to develop the guidelines that apply to the Chinese population. Thus, we intend to develop a holistic integrative guideline for TETs.
    UNASSIGNED: Under the leadership of the Chinese Anti-Cancer Association (CACA) Mediastinal Tumor Committee, a multidisciplinary guideline development group was established. Systemic literature review and two rounds of questionnaires regarding key clinical issues were carried out. The grading of recommendations assessment, development and evaluation (GRADE) approach was used to rate the quality of evidence and the strength of recommendations.
    UNASSIGNED: The CACA guideline provides recommendations for the clinical differential diagnosis of anterior mediastinal lesions, management of asymptomatic small anterior mediastinal nodules, pathological classification and staging systems of TETs, as well as principles of surgery, neoadjuvant and adjuvant therapies, systemic therapies for advanced TETs, and follow-up strategies after surgical resection.
    UNASSIGNED: This guideline provides holistic integrative management strategies for TETs and would be a useful tool for clinicians on decision-making.
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  • 文章类型: Journal Article
    尽管在良性阵发性位置性眩晕(BPPV)的治疗中,耳石重新定位动作(CRM)的成功率很高,越来越多的患者报告残留的头晕症状可能会持续很长时间。虽然大多数BPPV病例可以解释为牙管炎,病因复杂。考虑个体患者的病史和潜在的BPPV病理生理学可能为补充CRM的治疗方法提供潜力。对于禁用CRM的患者,也是一种有希望的替代方法。本文总结了BPPV和残留头晕的可能潜在原因,以及可能被考虑减轻残留症状负担的潜在管理方案的建议。
    Despite the high success rate of canalith repositioning maneuvers (CRMs) in the treatment of benign paroxysmal positional vertigo (BPPV), a growing number of patients report residual dizziness symptoms that may last for a significant time. Although the majority of BPPV cases can be explained by canalolithiasis, the etiology is complex. Consideration of the individual patient\'s history and underlying pathophysiology of BPPV may offer the potential for treatment approaches supplementary to CRMs, as well as a promising alternative for patients in whom CRMs are contraindicated. This article provides a summary of the possible underlying causes of BPPV and residual dizziness, along with suggestions for potential management options that may be considered to relieve the burden of residual symptoms.
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  • 文章类型: Journal Article
    偏头痛,一种频繁且高度致残的疾病,必须加强对偏头痛患者的教育,以减轻这一全球负担。快速发展的大型语言模型(LLM)领域为偏头痛患者的教育提供了一条有希望的途径。本研究旨在通过评估来自五个领先的LLM的响应的准确性来评估LLM在这种情况下的潜力,包括OpenAI的ChatGPT3.5和4.0,GoogleBard,MetaLlama2和AnthropicClaude2解决了30个常见的偏头痛相关查询。我们发现LLM表现出不同的准确性水平。ChatGPT-4.0提供了96.7%的适当响应,而其他聊天机器人提供了83.3%到90%的适当响应(皮尔逊的卡方检验,P=0.481)。此外,谷歌吟游诗人的评级比例为6.7%,其他LLM有3.3%(皮尔逊卡方检验,P=0.961)。这项研究强调了LLM准确解决常见偏头痛相关查询的潜力。这样的发现可以促进偏头痛患者的人工智能辅助教育,为偏头痛管理的整体方法提供见解。
    This study assessed the potential of large language models (OpenAI\'s ChatGPT 3.5 and 4.0, Google Bard, Meta Llama2, and Anthropic Claude2) in addressing 30 common migraine-related queries, providing a foundation to advance artificial intelligence-assisted patient education and insights for a holistic approach to migraine management.
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