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Abstract

Factor VII deficiency is a rare inheritable bleeding disorder that can be challenging to manage. Blood activity levels do not correlate with bleeding risk, and prophylaxis is a more difficult treatment option than for people with haemophilia due to the short half-life of factor VII. Acute bleeding manifestations and long-term complications are similar to those associated with haemophilia. This case study illustrates the psychological and physical impact of severe factor VII deficiency on a woman with impaired mobility due to haemarthropathy who must retain her independence to provide care for her elderly parents. She self-manages her joint pain and bleeding risk, but her life is limited by the need to avoid injury and her reluctance to engage fully with health services.

Fundamentals on Nanomaterials Toxicological Assessment
Series: De Gruyter STEM

Abstract

Background:

Guidance from the European Association for Haemophilia and Allied Disorders (EAHAD) sets out the educational milestones haemophilia nurses should aim to achieve. However, little is known about the resources nurses use for education and current awareness.

Aims:

To assess the current educational level of haemophilia nurses, how and where they access ongoing education, where they feel they need extra support, and how best this teaching could be delivered.

Methods:

Haemophilia nurses in the Haemnet Horizons group devised and piloted a questionnaire. This was distributed in hard copy to nurses attending the 2019 EAHAD Congress and promoted as an online survey hosted by Survey Monkey.

Results:

Seventy-five replies were received from nurses in Europe (46 in the UK), and two from nurses in Chile and the Philippines. Most described their role as ‘specialist nurse’, with the majority having worked in haemophilia care for up to ten years. Half had a nursing degree and one quarter had a nursing diploma. Three quarters had attended at least one course specifically related to haemophilia nursing. Almost all used academic sources, study days and the websites of health profession organisations as information sources. Most also used Google or Wikipedia, but fewer used Twitter. Patient association websites were more popular among non-UK nurses. About half attended sponsored professional meetings and three quarters reported that educational meetings were available in their workplace. A clear majority preferred interactive and face-to-face activities using patient-focused content.

Conclusions:

The study shows that nurses, predominantly in Western Europe, access a range of educational resources, most of which are ‘traditional’. Use of online sources is high, but social media are less popular than Google or Wikipedia. Further research is needed to explore the potential of new media for haemophilia nurse education, and whether the current educational levels and needs highlighted in the survey remains the same across the whole of Europe.

Abstract

Figures in the World Federation of Hemophilia (WFH) global annual survey indicate, by their absence, that there is under-recognition of bleeding disorders in women. The WFH and its national member organisations (NMOs) are working to raise awareness and improve the diagnosis of care of women with bleeding disorders globally, regionally and locally. WFH initiatives include a global programme focused on improving the diagnosis, care and treatment of women with von Willebrand disease (VWD), and programmes involving education and training in conjunction with NMOs in countries including Honduras and Malaysia. NMOs in Slovakia, Latvia and Sweden describe their local activities. The Slovak Hemophilia Society is in the process of establishing a Women’s Committee and considers peer support and network building as essential tools in addressing the issues faced by women with bleeding disorders. In Latvia, access to resources is difficult and von Willebrand factor is not available. There is concern in the Latvia Hemophilia Society that the fundamental human right of access to healthcare is not being met. It supports WFH initiatives through education and advocacy, and believes that the voices of women with bleeding disorders will be better heard through working together. The Swedish Hemophilia Society’s Women’s Project has worked since 2006 to promote better care for women with bleeding disorders and to raise public awareness. Despite resistance, their campaign to increase the identification of girls and women with VWD, improve diagnosis and care, and raise awareness has been well received by healthcare professionals and has had extensive media coverage.

Abstract

Men and women with bleeding disorders have similar symptoms but their experiences are different. It has been shown that women with a bleeding disorder rate their quality of life on a par with that of men with haemophilia who have HIV. Many factors determine quality of life, ranging from delay in diagnosis, to access to treatment and support from family and friends. Women should ask themselves what is important to them and recognise the barriers that determine whether they can achieve their aims in life. Quality of life instruments do not measure the impact of these disorders in a way that is specific to women. Psychosocial health – i.e. the mental, emotional, social, and spiritual aspects of what it means to be healthy – can have a major impact on quality of life. Women with bleeding disorders face a number of challenges to their psychosocial health. They struggle to be believed, they live with guilt, and they may have to fight for the best care for their children. They face obstacles to building relationships and their experiences can leave them isolated. Perhaps because of this, women with bleeding disorders are strong – but they also need to be encouraged to make time for themselves and look after their mental health.

Abstract

Prolonged menstrual bleeding interferes with daily life and causes marked blood loss, resulting in anaemia and fatigue. Treatment centres should address the issue of heavy menstrual bleeding (HMB) with pre-pubertal girls in advance of their first period, in order to best prepare them. It is common for a bleeding disorder to be overlooked in primary care and in gynaecology clinics, and women sometimes struggle to get a correct diagnosis. There are cultural taboos that inhibit open discussion of menstruation, and women tend to minimise the severity of their symptoms. Health professionals should work to destigmatise the issue and seek an accurate account of bleeding severity, with diagnosis and treatment provided in a joint clinic combining gynaecology and haematology expertise. Treatment should be individualised, taking into account personal, social and medical factors, with the aim of improving quality of life. Great care is needed with regard to choice of language when talking about treatment, and treatment centres should consider offering open access to women who need support in dealing with adverse effects. National member organisations have an important role to play in educating people with bleeding disorders, health professionals and the wider public about the burden of HMB associated with bleeding disorders.

Abstract

The purpose of the paper is to describe the results of the theoretical and empirical study of the mental and emotional state assessment of university students in the examination situation. The dependence of students’ mental and emotional state during the examination on personal traits, students’ self-assessment, as well as the specificity of their mental and emotional state with different levels of examination anxiety are discussed.

Materials and methods: In our research we used the following methods: Cattell’s 16-factor personality questionnaire, modified version of Max Luscher’s eight-color test – colors choice method (CChM), express test ‘The diagnostics of the examination anxiety’. The sample consisted of 72 first-year full-time students of the specialty ‘pedagogical education’. Age of the students is 17-18 years old. Methods of mathematical statistics are used to estimate data.

Research results: The data of the empirical research of the students’ mental and emotional state have revealed the negative impact of the examination situation on the students’ mental and emotional state. The level of examination anxiety, formed in response to a threatening situation, is determined by a set of the students’ personality traits. It has been established that the lower the person’s self-assessment is, the higher the level of students’ examination anxiety. For students with average data of personal anxiety, the state of stress and exam stress has appeared to be tonic, what allows to keep a sufficient level of ability to work and achieve good learning outcomes.

Discussion: The results of the research indicate that the assessment of the mental and emotional state of students in the examination situation will allow predicting human behavior in stressful situations, preventing the adverse impact of negative factors on human activity, and also will become the key to the developing a strategy for maintaining students’ psychological health.

Abstract

The аim is to study family influence on formation of eating and weight disorders. The concept of an “alimentary family” is defined as a family with dysfunctional, disharmonious relationships, which is a prerequisite for emergence and support of distorted patterns of eating behaviour, leading in the future to children’s eating and weight disorders.

Methods: The research was carried out using the method of a thematic retrospective analysis (MTRA)-food, which is a variant of the narrative method, the questionnaire “Parental convictions and control tactics as for eating behaviour of their children during food taking”. The data was processed by the content analysis method; Fisher’s φ-criterion was used to compare differences between the groups.

Results: The research has allowed us to clarify eating behavioural characteristics and to identify the “roots” of eating disorders. Various forms of forcing at eating, direct and indirect ways of making children to eat or blocking of eating are manifested in ignoring of children’s taste preferences, their desire and readiness to eat. Parents often use manipulative techniques influencing children’s eating behaviour (encouragement, inducement, reward promises, approval, recognition, warning, or switching attention), direct means of influence (coercion: prohibition, restriction, rejection, destructive criticism, intimidation, deprivation from various pleasures). There is the statistical confirmation that parents’ use of manipulative means and / or direct coercion towards their children during eating predetermines formation of pathological processes of corporeality, attitudes and psychological mechanisms stipulating eating disorders.

Conclusions: The research results indicate necessity to develop psychotherapeutic programs for people with eating disorders, as well as programs to help parents improve family relationships and, accordingly, to apply correctional effects on their children.

Abstract

The issue of parental neglect is a constantly topical one. Neglect is not only the lack of satisfying basic needs, but also the lack of ensuring a sense of security, belonging, and insufficient physical, emotional or verbal closeness with the child. Poor parental care, lack of a sense of closeness and availability of the parent, along with other environmental factors (e.g. addictions, diseases and mental disorders in the family) result in abnormal formation of the child’s personality, and can also be associated with depression, anxiety, self-harm or suicide attempts.

The aim of the study was to present the clinical cases of two teenage patients (AA. – 13 years old, BB. – 16 years old) staying in the I Department of Psychiatry, Psychotherapy and Early Intervention in Lublin (Department for Children and Youth), whose mental health problems were caused by a constant neglect on the part of parents.

Case reports: The patients came from dysfunctional families in which members showed a tendency to addiction (alcohol) and were emotionally and physically absent from the lives of the girls. Due to considerable upbringing problems, girls were hospitalized many times, both in paediatric wards and in psychiatric wards for children and adolescents, with various medical diagnoses.

Conclusions: The presented cases of two patients indicate a potential cause-and-effect relationship between parental neglect, coexisting environmental factors (addictions of family members) and abnormal formation of the child’s personality, self-harm or suicide attempts. In such family systems, it is extremely important, apart from a court-appointed family guardian, to introduce a family assistant to provide emotional or advisory support.

Abstract

The Rorschach test is the most well-known psychological test ever invented; it has captured the imagination of entire generations of clinicians, researchers, artists, writers, and ordinary participants in mass culture. Yet, no psychological test has faced such heavily emotional criticism. The drastically ambiguous status of this test in the community of psychologists can be call an identity crisis. This is the diagnosis presented in the book titled Assessment Using the Rorschach Inkblot Test by James P. Choca and Edward D. Rossini, American professors of clinical psychology currently affiliated with the Roosevelt University in Chicago. It was this book that inspired the present article. Choca and Rossini claim that the crisis associated with the use of the inkblot test stems from the lack of understanding of what the essence of this test actually is and from its improper usage. They also indicate realistic and practical ways to overcome this crisis.

Faced with the excessively elaborate systems for processing and interpreting the material obtained using the test, the authors attempt to create a short version of the inkblot test (Basic Rorschach). In the short version it is possible to use a smaller number of categories or even limit oneself to use only four plates instead of ten. Choca and Rossini admit that the Basic Rorschach requires further studies; they are also willing to give psychologists a great degree of freedom and the possibility of deciding what to take into account and what to ignore in the interpretation of results. They also propose to introduce a new final phase of the test, which, in a way, involves the examinee in the process of analyzing his or her responses.

In this paper I address the changes proposed by the authors, concerning both the procedure and the manner of categorizing and interpreting responses. For this purpose, I use own clinical experience and the results of my empirical research.