The Pictorial Representation of Illness and Self Measure (PRISM) assesses suffering. In this article, the authors explored the feasibility and psychometric qualities of 2 revised versions of the PRISM-PRISM-R1 and PRISM-R2-that they used in 3 studies of participants with different medical problems. The results showed significant differences between the patient groups in suffering as measured with the revised PRISMs. In addition, the revised PRISMs appeared to be sensitive to change in the predicted direction after an intervention. Last, the 2 measures of the revised PRISM seemed to indicate different aspects of suffering. These findings yield preliminary support for the feasibility and validity of the PRISM-R2.
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Control methods are applied worldwide to reduce predation on livestock by European red foxes (Vulpes vulpes). Lethal methods can inflict suffering; however, moral debate about their use is lacking. Non-lethal methods can also inflict suffering and can unintentionally lead to death, and yet both the welfare consequences and ethical perspectives regarding their use are rarely discussed. The aim of this study was to investigate the animal welfare consequences, the level of humaneness, the ethical considerations and the moral implications of the global use of fox control methods according to Tom Regan’s animal rights view and Peter Singer’s utilitarian view. According to Regan, foxes ought not to be controlled by either lethal or potentially harmful non-lethal methods because this violates the right of foxes not to be harmed or killed. According to Singer, if an action maximises happiness or the satisfaction of preferences over unhappiness or suffering, then the action is justified. Therefore, if and only if the use of fox control methods can prevent suffering and death in livestock in a manner that outweighs comparable suffering and death in foxes is one morally obligated t
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Patients living at home who suffer from Korsakoff's syndrome (KS) need highly specialistic care from competent healthcare professionals who can bridge the gap between specialistic and generalistic care. Patients suffering from KS lack insight into their illness and often do not have any care demands for themselves. A voluntary admission is not at issue.However, they need professional care due to physical and mental deterioration and without help they will literally drink themselves to death. An involuntary admission is only possible when the criteria mentioned in the Dutch Compulsory Admission Act (BOPZ) are met. Generally, the presence of KS is insufficient to consider a mental disorder, which means that an involuntary admission will not be possible. The only possibility for this group will be extramural healthcare.In 2020 two new acts will replace the BOPZ. The Compulsory Mental Health Care Act (WvGGZ) and the Care and Compulsion Act (WZD). The WZD can be applied on patients suffering from Korsakoff's syndrome. Both acts offer the possibility to apply coercive home healthcare.Healthcare professionals working with patients suffering from KS note that they are missing experience, skills and information about working in an extramural setting. What competencies do they need to provide good care for people with KS? New challenges are created when the new legislation has to be applied. This research project investigates, firstly, what good extramural care is for patients suffering from KS. Secondly, what competencies extramural healthcare professionals need in order to provide care that increases the quality of life of people with KS, meet the needs of people with KS and their informal caregivers, and takes into account the human rights of these patients.
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Traveling to places associated with death is not a new phenomenon. People have long been drawn, purposefully or otherwise, towards sites, attractions, and events linked in one way or another with death, suffering, violence, or disaster. War-related attractions, though diverse, are a subset of the totality of tourist sites associated with death and suffering. This article aims to assess how "dark" tourism may play a role in leveraging tourism in Palestine, which has largely relied on pilgrimage tourism in the past. This article investigates the potential for developing this form of tourism, since Palestine has been undergoing death, suffering, violence, or disaster through political tension and instability since 1948 and arguably for a generation earlier, but has not yet developed a strategy for tourism development that considers this type of tourism.
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Studies into affective publics often involve textual communication. However, emotive communication is increasingly visual. This study zooms in on the representation of the suffering other in seven re-workings of the Alan Kurdi photographs that resonated significantly on Instagram. Chouliaraki’s concept of post-humanitarian solidarity in The Ironic Spectator (2013) is used as a theoretical framework to analyse the content of re-worked images and their post captions. Her concept outlines how distant sufferers tend to be rendered invisible due to the self-reflexive nature of contemporary solidarity. This self-reflexivity gets in the way of solidarity for others unlike us. The study found that, although the sufferer is visually present in almost all re-worked images, the suffering is ‘replaced’ by emotions or political views of the creators. Both Chouliaraki’s ‘distant other’ as well as Markham’s similar other are ways to visually (re)construct the tragedy of Alan Kurdi and the refugee crisis in general. This study adds to this an understanding of how Instagram users, while visually constructing a similar or distant other, also write themselves – often their personal feelings – into such images. Their public, other Instagram users, engages in self-reflexivity by liking such re-workings, aligning with the communicated emotions or political views conveyed. In this way, the platform ‘like feature’ intensifies the self-reflexive nature of contemporary solidarity.
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The benefits of having a high indoor environmental quality (IEQ) for a healthy life and optimal performance are well known. In addition, research has been executed on the effects of indoor environmental parameters such as (day)light, sound/ acoustics, temperature, and air quality on people living with dementia.
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Purpose: Lactate is an established prognosticator in critical care. However, there still is insufficient evidence about its role in predicting outcome in COVID-19. This is of particular concern in older patients who have been mostly affected during the initial surge in 2020. Methods: This prospective international observation study (The COVIP study) recruited patients aged 70 years or older (ClinicalTrials.gov ID: NCT04321265) admitted to an intensive care unit (ICU) with COVID-19 disease from March 2020 to February 2021. In addition to serial lactate values (arterial blood gas analysis), we recorded several parameters, including SOFA score, ICU procedures, limitation of care, ICU- and 3-month mortality. A lactate concentration ≥ 2.0 mmol/L on the day of ICU admission (baseline) was defined as abnormal. The primary outcome was ICU-mortality. The secondary outcomes 30-day and 3-month mortality. Results: In total, data from 2860 patients were analyzed. In most patients (68%), serum lactate was lower than 2 mmol/L. Elevated baseline serum lactate was associated with significantly higher ICU- and 3-month mortality (53% vs. 43%, and 71% vs. 57%, respectively, p < 0.001). In the multivariable analysis, the maximum lactate concentration on day 1 was independently associated with ICU mortality (aOR 1.06 95% CI 1.02–1.11; p = 0.007), 30-day mortality (aOR 1.07 95% CI 1.02–1.13; p = 0.005) and 3-month mortality (aOR 1.15 95% CI 1.08–1.24; p < 0.001) after adjustment for age, gender, SOFA score, and frailty. In 826 patients with baseline lactate ≥ 2 mmol/L sufficient data to calculate the difference between maximal levels on days 1 and 2 (∆ serum lactate) were available. A decreasing lactate concentration over time was inversely associated with ICU mortality after multivariate adjustment for SOFA score, age, Clinical Frailty Scale, and gender (aOR 0.60 95% CI 0.42–0.85; p = 0.004). Conclusion: In critically ill old intensive care patients suffering from COVID-19, lactate and its kinetics are valuable tools for outcome prediction. Trial registration number: NCT04321265.
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A previous study found a variety of unusual sexual interests to cluster in a five-factor structure, namely submission/masochism, forbidden sexual activities, dominance / sadism, mysophilia, and fetishism (Schippers et al., 2021). The current study was an empirical replication to examine whether these findings generalized to a representative population sample. An online, anonymous sample (N = 256) representative of the Dutch adult male population rated 32 unusual sexual interests on a scale from 1 (very unappealing) to 7 (very appealing). An exploratory factor analysis assessed whether similar factors would emerge as in the original study. A subsequent confirmatory factor analysis served to confirm the factor structure. Four slightly different factors of sexual interest were found: extreme, illegal and mysophilic sexual activities; light BDSM without real pain or suffering; heavy BDSM that may include pain or suffering; and illegal but lower-sentenced and fetishistic sexual activities. The model fit was acceptable. The representative replication sample was more sexually conservative and showed less sexual engagement than the original convenience sample. On a fundamental level, sexual interest in light BDSM activities and extreme, forbidden, and mysophilic activities seem to be relatively separate constructs.
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