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Late imperial epidemiology, part 2
Published in Vivienne Lo, Michael Stanley-Baker, Dolly Yang, Routledge Handbook of Chinese Medicine, 2022
Several other scholars have contributed to an expanding trend to contextualise historically Chinese disease concepts. French historians Catherine Despeux and Frédéric Obringer published a book analysing concepts of the ‘cough’ (ke 咳, sou 嗽) that focused on actors’ categories in ancient and medieval Chinese medicine (Despeux and Obringer 1997). In the history of modern medicine in China, Bridie Andrews analysed how Chinese physicians first assimilated as well as questioned germ theory from the 1850s to 1930s through their various translations of the Western disease concept ‘tuberculosis’ (fei jiehe 肺結核 ‘lung tubercule’), including the Chinese disease concept literally meaning ‘exhaustion disorder’ (laobing 癆病) that corresponded well with the English ‘consumption’ (Andrews 1997). Angela Leung carried out a historical-conceptual analysis of the changing meanings of the Chinese disease concept ‘numbing wind’ (mafeng 痲瘋), which had many overlapping symptoms with those subsumed under the modern disease concept Hansen’s disease or the outdated leprosy (Leung 1999).
Medical History in Three Themes
Published in Marta E. Hanson, Speaking of Epidemics in Chinese Medicine, 2012
Scholars have yet to write historical biographies of diseases outside of western Europe and East Asia. When they do, they will undoubtedly center on nosologies different from those of modern bioscience. In the mean time, there have been a few studies of change in individual Chinese disease concepts.12 Catherine Despeux and Frédéric Obringer paid particular attention to these issues in their monograph on conceptions of the cough (ke 咳, sou 嗽) in ancient and medieval Chinese medicine.13 Bridie Andrews complicated the story of germ theory's assimilation in China by examining several attempts from the 1850s to 1930s to translate the Western understanding of tuberculosis (fei jiehe 肺結核 “lung tubercule”) in Chinese terms (laobing 勞 病, lit. “exhaustion disorder” or “consumption”).14 Carol Benedict also studied analytical questions in her book Bubonic Plague in Nineteenth-Century China. She cautioned against equating any traditional Chinese disease categories such as febrile epidemics (wenyi) or pestilence (li 癘) with modern-day bubonic plague. Nonetheless, her narrative focuses on the epidemiology of what, using a wide range of historical evidence, she determined was bubonic plague and attempts to control it in the nineteenth century.15 Hilary Smith explicitly used the biography of a disease as a model and investigated shifts in meanings of the disease concept jiaoqi 腳氣 (foot qi) over more than two thousand years. Although jiaoqi covered a range of ailments in medieval China, clinicians now equate it with biomedicine's beriberi and laymen use the word for athlete's foot. Smith reveals how much is hidden beneath the ahistorical and ontological equation of jiaoqi with beriberi.16 In Leprosy in China: A History, Angela Leung analysed the nosology of li, lai 癩 (skin afflictions)17 and mafeng 痲風 (lit. numbing wind), which covered a wide range of skin afflictions, including some resembling leprosy, and transformations in these terms' meanings over centuries following both a historicalistconceptualist and a biography-of-disease approach.18 As the modern disease concept bubonic plague became equated with the late-nineteenth-century neologism shuyi 鼠疫 (lit. rat epidemics)19 and beriberi with jiaoqi, modern leprosy also found Chinese equivalents in li, lai and mafeng. These studies of the history of disease in China have greatly informed my own research on and approach to the history of disease and epidemics in China.
Swedish occupational therapists’ considerations for leaving their profession: Outcomes from a national survey
Published in Scandinavian Journal of Occupational Therapy, 2022
Several of the participating occupational therapists described stress and high work pressure as resulting in development of mental health problems. This is consistent with several previous studies that show that deficiencies in both the organizational and social work environment can lead to various forms of mental health problems [11,12,29–33], including anxiety and depression [12,29]. Additionally, Reis et al. [34] have shown that exhaustion disorder is a major risk among occupational therapists. Previous research performed on the same data as the present study showed that occupational therapists could experience mild to moderate stress symptoms but also lasting symptoms of stress, which potentially indicates exhaustion disorder due to their work [19]. In the study by Gupta and colleagues [35], 34.8% of the included occupational therapists experienced a high level of stress and exhaustion, indicating a risk of developing a pronounced exhaustion disorder. The results of this study clearly demonstrate how work environment deficiencies such as stress and high work pressure can affect occupational therapists, leaving them dissatisfied with their job, at risk of developing mental health problems and at risk of leaving their profession. This needs to be addressed not only by managers but also at a political level to prevent inadequate services for patients. There is however a need to verify these results in a quantitative predictor study.
Perceived job strain among Swedish occupational therapists with less than 10 years of work experience
Published in Scandinavian Journal of Occupational Therapy, 2021
Annika Lexén, Kristine Kalsås, Julia Liiri, Carita Håkansson
As a sector where professionals work closely with other people, health and social work has been shown to have the highest rates of sick leave due to mental health problems resulting from a heavy workload, time pressure, lack of control over the work situation and the need to multitask [16]. Among health care professionals (n = 3719), the highest levels of self-reported exhaustion (37.1%) were among paramedical staff (occupational therapists, social workers, psychologists and physiotherapists) [17]. This is in keeping with a study by Bruschini, Carli and Burla, who found that 32% of the paramedical staff (n = 391) (occupational therapists, speech therapists and physiotherapists) showed signs of mental health problems such as emotional exhaustion and 14% were at high risk of burnout [18]. In a newly conducted study by Lexén and colleagues [1] of 3,658 Swedish occupational therapists, the participating occupational therapists generally rated their workload as heavy, with increased stress as a consequence. In the study, almost a fifth of the participating occupational therapists reported work-related mental health problems in the form of symptoms of mild incipient exhaustion or pronounced exhaustion disorder. For occupational therapists in Sweden, lack of resources and time at work are the main stressors associated with increased levels of stress [19].
Exhaustion disorder and altered brain activity in frontal cortex detected with fNIRS
Published in Stress, 2021
Simon Skau, Ingibjörg H. Jonsdottir, Anna Sjörs Dahlman, Birgitta Johansson, H. Georg Kuhn
The patients were clinically assessed by a physician at a specialist clinic for stress-related exhaustion, the Institute of Stress Medicine in Gothenburg, Sweden and were diagnosed with Exhaustion Disorder ED code F43.8A, ICD-10. Patients received information about the study during a follow up meeting at the clinic or by mail. Those who showed interest to participate were contacted by a research nurse. They were not compensated. All patients had received 12–18 months of multimodal treatment for ED, except one who was eight months in to the treatment at time of inclusion. This treatment has previously been described in detail (Glise et al. 2012). Exclusion criteria for the treatment program were a body mass index less than 18.5 kg/m2 or over 30 kg/m2, high blood pressure, infection, menopause, pregnancy, nursing, vitamin B-deficiency (high homocysteine), known systemic disease such as diabetes or thyroid disease or known psychiatric disease, except depression and anxiety disorder, which are common co-morbidity in the history of ED patients (Glise et al., 2012).