God, AIDS, Africa & HOPE

pensées of a Catholic priest

Fatigue and the lack of the art to think long-term

I guess nobody wants to be in the shoes of those in political office when it comes to Covid-19. Even when the theoretical threat of a pandemic was known to academics and politicians alike, Corona visited without real warning – and the Chinese system to hide unpleasant truth did not help in being prepared. Italy paid the heaviest price at the beginning of the pandemic arriving in Europe, but meanwhile many more countries experience what it means if the implicitness of daily life is pulled away from societies.

Of course in the times of social media, we have millions of people who know it better – and whatever politicians say or do, it is wrong for quite a portion of society and pepped up by fake news, ideology and outright concious lying we have arrived in split societies all over the world: those who rebel against any sort of restrictions or even questioning the pure existence of the virus and others on the other margin of society who can’t live without their daily dose of sanitizers on everything which theoretically could bring danger into their homes.

There are also massive failures to be noticed; in my country of residence I could mention :
the ordering of vaccines by the South African government and its non-existing transparency in this regard is an example for failure to live up to the duty of those in charge; there are also noticeable behaviour patterns, which warrant criticism like the visible sheer lust for authoritarian rule as presented by some ministers and the inability of thinking with logic and consistency or deliver the needed services at all.

Globally we see fatigue when it comes to rules regarding restrictions – and the willingness to adhere to seemingly every day changing rules is clearly going down. Generally besides all complexity there is one notion which seems to be present in all countries and societies:
The lack of the art to think long-term.

It does not matter where you look, the four or five years election circles in most democracies have changed the mindset of those in charge – instead of long-term vision there are only short-term thinking having the next voting day in mind – even in non-democratic countries like China there is the tendency visible to act and react rather with short-term vision pacifying people on a certain level. Gone are the days when leaders had real visions bigger than life and certainly their political life-span. Contributing to this short circuit thinking is certainly also the instant “feedback” via social media; the phrase “shitstorm” has entered the realms of communication and decision-making, and it is often not to the benefit of society.

Looking at my country of birth Germany – the currently constant onslaught in headlines promising more lockdown, harder lockdown, longer lockdown as a permanent feature is contrarily to fostering compliance and adherence to rules. The very core of being human: closeness, touch and social interactions are on the list of forbidden fruits in pandemic times – and only measured action and perspective given in positive language will bring people to endure hardship in this regard on the long run. Pushing, threatening, confusing through changing messages will spill back – making up and pretending are the enemies of compliance and peaceful adherence.

A clear indication of the state of mind is the non-celebratory reaction of the advent of available vaccines: instead of celebrating science rightfully for working hard and in short time to bring a solution to the table, in most countries the mourning and questioning of facts and advances is mind-boggling. And it should give cause to serious reflection.

Filed under: General, Politics and Society, Reflection, Society and living environment, South Africa, Uncategorized, , , , , , , ,

POZ magazine: Fatigue Common in People With HIV, Often Linked to Psychological Factors

Up to 88 percent of people with HIV experience fatigue, and psychological problems appear to be one of the most likely culprits, according to a study published online June 2 in AIDS. Fatigue has historically been a common problem among people living with HIV, with prevalence rates approaching 90 percent in some studies. Untreated fatigue can lead to unemployment and social isolation, and it can reduce people’s ability to effectively care for themselves. To examine fatigue in HIV disease in the modern treatment era, Eefje Jong, MD, of Slotervaart Hospital in Amsterdam, and her colleagues analyzed data from 42 studies published between January 1996 and August 2008. In addition to wanting to learn more about the prevalence of fatigue in more recent years, the researchers set out to understand the factors—including demographic, physiological, psychological and HIV-specific issues—associated with the condition. They also hoped to gain a better sense of the most effective treatment modalities for the condition. In previous studies, researchers have found that between 20 and 60 percent of people with chronic HIV infection, and up to 85 percent of people with an AIDS diagnosis, have suffered from fatigue at one time or another. In the studies reviewed for Jong and her colleagues’ analysis, fatigue prevalence rates ranged from 33 to 88 percent. The demographic factors most consistently predictive of fatigue were younger age and unemployment. The authors hypothesized that older people might report less fatigue because they had more effective coping strategies or more time to adjust to medication regimens. Studies that examined race, sex and income were not consistent, though lower income was associated with greater fatigue in at least one study. In terms of HIV-related issues, CD4 and viral load were not consistently linked with fatigue, though people with more HIV-related symptoms were more likely to have the condition. Studies on comorbid conditions—such as diabetes and hepatitis B or C—were mixed, with some studies finding a connection with fatigue and others showing no connection at all. Surprisingly, body weight and composition appeared to have no bearing on fatigue, nor did blood levels of proteins related to inflammation, such as interleukin-6 (IL-6) or tumor necrosis factor (TNF) alpha. Some studies showed that lower testosterone levels predicted fatigue, but others did not. Of all the factors considered, psychological disorders—particularly depression and anxiety—had the strongest and most consistent connection with fatigue. Sleep problems also predicted fatigue. Though the total hours a person slept didn’t have an impact, people who napped during the daytime were more likely to suffer with the problem. Finally, while a number of treatments for fatigue were explored in the studies, medication was not consistently helpful. Medications with the strongest evidence of fatigue treatment were testosterone and psychostimulants, including Adderall (dextroamphetamine) and Ritalin (methylphenidate hydrochloride). Non-medicinal interventions were more helpful, however, especially cognitive behavioral therapy. Graded exercise therapy (GET) is another possible option to fight fatigue. With GET, a person logs his or her daily activity and increases it to the point where the exercise begins to worsen symptoms. GET has been successful in HIV-negative people with chronic fatigue syndrome, but no good recent studies focused on HIV-positive people. Though exercise and fatigue studies have been conducted in people with HIV, the authors chose not to include any of them in their analysis, because none used a validated instrument for assessing fatigue either before or during the exercise intervention. “Currently the evidence for interventions with medication is not strong,” the authors said. “Behavioral interventions and GET seem more promising.” Because fatigue is so common, and so dramatically reduces a person’s quality of life, the authors urge care providers to assess their patients for the condition. The researchers state that “in case of fatigue, clinicians should not search only for physical mechanisms, but should question depression and anxiety in detail.” Finally, the authors are calling on researchers to develop an evidence-based approach to screening and treating fatigue in people with HIV.

Source: http://www.poz.com/rssredir/articles/hiv_fatigue_psychological_761_18540.shtml

Filed under: HIV and AIDS, HIV Treatment, Medical and Research, , , ,

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