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PubMed2003

[UCLA/RAND Cancer Prostate Index quality of life questionnaire after external beam radiotherapy for localized prostate cancer: repercussions of complications and quality of life in general].

INTRODUCTION: This study was designed to evaluate the quality of life after external beam radiotherapy for localized prostate cancer using the UCLA/RAND Cancer Prostate Index questionnaire. MATERIAL AND METHODS: An accurate translation of the questionnaire was retrospectively sent to 108 patients treated for localized prostate cancer by exclusive external beam radiotherapy between 1989 and 1999. The reference values adopted for comparison were those observed by Litwin in a control population without prostate cancer. Patient subgroups were constituted according to the presence or absence of neoadjuvant endocrine therapy and laboratory signs of progression (ASTRO). RESULTS: The response rate was 61.1%, the mean age of the patients was 71.9 years and the mean follow-up was 46.5 months. The percentage of patients "living in a couple" or with "a serious relationship" was 93.4% Three quarters of the population declared that they were "satisfied" or "very satisfied" with the treatment performed. General quality of life scores were comparable to those of Litwin's control population. A functional alteration and decreased tolerance of impairment were observed, in decreasing order, for the sexual, gastrointestinal and urinary factors. CONCLUSION: External beam radiotherapy essentially alters quality of life related to gastrointestinal and sexual functions, while the only aspect of urinary function studied by this questionnaire is continence.

Aged↗
PubMedDate not supplied

[Quality of life of patients during treatment of type I diabetes. Importance of a questionnaire focused on the subjective quality of life].

The aims of this study were 1) to study the quality of life in diabetic patients receiving one of two different forms of insulin delivery and 2) to check in this disease, the reliability and responsiveness of a questionnaire (SQLP: subjective quality of life profile) which we have previously used and validated in other pathological states. A total of 743 Type 1 diabetic subjects, receiving two different forms of insulin injection completed this questionnaire twice, at a monthly interval. These patients stressed a certain number of somatic manifestations as well as their difficulty to move around or perform every-day life activities. The results from this trial show that the questionnaire was capable of demonstrating that the easiest mode of insulin injection was selectively and significantly related to a higher satisfaction with being able to move around.

Adult↗
PubMed1993

[A questionnaire suitable for general practice for detection of the health status and quality of life of patients with hemato-oncologic diseases: psychometric properties. The Study G "Quality of Life" of the International Society for Chemo- and Immunotherapy (I.G.C.I.)].

In the evaluation of therapeutic measures it is important to consider the consequences of the proposed treatment on the subjective quality of health and the subjective quality of life. Since no adequate instrument existed to provide such assessments, a short, theoretically based questionnaire was developed and psychometrically tested. The construction phase was based on data of 104 adults with haemato-oncological diseases, leading to the design of a questionnaire which was tested using data of a further 292 patients. The validity of the "questionnaire for attitudes towards quality of health and quality of life" was assessed by comparing it with physicians' ratings and by correlation with the results of an extensive questionnaire. The reliability was satisfactory; the questionnaire met with high acceptance by patients, physicians and health care personnel. It complies with the requirements of clinical trials where the objective is to measure quality of health and quality of life.

Adaptation, Psychological↗
PubMed1996

End of life decisions at the beginning of life.

Modern neonatal intensive care technology enhances the ability to maintain vulnerable newborns. In some circumstances survival may be insufficient justification for care. "End of life" strategies, originally applicable to adults, are being considered for newborns. Unresolved ethical issues in the care of these newborns involve multiple considerations. Concern occurs regarding patient-centered beneficence, non-maleficence, distributive justice, futility, legal rights of infants, and autonomy. The benefits to a newborn of treatment may fail to overcome the burdens of subsequent life. Under what circumstances a newborn loses the right to have life prolonged becomes a difficult ethical issue. With time and debate the proper response will become implemented.

Decision Making↗
PubMed1996

Life and death in Hawaii: ethnic variations in life expectancy and mortality, 1980 and 1990.

Life expectancy in Hawaii is among the highest in the nation. Past research, however, found significant ethnic differences in longevity. This study presents life expectancy estimations for 1980 and 1990, along with ethnic differences in mortality rates for specific causes of death. The findings suggest that ethnic differences continue, with Chinese and Japanese having the longest life expectancy and Native Hawaiians having the shortest.

Asian↗
PubMed1998

[Measuring the quality of life of children and adolescents with asthma--The Pediatric Asthma Quality of Life Questionnaire].

Quality of life becomes more and more important in evaluating the effects of treatments. At the moment, different questionnaires to measure quality of life in children and adolescents with asthma are available. The Paediatric Asthma Quality of Life Questionnaire (PAQL) was developed by Juniper and co-workers in Canada and has already been translated into German. It is a self- or interviewer-administered instrument for children and adolescents between age 7 and 17. The PAQL contains 23 items in three domains: activity limitation, symptoms, and emotional function. The empirical results suggest that the PAQL is reliable and sensitive to clinical change. Problems associated with the administration are discussed.

Adolescent↗
PubMed1985

[Marriages, divorces, and number of children: life tables on the family life cycle in Austria].

A multistate life table approach to the analysis of the family life cycle is outlined. "After calculating one-dimensional nuptiality and divorce tables and presenting a recently developed model of a fertility table based on parity, a multi-state model is described in which the cells represent all possible combinations of marital status and parity." The model is applied to data from the 1976 and 1981 micro-censuses of Austria. Findings regarding marriage, divorce, fertility, and fertility differentials by education are discussed. (summary in ENG)

Austria↗
PubMed1984

Growth rate and life span in Drosophila. III. Effect of body size and developmental temperature on the biphasic relationship between growth rate and life span.

The previous finding of a biphasic relationship between life span and growth rate of Drosophila, developed at 25 degrees C, was confirmed at other temperatures in the usual range (19-28 degrees C) and for development in either a standard medium or one deprived of nutrients but with varying amounts of yeast added on the medium. The role of body size in this relationship was studied by developing flies in a nutrient-less medium with a constant, submaximal amount of added yeast and varying temperature. It was found that under these conditions, which abolished the usual inverse relationship between body size and developmental temperature, body size variations did not account for the observed variations in life span. Thus, corroborating previous studies from this laboratory, body size was ruled out as a causative factor in the life span-growth rate relationship.

Animals↗
PubMed2004

Influence of early life exposures on incidence and remission of asthma throughout life.

BACKGROUND: Knowledge of the effects of early environmental and congenital factors on the natural history of asthma may provide important clues to the pathogenesis of asthma. OBJECTIVE: We assessed associations between potential, early determinants and the incidence and remission of asthma throughout life, and tested whether the strength and direction of these associations varied in childhood, adolescence, and adulthood. METHODS: The data pertaining to the individual asthma history of 18,156 subjects, age 0 to 44 years, who attended the clinical stage of the European Community Respiratory Health Survey were analyzed retrospectively by life-event methods. Onset of asthma was defined as age at the first attack, and asthmatic patients were considered to be in remission if they had not been under treatment or had an attack of asthma in the past 24 months. Onset and remission were evaluated in 3 time windows: <10, 10 to 20, and > or =20 years of age. The associations of asthma with early determinants were estimated by hazard ratios (HRs). RESULTS: A family history of asthma or allergy was associated with a higher risk of developing asthma (HR, 1.89; 95% CI, 1.67-2.13) and a lower chance of remission (HR, 0.79; 95% CI, 0.64-0.99) throughout life. No matter what one's genetic predisposition was, early, acute respiratory infections were associated with an increased lifelong risk of asthma onset (pooled HR, 3.19; 95% CI, 2.75-3.69), whereas early contact with older children, which is a marker of prolonged, intermittent exposure to infectious agents, conferred permanent protection against asthma (HR, 0.84; 95% CI, 0.74-0.96) and increased the chance of remission in childhood asthma (HR, 1.50; 95% CI, 1.10-2.04). Pet ownership had a protective effect only in childhood (HR, 0.78; 95% CI, 0.74-0.96), whereas maternal smoking did not show a significant association with asthma. Female sex was negatively associated with the onset of asthma in childhood (HR, 0.62; 95% CI, 0.52-0.75) and positively in adulthood (HR, 2.01; 95% CI, 1.61-2.51). The pattern of associations was similar in sensitized (positive assay to specific IgE) and nonsensitized asthmatic patients. CONCLUSION: Genetic predisposition and exposure to infectious agents are major early determinants that influence a subsequent history of asthma. The length and type of exposure to infectious agents seem able either to promote or to suppress an anti-inflammatory process, unrelated to IgE, which can partially interfere with an acquired predisposition for asthma.

Adolescent↗
PubMed2005

Life cycle assessment of EPS and CPB inserts: design considerations and end of life scenarios.

Expanded polystyrene (EPS) and corrugated paperboard (CPB) are used in many industrial applications, such as containers, shock absorbers or simply as inserts. Both materials pose two different types of environmental problems. The first is the pollution and resource consumption that occur during the production of these materials; the second is the growing landfills that arise out of the excessive disposal of these packaging materials. Life cycle assessment or LCA will be introduced in this paper as a useful tool to compare the environmental performance of both EPS and CPB throughout their life cycle stages. This paper is divided into two main parts. The first part investigates the environmental impacts of the production of EPS and CPB from 'cradle-to-gate', comparing two inserts--both the original and proposed new designs. In the second part, LCA is applied to investigate various end-of-life cases for the same materials. The study will evaluate the environmental impacts of the present waste management practices in Singapore. Several 'what-if' cases are also discussed, including various percentages of landfilling and incineration. The SimaPro LCA Version 5.0 software's Eco-indicator 99 method is used to investigate the following five environmental impact categories: climate change, acidification/eutrophication, ecotoxicity, fossil fuels and respiratory inorganics.

Environmental Monitoring↗
PubMed2001

Effect of environmental manipulation in pregnancy and early life on respiratory symptoms and atopy during first year of life: a randomised trial.

BACKGROUND: Asthma places huge demands on health-care services, and its prevalence is increasing. Reduction of exposure to environmental allergens could offer a realistic chance for primary prevention. Our aim was to ascertain whether or not living in a low-allergen environment reduces the risk of asthma and atopic diseases in infants. METHODS: We assigned infants to four risk groups according to parental atopic status. We enrolled 291 high-risk couples (both parents atopic, no pets) into a prospective, prenatally randomised, cohort study, and allocated them to environmental manipulation, in which measures to reduce prenatal and postnatal allergen exposure were undertaken (active HRA) (n=145) or no intervention (control HRC) (n=146). Two further prospective groups were studied: 161 high-risk infants with pets in the home (HRP group) and 168 low-risk infants, whose parents were both non-atopic (LR group). The main outcome measures were signs and symptoms of atopic disease at 1 year of age. FINDINGS: 103 families dropped out or were lost to follow up. At age 1 year we followed-up 133 HRA, 118 HRC, 140 HRP, and 126 LR infants. Children in the HRA group were less likely to have respiratory symptoms during the first year of life than those in the HRC group. The most pronounced differences were in the relative risks for severe wheeze with shortness of breath (relative risk 0.44 [95% CI 0.20-1.00]), prescribed medication for the treatment of wheezy attacks (0.58 [0.36-0.95]), and wheezing after vigorous playing, crying, or exertion (0.18 [0.04-0.79]). Probability of respiratory symptoms in HRC and HRP infants was similar, whereas it was much lower in the LR than in the HRC group. Cat ownership was significantly associated with sensitisation to cats (24.6 [3.04-199.05]; p=0.003). INTERPRETATION: Environmental manipulation reduces some respiratory symptoms in the first year of life in high-risk infants. Further follow up is needed, however, to ascertain whether living in a low-allergen environment reduces allergy and asthma in later life.

Allergens↗
PubMedDate not supplied

Evaluation of quality of life in children and teenagers with allergic rhinitis: adaptation and validation of the Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ).

BACKGROUND: in the last decades, the study on life quality has stimulated an increasing interest among health researchers. Instruments to evaluate the chronic disease impact on patients day-by-day, have been developed and published by researchers in many countries. The objective of this study was to adapt to the Portuguese Language (Brazilian culture), the RQLQ questionnaire (Rhinoconjunctivitis Quality of Life Questionnaire), destined for life quality evaluation in teenagers with allergic rhinitis. METHODS: in the beginning of the study, a list with 75 items, translated from the original article, was applied to 57 teenagers with perennial allergic rhinitis. The most frequent and troublesome items were selected to compose the modified questionnaire. The validation, reproducibility and responsiveness of the new instrument were evaluated through an interview with 52 patients before the beginning of the treatment, and of 2 and 4 weeks after the treatment. The obtained scores in these interviews were statistically analyzed to verify the questionnaire capacity to detect clinical improvement after the treatment. RESULTS: a significant difference was observed between the total score and those regarding domains, obtained at the first evaluation, compared to later evaluations. A positive correlation was also observed during the treatment, between the questionnaire score and the patient grades related to nasal symptom severity. CONCLUSIONS: the adapted questionnaire is reproducible, valid to be used in longitudinal studies and useful as an instrument of evaluation, but it should be submitted to other investigations to consolidate its properties.

Activities of Daily Living↗
PubMed1996

The social impact of Life Education: estimating drug use prevalence among Victorian primary school students and the statewide effect of the Life Education programme.

Evaluations of drug education programmes focus on the effect on participating students. Although this is appropriate, where programmes are institutionalized the wider population impact should also be considered. This paper examines this argument and provides a practical methodology for examining programme impacts on populations. It illustrates this using the example of the Life Education (LE) programme-a mature early intervention programme operating internationally-on the Victorian (Australia) population of Year 6 schoolchildren. Data from a recent evaluation of Life Education in Victoria, Australia, were re-analysed enabling estimation of adjusted attributable risk percentage (which provide an estimate of programme effect among those who are exposed to it), population prevalence estimates and population attributable risk percentage (which provide estimates of programme impacts on the entire population). In 1992 when the data were collected LE operated in 43% of all Victorian primary schools. The findings showed that within LE-schools 43% of girls' and 35% of boys' recent smoking was attributable to participation in the LE-programme. For drinking within LE-schools, while there was no apparent effect on girls, the programme was associated with 40% of boys' recent drinking. When the data were extrapolated to the state-wide smoking and drinking estimates, these showed that of all smoking among Year 6 schoolchildren, 25% of girls' and 19% of boys' smoking could be attributed to participation in Life Education, as could 22% of all boys' recent drinking. This re-analysis showed there was no preventive effect associated with the programme, at either the school or the population level. The findings suggest that intervention programmes should be thoroughly evaluated prior to widespread implementation, and that such evaluations should include reference to the community-wide impacts of such programmes.

Adolescent↗
PubMed1982

Effect of feeding beta-sitosterol alone or in combination with cholestyramine during early life on subsequent response to cholesterol challenge in adult life in guinea-pigs.

The effect of feeding 20 g beta-sitosterol/kg alone or in combination with cholestyramine (20 g/kg) during neonatal life of guinea-pigs on their subsequent response to a dietary cholesterol challenge in adult life was examined. 2. beta-Sitosterol pretreated animals showed higher plasma cholesterol values following 2 weeks on a cholesterol challenge (2-5 g/kg) diet, but did not differ significantly from control values for the remainder of the cholesterol challenge period. 3. Guinea-pigs pretreated with beta-sitosterol plus cholestyramine, on the other hand, showed a marked increase in plasma cholesterol levels over those of controls during the cholesterol challenge period, and this "hyper-responder" behaviour was maintained throughout the study period. 4. Despite the increase in plasma cholesterol, beta-sitosterol plus cholestyramine pretreated animals excreted significantly (P less than 0.05) greater amounts of bile acids and total sterols. 5. These findings demonstrate that neonatal pretreatment with beta-sitosterol plus cholestyramine has detrimental effects on the handling of a cholesterol challenge in adult life, and does not achieve the beneficial effect previously noted with pretreatment with cholestyramine alone.

Animals↗
PubMed1992

Meaning in life and psychological well-being: an empirical study using the Chinese version of the Purpose in Life questionnaire.

The Chinese version of the Purpose in Life questionnaire (C-PIL) was administered to 2,150 Chinese secondary school students, along with other instruments assessing psychiatric symptoms and positive mental health. Total C-PIL and its two subscales, Quality of Existence (QEXIST) and Purpose of Existence (PEXIST), correlated significantly with all measures of psychological well-being. Relative to PEXIST scores, QEXIST scores were found to be more predictive of psychological well-being. Subjects with different existential status (defined by high vs. low levels of QEXIST and PEXIST) were associated with different degrees of psychological well-being. The concept of meaning in life, as indexed by the C-PIL, and the hypothesis that life meaning is related to psychological well-being require further elaboration and refinement.

Adaptation, Psychological↗
PubMed1971

Studies on the life history of lymphocytes. I. The life-span of cells responsive in the mixed lymphocyte interaction.

The life history, within the rat, of lymphocytes responsive to histocompatibility isoantigens in the mixed lymphocyte interaction was examined by the use of in vivo labeling with tritiated thymidine and radioautography. Lymphocytes in the peripheral blood and H-ARC (mitotic figures in the MLI) were compared with respect to the frequency of labeled cells and the median grain count. The following conclusions were drawn from this study: (a) Although some can be considered long-lived, the majority of H-ARC are the products of recent divisions in the body. (b) Adult thymectomy does not eliminate the production of long-lived lymphocytes, some of which are H-ARC. Hence, in addition to direct origin in the thymus, H-ARC, as well as other lymphocytes of the long-lived lymphocyte population, may derive from already existing thymus-derived cells in the circulation and thymus-dependent areas of the secondary lymphoid tissues. (c) Sublethal X-irradiation (600 R) in combination with adult thymectomy does not eliminate the capacity to produce some long-lived lymphocytes, however, few if any are H-ARC. (d) H-ARC and other long-lived lymphocytes appear to go through a series of rapid multiple divisions before they enter the circulation. Thereafter, long-lived lymphocytes appear to undergo intermittent single divisions which decrease both the frequency and median grain count of labeled cells gradually with time. On the other hand, labeled H-ARC maintain a more stable grain count despite a rapid decrease in frequency with time. This is taken to indicate that H-ARC are less likely to undergo occasional single divisions during their life-span, but may undergo periodic rapid sequential divisions. A speculative model is developed from these data on the life history of H-ARC which may be of predictive value in future studies and which can be tested against known facts.

Animals↗
PubMed2003

Completing a life: development of an interactive multimedia CD-ROM for patient and family education in end-of-life care.

There are relatively few comprehensive and empowering educational tools to assist people with terminal illness in addressing important end-of-life issues. Identifying this scarcity, a design team of health and multimedia professionals created an interactive, educational CD-ROM entitled Completing a Life. The primary goal of the project was to provide rich content in a style that was easy to access, understand, and use. The interactive medium of the CD-ROM enabled a large amount and wide array of material to be presented in manageable segments. These segments are connected by hyperlinks, providing self-guided control over the selection, pace, and order of material. The CD puts the learning experience in the hands of the learner. The format and design is also intended to generate a sense of empowerment, at a time and around issues often associated with a loss of control. Completing a Life covers a wide range of information for the user to choose from, spanning physical, emotional, family, and spiritual issues. A calm and comforting tone and welcoming environment enhances the users' ability to take in the information and make proactive decisions about his/her own well-being and care. The CD contains video narratives of individuals who tell their own stories of living with terminal illness. In addition to being a highly relevant means of conveying sensitive, health-related information, this collection of personal interviews may offer a form of "virtual support group" for the user. Finally, the interactive format allows stories and informational content to be linked in topic-specific ways that complement one another.

CD-ROM↗
PubMed2005

Who enrolls in observational end of life research? Report from the cultural variations in approaches to end of life study.

BACKGROUND: Response bias in end of life research is important though not well understood. OBJECTIVES: To compare consenting advanced cancer patient participants and refusers in observational end of life research. We hypothesized that, compared with refusers, consenters would: 1) have a stronger belief in personal gain from research participation, 2) be more satisfied with their medical care, 3) be more satisfied with support from family and friends, and 4) be in less physical discomfort compared with refusers. METHODS: Sixty eight patients consented to enroll in the 'parent' observational study. Thirty six patients refused to participate. Reasons for refusal were recorded verbatim and coded using qualitative techniques. Both patient consenters and patient refusers were asked the same questions regarding personal gain, satisfaction with medical care, family and social support, and physical discomfort. RESULTS: Consenters believed that they had more to gain from participation in research compared with refusers (p = 0.04). Consenters felt that aches or pain were more of a problem for them compared with refusers (p < 0.001). Both satisfaction with medical care and with support from family and friends were similar between consenters and refusers. CONCLUSIONS: Consenting study participants in observational research at end of life believe they have more to gain from study participation than do refusers. Contrary to our hypothesis, consenting participants were those who were experiencing greater physical discomfort compared to refusers.

Cultural Diversity↗