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PubMed1988

Myocardial infarction may induce positive changes in life-style and in the quality of life.

Eighty-four male patients with a mean age of 56.4 years were subjected to a semistructured interview 12-21 weeks after acute myocardial infarction. Twenty-eight individuals (group A) perceived a considerably or somewhat improved total life situation, 39 patients an unchanged (group B) and 17 patients (group C) a somewhat or considerably worsened total life situation. In all groups there were appreciable alterations with respect to stress on the job, physical activity and intake of fat/calories. Sixty per cent had reduced or quit smoking, and 19% had reduced their alcohol consumption. Fifty per cent of the patients perceived an increased gratitude at being alive. Similar recordings were found regarding "joy of life", value of hobbies, family and having good health. Concern associated with a reduced health status was experienced as the most distressing consequence of MI. There were no significant differences between groups A, B and C with respect to severity of the MI in contrast to the number of "psychiatric cases" (GHQ). The study concludes that it is considered important also to discover and reinforce possible positive changes after MI.

Adult↗
PubMed1992

Emotional and social aspects of cancer pain.

The emotional and social consequences of pain were studied in 93 consecutive in-patients, 44 males and 49 females, suffering from cancer-related pain. The methods used were Visual Analogue Scales (VAS), standardized interviews and comprehensive self-questionnaires. Forty-seven patients (51%) experienced certain or pronounced anxiety (4-6 or 7-9 on a 9-grade scale) because of their pain and 66 patients (71%) expressed depressive pain-associated symptoms, which had a high correlation with the intensity of their pain. Physical activities such as movements, dressing/undressing, washing, cooking were hampered in about 2/3 of the patients and mental activities such as reading were significantly disturbed in 48% of the cases. For every social activity listed in the questionnaires (hobbies, seeing friends, etc) most patients reported a decreased activity because of pain and in most cases the decrease correlated significantly with the intensity of the pain. The family roles had changed since the patient could not participate in a usual manner. The study underlines the profound consequences of pain: physical suffering, emotional distress, social handicap and altered family roles. Thus, pain control should be a high-priority matter in palliative care.

Activities of Daily Living↗
PubMed1992

Noise levels from toys and recreational articles for children and teenagers.

This study examined the noise level emitted by toys and recreational articles used by children and teenagers. The results indicate that many of the items tested emit sufficiently intense noise to be a source of noise induced hearing loss in school-age children. While the baby toys provided noise exposure within the limits of national regulations, they are most intense in a frequency range that corresponds to the resonance frequency of the external auditory canal of very young children. Hobby motors emit noise that may require protection depending upon the length of use. Fire-crackers and cap guns emit impulse noises that exceed even conservative standards for noise exposure.

Adolescent↗
PubMed1996

Weightings of items on the Code-Müller Protocols: the effects of clinical experience of aphasia therapy.

One hundred and twenty-two professionals engaged in aphasia therapy (graduates and undergraduates) ranked and weighted the relevance of the items of the Code-Müller Protocols (CMP) for assessing perceptions of psychosocial adjustment to aphasia using the multiattribute utility technique (MAUT). The degree of clinical experience with aphasia had a significant influence on participants' weightings of the items 'ability to follow interests and hobbies' and 'receiving speech therapy'.

Adaptation, Psychological↗
PubMed1985

A retrospective assessment of inhalant abuse in the barrio: implications for prevention.

An interview questionnaire was administered to a group of primarily Hispanic identified inhalant users (N = 40) and a comparison group of neighborhood youths (N = 17) in the barrio of Phoenix, Arizona. This retrospective assessment revealed that inhalant abusers had a history of multiple problems, stressors, and difficulty with school and the criminal justice system; initiated drug use between the ages of 10 and 15; confined their drug use primarily to marijuana, alcohol, and inhalants; and often came from families with drug problems. Inhalant abusers from drug-involved families experienced more poverty and family disruption, perceived their friends as being more favorable to the use of drugs and inhalants, and were less involved in conventional youth activities (e.g., sports, school, church, hobbies) than were inhalant abusers from drug-free families. The results are discussed in terms of developing preventative programs for this population.

Adolescent↗
PubMed1997

Acute hemiarthroplasty after proximal humerus fracture in old patients. A retrospective evaluation of 18 patients followed for 2-7 years.

We evaluated the outcome of acute shoulder hemiarthroplasty in 18 patients following displaced three- and four-part fractures of the proximal humerus. The mean age of the patients was 82 (70-92) years and the average follow-up time was 3.5 (2-7) years. No revision due to loosening was performed. All patients were evaluated concerning activities of daily living, degree of pain (VAS-scale, 0-100 mm) and range of motion. The patients had a low functional level, but were able to sleep on the operated side and keep up their hobby. 11 patients were painfree and the worst pain recorded was 28 mm. Range of motion for all movements, except extension, was statistically significant lower than for the non-operated side. We conclude that in elderly patients acute hemiarthroplasty following three- or four-part fractures of the proximal humerus results in good pain relief, but a more limited range of motion than that reported for younger patients.

Activities of Daily Living↗
PubMed1997

Quality of life after knee arthroplasty. A randomized study of 3 designs in 42 patients, compared after 4 years.

We assessed different yardsticks for outcome 4 (3-5) years after surgery in a prospective, randomized study of 42 patients, where 3 designs of cemmentless knee prostheses were used. The prognosis with regard to loosening, previously obtained by radiostereometry after 2 years of follow-up, was utilized. Patients with a prognosis of stable implant fixation (two thirds) were compared with those where loosening was predicted (one third). Hospital for Special Surgery score and Visual Analogue Scales regarding pain at rest, "first step" pain, pain during activity and global function, showed consistent postoperative improvements, but no differences between the design and prognosis groups were found. Radiolucent lines were registered both as yes/no and number of zones. Lines and prognosis were associated, but not lines and design groups. Quality of life assessment by the Nottingham Health Profile questionnaire showed that the poor prognosis group had increased pain and significant disturbances of sleep and emotions, as well as difficulty in enjoying hobbies and holiday activities. No differences were found between the design groups. Altogether, the patients showed profiles comparable to a healthy reference group. We conclude that the Nottingham Health Profile is a sensitive, relevant and simple measure of outcome after knee arthroplasty.

Activities of Daily Living↗
PubMedDate not supplied

Human exposure assessment and relief from neuropsychiatric symptoms: case study of a hairdresser.

Human exposure assessment and the results of implementing 'precautionary avoidance' suggested a relationship between a hairdresser's neuropsychiatric symptoms and occupational exposure to potentially hazardous chemicals. A variety of investigations in response to patient complaints of depression, emotional instability and various physical symptoms revealed no objective abnormality; the CH2OPD2 mnemonic (community, home, hobbies, occupation, personal habits, diet and drugs) recommended by the Ontario College of Family Physicians was used as a first-line screening tool to assess potential environmental exposure to toxins. After occupational leave of absence, the patient reported cessation of symptoms. Environmental causes for familiar medical problems are frequently undiagnosed; it is recommended that, where appropriate, a screening tool for evaluation of environmental exposure to toxics be incorporated into primary care assessment and management of patients.

Adult↗
PubMed1994

[A survey of the improvement of public transportation for the elderly. Reasons for giving up driving by retired automobile workers living in in Kanagawa Prefecture].

In order to improve the adequacy and safety of transportation for elderly people, the reasons for, and the after-effects of stopping driving by elderly people were analyzed. The subjects consisted of 500 car manufacturing retirees, aged 60 years old and over, living in Kanagawa prefecture. Of the 500 people questioned, 298 people (59.6%) responded. Of these 196 currently held licences. In this group, 149 still drove, 9 intended to stop driving soon, and 38 had already stopped. Of the 38 people who had already stopped driving, 7 quit before age 55. These people were omitted from analysis because factors other than aging possibly contributing to their stopping driving. We were interested in the 31 people older than 55 and the 9 people who intended to quit soon. The results were the following: I) The main reasons why they had stopped driving were the following: a) anxiety felt because of decreased driving ability and the feeling to need to walk in order to improve their health; b) the needlessness of driving because of availability of other means of transportation; II) The anxiety from decreased driving ability correlated with difficulty with narrow roads and imparied vision making it difficult to observed road signs; III) The reasons for stopping driving correlated with the effects: the needlessness of driving because of use of other means of transportation correlated with decreased frequency of going out for hobby and group activities. These results show that stopping driving also affects the social activities of the Japanese elderly. It was concluded that we should inform the elderly drivers of the effects of stopping driving as well as improving conditions on roads and comfort in automobiles.

Aged↗
PubMed1996

[Travel outside the home and perceived problems with such travel, among elderly people in a small town].

To study travel outside the home by elderly people and perceived problems with such travel, a questionnaire was sent to 238 men and women aged 60-year-old and over living in a small town in Kanagawa prefecture. Public transportation in this town consists mainly of buses, and the bus ride from the nearest train station takes about 50 minutes. A total of 190 people responded (83.3%, after exclusion of those who had died, moved away, or were in the hospital). Of those 190 people, 166 (74 men and 92 women) went out by themselves and their responses were analyzed. About 50% of both men and women said that they go to the hospital once or twice a month and go out for hobbies less than several times a year. The means of transportation differed according to sex and age: 80% of men in their 60s said that they drive alone, but many men in their 70s and older said that they ride buses or walk. Women in all the age studied said that they ride buses or drive with others. More than 50% of men and women reported problems with transportation: men reported anxiety about driving alone and women reported difficulties with the poor means of transportation or when walking upstairs or uphill. Many men and women in their 80s said that they would rather not be driven places by others or be helped by others while riding trains or buses. These findings show the patterns of travel outside the home by elderly people of different ages, and the problems these people perceive with regard to various modes of transportation. They should be useful in the design of transportation suitable to older people.

Activities of Daily Living↗
PubMed1996

[Negative effect of perceived transportation problems on social activities of elderly people living in a small town far from the nearest train station].

Social activities such as visiting friends or participating in community groups have been shown to correlate positively with active health promotion, more frequent physical exercise, and maintenance of activities of daily living in older people. Social inactivity may result from personal factors such as physical condition and from environmental factors such as limited means of transportation. To study the latter factors, we focused on perceived transportation difficulties and on the influence of those perceptions on the daily activities of elderly people. We sought to test the hypothesis that perceived transportation problems restrict health promotion or social activities and accelerate the decline in activities of daily living, and also to determine how transportation can be improved. A questionnaire was sent to 238 people (a fifth of the population) aged 60 years or older who were living in a small town in Kanagawa prefecture. Buses are the principal mode of public transportation from their residences to the nearest train station and the trip takes about 50 minutes. Responses were received from 190 persons (83.3%, excluding those who had died, moved, or were in the hospital). Of the respondents, 166 (74 men and 92 women) went out by themselves and their responses were subjected to logistic regression analysis. The results revealed the following points. (1) For both men and women, riding buses to the hospital was associated with a greater perception of problems with respect to convenience, physical exertion, or anxiety when crossing the road. (2) Among women, greater perceived inconvenience of transportation correlated with a lower frequency of going out for daily shopping; a higher frequency of visiting friends correlated with greater perception of physical exertion. (3) Among women, the main desire was to visit friends. Men indicated that they wanted to be more active in hobbies. The women indicated that the main reason they do not fulfill their desires was that transportation is inconvenient. These findings indicate that perceived transportation problems can prevent elderly people, especially women, from going out for health promotion and social activities. This indicates that to support social activities of elderly people, the means of transportation should be made more convenient and more physically accessible, and local circumstances should be taken into consideration.

Activities of Daily Living↗
PubMed1999

[A study of the degree of burden and subjective sense of well being in care-givers involved in home care].

We investigated the degree of burden on care-givers and their subjective sense of well being, and studied the factors affecting them. Twenty people who were responsible for at least a year for constant care of elderly or bed-ridden patients under visitation care and nursing supervision of this hospital were registered. Regarding the care-givers, we investigated age, sex, duration of care, the relations between the care-givers and the cared-for, assistant care-givers, profession and hobbies, if any, of the care-givers, the depression scores; the social support, the degree of burden imposed by care, and the subjective sense of well being. As for the cared-for, we investigated their age, disease and degree of ADL. The burden felt by the care-giver became greater if the care-giver was a woman (p < 0.05), if the relationship with the cared or the health status of the care-giver was poor (p < 0.05, respectively), and if the scores for functional and emotional support networks were poor (p < 0.005 and p < 0.05, respectively). As for the cared-for, the burden was greater if they were older (p < 0.05) and if it was difficult for them to leave bed (p < 0.05). The sense of subjective well being of the care-giver was greater if there was an assistant care-giver (p < 0.005); if the scores for the functional and the emotional support networks were higher (p < 0.05, respectively): and if understanding of information in terms of ADL was not adequate (p < 0.05). The present study suggested the importance of improving the emotional and functional support networks for the care-giver in helping them continue care by alleviating the burden and not suffering a loss in the subjective sense of well being.

Aged↗
PubMed1999

[Sex differences in subjective well-being and related factors in elderly people in the community aged 75 and over].

Sex differences in factors related to subjective well-being were evaluated in people in their late old age by interviewing individuals aged 75 years and over living in 2 regions of Enzan City, Yamanashi Prefecture. The 17-item revised "Philadelphia Geriatric Center (PGC) Morale Scale" was used for evaluation of subjective well-being. Factors related to family status, employment, health related factors, activities of daily living, and results of physical examinations were each classified into two or more categories, and PGC Morale Scale points were compared among the categories for all subjects and separately for males and females using the Mann-Whitney test and the Kruskal-Wallis test. 1) Although the mean age of males (80.0 +/- 4.4 years) and females (80.4 +/- 4.3 years) was no significantly difference, PGC Morale Scale points were significantly higher in males than in females (p < 0.05), indicating a sex difference in subjective well-being. 2) In elderly females, subjective well-being was related to many factors, and there was a particularly strong relationship between subjective well-being and both health related factors and activities of daily living. 3) In elderly males, the factors related to subjective well-being were fewer than in females, consisting only of "social opportunities", "hobbies", and "grip strength". Since factors related to subjective well-being differ between the sexes, these differences must be taken into account when evaluating subjective QOL of the elderly.

Aged↗
PubMed1999

Bilateral contemporaneous posteroventral pallidotomy for the treatment of Parkinson's disease: neuropsychological and neurological side effects. Report of four cases and review of the literature.

The authors report the underestimated cognitive, mood, and behavioral complications in patients who have undergone bilateral contemporaneous pallidotomy, as seen in their early experience with functional neurosurgery for Parkinson's disease (PD) that is accompanied by severe motor fluctuations before pallidal stimulation. Four patients, not suffering from dementia, with advanced (Hoehn and Yahr Stages III-IV), medically untreatable PD featuring severe "on-off" fluctuations underwent bilateral contemporaneous posteroventral pallidotomy (PVP). All patients were evaluated according to the Core Assessment Program for Intracerebral Transplantations (CAPIT) protocol without positron emission tomography scans but with additional neuropsychological cognitive, mood, and behavior testing. For the first 3 to 6 months postoperatively, all patients showed a mean improvement of motor scores on the Unified Parkinson's Disease Rating Scale (UPDRS), in the best "on" (21%) and worst "off" (40%) UPDRS III motor subscale, a mean 30% improvement in the UPDRS II activities of daily living (ADL) subscore, and 60% on the UPDRS IV complications of treatment subscale. Dyskinesia disappeared almost completely, and the mean daily duration of the off time was reduced by an average of 60%. Despite these good results in the CAPIT scores, one patient experienced a partially regressive corticobulbar syndrome with dysphagia, dysarthria, and increased drooling. No emotional lability was found in this patient, but he did demonstrate severe bilateral postoperative pretarsal blepharospasm (apraxia of eyelid opening), which interfered with walking and which required treatment with high-dose subcutaneous injections of botulinum toxin. No patient showed visual field defects or hemiparesis, but postoperative depression, changes in personality, behavior, and executive functions were seen in two individuals. Postoperative abulia was reported by the family of one patient, who lost his preoperative aggressiveness and drive in terms of ADL, speech, business, family life, and hobbies, and became more sleepy and fatigued. One patient reported postoperative mental automatisms, such as compulsive mental counting, and circular thoughts and reasoning during off phases; postoperative depression was found in two patients. However, none of the patients demonstrated these symptoms during intraoperative microelectrode stimulation. These findings are compatible with previous reports on bilateral pallidal lesions. A progressive lowering of UPDRS subscores was seen after 12 months, consistent with the progression of the disease. Bilateral simultaneous pallidotomy may be followed by emotional, behavioral, and cognitive deficits such as depression, obsessive-compulsive disorders, and loss of psychic autoactivation-abulia, as well as disabling corticobulbar dysfunction and apraxia of eyelid opening, in addition to previously described motor and visual field deficits, which make this surgery undesirable even though significant improvement in motor deficits can be achieved.

Activities of Daily Living↗
PubMed1996

[Dip-shaped hearing loss of Békésy audiogram in high school students].

Small dip-shaped hearing loss may be frequently observed on Bekesy audiograms in ears without any hearing loss on pure tone audiograms. Hearing tests and otoacoustic emission measurements were performed in club member of 2 senior high schools (K-D School and S-D School), in order to determine any relationship between inner ear impairments and the small dips on Bekesy audiograms. In the kendo, soccer, tennis and orchestral music clubs of K-D School micro-dips in depth over 10 dB were found to have incidences between 40% and 53%, and the micro-dips were distributed in frequencies above 5 kHz. In the of kendo, tennis, brass band and tea ceremony clubs of S-D School the incidences of micro-dips ears were between 30% and 48%, and the micro-dips tended to be distributed in higher frequencies except in the tea ceremony club. The micro-dips in the ears of the tea ceremony club members were distributed over all the frequencies examined, but most of them disappeared when counted for dip size above 15 dB remaining an ear at 7.5 kHz. Incidences of earphone or headphone users as a hobby were in the range of 30 to 70% in members of all clubs. There were no characteristic findings of clubs in the incidences of the earphone or headphone users. The degree of association between the micro-dip ears and the use of earphone or headphone was low. C-EOAEs which had a 6 ms or longer duration of evoked otoacoustic emissions were detected with an incidence of 40 to 65% and there was a significant association between the micro-dip ears and the C-EOAE ears. Incidences of spontaneous otoacoustic emissions were between 26% and 28% in all clubs and there were differences in the incidences between sexes. The frequency distribution of the spontaneous otoacoustic emissions were remarkably different to that of the micro-dips. To determine whether the C-EOAEs express a predisposition to inner ear susceptibility to noise-induced hearing loss and to ascertain that the micro-dip is a precursor notice to noise-induced hearing loss, further follow-up surveys are needed.

Adolescent↗
PubMed2005

[A correlational study among perceived stress, anger expression, and depression in cancer patients].

PURPOSE: This study was to identify the relationship between perceived stress, anger expression, and level of depression in cancer patients. METHOD: A cross-sectional descriptive study design was used. Data was collected by questionnaires from 185 in- and out-patients who were diagnosed with cancer at 3 university hospitals and the National Cancer Center using Spielberger et al.'s Anger Expression Scale, Cohen, Kamarch & Mermelstein's Perceived Stress, and Derogatise's SCL-90. The data was analyzed using descriptive statistics, Pearson correlation coefficient, and stepwise multiple regression with SAS/PC. RESULT: The perceived stress in cancer patients indicated a significant positive correlation to anger-in(r=.288, p=.000), anger-out(r=.232, p=.001), and depression(r=.68, p=.000), but no significant correlation to anger-control. The anger-in of cancer patients showed a significant positive relationship to anger-out(r=.53, p=.000), and depression(r=.383, p=.000), but no significant correlation to anger-control. Anger-out showed a significantly negative correlation to anger-control(r=-.248, p=.001) and a positive correlation to depression(r=.240, p=.001). The most significant predictor which influenced depression in cancer patients was perceived stress, followed by anger-in and hobby, and these factors explained their depression with a variance of 54%. CONCLUSION: These results suggested that cancer patients with a high degree of perceived stress are likely to be high in anger-out and anger-in. Perceived stress and anger-in are major factors which affect depression in cancer patients.

Adult↗
PubMed2005

Cutaneous larva migrans--a case report.

Cutaneous larva migrans or creeping eruption is an uncommon parasitic skin infection caused by the filariform larvae of dog or cat hook worms. We report a case of larva migrans on the anterior abdominal wall, in a 52 year old lady, who did gardening as a hobby.

Abdomen↗
PubMed1988

Outpatient treatment for an adult with traumatic brain injury.

In this case, occupational therapy was invaluable for continuity of care and facilitating the earliest possible successful return to work. The major goal of rehabilitation was for Aaron to prepare to go back to work by relearning or refining all the necessary physical, cognitive, emotional, and perceptual skills. This specialized occupational therapy plan meant that unnecessary services, and therefore unnecessary expenditures, were avoided. Occupational therapy intervention allowed for open communication between the family, the employer, the insurance carrier, and the physician. Throughout treatment, the insurance carrier received regular monthly reports supplemented with periodic telephone updates. The carrier commented favorably on the initial evaluation, believing the information to be comprehensive and relevant. The occupational therapist provided the family with medical information to decrease confusion over medical terminology, provided support as appropriate within the context of treatment, and demonstrated ways that the family could become more involved in Aaron's rehabilitation. Through the weekly treatment sessions and direct observation, Marie was able to more fully understand the scope of her husband's disability. It is interesting to contrast the hospital findings and the findings of the private therapist. Aaron had been diagnosed as having severe visual-spatial deficits on the standardized, clinical tests; however, he showed only limited deficits when tested in functional situations in the familiar home environment 2 weeks later. This contrast demonstrates occupational therapy's unique role in the home setting, where the therapist is able to use relevant and meaningful activities directly related to the client's roles, hobbies, interests, and cultural experiences. The flexibility possible at home should enhance cooperation and success.(ABSTRACT TRUNCATED AT 250 WORDS)

Accidents, Occupational↗