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PubMed2006

[Pediatric disability of the upper extremity and quality of life questionnaire: reliability, validity, and sensitivity to change].

OBJECTIVE: The aim of this study was to develop a specific questionnaire, designed to evaluate health-related quality of life of children and adolescents with congenital or acquired anomalies of the upper extremity. MATERIAL AND METHODS: Children who underwent operative or conservative treatment of the upper extremity at Kaunas University of Medicine Hospital and Kaunas Red Cross Hospital or conservative treatment at Kaunas Sanatorium "Zibute" and Druskininkai Sanatorium "Saulute" participated in the study. A total of 99 parents and 56 adolescents with congenital or acquired anomalies of the upper extremity filled out the questionnaires. The data were analyzed by the program SPSS 12.0.1 for Windows. RESULTS: Two versions of questionnaire were developed: one for parents of children and adolescents aged 5-18 years and another - for adolescents aged 11-18 years. Both versions consist of seven scales: self-care, daily activities, sports activities and hobby, self-image, emotional, social health, and patient's satisfaction with treatment. The testing of questionnaire reliability was performed by estimating a Cronbach alfa coefficient which varied from 0.80 to 0.97 for different scales of questionnaire designed for parents. The item-scale correlation was from 0.44 to 0.89. There was a statistically significant difference among separate items for all scales (p<0.001). The intraclass correlation coefficient ranged from 0.84 to 0.89 for all scales. Cronbach alfa coefficients of scales of questionnaire designed for children varied from 0.83 to 0.95, and item-scale correlation was moderate to strong. A statistically significant difference among separate items for all scales was obtained (p<0.001). The intraclass correlation coefficient varied from 0.79 to 0.86. The Pearson's correlation coefficient between questionnaires developed for parents and children was calculated, and strong correlation between corresponding scales was found. Sensitivity to changes was tested, and t-test was performed. A statistically significant difference in all scales was found (p<0.001).

Adolescent↗
PubMed2006

Factors related to frequency of engaging in outside activities among elderly persons living an independent life at home.

We examined by cross-sectional design the association between the frequency of outside activity and the demographic, health problem, lifestyle, psychosocial and environmental factors among 239 community-dwelling elderly Japanese people (105 men and 134 women) aged 65 years and older, who lived independently at home. The associations of the outside activities more than 6-7 days per week based on a categorical questionnaire choice with potential factors were expressed by odds ratio (OR) and 95% confidence interval (CI) calculated through logistic regression analysis by sex. The proportions of those engaging in outside activity more than 6-7 days per week were 38.1% and 21.6% among men and women, respectively. The associations of the factors belonging to various fields with the frequency of engaging in outside activities were clearly pronounced among men. Elderly men engaging in outside activities more often were scored less for depression and more socially active than men engaging in outside activities less often. Multiple regression analysis revealed meeting and talking often with friend (OR=4.18, 95% CI: 1.06-16.5), current alcohol consumption (3.01, 1.06-8.54), having any hobby (3.59, 0.94-13.7), and easy access to public transportation (3.43, 1.28-9.16) as significant or borderline significant factors related to engaging in outside activities more than 6-7 days per week. Women who were currently employed engaged in outside activities more frequently. The frequency of engaging in outside activities was associated with factors belonging to various fields among elderly people living independently, particularly among men, suggesting its usefulness as an indicator of comprehensive well-being.

Activities of Daily Living↗
PubMedDate not supplied

National epidemiologic surveillance systems of asbestos-related disease and the exposed workers register.

INTRODUCTION: Italy was the main European producer of asbestos for most of the 20th century and raw asbestos imports wee also significant until the 1990's; there was a mean delay of about ten years in the pattern of asbestos consumption in Italy compared with the USA, Australia, UK and Scandinavian countries. METHODS: A national surveillance system (ReNaM) was implemented to identify cases of mesothelioma and investigate the modalities of asbestos exposure. A register of exposed workers and a database of companies presumably involved in the asbestos exposure problem was also developed. ReNaM has a regional structure and an operative centres (COR) have been established in 16 Italian regions. RESULTS: The ReNaM database currently contains more than 5,000 mesothelioma cases and for 3,500 of these exposure modalities have been defined. Cases of pleural mesothelioma represent 93% of the total but there were also 334 cases of peritoneal mesothelioma, 15 of the pericardium and 14 of the tunica vaginalis of the testicle. Cases with ascertained exposure are thus distributed: 67.4% occupational exposure (ascertained, probable, possible), 4.3% domestic, 4.2% environmental and 1.3% hobby-related exposure, totalling 77.2%; 22.8% had unlikely or unknown exposure. The latency period is very long: on average 43.6 years. The register of asbestos-exposed workers contains figures on exposed workers notified to ISPESL up to 2004 and refers to the exposure period 1993-2003. The data registered cover 160 firms and about 700 workers. CONCLUSIONS: A national, coordinated and uniform epidemiological surveillance system of cases of mesothelioma and the definition of asbestos exposure through active research is extremely important in identifying unexpected contaminating sources. The register of asbestos-exposed workers allows risk to be monitored and protection measures to be implemented.

Aged↗
PubMed2006

Things we talk about, how frequently, and to whom: frequency of topics in everyday conversation as a function of gender, age, and marital status.

The questionnaire "Things I Talk About, How Frequently, and to Whom" measured the frequency with which people discussed 27 topics in everyday conversation. Twenty-three topics were subdivided into the topic in which content concerned a spectator perspective or a participant perspective. Factor analyses of 515 people yielded 5 factors for each perspective. Among the topic factors were beauty, worldly issues, everyday issues, hobbies, and sports and partying. Gender and age differences were observed not only in frequency of talk but also with whom people conversed. A detailed analysis of the kinds of spectator sports people talk about was included.

Adolescent↗
PubMed2006

[Limited geriatric assessment of the elderly in Kibbutzim of the Upper Galilee].

BACKGROUND: Since comprehensive geriatric assessment (CGA) is very time and money consuming, its implementation is limited in Israel. OBJECTIVE: Implementation of the ambulatory limited geriatric assessment (LGA). TARGET POPULATION: Persons over 65 years of age living in Kibbutzim in the Upper Galilee. METHODS: As in the case of CGA, the emphasis in LGA is mainly placed on the functional status of the elderly. In order to identify geriatric syndromes, we used routine screening methods. According to the agreement with Clalit Health Services, a geriatrician is allowed to spend one hour per person. The elderly to be checked were selected by the medical staff. At the time of LGA, medical staff and patients' relatives supplied all information needed, including this data in computerized ambulatory cards. In such a way, a considerable amount of medical, functional, epidemiological, and psychosocial information was retrieved thus enabling a geriatrician to elaborate individual programs of follow-up and treatment. A geriatrician could request additional consultations and analyses. Two years later the medical staff in the kibbutzim completed anonymous questionnaires referring to the remote results of LGA. RESULTS: A total of 121 elderly persons were included in the LGA, performed during the period 2001-2003. The main causes of patients' referral to LGA were the known geriatric syndromes, namely functional and cognitive decline, anxiety and depression, falls etc. We assessed: (1) epidemiological data: age, gender, familial state, education, number of children, place of residence, (2) clinical data: number of both geriatric syndromes and drugs, recent changes in weight, hearing, and vision, (3) functional status: activities of daily living (ADL) and instrumental activities of daily living (IADL), falls, risk of self-inflicted injury, work, hobbies, social activity, the need for familial and social support, (4) cognitive and psychosocial status including depressive symptoms and anxiety, sleep disturbances, casualties in families or among friends, changes in mood and fears. After conducting the LGA, we recommended changes in the drug treatment, nursing, rehabilitation, institutionalization, and social help, if needed. Analysis of anonymous questionnaires showed that both medical staff and elderly in kibbutzim were satisfied with LGA implemented at the old persons' residence, they noted availability and high professional levels of LGA, additionally, they reported on the successful implementation of recommendations. The method became routine in the Upper Galilee. CONCLUSION: Since CGA is a very time- and money-consuming procedure, LGA has been tested and appears to be effective in the identification of geriatric syndromes. Within one hour of assessment, a geriatrician could retrieve a lot of the relevant information that allowed him to build individual programs for follow-up, prophylactic measures, drug and rehabilitation treatment and institutionalization.

Aged↗
PubMed2006

[What do cancer chemotherapy outpatients want?--results of a questionnaire survey].

We conducted a questionnaire survey to evaluate patients at the cancer chemotherapy center of the university of occupational and environmental health hospital from January to March 2006. Thirty-three (61.1%) and 5 (9.2%) of 54 patients wished to receive chemotherapy on an outpatient basis and as inpatients, respectively. Among the reasons for wishing to be treated as outpatients were the following: Keeping in touch with family, not wanting to be hospitalized, a desire to work, and the wish to continue hobbies, at 45.5 (15/33), 36.4 (12/33), 24.2 (8/33), and 24.2 (8/33), respectively. Twenty-four (44.4%) patients voiced concerns about chemotherapy at an outpatient clinic in terms of associated adverse events, feeling bad about causing trouble to their family, and the desire to have consultations at night or on holidays. Thirty-eight (70.4%) patients wished to have chemotherapy within 3 hours, and 42 (77.7%) of them requested improvements in the examinations, time, duration of chemotherapy, and the effect of chemotherapy. These findings indicate that a major part of patients wish to receive cancer chemotherapy at an outpatient clinic within 3 hours. However, they also have serious reservations about any associate adverse events. We therefore need to improve the overall environment for cancer chemotherapy patients in order to allow them to feel safe when undergoing such treatments.

Ambulatory Care↗
PubMedDate not supplied

Quality of life in long-term survivors of the Hemopump left ventricular assist device.

The courses of 10 patients (nine men and one woman; mean age, 54 years) were reviewed to determine the long-term results of treatment with the Hemopump (Nimbus Medical, Inc., Rancho Cordova, CA) left ventricular assist device. Indications for treatment were postcardiotomy cardiogenic shock (n = 8) and acute cardiac allograft rejection (n = 2). Two of the patients with postcardiotomy shock required a bridge to transplantation. At follow-up (mean, 21 months), eight patients were alive: four were in New York Heart Association Functional Class I and four were in Class II. None had long-term adverse effects that were attributable to the site of insertion (e.g., limb ischemia or infected groin wounds). All the patients considered themselves independent in their daily activities, and most of the patients were able to exercise and pursue hobbies. The Hemopump appears to offer long-term survival with an acceptable quality of life to a population of patients whose survival would have been highly unlikely otherwise.

Activities of Daily Living↗
PubMed1991

Nicardipine as antihypertensive monotherapy: positive effects on quality of life.

The effects of nicardipine and propranolol on patients' quality of life were compared during a double-blind, multicentre, parallel, randomised study of hypertension therapy. After a placebo run-in period, the doses for each patient were successfully titrated to reduce supine diastolic blood pressure to less than 90 mmHg with either nicardipine 60 or 90 mg/day (123 patients) or with propranolol 90-240 mg/day (120 patients). Both drugs demonstrated similar efficacy in reducing systolic and diastolic blood pressure. Total duration of therapy ranged from 6-12 weeks. The Nottingham Health Profile questionnaire was used to assess the effect of each treatment on the patients' quality of life. The overall quality of life score for patients on nicardipine showed a tendency toward improvement, while for those on propranolol, the trend was toward overall worsening. The differences between the two treatment groups were statistically significant for males (P = 0.02). The analysis of the separate components of this evaluation demonstrated that physical mobility was reported to be decreased more for the propranolol-treated patients than for the nicardipine-treated patients (P = 0.02). In contrast to the propranolol-treated patients, the nicardipine-treated patients reported improvements for sleep, social life, work, sex life, and for activities related to hobbies and interests. A second questionnaire was used to assess the effects of the therapies on work productivity. Among those patients who worked for pay, more patients treated with propranolol than those treated with nicardipine rated themselves as less productive at work (P = 0.02).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

[Changes in personality and hypertension. The "athymhormic" syndrome].

In 3 hypertensive patients, aged 57 to 66, profound behavioral and personality changes occurred rather abruptly, characterized by total loss of spontaneous activity and initiative, apathetic behavior, passivity, lack of drive and motivation, loss of interest for any of previous occupations and hobbies, and total flatness of affect. Neurological examination was normal or only showed mild extra-pyramidal signs. Neuropsychological evaluation was only remarkable for mild intellectual impairment suggestive of frontal lobe dysfunction. None of the 3 patients fulfilled criteria for dementia or severe depression. This neurobehavioral syndrome has been coined "athymhormic syndrome" (Habib & Poncet, 1988), a term emphasizing the specific defect in drive ("horme") and affect ("thumos"). Electrical and clinical heart examination was unremarkable. Blood pressure was always found within normal limits during hospitalization, including 24-hour monitoring in one case. However, all patients were known as hypertensive in the past, with repeated bouts of high blood pressure (up to 270 mmHg systolic in one case). X-ray CT-scan was usually normal or showed non-specific white matter changes (so-called "leukoaraiosis"). In all 3 cases, a brain MRI scan showed multiple small infarcts mainly involving deep subcortical structures (caudate nuclei and/or adjacent periventricular white matter) of both hemispheres, consistent with the definition of lacunes.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1991

A comparison of quality of life before and after arthroplasty in patients who had arthrosis of the hip joint.

Quality of life before and one year after total hip arthroplasty was evaluated in fifty-six patients who had arthrosis of the hip joint. There were twenty-one men and thirty-five women, and the median age was sixty-five years (range, thirty to seventy-nine years). Before and after total hip arthroplasty, a functional assessment was done with the Charnley-Merle d'Aubigné scoring system. The patients assessed quality of life using the Nottingham Health Profile. In the comparison of quality of life before and after the arthroplasty, significant improvement was observed regarding pain (p less than 0.0001), energy (p less than 0.0001), sleep (p less than 0.0001), and social isolation (p = 0.001). Similarly, there was a significant reduction in the frequency of health-related problems pertaining to housework (p less than 0.0001), holidays (p less than 0.0001), hobbies (p = 0.0001), social life (p less than 0.0001), sexual function (p = 0.001), and family life (p = 0.0005), and among patients who were sixty-five years old or less and who worked at paid employment (p = 0.04). Quality of life after total hip arthroplasty was in close agreement with that of a healthy reference group of similar age and sex distribution. It was concluded that quality of life after total hip arthroplasty is improved considerably. The Nottingham Health Profile is a valuable tool in the evaluation of the result of, as well as the indicators for, total hip arthroplasty.

Activities of Daily Living↗
PubMed1991

[Solitude at all ages].

The feeling of loneliness follows us throughout our lives--we can't get away from it, maintains the author. However, we can learn to cope with loneliness in a positive way, by discovering how to enjoy our own company. Even from earliest infancy, children can be given the security and self-confidence needed to resist the inevitable separations from their parents and significant others. For adults, the author suggests concrete ways in which loneliness can be mastered and overcome. For example, sharing one's house with another person, having a pet, doing volunteer work, travelling, taking up a hobby, etc. In short, we need to reach out to life and not wait for it to come to us.

Adaptation, Psychological↗
PubMed1990

The Nottingham Health Profile--a measure of health-related quality of life.

Assessment of quality of life has attracted increasing interest in recent years. A standardized way of evaluating quality of life is by using questionnaires. One such, the Nottingham Health Profile (NHP), measures health-related quality of life within the sections of energy, sleep, emotions, pain, mobility and social isolation as well as the frequency of health-related problems pertaining to paid employment, housework, hobbies, family life, social life, sex life and holidays. The NHP is well-documented with regard to reliability and validity, and is useful in describing the impact of chronic disease. The NHP is, moreover, a useful evaluative tool in patients with more pronounced disability.

Adult↗
PubMed1990

[Pollen allergy as an occupational disease in gardeners].

Pollinosis due to pollens of insect-pollinated ornamental plants is only acquired under special work specific conditions of exposure, first of all in manual pollination for seed production and in cultivation of new sorts. In a big plant nursery and in hobby gardeners we found 8 cases of pollinosis to cyclamens, 3 to begonia, 1 to gloriosa rothschildiana and 1 to several kinds of lilies. The confirmation as occupational disease and a successful prevention of relapses require a change of the work place. Hyposensitization may be tried. For a primary prevention recommendations are made.

Adult↗
PubMed1990

Regulation of epidermal growth factor receptor signal transduction. Role of gangliosides.

The addition of gangliosides to tissue culture cells causes a decrease in the tyrosine protein kinase activity of the epidermal growth factor (EGF) receptor and an inhibition of EGF-stimulated growth. Based on these data, the hypothesis that the EGF receptor is physiologically regulated by gangliosides has been proposed by E.G. Bremer, J. Schlessinger, and S. Hakomori (J. Biol. Chem. (1986) 261, 2434-2440). To test this hypothesis, a mutant Chinese hamster ovary cell line (clone Idl D) that has a reversible defect in the biosynthesis of gangliosides (Kingsley, D.M., Kozarsky, K. F., Hobbie, L., and Krieger, M. (1986) Cell 44, 749-759) was investigated. The human EGF receptor cDNA was expressed in the mutant cells, and the properties of the EGF receptor were examined using cells grown under permissive and nonpermissive conditions. Changes in ganglioside expression were not observed to cause any significant alterations in the affinity or number of EGF receptors detected at the cell surface. However, decreased levels of ganglioside expression were associated with 1) increased EGF receptor autophosphorylation on tyrosine residues, and 2) increased EGF-stimulated cellular proliferation. The inverse correlation observed between the level of ganglioside expression and signal transduction by the EGF receptor is consistent with the hypothesis that the function of the EGF receptor is physiologically regulated by gangliosides.

1-Deoxynojirimycin↗
PubMed1990

A review of screening instruments for assessing cognition and mental status in older adults.

Older adults in non-psychiatric acute and long-term care settings need to be screened routinely for cognitive function and mental status by clinicians and health care providers. Screening instruments increasingly are being used in order to evaluate programs, implement clinical decisions and conduct research. The purpose, scope and depth of needed assessment guides the selection of the screening instrument. This article critically reviews 11 screening instruments used to assess cognitive function and mental status in older adults: Dementia of the Alzheimer Type Inventory, Brief Cognitive Rating Scale, Blessed Dementia Scale, Cognitive Capacity Screening Examination, Cognitive Levels Scale, FROMAJE, Global Deterioration Scale, Mini-Mental State Exam, Clinical Dementia Rating, Mental Status Questionnaire and the Short Portable Mental Status Questionnaire. Since cognitive impairment is a broad construct, the descriptors used to search the literature were the following: age-associated memory impairment, acute confusional states, Alzheimer's disease, cognition, confusion, delirium, dementia, mental status, multi-infarct dementia, Pick's disease, primary degenerative dementia, pseudodementia and senile dementia of the Alzheimer's type. The Brief Cognitive Rating Scale and the Dementia of the Alzheimer Type Inventory are the only two instruments capable of distinguishing Alzheimer's from other dementias, and the CDR is the only instrument that assesses hobbies.

Aged↗
PubMed1990

[Ray amputation of the hand].

The aim of a ray amputation is to improve the cosmetic appearance and function of the hand after finger amputation. Pain, reasons of appearance and impaired function of amputation stumps are good indications. The patient's occupation, hobbies, handedness and emotional attitude regarding the amputation should be assessed when ray amputation is considered.

Adolescent↗
PubMed1990

Double penetrating nail injury to the eye: a case report.

We report an unusual double penetrating eye injury in which a 26 mm carpenter's nail pierced the eye. The nail penetrated the sclera equatorially and pierced the retina posteriorly just above the superior temporal retinal vascular arcade. Six hours following the injury the nail was removed from the eye, trans-scleral cryotherapy was applied to the entry site, and an episcleral silicone band was used to create an encircling buckle. Visual acuity at 2 months and most recently at 33 months following the injury was 20/30. This case demonstrates that selected double penetrating injuries of the posterior segment may be successfully managed with conventional scleral buckling techniques and underscores the importance of protective eye wear for hobby work or leisure activities.

Adult↗
PubMed1990

Starting out. The first six months posthospital for spinal cord-injured veterans.

Thirty-one former patients were contacted 6 mo after their completion of a spinal cord injury rehabilitation program: 14, paraplegics; 8, complete quadriplegics; 9, incomplete quadriplegics. Mean age was 38.5 yr. Most respondents were living in a family setting. Income ranged from substantial to barely adequate. Half of the respondents needed no assistance with activities of daily living; for the others, family members were the primary helpers. Almost all described their social contacts as sufficient for their needs. Half had not needed to use community resources for the disabled; the others had used a range of resources. Two respondents were employed, four were in school, six others had plans for eventual employment. Neither extent of disability nor income seemed related to likelihood of entering the workforce. Most respondents reported frequent local travel; some had traveled extensively. The large majority engaged in one or more hobbies and/or physical activities. Just over half of the respondents had had no sexual activity after discharge. Of the sexually active, half had found the experience frustrating. Except for the 30- to 39-yr-old respondents, the majority expressed satisfaction with most aspects of their lives.

Activities of Daily Living↗