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At least 685 records · Page 38Linked to original sources
PubMed1989

[Progress in surgery and quality of life, quality of life after organ transplantation].

Kidney and liver transplantations are well established surgical procedures. During the past years survival rates have improved 3% of kidney transplantations have 1-year mortality. Subjective quality of life and professional rehabilitation are associated with the graft function parameters of successful therapy. Seventy-six percent of liver-transplanted patients consider their quality of life improved after the operation. 52% are able to return to work. Future efforts must focus on improving immunosuppression for specific tolerance and sensitizing the public to the problems of obtaining organs for transplantation.

Activities of Daily Living↗
PubMed1987

[Quality of life and resumption of social life after heart transplantation].

An enquiry by means of a questionnaire was conducted among 48 patients who had received a heart transplant, in order to evaluate their quality of life and their reinsertion into the french society. Health status, physical capacities, daily social and occupational activities and degree of satisfaction are analyzed. Eighty per cent of the patients considered themselves in excellent or good health; their Karnofsky's index, which globally assesses functional capacities, was 1.6, i.e. close to the normal value of 1 and to the results obtained in heart transplant recipients in the USA and in kidney transplant recipients; 61% of non-retired patients had resumed professional or learning activities. There were little changes in leisure activities. Matrimonial happiness was high, although sexual satisfaction was less complete than normally. Ninety-three per cent were satisfied with their life after transplantation.

Activities of Daily Living↗
PubMed1988

On the decomposition of changes in expectation of life and differentials in life expectancy.

The projection of mortality rates requires inter alia close examination of the mortality experience of a population over a long period of time and will usually also involve the analysis of mortality trends by cause of death. In two of the more important recent contributions, techniques were devised for explaining change in life expectancy in terms of mortality changes in particular age groups and by different causes of death. The approaches adopted by the authors differ, and the purpose of this article is to reconcile the two and tie the results in with those obtained by earlier writers. A new method for explaining the change in a life expectancy differential in terms of the observed changes in the mortality differentials and the observed change in overall mortality level is also described.

Adolescent↗
PubMedDate not supplied

Patients evaluate a quality of life scale: whose life is it anyway?

Patients with cervical cancer were interviewed in a focus group format to obtain their retrospective views of quality of life (QL) in the context of cancer treatment. In addition, they were asked to evaluate the European Organization for Research and Treatment of Cancer's QL questionnaire (EORTC QLQ-C30) as an indicator of their QL. Ethnographic analysis of group transcripts revealed a number of dimensions of QL that these women did not believe were adequately addressed by the EORTC QLQ-C30. They were: (1) perceived control over one's body, (2) a sense of normalcy in one's life, (3) invasiveness experienced as a result of medical interventions, and (4) the degree of predictability of disease and treatment. Patients also indicated that QL was determined more by the meaning and value they placed on their experience than by the occurrence of specific functional changes, symptoms, or side effects. The results have implications for how QL is conceptualized. An alternative model of QL assessment, based on the patient as expert, is illustrated and described.

Adult↗
PubMed1993

Basic Life Support and Advanced Cardiac Life Support changes.

Short article that delineates recent changes in Basic Life Support and Advanced Cardiac Life Support. These changes are based on recommendations from the 1992 National Conference on Cardiopulmonary Resuscitation (CPR) and Emergency Cardiac Care (ECC).

Adult↗
PubMed1997

Combat trauma life support training versus the original advanced trauma life support course: the impact of enhanced curriculum on final student scores.

BACKGROUND: Within a military framework, the trauma course student, a young medical officer, is trained to become a trauma team leader and the first provider of medical aid. By adding battlefield medicine-related subjects to the basic Advanced Trauma Life Support (ATLS) course, as well as exercises tailored to the distinctive demands of military medicine, we could develop a special teaching unit: Combat Trauma Life Support (CTLS). The curriculum is basically the complete unchanged ATLS course of the American College of Surgeons enriched with lectures and practicums to fill the gap between the essentially civilian emergency department character of the ATLS course and the military tasks of the medical officer. PURPOSE OF STUDY: To compare the cognitive knowledge achievements of trauma course participants in the Israel Defence Force Medical Corps and to delineate the impact of the course type on students' written test results. DESIGN: A retrospective comparison analysis of pre- and post-course written test scores of 2,614 physicians who had participated in the ATLS and CTLS courses in the Israel Defence Force School of Military Medicine between 1990 and 1993. RESULTS: The analysis indicated that students who undertook the CTLS course achieved statistically better results in written tests (87.9 +/- 8.7 vs. 79.6 +/- 11.4, R2 = 0.33). CONCLUSIONS: We conclude that the CTLS comprehensive curriculum provides an improved training basis for the complex task of army battlefield trauma care support.

Curriculum↗
PubMed1997

[Health conditions and life styles of residential elderly. Part 1. Characteristics and factors related to being healthy elderly persons from a survey of health life style].

A survey was conducted in a highland community of Gifu prefecture on 815 residential elderly persons, over 65 years old, utilizing self-administered questionnaires to study the degree of association between life style factors and health conditions. A total of 718 valid participants (90.6% of the total) were analyzed and cross-examined by applying Breslow's seven health factors, daily behavior factors, physical health consciousness, social mobility factors (13 behavior factors which were determined by the Institute of the Elderly) to determine associations with respondents health conditions. Of the participants, 310 were male and 408 were female with mean ages of 73.8 +/- 6.9 years old and 74.0 +/- 6.9 respectively. The survey results indicated that there were no prominent gender differences over the mobility rate and physical health consciousness among participants. However, it was also found that in the male participants the per person prevalence of past history of illness was higher than in females. In the daily activity analysis, female participants indicated a higher prevalence of difficulty in walking and balance maintenance while ascending and descending stairs. In the general daily activity analysis, male participants had a higher requirement for an aide. In social mobility, male participants recorded a high degree of self-reliance by being physically, socially, and intellectually active and the female participants by fulfilling their social responsibilities. Breslow's seven health indicators were applied and their evaluation points were calculated as 3.9 +/- 1.7 for male participants and 3.5 +/- 1.8 for female participants which showed a significantly higher score for the male participants. The survey also indicated that factors which increase the Breslow score for males, were having a spouse, hobbies, a satisfactory life, a habit of exercising, and non-smoking which in females an appropriate sleeping habit (not less than 7 hours), and working, were the positively related factors.

Activities of Daily Living↗
PubMed1997

Measuring quality of life in women with osteoporosis. Osteoporosis Quality of Life Study Group.

The objective of the study was to test an instrument for measuring health-related quality of life (HRQL) for women with osteoporosis and back pain caused by vertebral fractures related to osteoporosis. A longitudinal cohort study design was used in which women were seen at baseline, after 2 weeks, and after 6 months. The setting was a secondary care rheumatology practice in Canada and four separate secondary care metabolic bone disease practices in the United States. The patients were 226 women suffering from osteoporosis and back pain with a mean bone mineral density of 0.84 +/- 0.14 g/cm2 and a mean of 2.78 (median 2, range 1-11) vertebral fractures. We administered the Osteoporosis Quality of Life Questionnaire (OQLQ) with 30 items distributed across five domains: Symptoms, Physical Function, Activities of Daily Living, Emotional Function, and Leisure. In addition, we administered the Sickness Impact Profile (SIP), the 36-item short form of the Medical Outcomes Survey instrument (MOS SF-36), and the Brief Pain Inventory (BPI). On the basis of what women told us about the areas of their lives adversely affected by their osteoporosis, we constructed the OQLQ. Reliability coefficients between baseline and 2-week follow-up varied from 0.80 to 0.89 for the five domains. Cross-sectional correlations between OQLQ domains and other measures were consistently higher than predicted (0.51-0.81). The OQLQ proved to be as powerful or more powerful than alternative instruments for detecting improvement or deterioration in patients whose status changed. Sample sizes of less than 150 per group should be required to detect minimally important differences in parallel-group clinical trials. Longitudinal correlations between OQLQ and other measures were generally lower than predicted. This may be due to limitations in either the OQLQ or the other instruments. It is concluded that the OQLQ may prove to be a useful instrument for discriminating between women with different levels of impaired HRQL, and for evaluating change in women undergoing treatment for back pain related to osteoporosis.

Activities of Daily Living↗
PubMedDate not supplied

Organ preservation and quality of life: the quality of life of patients undergoing radiation therapy.

In the definition of quality of life (QL) conventional medical indicators (rate of cure, disease-free survival, side-effects, costs) should be combined with those of the patient's personality the impact of the disease, the level of satisfaction, the general health conditions. This assessment being complex, obviously needs an integration of competences for correct decision making in diagnosis and treatment. In oncology, numerous attempts have been made towards the systematization of toxicity in radiotherapy based on physical and functional rather than multidimensional criteria. However the categorization of possible side-effects according to scoring systems already marks an improvement towards the quality assurance of care and thus the patient's quality of life.

Humans↗
PubMed1998

[Decisions about life and death. An empirical study of the position of Danish physicians concerning end-of-life decisions].

In a postal questionnaire investigation of experiences and attitudes concerning end-of-life decisions among Danish physicians, most of the respondents reported having made decisions involving the hastening of a patient's death, and considered this acceptable. Such decisions were more frequent, and were considered ethically more acceptable, when made with the patient's informed consent than without. Of the respondents, two per cent had participated in assisted suicide, and five per cent had administered a lethal injection at the patient's request, practices considered ethically acceptable by 37 per cent and 34 per cent, respectively, of the respondents. The most frequently cited reasons for opposing such practices were double effect principle, the active killing/allowed-death distinction, and the sanctity of life; and the most frequently cited justifications were respect for the patient's autonomy, the avoidance of unnecessary suffering, and the patient's right to a death with dignity.

Decision Making↗
PubMed1998

Advanced trauma life support versus Combat Trauma Life Support courses: a comparison of cognitive knowledge decline.

This prospective study was conducted to compare cognitive knowledge decline among graduates of the Advanced Trauma Life Support (ATLS) and Combat Trauma Life Support (CTLS) courses in Israel. The investigation was based on multiple-choice questions that tested the results of 211 ATLS and CTLS course graduates and was performed 3 to 66 months after completion of the courses. These results were then compared with the examination outcomes immediately after the course. A statistical model based on survival analysis was used to evaluate the decline pattern and extent and to compare the two courses. No significant difference was found in the rate of decline in knowledge gained from the two courses after a given period. Priority for refresher courses should be set regardless of type of course previously attended by physicians.

Adult↗
PubMed1981

Life span and organ pathology in rats after life-long noise exposure.

The role of ambient sound level in longevity, cause of death, and incidence of disease was investigated in rats. Two hundred twenty-seven rats (154 Sprague-Dawley (N), 73 spontaneously hypertensive Wistar (SH)), were housed in three sound isolated boxes and subjected to controlled acoustic milieus from approximately three months of age until their natural death. Thirty-nine of the N rats were kept as external controls in a regular animal room. In one of the boxes, no noise was introduced (control). In the other two, the rats were exposed, respectively, to a frequency-modulated, chopped noise with an equivalent level of 80 dB Leq and 100 dB Leq, ten hours daily. It was found that the SH animals had a shorter life span and a higher incidence of cardiovascular disease than the N rats but a lower rate of malignant tumors. No measurable effects on life span or total incidence of disease were seen. Minor differences in incidence of various disease entities were observed but were not consistent across groups. The results do not support the hypothesis that physical sound environment represents a significant cause of somatic disease.

Animals↗
PubMed1996

Outlook on life: how adolescents and children view the life-style of parents, adults and self

A new Outlook on Life measure was constructed to identify how adolescents and children see their lives. Three scales were formed and named the View of Parents, View of Adults and View of Self scales. The three scales were found to correlate highly with subjects' emotional state: the more positive views they had of their parents, adults and their own life, the less depressed they felt.

Journal Article↗
PubMed1987

Cholestyramine treatment in early life of low-density lipoprotein receptor deficient Watanabe rabbits: decreased aortic cholesteryl ester accumulation and atherosclerosis in adult life.

Effect of cholestyramine treatment in early life of Watanabe heritable hyperlipidemic rabbits (an animal model lacking low-density lipoprotein receptor activity) on subsequent (6 months recovery) occurrence of natural atherosclerotic lesion and arterial cholesterol metabolism was investigated. Initial cholestyramine treatment decreased both plasma total cholesterol and HDL-cholesterol levels which normalized within 4 weeks after treatment was discontinued. At 9 months of age (age of occurrence of spontaneous atherosclerotic lesions), the extent of aortic atherosclerosis in cholestyramine pre-treated animals was modestly lower (P less than 0.05), as compared to controls, with a significant (P less than 0.05) decrease in aortic cholesteryl ester content. Furthermore, at the end of the recovery period aortic activity of acyl-CoA: cholesterol acyltransferase and neutral cholesterol esterase activity was significantly (P less than 0.05) lower in cholestyramine-pretreated animals. These studies show that early cholestyramine pre-treatment in a low-density lipoprotein receptor-deficient animal model causes persistent changes which might influence cholesteryl ester accumulation and atherogenesis in adult life, even after cholestyramine treatment is discontinued.

Age Factors↗
PubMed1987

Luteinizing hormone and progesterone concentrations in serum of heifers administered a short half-life prostaglandin (PGF(2alpha)) or long half-life prostaglandin analogue (fenprostalene) on days six or eleven of the estrous cycle.

Two trials were conducted to measure the progesterone (P(4)) decline and luteinizing hormone (LH) surge in serum subsequent to administration of a short half-life (short t (1 2 )) prostaglandin (PGF(2alpha)) or a long half-life (long t (1 2 )) prostaglandin analogue (fenprostalene) on Days 6 or 11 of the estrous cycle. Twenty-five crossbred Shorthorn and five Hereford heifers with a mean weight of 331.4 +/- 29.8 kg were used in both trials. The heifers were randomly allotted to receive either a short t (1 2 ) or long t (1 2 ) prostaglandin treatment on Day 6 or 11 of the estrous cycle. A crossover design for the main effect, treatment (type of prostaglandin), was conducted. Heifers that received PGF(2alpha) in Trial I were given fenprostalene in Trial II and vice versa. Stage of the estrous cycle (day) was the same for each heifer in both trials. Stage of estrous cycle was standardized to either Day 6 or 11 by administering Syncro-Mate B (SMB). Blood was collected every hour for 80 h post injection to quantify LH and P(4) concentrations. There were no significant differences (P > 0.05) between the short t (1 2 ) or long t (1 2 ) for either P(4) or LH profiles. In addition, no differences were detected between stages of the estrous cycle for the timing of the preovulatory surge of LH after prostaglandin administration.

Journal Article↗
PubMed1993

Horizontal transfer of ATPase genes--the tree of life becomes a net of life.

An ancient gene duplication gave rise to the catalytic and non-catalytic subunits of each of the three types of proton pumping ATPases: vacuolar, archaebacterial and eubacterial. Previously, this gene duplication has been used to root the universal tree of life. However, recent findings of archaebacterial type ATPases in eubacteria and of eubacterial type in an archaebacterium suggested that both types of ATPases may have been already present in the last common ancestor. Here we show that a phylogenetic analysis of these ATPase subunits indicates that this conclusion is premature. We suggest that horizontal gene transfer can explain the data. In addition, we show that the analysis of glutamate dehydrogenases data neither affirm nor contradict any particular placement of the last common ancestor in the universal tree of life. The prevalence and the mode of horizontal gene transfer is discussed.

Adenosine Triphosphatases↗
PubMed2005

Life-saving or life-prolonging? Interpreting trial data and survival curves for patients with congestive heart failure.

Chronic heart failure is responsible for considerable suffering and mortality throughout the world. Clinical trials have consistently demonstrated the benefits of pharmacological therapies such as angiotensin-converting enzyme inhibitors and beta-adrenoceptor blockers. These drugs are often quoted as reducing mortality from heart failure, yet all patients with heart failure deteriorate and most will die because of their disease. Therapies in heart failure are not truly life saving; they modify the natural history of the disease and delay the time to deterioration. The time benefit in survival is not usually reported in clinical trials, which are conducted over fixed time points and report risk reductions during this period only. In this paper, we discuss the use of prolongation of life statistics as an outcome measure in clinical trials and review simple techniques for calculating the lifetime benefit of pharmacological intervention in heart failure using data from a number of major studies

Clinical Trials as Topic↗
PubMed2006

Women's health in mid-life: life course social roles and agency as quality.

Data from a prospective British birth cohort study showed that women who were childless, lone mothers or full-time homemakers between the ages of 26 and 53 were more likely to report poor health at age 54 than women who occupied multiple roles between these ages. To explain this finding we developed and tested a theory of role quality based on the concept of agency by drawing on Giddens' theory of structuration and Doyal and Gough's theory of human needs. According to our theory, the patriarchal structuration (drawing on Giddens' term) of work and family roles provides both limitation and opportunity for the expression of agency. Doyal and Gough's theory of human needs was then used to identify the restriction of agency as a possible influence on health. This theory of role quality was operationalised using a measure of work (paid and unpaid) quality at age 36 and a measure of work and family stress between ages 48 and 54. The relatively poor subjective health in mid-life of lone mothers was explained by work and family stress and adult social class. In contrast, the poor health in mid-life of long-term homemakers and childless women was less easily explained. Homemaker's excess risk of reporting poor health at age 54 remained strong and significant even after adjusting for role quality and socioeconomic indicators, and childless women were at an increased risk of reporting poor health despite the social advantage inherent in attaining educational qualifications and occupying professional or managerial occupations. This study highlights the need to develop measures of role quality specifically designed to capture agency aspects of social roles.

Adult↗