WorldWideScience

Sample records for long-term finite life

  1. Increasing cell culture population doublings for long-term growth of finite life span human cell cultures

    Science.gov (United States)

    Stampfer, Martha R; Garbe, James C

    2015-02-24

    Cell culture media formulations for culturing human epithelial cells are herein described. Also described are methods of increasing population doublings in a cell culture of finite life span human epithelial cells and prolonging the life span of human cell cultures. Using the cell culture media disclosed alone and in combination with addition to the cell culture of a compound associated with anti-stress activity achieves extended growth of pre-stasis cells and increased population doublings and life span in human epithelial cell cultures.

  2. Long-term creep test with finite elements

    International Nuclear Information System (INIS)

    Argyris, J.H.; Szimmat, J.; Willam, K.J.

    1975-01-01

    Following a presentation of concrete creep, a brief summary of the direct and incremental calculation methods for long-term creep behaviour is given. In addition, a survey on the methods of the inner state variables is given which, on the one hand, gives a uniform framework for the various formulations of concrete creep, and on the other hand leads to a computable calculation method. Two examples on long-term creep behaviour illustrate the application field of the calculation method. (orig./LH) [de

  3. On the long-term analysis with finite elements

    International Nuclear Information System (INIS)

    Argyris, J.H.; Szimmat, J.; Willam, K.J.

    1975-01-01

    Following a presentation of concrete creep, a brief summary of the direct and incremental calculation methods on long-term behaviour is given. This is followed by a survey of the method of the inner state variables, which on the one hand gives a uniform framework for the various formulations of concrete creep, and on the other hand leads to a computer-ready calculation process. Two examples on long-term behaviour illustrate the regions of application of the computer methods. (orig./LH) [de

  4. Life assessment of gas turbine blades after long term service

    Energy Technology Data Exchange (ETDEWEB)

    Auerkari, Pertti; Salonen, Jorma [VTT, Espoo (Finland); Maekinen, Sari [Helsingin Energia, Helsinki (Finland); Karvonen, Ikka; Tanttari, Heikki [Lappeenrannan Laempoevoima, Lappeenranta (Finland); Kangas, Pekka [Neste Oil, Kilpilahti (Finland); Scholz, Alfred [Technische Univ. Darmstadt (Germany); Vacchieri, Erica [Ansaldo Richerche, Genoa (Italy)

    2010-07-01

    Turbine blade samples from three land based gas turbines have been subjected to systematic condition and life assessment after long term service (88000 - 109000 equivalent operating hours, eoh), when approaching the nominal or suggested life limits. The blades represent different machine types, materials and design generations, and uncooled blading outside the hottest front end of the turbine, i.e. blades with relatively large size and considerable expected life. For a reasonable assessment, a range of damage mechanisms need to be addressed and evaluated for the impact in the residual life. The results suggested significant additional safe life for all three blade sets. In some cases this could warrant yet another life cycle comparable to that of new blades, even after approaching the nominal end of life in terms of recommended equivalent operating hours. This is thought to be partly because of base load combined cycle operation and natural gas fuel, or modest operational loading if the design also accounted for more intensive cycling operation and more corrosive oil firing. In any case, long term life extension is only appropriate if not intervened by events of overloading, overheating or other sudden events such as foreign object damage (FOD), and if supported by the regular inspection and maintenance program to control in-service damage. Condition based assessment therefore remains an important part of the blade life management after the decision of accepted life extension. (orig.)

  5. Comparison of Plant Life Management Approaches for Long Term Operations

    International Nuclear Information System (INIS)

    Kang, Kisig

    2012-01-01

    Plant life management can be defined as the integration of ageing and economic planning to maintain a high level of safety and optimize operations. Many Member States have given high priority to long term operation of nuclear power plants beyond the time frame originally anticipated (e. g. 30 or 40 years). Out of a total of 445 (369 GWe) operating nuclear power plants, 349 units (297 GWe) have been in operation for more than 20 years (as of November 2011). The need for engineering support to operation, maintenance, safety review and life management for long term operation as well as education and training in the field is increasingly evident. In addition the Fukushima accident has rendered all stake holders even more attentive to safety concerns and to the provision of beyond safety measures in the preparation and scrutiny of applications for operational design life extensions. In many countries, the safety performance of NPPs is periodically followed and characterized via the periodic safety review (PSR) approach. The regulatory The regulatory review and acceptance of the PSR gives the licensee the permission to operate the plant for up to the end of the next PSR cycle (usually 10 years). In the USA and other countries operating US designed plants, the license renewal application is based on the five pre-requisite requirements and ageing management programme for passive long life system structure and components(SSCs) and active systems is adequately addressed by the maintenance rule (MR) requirements and other established regulatory processes. Other Member States have adopted a combined approach that incorporates elements of both PSR and additional LRA specific requirements primarily focused on time limited ageing analysis. Taking into account this variety of approaches, the international atomic energy agency (IAEA) initiated work for collecting and sharing information among Member States about good practices on plant life management for long term operation in

  6. Plant life time management for safe long term operation

    International Nuclear Information System (INIS)

    Burket, Danes

    2010-01-01

    The topics discussed include LTO (long-term operation) and licensing procedure in general and specifically for the Dukovany NPP, components of an LTO programme, the PLIM (plant life management) concept for Dukovany and Temelin, the LTO implementation project for Dukovany, LTO strategy, LTO risk study, international verification. The Conclusions include the following items: (i) Technical-economic study of Dukovany NPP LTO demonstrates technical feasibility and economic profitability of Dukovany NPP LTO with perspective for up to 60 years of operation. (ii) Safety part of Program for assurance of Dukovany NPP LTO complies with IAEA SALTO recommendations. (iii) Dukovany NPP LTO programme incorporated IAEA SALTO Peer Review Mission recommendations. (iv) LTO Implementation Project for 2009-2015 was approved with major targets to renew operational permission and prepare NPP for operation up to 60 years. (v) Preparation of Temelin NPP LTO programme has been started. (P.A.)

  7. Depression and quality of life in patients on long term hemodialysis ...

    African Journals Online (AJOL)

    Depression and quality of life in patients on long term hemodialysis at a national ... Quality of Life instrument were used to assess depression and quality of life. ... Haemodialysis patients who obtained low scores on quality of life measures ...

  8. Life after Kyoto? Exploration of long term strategies

    International Nuclear Information System (INIS)

    Van Vuuren, D.P.

    2001-01-01

    The current international climate negotiations (including CoP-6,recently held in The Hague, Netherlands) are mainly concerned with short term actions and barriers, and are experiencing considerable difficulties, as was once again revealed in The Hague. But we should not forget that keeping climate risks under control also demands a long term perspective. Such a perspective demands an estimate of both possible consequences and risks of climate change, and the possible solutions, in terms of strategies, policy measures, consequences and costs. 2 refs

  9. Long-Term Recovery of Life in the Chicxulub Crater

    Science.gov (United States)

    Lowery, C.; Jones, H.; Bralower, T. J.; Smit, J.; Rodriguez-Tovar, F. J.; Whalen, M. T.; Owens, J. D.; Expedition 364 Science Party, I. I.

    2017-12-01

    The Chicxulub Crater on the Yucatán Peninsula of Mexico was formed by the impact of an asteroid 66 Ma that caused the extinction of 75% of genera on Earth. Immediately following the impact, the decimated ecosystem began the long process of recovery, both in terms of primary productivity and species diversity. This well-documented process was heterogeneous across the world ocean, but until the present time it has been inaccessible at ground zero of the impact. IODP/ICDP Exp. 364 recovered 9.5 m of pelagic limestone spanning the entire Paleocene, including a continuous section spanning the first 5 myr following the impact. The Chicxulub Crater is the largest known marine impact crater on Earth, and the recovery of the ecosystem presented here is the first such record of long-term primary succession in the sterile zone of a large impact crater. Planktic and benthic foraminifera, calcareous nannoplankton, calcispheres, bioturbation, and geochemical proxies all indicate that export productivity in the Chicxulub Crater recovered rapidly (within 30 kyr) following the impact. Recovery in terms of diversity and species abundance took much longer, and varied between groups. Planktic foraminifera quickly diversified, with all common Paleocene tropical/subtropical species appearing roughly when expected. Trace fossils appear rapidly after the event, with a progressive recovery through the lowermost Paleocene. Calcareous nannoplankton took much longer to recover, and disaster taxa like Braarudosphaera dominated the assemblage well into the late Paleocene. Paleoecology and geochemistry relate these trends to oceanographic conditions within the Chicxulub Crater. Planktic foraminifera from known depth habitats, including Morozovellids, Acarininids, Chiloguembelinids, and Subbotinids, track changes in the water column structure and paleoredox conditions within the crater. Diverse and abundant macro- and microbenthic organisms indicate food availability and good oxygen conditions

  10. Health-related quality of life of long-term high-grade glioma survivors

    NARCIS (Netherlands)

    Bosma, Ingeborg; Reijneveld, Jaap C.; Douw, Linda; Vos, Maaike J.; Postma, Tjeerd J.; Aaronson, Neil K.; Muller, Martin; Vandertop, W. Peter; Slotman, Ben J.; Taphoorn, Martin J. B.; Heimans, Jan J.; Klein, Martin

    2009-01-01

    The objective of this study was to compare the health-related quality of life (HRQOL) of long-term to short-term high-grade glioma (HGG) survivors, determine the prognostic value of HRQOL for overall survival, and determine the effect of tumor recurrence on HRQOL for long-term survivors. Following

  11. Fatigue and quality of life in breast cancer survivors: temporal courses and long-term pattern

    NARCIS (Netherlands)

    Schmidt, M.E.; Chang-Claude, J.; Vrieling, A.; Heinz, J.; Flesch-Janys, D.; Steindorf, K.

    2012-01-01

    INTRODUCTION: Fatigue is a frequent problem during and after cancer treatment. We investigated different courses of fatigue from pre-diagnosis, through therapy, to long-term survivorship and evaluated potential implications on long-term quality of life (QoL). METHODS: Breast cancer patients

  12. Long-term effects and quality of life after treatment for rectal cancer

    NARCIS (Netherlands)

    Wiltink, L.M.

    2017-01-01

    In this thesis long-term effects and quality of life after treatment for rectal cancer are evaluated. Long-term data were assessed from the TME trial. In this trial 1530 Dutch patients with rectal cancer were included between 1996 and 1999. These patients were randomly assigned to total mesorectal

  13. Protein needs early in life and long-term health

    DEFF Research Database (Denmark)

    Michaelsen, Kim F.; Greer, Frank R

    2014-01-01

    foods have been introduced. At this age, mean protein intake is ∼3 times as high as the physiologic requirement, but some children receive 4-5 times their physiologic requirement. Protein from cow milk constitutes a main part of protein intake in toddlers and seems to have a specific effect on insulin......-like growth factor I concentrations and growth. Meat has a high protein content, but the small amounts of meat needed to ensure good iron status have less impact on total protein intake. The difference in protein intake between breastfed and formula-fed infants is likely to play a role in the difference...... between breastfed and formula-fed infants. There is emerging evidence that high protein intake during the first 2 y of life is a risk factor for later development of overweight and obesity. It therefore seems prudent to avoid a high protein intake during the first 2 y of life. This could be accomplished...

  14. Long-term quality of life after living kidney donation.

    Science.gov (United States)

    Glotzer, O S; Singh, T P; Gallichio, M H; Conti, D J; Siparsky, N F

    2013-11-01

    The supply of deceased donor kidneys available for transplantation is not sufficient to meet the demand. Despite a low rate of complications for donors and superior outcomes for recipients, living kidney donation (LKD) is on the decline for reasons that remain unclear. We performed a retrospective review and analysis of living kidney donors (LDs) who underwent donor nephrectomy between January 1, 2000 and December 31, 2010. Candidates who were excluded from LKD were identified as control subjects (CSs). LDs and CSs were invited to voluntarily undergo a quality of life assessment using Short Form 12 v1.0 Questionnaire (SF-12) and an addendum questionnaire (AQ). The SF-12 and AQ were administered by telephone. Statistical analysis of the results was performed to obtain the SF-12 physical component score (PCS), SF-12 mental component score (MCS), and the AQ score. PCS and MCS for the general population were obtained from the 1998 National Survey of Functional Health Status. During the study period, 83 LDs and 116 CSs were interviewed. LDs were noted to have higher PCS (54.1 vs 49.6) and MCS (55.7 vs 49.4) compared with the general population. Ninety-nine percent of LDs believed that their quality of life did not decrease after LKD; 21.7% reported experiencing complications. Half of the LDs (48%) reported missing 1 day of work for evaluation; 71% of LDs reported missing at least 4 weeks of work after LKD. Nearly all LDs (99%) would undergo donation again. Fifty-two percent of LDs reported adhering to the recommended 2-year follow-up schedule with the transplantation team; 87% of LDs reported seeing their primary care physician. LDs are physically and mentally healthier after LKD compared to the general population. Most donors miss at least 1 month of work for LKD and undergo some form of post-donation monitoring. Despite this commitment, LKD is a very satisfying experience. Copyright © 2013 Elsevier Inc. All rights reserved.

  15. Exploration of life experiences of positive growth in long-term childhood cancer survivors.

    Science.gov (United States)

    Kim, Yoonjung

    2017-10-01

    The aim of this study was to explore experiences of positive growth in long-term childhood cancer survivors, from their perspective. Fifteen long-term survivors of childhood cancer provided descriptions of their experiences. Data were collected through face-to-face interviews and the analysis was based on Giorgi's phenomenological research method. The analysis of positive growth experienced by long-term childhood cancer survivors revealed three themes: self-directed life, normalcy in life, and inner maturity. Long-term survivors defined positive growth as a successful transition to a self-satisfactory life based on motivation acquired through their cancer experience and on subjective goal-setting, as well as becoming cancer-free and living a normal life within society. They seemed to have acquired optimistic, flexible, active attitudes toward life while demonstrating profound gratefulness and consideration of people around them, as well as prudent approaches to health. The findings of this study verified that long-term survivors of childhood cancer have grown positively due to their negative past experience. We expect these findings to contribute to the development of programs that promote positive growth in long-term childhood cancer survivors. Copyright © 2017 Elsevier Ltd. All rights reserved.

  16. Evaluation of long term creep-fatigue life for type 304 stainless steel

    International Nuclear Information System (INIS)

    Kawasaki, Hirotsugu; Ueno, Fumiyoshi; Aoto, Kazumi; Ichimiya, Masakazu; Wada, Yusaku

    1992-01-01

    The long term creep-fatigue life of type 304 stainless steel was evaluated by the creep-fatigue life prediction method based on a linear damage fraction rule. The displacement controlled creep-fatigue tests were carried out, and the time to failure of longer than 10000 hours was obtained. The creep damage of long term creep-fatigue was evaluated by taking into account the stress relaxation behavior with elastic follow-up during the hold period. The relationship between life reduction of creep-fatigue and fracture mode was provided by the creep cavity growth. The results of this study are summarized as follows; (1) The long term creep-fatigue data can be reasonably evaluated by the present method. The predicted lives were within a factor of 3 of the observed ones. (2) The present method provides the capability to predict the long term creep-fatigue life at lower temperatures as well as that at the creep dominant temperature. (3) The value of creep damage for the long term creep-fatigue data increased by elastic follow-up. The creep-fatigue damage diagram intercepted between 0.3 and 1 can represent the observed creep-fatigue damages. (4) The cavity growth depends on the hold time. The fracture of long term creep-fatigue is caused by the intergranular cavity growth. The intergranular fracture of creep-fatigue is initiated by the cavity growth and followed by the microcrack propagation along grain boundaries starting from creep cavities. (author)

  17. Numeric simulation model for long-term orthodontic tooth movement with contact boundary conditions using the finite element method.

    Science.gov (United States)

    Hamanaka, Ryo; Yamaoka, Satoshi; Anh, Tuan Nguyen; Tominaga, Jun-Ya; Koga, Yoshiyuki; Yoshida, Noriaki

    2017-11-01

    Although many attempts have been made to simulate orthodontic tooth movement using the finite element method, most were limited to analyses of the initial displacement in the periodontal ligament and were insufficient to evaluate the effect of orthodontic appliances on long-term tooth movement. Numeric simulation of long-term tooth movement was performed in some studies; however, neither the play between the brackets and archwire nor the interproximal contact forces were considered. The objectives of this study were to simulate long-term orthodontic tooth movement with the edgewise appliance by incorporating those contact conditions into the finite element model and to determine the force system when the space is closed with sliding mechanics. We constructed a 3-dimensional model of maxillary dentition with 0.022-in brackets and 0.019 × 0.025-in archwire. Forces of 100 cN simulating sliding mechanics were applied. The simulation was accomplished on the assumption that bone remodeling correlates with the initial tooth displacement. This method could successfully represent the changes in the moment-to-force ratio: the tooth movement pattern during space closure. We developed a novel method that could simulate the long-term orthodontic tooth movement and accurately determine the force system in the course of time by incorporating contact boundary conditions into finite element analysis. It was also suggested that friction is progressively increased during space closure in sliding mechanics. Copyright © 2017. Published by Elsevier Inc.

  18. Health-related quality of life in long-term survivors of testicular cancer

    DEFF Research Database (Denmark)

    Rossen, Philip Blach; Pedersen, Anette Fischer; Zachariae, Robert

    2009-01-01

    PURPOSE: A growing number of patients with testicular cancer (TC) become long-term survivors. As a consequence, quality-of-life (QOL) issues become increasingly important. The objective of this study was to investigate QOL among Danish TC survivors. METHODS: A long-term follow-up assessment of all...... patients with TC treated at Aarhus University Hospital in Denmark between 1990 and 2000 was conducted. A total of 401 survivors (response rate, 66%) completed questionnaires concerning QOL (European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire C30), depression (Beck...

  19. Long-term storage life of light source modules by temperature cycling accelerated life test

    International Nuclear Information System (INIS)

    Sun Ningning; Tan Manqing; Li Ping; Jiao Jian; Guo Xiaofeng; Guo Wentao

    2014-01-01

    Light source modules are the most crucial and fragile devices that affect the life and reliability of the interferometric fiber optic gyroscope (IFOG). While the light emitting chips were stable in most cases, the module packaging proved to be less satisfactory. In long-term storage or the working environment, the ambient temperature changes constantly and thus the packaging and coupling performance of light source modules are more likely to degrade slowly due to different materials with different coefficients of thermal expansion in the bonding interface. A constant temperature accelerated life test cannot evaluate the impact of temperature variation on the performance of a module package, so the temperature cycling accelerated life test was studied. The main failure mechanism affecting light source modules is package failure due to solder fatigue failure including a fiber coupling shift, loss of cooling efficiency and thermal resistor degradation, so the Norris-Landzberg model was used to model solder fatigue life and determine the activation energy related to solder fatigue failure mechanism. By analyzing the test data, activation energy was determined and then the mean life of light source modules in different storage environments with a continuously changing temperature was simulated, which has provided direct reference data for the storage life prediction of IFOG. (semiconductor devices)

  20. Long-term capital planning considering nuclear plant life-cycle management

    International Nuclear Information System (INIS)

    Negin, C.A.; Simpson, J.M.; Hostetler, D.R.

    1992-09-01

    The creation of a Life Cycle Management (LCM) group at utilities to evaluate the long term capital refurbishment needs is gaining favor. Among the functions of such groups can be the responsibility for recommending long term capital planning projects based on results of evaluations of systems, structures, and components that are not only essential to achieving the full current license term of operation, but also to extend the service life of the plant. Making such recommendations, in content and timing, requires the ability to view all recommendations in the context of an overall capital budget and long range outage impacts. This report illustrates an approach for creating a Long-Term Capital Plan with methods for deciding on, compiling, integrating, and presenting projects from the perspective of an LCM program for a nuclear power plant. It also addresses a rationale for capitalization of LCM program activities that would not be allowed under current accounting treatment

  1. Long-term quality of life and tumour control following gamma knife radiosurgery for vestibular schwannoma

    DEFF Research Database (Denmark)

    Wangerid, Theresa; Bartek, Jiri; Svensson, Mikael

    2014-01-01

    Gamma knife radiosurgery (GKRS) has for the last decades been an established treatment option for patients with small- or medium-sized vestibular schwannomas (VS), although little data is reported on long-term outcome regarding quality of life (QOL) and tumour control in this patient category...

  2. State-dependent life-history strategies : A long-term study on oystercatchers

    NARCIS (Netherlands)

    van de Pol, Martijn

    2006-01-01

    The research described in this thesis is part of a long-term field study on free-living Oystercatchers (Haematopus ostralegus), on the Dutch Wadden Sea island of Schiermonnikoog.The study was started in 1983 by Jan Hulscher, and since then a lineage of PhDstudents has investigated life-history

  3. Long-term quality-of-life outcome after mesh sacrocolpopexy for vaginal vault prolapse.

    LENUS (Irish Health Repository)

    Thomas, Arun Z

    2009-12-01

    To evaluate the long-term outcome of mesh sacrocolpopexy (MSC, which aims to restore normal pelvic floor anatomy to alleviate prolapse related symptoms) and its effect on patient\\'s quality of life, as women with vaginal vault prolapse commonly have various pelvic floor symptoms that can affect urinary, rectal and sexual function.

  4. Long-term intended and unintended experiences after Advanced Life Support training

    DEFF Research Database (Denmark)

    Rasmussen, M.B.; Dieckmann, Peter; Issenberg, Berry

    2012-01-01

    Highly structured simulation-based training (SBT) on managing emergency situations can have a significant effect on immediate satisfaction and learning. However, there are some indications of problems when applying learned skills to practice. The aim of this study was to identify long-term intended...... and unintended learner reactions, experiences and reflections after attending a simulation based Advanced Life Support (ALS) course....

  5. Long-term impact on work and private life after Guillain-Barre syndrome

    NARCIS (Netherlands)

    Bernsen, RAJAM; de Jager, AEJ; Schmitz, PIM; van der Meche, FGA

    2002-01-01

    Objective: To determine the long-term impact of Guillain-Barre syndrome (GBS) on work and private life of patients and their partners. Methods: Three to six years after the onset of GBS 150 patients who participated in the Dutch Guillain-Barre trial received a questionnaire specifically drafted for

  6. Impact of long-term HPN on daily life in adults

    NARCIS (Netherlands)

    Persoon, Anke; Huisman-de Waal, Getty; Naber, Ton A.; Schoonhoven, Lisette; Tas, Tirzah; Sauerwein, Hans; van Achterberg, Theo

    2005-01-01

    Home parenteral nutrition (HPN) is a therapy that changes life radically and often means lifelong dependence on parenteral feeding. The aim of this study was to gain insight into problems experienced by adult patients who were dependent on long-term HPN. A survey was performed on all patients at the

  7. Impact of long-term HPN on daily life in adults.

    NARCIS (Netherlands)

    Persoon, A.; Huisman-de Waal, G.J.; Naber, A.H.J.; Schoonhoven, L.; Tas, T.; Sauerwein, H.P.; Achterberg, T. van

    2005-01-01

    BACKGROUND AND AIMS: Home parenteral nutrition (HPN) is a therapy that changes life radically and often means lifelong dependence on parenteral feeding. The aim of this study was to gain insight into problems experienced by adult patients who were dependent on long-term HPN. METHODS: A survey was

  8. Quality of life in patients after long-term biochemical cure of cushing's disease

    NARCIS (Netherlands)

    M.O. van Aken (Maarten); A.M. Pereira (Alberto); N.R. Biermasz; S.W. van Thiel (Sjoerd); H. Hoftijzer (Hendrieke); J.W.A. Smit (Jan); F. Roelfsema (Ferdinand); S.W.J. Lamberts (Steven); J.A. Romijn (Johannes)

    2005-01-01

    textabstractTo evaluate the long-term impact of cured Cushing's disease on subjective well-being, we assessed quality of life by validated health-related questionnaires in 58 patients cured from Cushing's disease by transsphenoidal surgery (n = 58), some of whom received additional radiotherapy (n =

  9. Quality of life in patients after long-term biochemical cure of Cushing's disease

    NARCIS (Netherlands)

    van Aken, M. O.; Pereira, A. M.; Biermasz, N. R.; van Thiel, S. W.; Hoftijzer, H. C.; Smit, J. W. A.; Roelfsema, F.; Lamberts, S. W. J.; Romijn, J. A.

    2005-01-01

    To evaluate the long-term impact of cured Cushing's disease on subjective well-being, we assessed quality of life by validated health-related questionnaires in 58 patients cured from Cushing's disease by transsphenoidal surgery (n = 58), some of whom received additional radiotherapy (n = 11) and/or

  10. Long-Term Quality of Life Outcome After Proton Beam Monotherapy for Localized Prostate Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Coen, John J., E-mail: jcoen@partners.org [Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA (United States); Paly, Jonathan J.; Niemierko, Andrzej; Weyman, Elizabeth [Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA (United States); Rodrigues, Anita [Department of Medical Oncology, Massachusetts General Hospital, Boston, MA (United States); Shipley, William U.; Zietman, Anthony L. [Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA (United States); Talcott, James A. [Department of Medical Oncology, Massachusetts General Hospital, Boston, MA (United States)

    2012-02-01

    Objectives: High-dose external radiation for localized prostate cancer results in favorable clinical outcomes and low toxicity rates. Here, we report long-term quality of life (QOL) outcome for men treated with conformal protons. Methods: QOL questionnaires were sent at specified intervals to 95 men who received proton radiation. Of these, 87 men reported 3- and/or 12-month outcomes, whereas 73 also reported long-term outcomes (minimum 2 years). Symptom scores were calculated at baseline, 3 months, 12 months, and long-term follow-up. Generalized estimating equation models were constructed to assess longitudinal outcomes while accounting for correlation among repeated measures in an individual patient. Men were stratified into functional groups from their baseline questionnaires (normal, intermediate, or poor function) for each symptom domain. Long-term QOL changes were assessed overall and within functional groups using the Wilcoxon signed-rank test. Results: Statistically significant changes in all four symptom scores were observed in the longitudinal analysis. For the 73 men reporting long-term outcomes, there were significant change scores for incontinence (ID), bowel (BD) and sexual dysfunction (SD), but not obstructive/irritative voiding dysfunction (OID). When stratified by baseline functional category, only men with normal function had increased scores for ID and BD. For SD, there were significant changes in men with both normal and intermediate function, but not poor function. Conclusions: Patient reported outcomes are sensitive indicators of treatment-related morbidity. These results quantitate the long-term consequences of proton monotherapy for prostate cancer. Analysis by baseline functional category provides an individualized prediction of long-term QOL scores. High dose proton radiation was associated with small increases in bowel dysfunction and incontinence, with more pronounced changes in sexual dysfunction.

  11. Health-related quality of life in long-term breast cancer survivors

    DEFF Research Database (Denmark)

    Peuckmann, Vera; Ekholm, Ola; Rasmussen, Niels Kristian

    2007-01-01

    AIM: To investigate health-related quality of life (HRQOL) in a nationally representative sample of long-term breast cancer survivors (BCS) in Denmark. PARTICIPANTS AND METHODS: An age-stratified random sample of 2,000 female BCS > or = 5 years after primary surgery without recurrence was drawn...... from the Danish Breast Cancer Cooperative Group register, which is representative regarding long-term BCS in Denmark, and compared with 3,104 women of the nationally representative Danish Health and Morbidity Survey 2000. The Short Form-36 questionnaire assessed HRQOL and its association with BCS...... health" (P mental health" (P

  12. Long-Term Effects of Early-Life Otitis Media on Language Development

    Science.gov (United States)

    Zumach, Anne; Gerrits, Ellen; Chenault, Michelene; Anteunis, Lucien

    2010-01-01

    Purpose: The aim of the present study was to examine the long-term consequences of early-life otitis media (OM) and the associated hearing loss (HL) on language skills of school-aged children. Method: In a prospective study, the middle-ear status of 65 Dutch healthy-born children was documented every 3 months during their first 2 years of life;…

  13. Long-term Creep Life Prediction for Type 316LN Stainless Steel

    International Nuclear Information System (INIS)

    Kim, Woo Gon; Ryu, Woo Seog; Kim, Sung Ho; Lee, Chan Bok

    2007-01-01

    Since Sodium Fast Cooled Reactor (SFR) components are designed to be use for more than 30 years at a high temperature of 550 .deg. C, one of the most important properties of these components is the long term creep behavior. To accurately predict the long-term creep life of the components, it is essential to achieve reliable long-term test data beyond their design life. But, it is difficult to actually obtain long duration data because it is time-consuming work. So far, a variety of time-temperature parameters (TTPs) have been developed to predict a long-term creep life from shorter-time tests at higher temperatures. Among them, the Larson-Miller, the Orr-Sherby-Dorn, the Manson-Harferd and the Manson-Succop parameters have been typically used. None of these parameters has an overwhelming preference, and they have certain inherent restrictions imposed on their data in the application of the TTPs parameters. Meanwhile, it has been reported that the Minimum Commitment Method (MCM) proposed by Manson and Ensign has a greater flexibility for a creep rupture analysis. Thus, the MCM will be useful as another approach. Until now, the applicability of the MCM has not been investigated for type 316LN SS because of insufficient creep data. In this paper, the MCM was applied to predict a long-term creep life of type 316LN stainless steel (SS). Lots of creep rupture data was collected through literature surveys and the experimental data of KAERI. Using the short-term experimental data for under 2,000 hours, a longer-time rupture above 105 hours was predicted by the MCM at temperatures from 550 .deg. C to 800 .deg. C

  14. Plant life management for long term operation of light water reactors. Principles and guidelines

    International Nuclear Information System (INIS)

    2006-01-01

    The subject of this report was originally suggested by the IAEA Technical Working Group on Life Management of Nuclear Power Plants. It was then approved by the IAEA for work to begin in 2004. The participants in the group felt that it was time to address plant life management and ageing issues from the point of view of long term operation and licence renewal. It is believed that the nuclear power industry will only be able to survive if plant economics are favourable and safety is maintained. Therefore, the issue of ageing and obsolescence has to be addressed from an operational and safety standpoint, but also in the context of plant economics in terms of the cost of electricity production, including initial and recurring capital costs. Use of new technologies, such as advanced in-service inspection and condition based maintenance, should be considered, not only to predict the consequences of ageing and guard against them, but also to monitor equipment performance throughout the lifetime of the plant and to help establish replacement schedules for critical systems, structures and components, and to better estimate the optimum end of the operating licence, which means the end of the nuclear power plant's lifetime. The importance of nuclear power plant life management in facilitating the technical and economic goals of long term operation is presented in this report in terms of the requirement to ensure safe long term supplies of electricity in the most economically competitive way. Safe and reliable operation is discussed in terms of the overall economic benefits when plant life management is implemented. Preconditions for plant life management for long term operation are identified and approaches are reviewed. Plant life management should not be associated only with the extension of the operational lifetime of the nuclear power plant, but with an owner's attitude and a rational approach of the operating company towards running the business economically and safely

  15. Quality of Life and Functional Health Status of Long-Term Meditators

    Directory of Open Access Journals (Sweden)

    Ramesh Manocha

    2012-01-01

    Full Text Available Background. There is very little data describing the long-term health impacts of meditation. Aim. To compare the quality of life and functional health of long-term meditators to that of the normative population in Australia. Method. Using the SF-36 questionnaire and a Meditation Lifestyle Survey, we sampled 343 long-term Australian Sahaja Yoga meditation practitioners and compared their scores to those of the normative Australian population. Results. Six SF-36 subscales (bodily pain, general health, mental health, role limitation—emotional, social functioning, and vitality were significantly better in meditators compared to the national norms whereas two of the subscales (role limitation—physical, physical functioning were not significantly different. A substantial correlation between frequency of mental silence experience and the vitality, general health, and especially mental health subscales (P<0.005 was found. Conclusion. Long-term practitioners of Sahaja yoga meditation experience better functional health, especially mental health, compared to the general population. A relationship between functional health, especially mental health, and the frequency of meditative experience (mental silence exists that may be causal. Evidence for the potential role of this definition of meditation in enhancing quality of life, functional health and wellbeing is growing. Implications for primary mental health prevention are discussed.

  16. A finite element modeling method for predicting long term corrosion rates

    International Nuclear Information System (INIS)

    Fu, J.W.; Chan, S.

    1984-01-01

    For the analyses of galvanic corrosion, pitting and crevice corrosion, which have been identified as possible corrosion processes for nuclear waste isolation, a finite element method has been developed for the prediction of corrosion rates. The method uses a finite element mesh to model the corrosive environment and the polarization curves of metals are assigned as the boundary conditions to calculate the corrosion cell current distribution. A subroutine is used to calculate the chemical change with time in the crevice or the pit environments. In this paper, the finite element method is described along with experimental confirmation

  17. Impairments in quality of life and cognitive functions in long-term survivors of glioblastoma

    Directory of Open Access Journals (Sweden)

    Chirag Solanki

    2017-01-01

    Full Text Available Background: The incidence of long-term survival in glioblastoma (GBM, i.e., >3 years, ranges from 3% to 5%. Although extensive research is performed in novel therapies for prolonging survival, there is a scarcity of research focusing on the impact of tumor and treatment on cognitive, psychological, and social status of survivors. This study is an attempt to look into this poorly addressed important issue. Materials and Methods: Nine patients (six adults and three children with GBM who had survived >3 years were included in the study. The quality of life (QOL functions were assessed with the World Health Organization QOL Questionnaire BREF questionnaire. The neuropsychological assessment was done using the National Institute of Mental Health and Neurosciences neuropsychology battery for adults and children. The scores were compared with normative data. Results: The physical and psychological health-related QOL of long-term GBM survivors were affected considerably due to fatigue, poor quality of sleep, inability to concentrate, presence of depression, financial burden with impaired personal and social relationships (P < 0.05. Different domains of cognitions such as motor speed (P = 0.0173, mental speed (P = 0.0022, sustained attention (P = 0.0001, long-term memory (P = 0.0431, mental flexibility (P < 0.05, and planning and executive functions (P < 0.05 were significantly impaired affecting personal, social, and professional lives. Conclusion: The health-related QOL and cognition are significantly impaired in GBM long-term survivors. As the incidence of long-term survival is very less, there is a need for larger multicenter studies to come up with definitive results, which in turn can help in formatting the rehabilitative and support programs for these patients.

  18. Life Limiting Issues for Long Term Operation of Nuclear Power Plants

    International Nuclear Information System (INIS)

    Esselman, Thomas; Gaertner, John

    2012-01-01

    This paper reports on a study which identified and characterized life limiting issues for consideration by nuclear plant owners in their decision to extend plant life or seek subsequent license renewal. As nuclear plants operate for longer periods, the risk that a condition in the plant or an event that occurs, at the plant or elsewhere, will cause a plant owner not to extend plant life increases. The Fukushima accident has made this concept concrete. This paper defines 'Life Limiting' concepts for nuclear plants. It identifies the highest risk conditions and events that may limit duration of continued operation in nuclear plants and employs a survey to prioritize these concerns. Methods for evaluating these risks and changing the capability of systems, structures, and components (SSC) to reduce and manage this risk in long term operation are presented. Integrated obsolescence -the existence of an accumulation of events or condition that can threaten long term operation- is discussed. Many of the life limiting conditions or events may be controllable by early identification, recognition, and mitigation of the potential threat. The recognition of conditions may allow measures to be taken to mitigate the condition. Recognition of the potential for events that may be life limiting may allow actions to be taken that will minimize the likelihood or consequences of the event. These actions may include enhanced research on the expected behavior of the SSC, risk assessment and management, and enhanced monitoring and aging management at the plant. (author)

  19. Early Life Exposure to Fructose and Offspring Phenotype: Implications for Long Term Metabolic Homeostasis

    Science.gov (United States)

    Sloboda, Deborah M.; Li, Minglan; Patel, Rachna; Clayton, Zoe E.; Yap, Cassandra; Vickers, Mark H.

    2014-01-01

    The consumption of artificially sweetened processed foods, particularly high in fructose or high fructose corn syrup, has increased significantly in the past few decades. As such, interest into the long term outcomes of consuming high levels of fructose has increased significantly, particularly when the exposure is early in life. Epidemiological and experimental evidence has linked fructose consumption to the metabolic syndrome and associated comorbidities—implicating fructose as a potential factor in the obesity epidemic. Yet, despite the widespread consumption of fructose-containing foods and beverages and the rising incidence of maternal obesity, little attention has been paid to the possible adverse effects of maternal fructose consumption on the developing fetus and long term effects on offspring. In this paper we review studies investigating the effects of fructose intake on metabolic outcomes in both mother and offspring using human and experimental studies. PMID:24864200

  20. Early Life Fructose Exposure and Its Implications for Long-Term Cardiometabolic Health in Offspring.

    Science.gov (United States)

    Zheng, Jia; Feng, Qianyun; Zhang, Qian; Wang, Tong; Xiao, Xinhua

    2016-11-01

    It has become increasingly clear that maternal nutrition can strongly influence the susceptibility of adult offspring to cardiometabolic disease. For decades, it has been thought that excessive intake of fructose, such as sugar-sweetened beverages and foods, has been linked to increased risk of obesity, type 2 diabetes, and cardiovascular disease in various populations. These deleterious effects of excess fructose consumption in adults are well researched, but limited data are available on the long-term effects of high fructose exposure during gestation, lactation, and infancy. This review aims to examine the evidence linking early life fructose exposure during critical periods of development and its implications for long-term cardiometabolic health in offspring.

  1. Early Life Exposure to Fructose and Offspring Phenotype: Implications for Long Term Metabolic Homeostasis

    Directory of Open Access Journals (Sweden)

    Deborah M. Sloboda

    2014-01-01

    Full Text Available The consumption of artificially sweetened processed foods, particularly high in fructose or high fructose corn syrup, has increased significantly in the past few decades. As such, interest into the long term outcomes of consuming high levels of fructose has increased significantly, particularly when the exposure is early in life. Epidemiological and experimental evidence has linked fructose consumption to the metabolic syndrome and associated comorbidities—implicating fructose as a potential factor in the obesity epidemic. Yet, despite the widespread consumption of fructose-containing foods and beverages and the rising incidence of maternal obesity, little attention has been paid to the possible adverse effects of maternal fructose consumption on the developing fetus and long term effects on offspring. In this paper we review studies investigating the effects of fructose intake on metabolic outcomes in both mother and offspring using human and experimental studies.

  2. Meaning in life: the perspective of long-term care residents.

    Science.gov (United States)

    Welsh, Darlene; Moore, Sharon L; Getzlaf, Beverley A

    2012-07-01

    A qualitative approach was used in the exploration of meaning in life for long-term care (LTC) residents. This hermeneutic phenomenological study, as described by van Manen, was conducted using semi-structured interviews with 11 LTC residents from a rural region in Atlantic Canada. Four themes emerged as enhancing meaning in life for the residents in this study: Connectedness, Survival Despite Declining Functional Capacity, Engaging in "Normal" Activities, and Seeking a Place of Refuge. In this article, we describe the emerging themes and the implications for LTC education, practice, and future research. Copyright 2012, SLACK Incorporated.

  3. Long-term evolution of broken wakefields in finite radius plasmas

    CERN Document Server

    Lotov, Konstantin; Petrenko, Alexey

    2014-01-01

    A novel effect of fast heating and charging a finite-radius plasma is discovered in the context of plasma wakefield acceleration. As the plasma wave breaks, the most of its energy is transferred to plasma electrons which create strong charge-separation electric field and azimuthal magnetic field around the plasma. The slowly varying field structure is preserved for hundreds of wakefield periods and contains (together with hot electrons) up to 80% of the initial wakefield energy.

  4. Long-Term Quality of Life Improvement in Subjects with Healed Erosive Esophagitis: Treatment with Lansoprazole

    Science.gov (United States)

    Freston, James W.; Haber, Marian M.; Atkinson, Stuart; Hunt, Barbara; Peura, David A.

    2009-01-01

    Background Gastroesophageal reflux disease (GERD) is a chronic symptomatic condition and may be associated with erosive esophagitis (EE). Considerable data on the long-term maintenance of healing of EE are available, but data on long-term GERD symptom prevention and patient quality of life (QOL) are limited. Aims To investigate QOL in subjects with healed EE who received 12 months of double-blind maintenance treatment with lansoprazole or ranitidine, followed by long-term open-label lansoprazole therapy to prevent recurrence of EE. Methods Subjects with healed EE received 12 months of double-blind maintenance treatment with lansoprazole 15 mg once daily or ranitidine 150 mg twice daily, followed by dose-titrated, open-label lansoprazole therapy for up to 82 months. Results During double-blind treatment (n = 206), lansoprazole-treated patients showed significantly (P ≤ 0.05) greater improvements than ranitidine-treated patients in the frequency, severity, and ‘bothersomeness’ of heartburn, the symptom index, problems of activity limitation, eating and drinking problems, symptom problems, health distress, and social functioning. During dose-titrated, open-label treatment (n = 195), all disease-specific QOL scales except sleep improved significantly (P lansoprazole for 12 months in healed EE subjects produced significantly greater improvements in QOL indicators than ranitidine. These improvements were sustained during dose-titrated, open-label lansoprazole treatment. PMID:19582579

  5. Long-term oxygen therapy for COPD. Improving longevity and quality of life in hypoxemic patients.

    Science.gov (United States)

    Weg, J G; Haas, C F

    1998-04-01

    Long-term oxygen therapy can increase life expectancy in hypoxemic patients with COPD. Accurate identification of hypoxemia requires arterial blood gas measurements. Pulse oximetry can be used to measure trends in oxygenation, oxygen needs, and oxygen requirements during exercise and sleep. A detailed oxygen prescription indicates: (1) the oxygen dose (L/min), (2) the number of hours per day that oxygen therapy is required, (3) the dose required during exercise, (4) the oxygen supply system: concentrator, compressed gas cylinder, or liquid oxygen reservoir, and (5) the delivery device: nasal cannula, demand-flow device, reservoir cannula, or transtracheal oxygen catheter.

  6. The Long-Term Impact of Autoimmune Pancreatitis on Pancreatic Function, Quality of Life, and Life Expectancy

    NARCIS (Netherlands)

    Buijs, Jorie; Cahen, Djuna L.; van Heerde, Marianne J.; Rauws, Erik A.; de Buy Wenniger, Lucas J. Maillette; Hansen, Bettina E.; Biermann, Katharina; Verheij, Joanne; Vleggaar, Frank P.; Brink, Menno A.; Beuers, Ulrich H. W.; van Buuren, Henk R.; Bruno, Marco J.

    2015-01-01

    To evaluate the long-term outcome of autoimmune pancreatitis. Patients with at least 2 years of follow-up were included. Information was collected regarding disease characteristics, treatment outcome, diagnosed malignancies, and mortality. In addition, pancreatic function and quality of life were

  7. Mortality and life expectancy in relation to long-term cigarette, cigar and pipe smoking: The Zutphen Study

    NARCIS (Netherlands)

    Streppel, M.T.; Boshuizen, H.C.; Ocké, M.C.; Kok, F.J.; Kromhout, D.

    2007-01-01

    Study objective: To study the effect of long-term smoking on all-cause and cause-specific mortality, and to estimate the effects of cigarette and cigar or pipe smoking on life expectancy. Design: A long-term prospective cohort study. Setting: Zutphen, The Netherlands. Participants: 1373 men from the

  8. Long-term health-related quality of life for disease-free esophageal cancer patients.

    LENUS (Irish Health Repository)

    Donohoe, Claire L

    2012-02-01

    BACKGROUND: Health-related quality of life (HRQL) has been studied extensively during the first year following esophagectomy, but little is known about HRQL in long-term survivors. The aim of this study was to investigate HRQL in patients alive at least 1 year after surgical resection for esophageal cancer using validated European Organisation for Research and Treatment of Cancer (EORTC) quality of life (QOL) questionnaires (QLQ). METHODS: Eligible patients, without known disease recurrence and at least 1 year after esophagectomy, were identified from a prospectively maintained database. Patients completed general (QLQ-C30) and esophageal cancer-specific (QLQ-OES18, OG25) questionnaires. A numeric score (0-100) was computed in each conceptual area and compared with validated cancer (n = 1031) and age-matched (n = 7802) healthy populations using two-tailed unpaired t-tests. A cohort of 80 patients had pretreatment scores recorded. RESULTS: Altogether, 132 of 156 eligible patients (84%) completed the self-rated questionnaire, 105 (67.3%) were men, and the mean age was 62 years (range 29-84 years). The mean time since esophagectomy was 70.3 months (12-299 months). Global health status was significantly reduced at least 1 year after esophagectomy (mean +\\/- SD score 48.4 +\\/- 18.6) when compared with patients with esophageal cancer prior to treatment (55.6 +\\/- 24.1) and the general population (71.2 +\\/- 22.4) (p < 0.0001). In a prospective cohort of eighty patients, symptoms related to swallowing difficulty, reflux, pain, and coughing significantly decreased in the long term (p < 0.0001). The degree of subjective swallowing dysfunction was highly correlated with a poor QOL (Spearman\\'s rho = 0.508, p < 0.01). CONCLUSIONS: Global health status remains significantly reduced in long-term survivors after esophagectomy compared with population controls, and swallowing dysfunction is highly associated with this compromised QOL.

  9. In utero and early life arsenic exposure in relation to long-term health and disease

    Energy Technology Data Exchange (ETDEWEB)

    Farzan, Shohreh F.; Karagas, Margaret R. [Children' s Environmental Health and Disease Prevention Research Center at Dartmouth, Hanover, NH 03755 (United States); Section of Biostatistics and Epidemiology, Department of Community and Family Medicine and Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth, Lebanon, NH 03756 (United States); Chen, Yu, E-mail: yu.chen@nyumc.org [Department of Population Health, New York University School of Medicine, New York, NY 10016 (United States)

    2013-10-15

    Background: There is a growing body of evidence that prenatal and early childhood exposure to arsenic from drinking water can have serious long-term health implications. Objectives: Our goal was to understand the potential long-term health and disease risks associated with in utero and early life exposure to arsenic, as well as to examine parallels between findings from epidemiological studies with those from experimental animal models. Methods: We examined the current literature and identified relevant studies through PubMed by using combinations of the search terms “arsenic”, “in utero”, “transplacental”, “prenatal” and “fetal”. Discussion: Ecological studies have indicated associations between in utero and/or early life exposure to arsenic at high levels and increases in mortality from cancer, cardiovascular disease and respiratory disease. Additional data from epidemiologic studies suggest intermediate effects in early life that are related to risk of these and other outcomes in adulthood. Experimental animal studies largely support studies in humans, with strong evidence of transplacental carcinogenesis, atherosclerosis and respiratory disease, as well as insight into potential underlying mechanisms of arsenic's health effects. Conclusions: As millions worldwide are exposed to arsenic and evidence continues to support a role for in utero arsenic exposure in the development of a range of later life diseases, there is a need for more prospective studies examining arsenic's relation to early indicators of disease and at lower exposure levels. - Highlights: • We review in utero and early-life As exposure impacts on lifelong disease risks. • Evidence indicates that early-life As increases risks of lung disease, cancer and CVD. • Animal work largely parallels human studies and may lead to new research directions. • Prospective studies and individual exposure assessments with biomarkers are needed. • Assessing intermediary

  10. In utero and early life arsenic exposure in relation to long-term health and disease

    International Nuclear Information System (INIS)

    Farzan, Shohreh F.; Karagas, Margaret R.; Chen, Yu

    2013-01-01

    Background: There is a growing body of evidence that prenatal and early childhood exposure to arsenic from drinking water can have serious long-term health implications. Objectives: Our goal was to understand the potential long-term health and disease risks associated with in utero and early life exposure to arsenic, as well as to examine parallels between findings from epidemiological studies with those from experimental animal models. Methods: We examined the current literature and identified relevant studies through PubMed by using combinations of the search terms “arsenic”, “in utero”, “transplacental”, “prenatal” and “fetal”. Discussion: Ecological studies have indicated associations between in utero and/or early life exposure to arsenic at high levels and increases in mortality from cancer, cardiovascular disease and respiratory disease. Additional data from epidemiologic studies suggest intermediate effects in early life that are related to risk of these and other outcomes in adulthood. Experimental animal studies largely support studies in humans, with strong evidence of transplacental carcinogenesis, atherosclerosis and respiratory disease, as well as insight into potential underlying mechanisms of arsenic's health effects. Conclusions: As millions worldwide are exposed to arsenic and evidence continues to support a role for in utero arsenic exposure in the development of a range of later life diseases, there is a need for more prospective studies examining arsenic's relation to early indicators of disease and at lower exposure levels. - Highlights: • We review in utero and early-life As exposure impacts on lifelong disease risks. • Evidence indicates that early-life As increases risks of lung disease, cancer and CVD. • Animal work largely parallels human studies and may lead to new research directions. • Prospective studies and individual exposure assessments with biomarkers are needed. • Assessing intermediary endpoints may

  11. Physical activity history and end-of-life hospital and long-term care

    DEFF Research Database (Denmark)

    von Bonsdorff, Mikaela B; Rantanen, Taina; Leinonen, Raija

    2009-01-01

    persons aged 66-98 years at death, who, on average 5.8 years prior to death, had participated in an interview about their current and earlier physical activity. Data on the use of care in the last year of life are register-based data and complete. RESULTS: Men needed on average 96 days (SD 7.0) and women.......06-2.43), than for those who had been consistently active from midlife onward, whereas use of hospital care did not correlate with physical activity history. CONCLUSION: People who had been physically active since midlife needed less end-of-life inpatient care but patterns differed between men and women....... had been consistently physically active, whereas use of long-term care did not correlate with physical activity history. Among women, the risk for long-term care was higher for those who had been sedentary (IRR 2.03, 95% CI 1.28-3.21) or only occasionally physically active (IRR 1.60, 95% CI 1...

  12. Long-term quality of life and outcomes following robotic assisted TAPP inguinal hernia repair.

    Science.gov (United States)

    Iraniha, Andrew; Peloquin, Joshua

    2018-06-01

    Laparoscopic TAPP inguinal hernia repair is an established alternative to open hernia repair, which offers equivalent outcomes with less postoperative pain and faster recovery. Unfortunately, it remains technically challenging, requiring advanced laparoscopic skills which have limited its popularity among surgeons. The robotic platform has the potential to overcome these challenges. The objective of this study was to examine the long-term quality of life and outcomes following robotic assisted TAPP inguinal hernia repair, since these data have not been reported up to now. From October 2012 to October 2015, 159 inguinal hernias in 82 consecutive patients were repaired with 3D mesh (BARD) using da Vinci Si Surgical System (Intuitive Surgical, Sunnyvale, CA, USA). The patients' demographics and intraoperative data were documented. Patients were seen 2 and 6 weeks after the surgery and the complications were recorded. Patients were assessed 6 weeks after the surgery by a survey using a universal pain assessment tool to document their post-operative pain, narcotic use and time of return to work and exercise. A modified short form 12 (SF 12) was also sent out to the patients 12-36 months after the surgery to measure their health-related quality of life prior to surgery and at the 12- to 36-month follow-up, and to document any evidence of recurrence. Postoperative health-related quality of life scores were compared to the pre-operative baseline quality of life scores using the unpaired t test. Over the course of 3 years, 159 robotic assisted TAPP inguinal hernia repair were performed in 82 patients, 73 men and 9 women by one surgeon as an outpatient basis. The mean age was 53 and mean body mass index was 26. There were no intraoperative complications or conversions. The average operative time was 99 min. Four patients developed urinary retention post-operatively and one patient developed postoperative bowel obstruction requiring laparoscopic lysis of adhesion with no

  13. Genetic tools link long-term demographic and life-history traits of anemonefish to their anemone hosts

    KAUST Repository

    Salles, Océ ane C.; Saenz-Agudelo, Pablo; Almany, Glenn R.; Berumen, Michael L.; Thorrold, Simon R.; Jones, Geoffrey P.; Planes, Serge

    2016-01-01

    The life-history traits and population dynamics of species are increasingly being attributed to the characteristics of their preferred habitats. While coral reef fish are often strongly associated with particular habitats, long-term studies

  14. Long-term survivors of childhood cancer report quality of life and health status in parity with a comparison group

    OpenAIRE

    Sundberg, K. K.; Doukkali, E. B.; Lampic, C.; Eriksson, L. E.; Arvidson, J.; Wettergren, L.

    2010-01-01

    Background: There is a need for more knowledge about how survivors of childhood cancer perceive their lives and what influence current health status has on their quality of life. The purpose was to describe this among a group of long-term survivors and among a comparison group. \\ud \\ud Procedure: Telephone interviews were performed with a cohort of 246 long-term survivors and 296 randomly selected from the general population using the Schedule for the Evaluation of Individual Quality of Life-...

  15. Study of scenarios of long term management of low-activity long-life wastes

    International Nuclear Information System (INIS)

    2012-01-01

    This document reports the study of scenarios for the management of different low-activity long-life radioactive wastes with reference to different French legal texts. After a presentation of the legal and technical context, the report presents different existing and projected storages (description and safety principles for the Cires and Aube centres and for the Cigeo project of deep geological storage centre). It addresses the various aspects of radiferous and graphite waste management on a long term: inventory, parcel, waste peculiarities, management scenarios, assessment of storage in SCR. It also addresses the case of other wastes such as bituminous coated wastes, those presenting a reinforced natural radioactivity or residues of uranium conversion processing. The last part presents the main orientations for the project

  16. Sexual Function and Health-Related Quality of Life in Long-Term Rectal Cancer Survivors.

    Science.gov (United States)

    Sun, Virginia; Grant, Marcia; Wendel, Christopher S; McMullen, Carmit K; Bulkley, Joanna E; Herrinton, Lisa J; Hornbrook, Mark C; Krouse, Robert S

    2016-07-01

    Sexual dysfunction is a treatment sequela in survivors of rectal cancer (RC). Differences in health-related quality of life (HRQOL) can occur based on ostomy status (permanent ostomy vs anastomosis). To describe alterations in sexual function and HRQOL based on ostomy status in long-term (≥5 years) survivors of RC. Survivors of RC with an ostomy (n = 181) or anastomosis (n = 394) were surveyed using validated HRQOL and functional status tools. We compared sexuality outcomes between the ostomy and anastomosis groups and reported differences adjusted for clinical and demographic characteristics. Qualitative data from one open-ended question on survivors' greatest challenges since their surgery were analyzed to explore sexuality, symptoms, and relationships. Whether sexually active, satisfaction with sexual activity, and select sexual dysfunction items from the Modified City of Hope Quality of Life-Colorectal. Survivors with a permanent ostomy were more likely to have been sexually inactive after surgery if it occurred before 2000 and experience dissatisfaction with appearance, interference with personal relationships and intimacy, and lower overall HRQOL. Female survivors of RC with an ostomy were more likely to have problems with vaginal strictures and vaginal pain after surgery that persisted at the time of the survey (≥5 years later). Radiation treatment, tumor stage, soilage of garments in bed, and higher Charlson-Deyo comorbidity scores were negatively associated with outcomes. Six qualitative themes emerged: loss of and decreased sexual activity, psychological issues with sexual activity, physical issues with sexual activity, partner rejection, ostomy interference with sexual activity, and positive experiences with sexuality. Sexual dysfunction is a common long-term sequela of RC treatment, with more problems observed in survivors with a permanent ostomy. This warrants widespread implementation of targeted interventions to manage sexual dysfunction and

  17. [Long-term outcomes after hypospadias surgery: Sexual reported outcomes and quality of life in adulthood].

    Science.gov (United States)

    Even, L; Bouali, O; Moscovici, J; Huyghe, E; Pienkowski, C; Rischmann, P; Galinier, P; Game, X

    2015-09-01

    To evaluate outcomes and long-term sexual quality of life after hypospadias surgery. Seventeen-years-old patients operated for a posterior hypospadias in childhood were included in a transversal study. Fifteen patients, among the forty children treated since 1997, accepted to participate. These young men (mean age at the first surgery was 27.9±20months) were clinically reviewed and responded to questionnaires (EUROQOL 5, IIEF15 and non-validated questionnaire). This study arises about 8.4±5years after the last visit in paediatric department. Mean study age was 21.2±4.7years. One third of patients thought that global quality of life was distorted. Although 33% of the patients had erectile dysfunction, 80% were satisfied with their sexual quality of life. The most important complains were relative to the penile appearance. Number of procedures was not predictive of patient's satisfaction about penile function and appearance. Thirty-three percents of the patients would have been satisfied to have psychological and medical support. They would be interested in having contact with patients who suffered from the same congenital abnormality. These patients had functional and esthetical disturbances. This visit leads to a specific visit in 20% cases. In this study, medical follow-up does not seem to be counselling and had to be adapted. Adequate follow-up transition between paediatric and adult departments especially during adolescence seems to be necessary. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  18. Mediating Systems of Care: Emergency Calls to Long-Term Care Facilities at Life's End.

    Science.gov (United States)

    Waldrop, Deborah P; McGinley, Jacqueline M; Clemency, Brian

    2018-04-09

    Nursing home (NH) residents account for over 2.2 million emergency department visits yearly; the majority are cared for and transported by prehospital providers (emergency medical technicians and paramedics). The purpose of this study was to investigate prehospital providers' perceptions of emergency calls at life's end. This article focuses on perceptions of end-of-life calls in long-term care (LTC). This pilot study employed a descriptive cross-sectional design. Concepts from the symbolic interaction theory guided the exploration of perceptions and interpretations of emergency calls in LTC facilities. A purposeful sample of prehospital providers was developed from one agency in a small northeastern U.S. city. Semistructured interviews were conducted with 43 prehospital providers to explore their perceptions of factors that trigger emergency end-of-life calls in LTC facilities. Qualitative data analysis involved iterative coding in an inductive process that included open, systematic, focused, and axial coding. Interview themes illustrated the contributing factors as follows: care crises; dying-related turmoil; staffing ratios; and organizational protocols. Distress was crosscutting and present in all four themes. The findings illuminate how prehospital providers become mediators between NHs and emergency departments by managing tension, conflict, and challenges in patient care between these systems and suggest the importance of further exploration of interactions between LTC staff, prehospital providers, and emergency departments. Enhanced communication between LTC facilities and prehospital providers is important to address potentially inappropriate calls and transport requests and to identify means for collaboration in the care of sick frail residents.

  19. Relevance of a subjective quality of life questionnaire for long-term homeless persons with schizophrenia.

    Science.gov (United States)

    Girard, V; Tinland, A; Bonin, J P; Olive, F; Poule, J; Lancon, C; Apostolidis, T; Rowe, M; Greacen, T; Simeoni, M C

    2017-02-17

    Increasing numbers of programs are addressing the specific needs of homeless people with schizophrenia in terms of access to housing, healthcare, basic human rights and other domains. Although quality of life scales are being used to evaluate such programs, few instruments have been validated for people with schizophrenia and none for people with schizophrenia who experience major social problems such as homelessness. The aim of the present study was to validate the French version of the S-QoL a self-administered, subjective quality of life questionnaire specific to schizophrenia for people with schizophrenia who are homeless. In a two-step process, the S-QoL was first administered to two independent convenience samples of long-term homeless people with schizophrenia in Marseille, France. The objective of the first step was to analyse the psychometric properties of the S-QoL. The objective of the second step was to examine, through qualitative interviews with members of the population in question, the relevance and acceptability of the principle quality of life indicators used in the S-QoL instrument. Although the psychometric characteristics of the S-QoL were found to be globally satisfactory, from the point of view of the people being interviewed, acceptability was poor. Respondents frequently interrupted participation complaining that questionnaire items did not take into account the specific context of life on the streets. Less intrusive questions, more readily understandable vocabulary and greater relevance to subjects' living conditions are needed to improve the S-QoL questionnaire for this population. A modular questionnaire with context specific sections or specific quality of life instruments for socially excluded populations may well be the way forward.

  20. Control of the Onboard Microgravity Environment and Extension of the Service Life of the Long-Term Space Station

    Science.gov (United States)

    Titov, V. A.

    2018-03-01

    The problem of control of the on-board microgravity environment in order to extend the service life of the long-term space station has been discussed. Software developed for the ISS and the results of identifying dynamic models and external impacts based on telemetry data have been presented. Proposals for controlling the onboard microgravity environment for future long-term space stations have been formulated.

  1. Plant life management for long term operation of nuclear power plants

    International Nuclear Information System (INIS)

    2005-01-01

    The world's fleet of Nuclear Power Plants (NPPs) is approximately 20 years old on average, and most plants are believed to be able to operate for 60 years or more. The design life of a NPP is typically 30 to 40 years. This may be extended by 10 to 20 years, or more, provided that the plant can demonstrate by analysis, trending, equipment and system upgrades, increased vigilance, testing, ageing management, and other means that license renewal presents no threat to public health and safety. The basic goal of Plant Life Management (PLiM) is to satisfy requirements for safe long-term supplies of electricity in an economically competitive way. The basic goal of the operating company and the owners to operate as long as economically reasonable and possible from safety point of view. PLiM is a management tool for doing that. PLiM is a system of programmes and procedures to satisfy safety requirements for safe operation and for power production in a competitive way and for time which is rational from technical and economical point of view. PLiM is not only a technical system, it is also an attitude of the operational company to keep the plant in operation as long as possible from safety and business point of view. The common objectives of PLiM assessment is to help and review the pre-conditions for PLiM and long-term operation approaches. PLiM should not be associated with extension of operational life-time of the NPP only. It is an owner's attitude and rational approach of the operating company to run the business economically and safely. The effectiveness of PLiM Programme can be assessed by three complementary kinds of assessment: self-assessment, peer review and comprehensive programme review by the plant owner/ operator. IAEA will provide the assessment service for peer review of PLiM. Preparation for a PLiM Assessment service will be initiated only after the IAEA has been formally approached by a MS and funding (e.g. an existing Technical cooperation project) has

  2. Long-term effects of tetanus toxoid inoculation on the demography and life expectancy of the Cayo Santiago rhesus macaques.

    Science.gov (United States)

    Kessler, Matthew J; Hernández Pacheco, Raisa; Rawlins, Richard G; Ruiz-Lambrides, Angelina; Delgado, Diana L; Sabat, Alberto M

    2015-02-01

    Tetanus was a major cause of mortality in the free-ranging population of rhesus monkeys on Cayo Santiago prior to 1985 when the entire colony was given its first dose of tetanus toxoid. The immediate reduction in mortality that followed tetanus toxoid inoculation (TTI) has been documented, but the long-term demographic effects of eliminating tetanus infections have not. This study uses the Cayo Santiago demographic database to construct comparative life tables 12 years before, and 12 years after, TTI. Life tables and matrix projection models are used to test for differences in: (i) survival among all individuals as well as among social groups, (ii) long-term fitness of the population, (iii) age distribution, (iv) reproductive value, and (v) life expectancy. A retrospective life table response experiment (LTRE) was performed to determine which life cycle transition contributed most to observed changes in long-term fitness of the population post-TTI. Elimination of clinical tetanus infections through mass inoculation improved the health and well-being of the monkeys. It also profoundly affected the population by increasing survivorship and long-term fitness, decreasing the differences in survival rates among social groups, shifting the population's age distribution towards older individuals, and increasing reproductive value and life expectancy. These findings are significant because they demonstrate the long-term effects of eradicating a major cause of mortality at a single point in time on survival, reproduction, and overall demography of a naturalistic population of primates. © 2014 Wiley Periodicals, Inc.

  3. Extracorporeal life support for critical enterovirus 71 rhombencephalomyelitis: long-term neurologic follow-up.

    Science.gov (United States)

    Lee, Hsiu-Fen; Chi, Ching-Shiang; Jan, Sheng-Ling; Fu, Yun-Ching; Huang, Fang-Liang; Chen, Po-Yen; Wang, Chung-Chi; Wei, Hao-Ji

    2012-04-01

    Enterovirus 71 rhombencephalomyelitis with cardiopulmonary dysfunction has become an endemic problem in Taiwan since an epidemic outbreak in 1998. Such cases frequently involve significant morbidity and mortality. From October 2000-June 2008, we collected 10 consecutive patients diagnosed with enterovirus 71 rhombencephalomyelitis complicated by left heart failure, with or without pulmonary edema, and surviving more than 3 months after receiving extracorporeal life support. Follow-up neurologic outcomes were analyzed prospectively. The median duration of neurologic follow-up was 7 years and 2 months. Significant morbidities included bulbar dysfunction, respiratory failure, and flaccid quadriparesis. Eight patients exhibited bulbar dysfunction, and feeding tubes could be removed from four patients (median, 15.5 months). Respiratory failure was observed in seven patients. Three patients were gradually withdrawn from their tracheostomy tube (median period, 30 months). Intelligence tests revealed four patients with normal cognitive function, one with borderline cognitive function, and one with mild mental retardation. Four were bedridden survivors. Extracorporeal life support for critical enterovirus 71 rhombencephalomyelitis demonstrated decreased neurologic sequelae during long-term follow-up, allowing for decannulation of feeding and tracheostomy tubes, and resulting in improved cognitive function. Copyright © 2012 Elsevier Inc. All rights reserved.

  4. Long-term life and partnership satisfaction in infertile patients: a 5-year longitudinal study.

    Science.gov (United States)

    Schanz, Stefan; Reimer, Thorisa; Eichner, Martin; Hautzinger, Martin; Häfner, Hans-Martin; Fierlbeck, Gerhard

    2011-08-01

    To describe the long-term effects of infertility on life and partnership satisfaction. Longitudinal cohort study. A university outpatient andrology and gynecology infertility clinic. 275 men and 272 women treated for infertility between August 2000 and December 2001. None. The Life Satisfaction Questionnaire (FLZ), the Partnership Questionnaire (PFB), and sociodemographic items at baseline (T1) and 5 years later (T2). Compared with a representative sample, our male and female participants had higher Finance and Partnership scores and lower Health scores on the FLZ at T1. They also had markedly higher PFB scores, with the exception of Conflict Behavior. After 5 years (T2), 101 men and 113 women rated the Partnership and Sexuality FLZ subscales as well as all the PFB subscales statistically significantly lower than at baseline. Only the women rated the Self-esteem FLZ subscale lower than at baseline (T1). Participants who became parents had lower Leisure and Partnership FLZ subscale scores, and fathers had lower Finance FLZ subscale scores. Satisfaction declined over 5 years for both men and women, but only in the partnership-related domains. Women were more affected than men. The success of infertility treatment had only a minor influence on a couple's future satisfaction. Copyright © 2011. Published by Elsevier Inc.

  5. Long-term cost and life-expectancy consequences of hypertension.

    Science.gov (United States)

    Kiiskinen, U; Vartiainen, E; Puska, P; Aromaa, A

    1998-08-01

    To estimate hypertension's long-term cost and impact on life expectancy. A 19-year individual follow-up study. Subjects were categorized according to their baseline (1972) diastolic blood pressure (DBP) level into three groups: normotensive (DBP 104 mmHg). By using their social security identification numbers, we linked the subjects to a set of national registers covering hospital admissions, use of major drugs, absence due to sickness, disability pensions, and deaths. A random population sample of 10 284 men and women aged 25-59 years from the provinces of Kuopio and North Karelia in eastern Finland. The numbers of years of life and years of work lost, the cost of drugs and hospitalization, and the value of productivity lost due to disability and premature mortality. The difference in life expectancy between normotensive and severely hypertensive men was 2.7 years, of which 2.0 years was due to cardiovascular disease (CVD). Among women the corresponding differences were 2.0 and 1.5 years. Severely hypertensive men lost 2.6 years of work more than did normotensive men, of which 1.7 years was due to CVD. Among women the differences were 2.2 and 1.3 years. The mean undiscounted total costs (USA dollars at 1992 prices) were $132 500 among normotensive, $146 500 among mildly hypertensive, and $219 300 among severely hypertensive men, of which CVD accounted for 28, 39, and 43%, respectively. More than 90% of the total costs were indirect productivity losses. Among women the total costs were lower for all DBP categories, as were the shares of CVD-related costs. The proportional increase in costs on going from the lowest to the highest DBP category was, however, somewhat larger among women. On the population level, severe hypertension leads to considerable losses in terms of years of life lost, years of work lost, and costs. However, the overall impact of mild hypertension is much more limited.

  6. Long-term medical costs and life expectancy of acute myeloid leukemia: a probabilistic decision model.

    Science.gov (United States)

    Wang, Han-I; Aas, Eline; Howell, Debra; Roman, Eve; Patmore, Russell; Jack, Andrew; Smith, Alexandra

    2014-03-01

    Acute myeloid leukemia (AML) can be diagnosed at any age and treatment, which can be given with supportive and/or curative intent, is considered expensive compared with that for other cancers. Despite this, no long-term predictive models have been developed for AML, mainly because of the complexities associated with this disease. The objective of the current study was to develop a model (based on a UK cohort) to predict cost and life expectancy at a population level. The model developed in this study combined a decision tree with several Markov models to reflect the complexity of the prognostic factors and treatments of AML. The model was simulated with a cycle length of 1 month for a time period of 5 years and further simulated until age 100 years or death. Results were compared for two age groups and five different initial treatment intents and responses. Transition probabilities, life expectancies, and costs were derived from a UK population-based specialist registry-the Haematological Malignancy Research Network (www.hmrn.org). Overall, expected 5-year medical costs and life expectancy ranged from £8,170 to £81,636 and 3.03 to 34.74 months, respectively. The economic and health outcomes varied with initial treatment intent, age at diagnosis, trial participation, and study time horizon. The model was validated by using face, internal, and external validation methods. The results show that the model captured more than 90% of the empirical costs, and it demonstrated good fit with the empirical overall survival. Costs and life expectancy of AML varied with patient characteristics and initial treatment intent. The robust AML model developed in this study could be used to evaluate new diagnostic tools/treatments, as well as enable policy makers to make informed decisions. Copyright © 2014 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  7. Long-term quality of life in children treated for posterior fossa brain tumors.

    Science.gov (United States)

    Kulkarni, Abhaya V; Piscione, Janine; Shams, Iffat; Bouffet, Eric

    2013-09-01

    In the face of increasing survival, quality of life (QOL) has become an important indicator of treatment success in children with posterior fossa brain tumors (PFBTs). The authors' objective was to assess the long-term QOL in survivors of PFBT. The authors conducted a cross-sectional study of children who, between birth and age 18 years at diagnosis, had previously been treated at their institution for a PFBT. At the time of assessment for this study, children were between 5 and 19 years old and had received standard treatment for PFBT ending at least 6 months before the assessment. The QOL was measured with the Pediatric Quality of Life Inventory (PedsQL) generic score scales and the Health Utilities Index Mark 3 (HUI3). Multivariate analyses were used to assess several variables (patient related, treatment related, and socioeconomic) for association with QOL. A total of 62 children participated in the study (median age at assessment 11.9 years, interquartile range [IQR] 7.8-14.8, and median age at tumor diagnosis of 4.9 years, IQR 2.5-6.9). Median time since active treatment for their PFBT was 5.2 years (IQR 2.4-10.1). Tumor types included cerebellar pilocytic astrocytoma (45.2%), medulloblastoma (30.6%), ependymoma (11.3%), and brainstem astrocytoma (11.3%). Adjuvant therapy included chemotherapy (40.3%) or radiotherapy (14.5% focal and 21.0% craniospinal radiotherapy). Permanent treatment for hydrocephalus was required in 38.7% of the patients. Tumors recurred in 11.3%, requiring repeat treatment in these patients. The median HUI3 utility score was 0.91 (IQR 0.71-1.00) and the median PedsQL total score was 78.3 (IQR 64.1-92.4). Only the following variables were significantly associated with decreased QOL in multivariable model testing (all p size, decreased family functioning, and lower family income. As a group, long-term survivors of pediatric PFBT appear to have QOL indicators that are similar to those of the general population, although a reasonable

  8. Quality of Life in Long-term Survivors of Muscle-Invasive Bladder Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Mak, Kimberley S. [Harvard Radiation Oncology Program, Boston, Massachusetts (United States); Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts (United States); Smith, Angela B. [University of North Carolina at Chapel Hill, Chapel Hill, North Carolina (United States); Eidelman, Alec; Clayman, Rebecca; Niemierko, Andrzej; Cheng, Jed-Sian [Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts (United States); Matthews, Jonathan [University of North Carolina at Chapel Hill, Chapel Hill, North Carolina (United States); Drumm, Michael R. [Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts (United States); Nielsen, Matthew E. [University of North Carolina at Chapel Hill, Chapel Hill, North Carolina (United States); Feldman, Adam S.; Lee, Richard J.; Zietman, Anthony L. [Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts (United States); Chen, Ronald C. [University of North Carolina at Chapel Hill, Chapel Hill, North Carolina (United States); Shipley, William U. [Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts (United States); Milowsky, Matthew I. [University of North Carolina at Chapel Hill, Chapel Hill, North Carolina (United States); Efstathiou, Jason A., E-mail: jefstathiou@partners.org [Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts (United States)

    2016-12-01

    Purpose: Health-related quality of life (QOL) has not been well-studied in survivors of muscle-invasive bladder cancer (MIBC). The present study compared long-term QOL in MIBC patients treated with radical cystectomy (RC) versus bladder-sparing trimodality therapy (TMT). Methods and Materials: This cross-sectional bi-institutional study identified 226 patients with nonmetastatic cT2-cT4 MIBC, diagnosed in 1990 to 2011, who were eligible for RC and were disease free for ≥2 years. Six validated QOL instruments were administered: EuroQOL EQ-5D, European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Core Questionnaire and EORTC MIBC module, Expanded Prostate Cancer Index Composite bowel scale, Cancer Treatment and Perception Scale, and Impact of Cancer, version 2. Multivariable analyses of the mean QOL scores were conducted using propensity score matching. Results: The response rate was 77% (n=173). The median follow-up period was 5.6 years. Of the 173 patients, 64 received TMT and 109, RC. The median interval from diagnosis to questionnaire completion was 9 years after TMT and 7 years after RC (P=.009). No significant differences were found in age, gender, comorbidities, tobacco history, performance status, or tumor stage. On multivariable analysis, patients who received TMT had better general QOL by 9.7 points of 100 compared with those who had received RC (P=.001) and higher physical, role, social, emotional, and cognitive functioning by 6.6 to 9.9 points (P≤.04). TMT was associated with better bowel function by 4.5 points (P=.02) and fewer bowel symptoms by 2.7 to 7.1 points (P≤.05). The urinary symptom scores were similar. TMT was associated with better sexual function by 8.7 to 32.1 points (P≤.02) and body image by 14.8 points (P<.001). The patients who underwent TMT reported greater informed decision-making scores by 13.6 points (P=.01) and less concern about the negative effect of cancer by 6.8 points (P=.006). The study

  9. Quality of Life in Long-term Survivors of Muscle-Invasive Bladder Cancer

    International Nuclear Information System (INIS)

    Mak, Kimberley S.; Smith, Angela B.; Eidelman, Alec; Clayman, Rebecca; Niemierko, Andrzej; Cheng, Jed-Sian; Matthews, Jonathan; Drumm, Michael R.; Nielsen, Matthew E.; Feldman, Adam S.; Lee, Richard J.; Zietman, Anthony L.; Chen, Ronald C.; Shipley, William U.; Milowsky, Matthew I.; Efstathiou, Jason A.

    2016-01-01

    Purpose: Health-related quality of life (QOL) has not been well-studied in survivors of muscle-invasive bladder cancer (MIBC). The present study compared long-term QOL in MIBC patients treated with radical cystectomy (RC) versus bladder-sparing trimodality therapy (TMT). Methods and Materials: This cross-sectional bi-institutional study identified 226 patients with nonmetastatic cT2-cT4 MIBC, diagnosed in 1990 to 2011, who were eligible for RC and were disease free for ≥2 years. Six validated QOL instruments were administered: EuroQOL EQ-5D, European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Core Questionnaire and EORTC MIBC module, Expanded Prostate Cancer Index Composite bowel scale, Cancer Treatment and Perception Scale, and Impact of Cancer, version 2. Multivariable analyses of the mean QOL scores were conducted using propensity score matching. Results: The response rate was 77% (n=173). The median follow-up period was 5.6 years. Of the 173 patients, 64 received TMT and 109, RC. The median interval from diagnosis to questionnaire completion was 9 years after TMT and 7 years after RC (P=.009). No significant differences were found in age, gender, comorbidities, tobacco history, performance status, or tumor stage. On multivariable analysis, patients who received TMT had better general QOL by 9.7 points of 100 compared with those who had received RC (P=.001) and higher physical, role, social, emotional, and cognitive functioning by 6.6 to 9.9 points (P≤.04). TMT was associated with better bowel function by 4.5 points (P=.02) and fewer bowel symptoms by 2.7 to 7.1 points (P≤.05). The urinary symptom scores were similar. TMT was associated with better sexual function by 8.7 to 32.1 points (P≤.02) and body image by 14.8 points (P<.001). The patients who underwent TMT reported greater informed decision-making scores by 13.6 points (P=.01) and less concern about the negative effect of cancer by 6.8 points (P=.006). The study

  10. Evaluation of quality of life in long-term survivors of paediatric brain stem tumors, treated with radiotherapy

    International Nuclear Information System (INIS)

    Skowronska-Gardas, Anna; Pedziwiatr, Katarzyna; Chojnacka, Marzanna

    2004-01-01

    The quality of life in long-term survivors of paediatric brain stem tumors, treated with radiotherapy is evaluated. They suffer predominantly from pre-treatment neurological impairments, which seriously influence their quality of life. The most often observed treatment sequelae are pituitary insufficiency and hearing loss

  11. Taylor Series-Based Long-Term Creep-Life Prediction of Alloy 617

    International Nuclear Information System (INIS)

    Yin, Song Nan; Kim, Woo Gon; Kim, Yong Wan; Park, Jae Young; Kim, Soen Jin

    2010-01-01

    In this study, a Taylor series (T-S) model based on the Arrhenius, McVetty, and Monkman-Grant equations was developed using a mathematical analysis. In order to reduce fitting errors, the McVetty equation was transformed by considering the first three terms of the Taylor series equation. The model parameters were accurately determined by a statistical technique of maximum likelihood estimation, and this model was applied to the creep data of alloy 617. The T-S model results showed better agreement with the experimental data than other models such as the Eno, exponential, and L-M models. In particular, the T-S model was converted into an isothermal Taylor series (IT-S) model that can predict the creep strength at a given temperature. It was identified that the estimations obtained using the converted ITS model was better than that obtained using the T-S model for predicting the long-term creep life of alloy 617

  12. Impact of long term Yoga practice on sleep quality and quality of life in the elderly

    Directory of Open Access Journals (Sweden)

    Mangesh A Bankar

    2013-01-01

    Full Text Available Background: Sleep disturbances and decline in the physical functionality are common conditions associated with aging. Pharmacological treatment of sleep disturbances can be associated with various adverse effects. Short term trials of Yoga on sleep have shown beneficial effects. Objectives: To evaluate the effect of long-term Yoga exercises on sleep quality and quality of life (QOL in the elderly. Materials and Methods: This was a cross-sectional study in which data were collected from elderly people aged 60 years or more living in Nagpur city. We employed two types of survey questionnaires: Pittsburgh sleep quality index (PSQI and QOL Leiden-Padua (LEIPAD Questionnaire. A total of 65 elderly men and women who signed an informed consent and completed questionnaires were included in the study. Sleep quality score PSQI and QOL (LEIPAD Questionnaire score of the study group were evaluated and compared with the control group using Mann-Whitney U test. Results: Total PSQI score in Yoga group was lower than that of the control group. Also various QOL scores of the Yoga groups were higher than the control group. Conclusion: Addition of regular Yoga exercises in the daily routine of elderly people can help to achieve good sleep quality as well as improve the QOL.

  13. GENDER DIFFERENCES IN QUALITY OF LIFE AMONG LONG-TERM COLORECTAL CANCER SURVIVORS WITH OSTOMIES

    Science.gov (United States)

    Grant, Marcia; McMullen, Carmit K.; Altschuler, Andrea; Mohler, M. Jane; Hornbrook, Mark C.; Herrinton, Lisa J.; Wendel, Christopher S.; Baldwin, Carol M.; Krouse, Robert S.

    2011-01-01

    Objective To describe how gender shapes the concerns and adaptations of long-term (> 5 years) colorectal cancer (CRC) survivors with ostomies. Design Qualitative study using content analysis of focus group content. Setting Member of Kaiser Permanente, residing in either Oregon, Southwest Washington State, or Northern California. Sample Four female and four male focus groups selected from quantitative survey participants with health-related quality of life (HRQOL) scores in the highest or lowest quartile. Methods Eight focus groups, discussed challenges of living with an ostomy. Content was recorded, transcribed, and analyzed using directive and summative content analysis. Main Research Variables HRQOL domains of physical, psychological, social and spiritual well being. Findings All groups reported avoiding foods that cause gas or rapid transit, and discussed how limiting the amount of food eaten controlled the output. All groups discussed physical activities, getting support from friends and family, and the importance of being resilient. Both genders identified challenges with sexuality/intimacy. Coping and adjustment difficulties were discussed by women with men only discussing these issues to a small extent. Difficulties with sleep were primarily identified by Low HRQOL women. Problems with body image and depression were discussed only by Low HRQOL women. Conclusions Common issues included diet management, physical activity, social support and sexuality. Women with low HRQOL discussed problems with depression, body image, and sleep. Implications for Nursing Application of these gender-based differences can inform educational interventions for CRC survivors with ostomies. PMID:21875846

  14. Addressing Quality of Life Issues in Long Term Survivors of Head & Neck Cancer treated with Radiation Therapy

    Directory of Open Access Journals (Sweden)

    Bishan Basu

    2015-04-01

    Full Text Available The rapid advancement of curative treatment modalities has resulted in improvement of cure rates of head neck cancer leaving us with a larger number of long term survivors from the disease. Unfortunately, long term complications of therapy continue to hurt patients even after cure, compromising their quality of life. This is particularly true for the patients treated with primary radiation/chemo-radiation therapy, where so called organ preservation does not necessarily translate into preservation of organ function. Long term sequelae of treatment, particularly xerostomia and swallowing difficulties compromise the survivors’ quality of life. More studies, particularly suited to our clinical scenario, are warranted to address the quality of life issues in these patients, so that better evidence-based guidelines may be developed for their benefit.

  15. Quality of life in long-term survivors of oropharynx carcinoma

    International Nuclear Information System (INIS)

    Pourel, Nicolas; Peiffert, Didier; Lartigau, Eric; Desandes, Emmanuel; Luporsi, Elisabeth; Conroy, Thierry

    2002-01-01

    Purpose: To collect data on the health-related quality of life (QOL) of long-term survivors and to determine to what extent QOL might be an appropriate end point in the comparison of treatment options in oropharyngeal carcinoma. Methods and Materials: All patients treated between 1992 and 1998, in two French comprehensive cancer centers, by brachytherapy (BT) ± external beam radiotherapy (EBRT) or surgery plus RT, or exclusive EBRT for T1-T3 (International Union Against Cancer staging system) oropharynx squamous cell carcinoma, were included. QOL was measured once in disease-free patients at least 2 years after treatment initiation. The European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 questionnaire and the specific H and N35 module were self-administered by all participating patients. Sociodemographic data were collected using a questionnaire specifically designed for the study. The association between the QOL scores of the various treatment-, disease-, and patient-related variables was performed through bivariate analysis and then by multivariate analysis. The mean QOL scores of the EORTC QLQ-C30 questionnaire were compared with the mean scores in the general population. Results: Of the 159 eligible patients, 113 agreed to participate (97 men and 16 women, median age 61 years, range 41-83). The initial treatment was EBRT plus BT in 49 patients, surgery plus RT in 27, and EBRT alone in 37. The median follow-up time was 62 months (range 24-110). Compared with the general population, the three scores indicating the most impaired QOL were emotional and social functioning and fatigue. The clinical significance of global QOL impairment was borderline. The physical functioning, role functioning, and pain scores did not significantly differ from those of the general population. In multivariate analysis, the initial treatment had no significant influence on any dimension of QOL, except global QOL and emotional functioning. Surprisingly, surgery

  16. Developments in long-term explicit memory late in the first year of life: behavioral and electrophysiological indices.

    Science.gov (United States)

    Bauer, Patricia J; Wiebe, Sandra A; Carver, Leslie J; Waters, Jennie M; Nelson, Charles A

    2003-11-01

    Coincident with developments in the temporal-cortical explicit memory network, long-term recall abilities are newly emergent late in the first year of human life. We recorded event-related potentials (ERPs) in 9-month-olds as an index of the integrity of the neural substrate underlying a task thought to reflect explicit memory, namely, deferred imitation. ERP measures of recognition memory 1 week after unique laboratory experiences predicted whether and how much infants recalled of the experiences 1 month later. The findings further imply that memory storage and consolidation processes are a major source of variability in long-term recall memory late in the first year of life.

  17. Service Life Extension of the Propulsion System of Long-Term Manned Orbital Stations

    Science.gov (United States)

    Kamath, Ulhas; Kuznetsov, Sergei; Spencer, Victor

    2014-01-01

    One of the critical non-replaceable systems of a long-term manned orbital station is the propulsion system. Since the propulsion system operates beginning with the launch of station elements into orbit, its service life determines the service life of the station overall. Weighing almost a million pounds, the International Space Station (ISS) is about four times as large as the Russian space station Mir and about five times as large as the U.S. Skylab. Constructed over a span of more than a decade with the help of over 100 space flights, elements and modules of the ISS provide more research space than any spacecraft ever built. Originally envisaged for a service life of fifteen years, this Earth orbiting laboratory has been in orbit since 1998. Some elements that have been launched later in the assembly sequence were not yet built when the first elements were placed in orbit. Hence, some of the early modules that were launched at the inception of the program were already nearing the end of their design life when the ISS was finally ready and operational. To maximize the return on global investments on ISS, it is essential for the valuable research on ISS to continue as long as the station can be sustained safely in orbit. This paper describes the work performed to extend the service life of the ISS propulsion system. A system comprises of many components with varying failure rates. Reliability of a system is the probability that it will perform its intended function under encountered operating conditions, for a specified period of time. As we are interested in finding out how reliable a system would be in the future, reliability expressed as a function of time provides valuable insight. In a hypothetical bathtub shaped failure rate curve, the failure rate, defined as the number of failures per unit time that a currently healthy component will suffer in a given future time interval, decreases during infant-mortality period, stays nearly constant during the service

  18. Bayes approach in RDT using accelerated and long-term life data

    International Nuclear Information System (INIS)

    Bris, R.

    2000-01-01

    A common problem of reliability demonstration testing (RDT) is the magnitude of total time on test required to demonstrate reliability to the consumer's satisfaction, particularly in the case of high reliability components. One solution is the use of accelerated life testing (ALT) techniques. Another is to incorporate prior beliefs, engineering experience, or previous data into the testing framework. This may have the effect of reducing the amount of testing required in the RDT in order to reach a decision regarding conformance to the reliability specification. It is in this spirit that the use of a Bayesian approach can, in many cases, significantly reduce the amount of testing required. We demonstrate the use of this approach to estimate the acceleration factor in the Arrhenius reliability model based on long-term data given by a manufacturer of electronic components (EC). Using the Bayes approach we consider failure rate and acceleration factor to vary randomly according to some prior distributions. Bayes approach enables for a given type of technology the optimal choice of test plan for RDT under accelerated conditions when exacting reliability requirements must be met. These requirements are given by a hypothetical consumer by two different ways. The calculation of posterior consumer's risk is demonstrated in both cases. The test plans are optimum in that they take into account Var{λ vertical bar data}, posterior risk, E{λ vertical bar data}, Median λ or other percentiles of λ at data observed at the accelerated conditions. The test setup assumes testing of units with time censoring

  19. [Cardiac surgery in octogenarian patients: evaluation of predictive factors of mortality, long-term outcome and quality of life].

    Science.gov (United States)

    Viana-Tejedor, Ana; Domínguez, Francisco J; Moreno Yangüela, Mar; Moreno, Raúl; López de Sá, Esteban; Mesa, José M; López-Sendón, José

    2008-10-04

    Increasing life expectancy in Western countries in the last decades has resulted in a significant gradual increasing number of octogenarians referred for cardiac surgery. There is a need for a critical evaluation of the long-term surgical outcome and quality of life in the elderly. The aim of this study is to identify risk factors of mortality in octogenarians undergoing cardiac surgery and to assess the long term survival and quality of life. Data were reviewed on 150 patients aged over 80 years--mean age (standard deviation): 82.7 (2.5) years--who underwent cardiac surgery at our institution in the last 26 years. We analyzed clinical and epidemiological variables included in the European System for Cardiac Operative Risk Evaluation (euroSCORE), in-hospital morbidity and mortality, long term survival and quality of life after cardiac surgery. The 30-day mortality rate was 30.1%, with a mean hospital stay of 16.5 days (13-27). Emergent procedure, reparation of postinfarction ventricular ruptures, New York Heart Association functional class IV, chronic renal failure and previous myocardial infarction were independent predictors of in-hospital mortality. Mean follow up was 72.2 (9.9) months with survival rates of 87.3% and 57% at 1 and 5 years, respectively. Late postoperative quality of life in our 53 long-term survivors was significantly better than prior to surgery. New York Heart Association functional class improved from 2.52 to 1.48. Most survivors (97.7%) were satisfied with present quality of life Cardiac surgery in octogenarians is associated with increased in-hospital mortality rate and longer hospital stay. Our findings support that cardiac surgery can be performed in a selected elderly population with good long-term survival and quality of life.

  20. Long-term care: the family, post-modernity, and conflicting moral life-worlds.

    Science.gov (United States)

    Engelhardt, H Tristram

    2007-01-01

    Long-term care is controversial because it involves foundational disputes. Some are moral-economic, bearing on whether the individual, the family, or the state is primarily responsible for long-term care, as well as on how one can establish a morally and financially sustainable long-term-care policy, given the moral hazard of people over-using entitlements once established, the political hazard of media democracies promising unfundable entitlements, the demographic hazard of relatively fewer workers to support those in need of long-term care, the moral hazard to responsibility of shifting accountability to third parties, and the bureaucratic hazard of moving from individual and family choice to bureaucratic oversight. These disputes are compounded by controversies regarding the nature of the family (Is it to be regarded primarily as a socio-biological category, a fundamental ontological category of social reality, or a construct resulting from the consent of the participants?), as well as its legal and moral autonomy and authority over its members. As the disputes show, there is no common understanding of respect and human dignity that will easily lead out of these disputes. The reflections on long-term care in this issue underscore the plurality of moralities defining bioethics.

  1. Long-term Impact of Bile Duct Injury on Morbidity, Mortality, Quality of Life, and Work Related Limitations

    NARCIS (Netherlands)

    Booij, Klaske A. C.; de Reuver, Philip R.; van Dieren, Susan; van Delden, Otto M.; Rauws, Erik A.; Busch, Olivier R.; van Gulik, Thomas M.; Gouma, Dirk J.

    2017-01-01

    Assessment of long-term comprehensive outcome of multimodality treatment of bile duct injury (BDI) in terms of morbidity, mortality, quality of life (QoL), survival, and work related limitations. The impact of BDI on work ability is scarcely investigated. BDI patients referred to a tertiary center

  2. Young traffic victims' long-term health-related quality of life : Child self-reports and parental reports

    NARCIS (Netherlands)

    Sturms, LM; van der Sluis, CK; Groothoff, JW; ten Duis, HJ; Eisma, WH

    Objectives: To describe the long-term health-related quality of life (HRQOL) reported by young traffic injury victims and to assess the child-parent agreement on the child's HRQOL. Design: Cohort study with a mean follow-up of 2.4 years. Setting: Traumatology department in a university hospital in

  3. Quality of life and stress response symptoms in long-term and recent spouses of testicular cancer survivors

    NARCIS (Netherlands)

    Tuinman, MA; Fleer, J; Hoekstra, HJ; Sleijfer, DT; Hoekstra-Weebers, JEHM

    The aim of this study was to gain insight into the quality of life (QoL) and stress response of female spouses of men cured of testicular cancer in the long-term. Time since treatment completion varied from 0.5 to 23.8 years. Two hundred and fifty nine testicular cancer survivors and their spouses

  4. Space Life Sciences Research: The Importance of Long-Term Space Experiments

    Science.gov (United States)

    1993-01-01

    This report focuses on the scientific importance of long-term space experiments for the advancement of biological science and the benefit of humankind. It includes a collection of papers that explore the scientific potential provided by the capability to manipulate organisms by removing a force that has been instrumental in the evolution and development of all organisms. Further, it provides the scientific justification for why the long-term space exposure that can be provided by a space station is essential to conduct significant research.

  5. Long-term survivors of childhood cancer report quality of life and health status in parity with a comparison group.

    Science.gov (United States)

    Sundberg, Kay K; Doukkali, Eva; Lampic, Claudia; Eriksson, Lars E; Arvidson, Johan; Wettergren, Lena

    2010-08-01

    There is a need for more knowledge about how survivors of childhood cancer perceive their lives and what influence current health status has on their quality of life. The purpose was to describe this among a group of long-term survivors and among a comparison group. Telephone interviews were performed with a cohort of 246 long-term survivors and 296 randomly selected from the general population using the Schedule for the Evaluation of Individual Quality of Life-Direct Weighting (SEIQoL-DW). The participants nominated the areas they considered to be most important in life and rated the current status of each area on a seven-point category scale. An overall individual index score was calculated as a measure of quality of life. Self-reported health status was assessed using the Short Form Health Survey (SF-36). Long-term survivors rated their overall quality of life and self-reported health status almost in parity with the comparison group. In both groups, family life, relations to other people, work and career, interests and leisure activities were the areas most frequently reported to influence quality of life. The survivors only differed from the comparison group on one of eight SF-36 scales reflecting problems with daily activities owing to physical health. Health status was not shown to have a major impact on overall quality of life, indicating that health and quality of life should be evaluated distinctively as different constructs. This should be taken in consideration in clinical care of children with childhood cancer and long-term survivors. (c) 2010 Wiley-Liss, Inc.

  6. Recent life stress exposure is associated with poorer long-term memory, working memory, and self-reported memory.

    Science.gov (United States)

    Shields, Grant S; Doty, Dominique; Shields, Rebecca H; Gower, Garrett; Slavich, George M; Yonelinas, Andrew P

    2017-11-01

    Although substantial research has examined the effects of stress on cognition, much of this research has focused on acute stress (e.g. manipulated in the laboratory) or chronic stress (e.g. persistent interpersonal or financial difficulties). In contrast, the effects of recent life stress on cognition have been relatively understudied. To address this issue, we examined how recent life stress is associated with long-term, working memory, and self-reported memory in a sample of 142 healthy young adults who were assessed at two time points over a two-week period. Recent life stress was measured using the newly-developed Stress and Adversity Inventory for Daily Stress (Daily STRAIN), which assesses the frequency of relatively common stressful life events and difficulties over the preceding two weeks. To assess memory performance, participants completed both long-term and working memory tasks. Participants also provided self-reports of memory problems. As hypothesized, greater recent life stress exposure was associated with worse performance on measures of long-term and working memory, as well as more self-reported memory problems. These associations were largely robust while controlling for possible confounds, including participants' age, sex, and negative affect. The findings indicate that recent life stress exposure is broadly associated with worse memory. Future studies should thus consider assessing recent life stress as a potential predictor, moderator, or covariate of memory performance.

  7. [Prenatal intestinal volvulus: A life-threatening event with good long-term outcome].

    Science.gov (United States)

    Raherison, R; Grosos, C; Lemale, J; Blondiaux, E; Sabourdin, N; Dahan, S; Rosenblatt, J; Guilbert, J; Jouannic, J-M; Mitanchez, D; Audry, G; Auber, F

    2012-04-01

    . Median duration of parenteral nutrition was 29 days (range, 6-667 days). None of the patients had cystic fibrosis. Unlike postnatal volvulus, most prenatal volvulus occurs without malrotation. Although prenatal volvulus is a life-threatening condition, our results suggest that good long-term outcome can be achieved in most cases. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

  8. Plant life (PLIM) and ageing management (AM) in German NPPs. Prerequisite for long term operation (LTO)

    International Nuclear Information System (INIS)

    Schuler, X.

    2010-01-01

    dependant) or based on monitoring of relevant parameters (predictive). The results of these procedures are assessed for each SSC, specifically. For both groups of SSC, in addition to the control of (known) damage mechanisms, all significant plant data (e.g. reports of failures, work orders) and the reports from other plants (incl. exchange of knowledge) are assessed regularly in order to be prepared for new damage mechanisms (and to prevent / control them consequently). This is performed by an appropriate software approach. Within this SSC-specific assessment the entity of measures to control degradation effects is reviewed and modified / extended, if necessary. On the basis of good experiences with the AM procedure and driven by the latest political development (nuclear power is an option in energy supply again) the utilities are re-structuring their plant life management (PLIM), actually. PLIM addresses both safety and economical aspects. Consequently, all SSC of a plant and every possible degradation mechanism have to be considered within PLIM - besides other more not-technical aspects. AM is part of the plant life management. Regarding technical equipment, the PLIM procedure is similar to that established in AM. Depending on the requirements it is necessary to - establish quality during design and manufacture - safeguard this quality in operation by appropriate measures - assess procedure / measures and existing quality, regularly. Living an effective PLIM procedure the utilities are kept on the state of the art; on this basis energy production can be safe and economic at any time. This is an essential prerequisite for long term operation (LTO). (orig.)

  9. Long term health-related quality of life in survivors of sepsis in South West Wales: an epidemiological study.

    Science.gov (United States)

    Battle, Ceri E; Davies, Gareth; Evans, Phillip A

    2014-01-01

    Survivors of sepsis report persistent problems that can last years after hospital discharge. The main aim of this study was to investigate long-term health-related quality of life in survivors of SIRS and sepsis compared with Welsh normative data, controlling for age, length of stay and pre-existing conditions. The second aim was to investigate any differences in long-term health-related quality of life specifically with the patients categorised into three groups; SIRS, uncomplicated sepsis and severe sepsis/septic shock. A prospective study design was used in order to investigate all sepsis patients either presenting to the Emergency Department or admitted to the Intensive Care Unit of a regional trauma centre. Baseline demographics, clinical characteristics and outcomes were collected and surviving patients were sent a SF-12v2 survey at between six months to two years post-hospital discharge. Quality of life was significantly reduced in all patients when compared to local normative data (all pquality of life were more pronounced in severe sepsis/septic shock patients when compared to uncomplicated sepsis and SIRS patients, when controlling for age, pre-existing conditions, hospital and ICU length of stay. This is the first observational study to specifically focus on the different groups of SIRS and sepsis patients to assess long-term quality of life. Local population norms were used for comparison, rather than UK-wide norms that fail to reflect the intricacies of a country's population.

  10. Long-term quality of life after conservative treatment versus surgery for different stages of acute sigmoid diverticulitis.

    Science.gov (United States)

    Brandlhuber, Martina; Genzinger, Christian; Brandlhuber, Bernhard; Sommer, Wieland H; Müller, Mario H; Kreis, Martin E

    2018-03-01

    It is controversial whether patients fare better with conservative or surgical treatment in certain stages of acute diverticulitis (AD), in particular when phlegmonous inflammation or covered micro- or macro-perforation are present. The aim of this study was to determine long-term quality of life (QoL) for AD patients who received either surgery or conservative treatment in different stages. We included patients treated for AD at the University Hospital Grosshadern, Munich, Germany, between January 1, 2000, and December 31, 2010. Patients were classified by the Hansen and Stock (HS) classification, the modified Hinchey classification, and the German classification of diverticular disease (CDD). Pre-therapeutic staging was based on multidetector computed tomography. Long-term QoL was assessed by the Cleveland Global Quality of Life (CGQL) questionnaire, the Short Form 36 (SF-36), and the Gastrointestinal Quality of Life Index (GIQLI). Data are mean ± SEM. Patients with phlegmonous AD (HS type 2a, Hinchey Ia and CDD 1b, respectively) had a better long-term QoL on the GIQLI when they were operated (78.5 ± 2.5 vs. 70.7 ± 2.1; p life, patients fare better after elective sigmoid colectomy when abscess size exceeds 1 cm.

  11. Early-life exposure to fibroblast growth factor-2 facilitates context-dependent long-term memory in developing rats.

    Science.gov (United States)

    Graham, Bronwyn M; Richardson, Rick

    2010-06-01

    Fibroblast growth factor-2 (FGF2) is a potent neurotrophic factor that is involved in brain development and the formation of long-term memory. It has recently been shown that acute FGF2, administered at the time of learning, enhances long-term memory for contextual fear conditioning as well as extinction of conditioned fear in developing rats. As other research has shown that administering FGF2 on the first day of life leads to long-term morphological changes in the hippocampus, in the present study we investigated whether early life exposure to FGF2 affects contextual fear conditioning, and renewal following extinction, later in life. Experiment 1 demonstrated that a single injection of FGF2 on Postnatal Day (PND) 1 did not lead to any detectable changes in contextual fear conditioning in PND 16 or PND 23 rats. Experiments 2 and 3 demonstrated that 5 days of injections of FGF2 (from PND 1-5) facilitated contextual fear conditioning in PND 16 and PND 23 rats. Experiment 4 demonstrated that the observed facilitation of memory was not due to FGF2 increasing rats' sensitivity to foot shock. Experiment 5 showed that early life exposure to FGF2 did not affect learning about a discrete conditioned stimulus, but did allow PND 16 rats to use contextual information in more complex ways, leading to context-dependent extinction of conditioned fear. These results further implicate FGF2 as a critical signal involved in the development of learning and memory.

  12. Activity involvement and quality of life of people at different stages of dementia in long term care facilities.

    Science.gov (United States)

    Smit, Dieneke; de Lange, Jacomine; Willemse, Bernadette; Twisk, Jos; Pot, Anne Margriet

    2016-01-01

    Involvement in activities is assumed to positively influence the quality of life of people with dementia, yet activity provision in long-term care remains limited. This study aims to provide more insight into the value of activity involvement for domains of the quality of life of long-term dementia care residents, taking resident characteristics and cognitive status into account. Data were derived from 144 long-term care facilities participating in the second measurement (2010/2011) of the living arrangements for dementia study. Amongst 1144 residents, the relationship between time involved in activities (activity pursuit patterns; RAI-MDS) and quality of life (Qualidem) was studied using multilevel linear regression analyses. Analyses were adjusted for residents' age, gender, neuropsychiatric symptoms, ADL dependency and cognition. To check for effect modification of cognition, interactions terms of the variables activity involvement and cognitive status were added to the analyses. Despite resident's cognitive status, their activity involvement was significantly related to better scores on care relationship, positive affect, restless tense behaviour, social relations, and having something to do. A negative relationship existed between the activity involvement and positive self-image. The explained variance in the quality of life between residents caused by the activity involvement was small. Activity involvement seems to be a small yet important contributor to higher well-being in long-term care resident at all stages of dementia. Adjusting activities to individual preferences and capabilities might enlarge this relationship. Further research is needed to confirm this hypothesis, using measurement instruments less sensitive to recall bias and differentiating between the active and passive activity involvement.

  13. Low-dose penicillin in early life induces long-term changes in murine gut microbiota, brain cytokines and behavior

    Science.gov (United States)

    Leclercq, Sophie; Mian, Firoz M.; Stanisz, Andrew M.; Bindels, Laure B.; Cambier, Emmanuel; Ben-Amram, Hila; Koren, Omry; Forsythe, Paul; Bienenstock, John

    2017-01-01

    There is increasing concern about potential long-term effects of antibiotics on children's health. Epidemiological studies have revealed that early-life antibiotic exposure can increase the risk of developing immune and metabolic diseases, and rodent studies have shown that administration of high doses of antibiotics has long-term effects on brain neurochemistry and behaviour. Here we investigate whether low-dose penicillin in late pregnancy and early postnatal life induces long-term effects in the offspring of mice. We find that penicillin has lasting effects in both sexes on gut microbiota, increases cytokine expression in frontal cortex, modifies blood–brain barrier integrity and alters behaviour. The antibiotic-treated mice exhibit impaired anxiety-like and social behaviours, and display aggression. Concurrent supplementation with Lactobacillus rhamnosus JB-1 prevents some of these alterations. These results warrant further studies on the potential role of early-life antibiotic use in the development of neuropsychiatric disorders, and the possible attenuation of these by beneficial bacteria. PMID:28375200

  14. Long Term Depression in Rat Hippocampus and the Effect of Ethanol during Fetal Life

    Directory of Open Access Journals (Sweden)

    Olivier Pierrefiche

    2017-11-01

    Full Text Available Alcohol (ethanol disturbs cognitive functions including learning and memory in humans, non-human primates, and laboratory animals such as rodents. As studied in animals, cellular mechanisms for learning and memory include bidirectional synaptic plasticity, long-term potentiation (LTP, and long-term depression (LTD, primarily in the hippocampus. Most of the research in the field of alcohol has analyzed the effects of ethanol on LTP; however, with recent advances in the understanding of the physiological role of LTD in learning and memory, some authors have examined the effects of ethanol exposure on this particular signal. In the present review, I will focus on hippocampal LTD recorded in rodents and the effects of fetal alcohol exposure on this signal. A synthesis of the findings indicates that prenatal ethanol exposure disturbs LTD concurrently with LTP in offspring and that both glutamatergic and γ-aminobutyric acid (GABA neurotransmissions are altered and contribute to LTD disturbances. Although the ultimate mode of action of ethanol on these two transmitter systems is not yet clear, novel suggestions have recently appeared in the literature.

  15. Intermediate and long-term quality of life after total knee replacement: a systematic review and meta-analysis.

    Science.gov (United States)

    Shan, Leonard; Shan, Bernard; Suzuki, Arnold; Nouh, Fred; Saxena, Akshat

    2015-01-21

    Total knee replacement is a highly successful and frequently performed operation. Technical outcomes of surgery are excellent, with favorable early postoperative health-related quality of life. This study reviews intermediate and long-term quality of life after surgery. A systematic review and meta-analysis of all studies published from January 2000 onward was performed to evaluate health-related quality of life after primary total knee replacement for osteoarthritis in patients with at least three years of follow-up. Key outcomes were postoperative quality of life, function, and satisfaction compared with the preoperative status. Strict inclusion and exclusion criteria were applied. Quality appraisal and data tabulation were performed with use of predefined criteria. Data were synthesized by narrative review and random-effects meta-analysis utilizing standardized mean differences. Heterogeneity was assessed with the tau(2) and I(2) statistics. Nineteen studies were included in the review. Intermediate and long-term postoperative quality of life was superior to the preoperative level in qualitative and quantitative analyses. The pooled effect in combined WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index) and KSS (Knee Society Score) outcomes was a marked improvement from baseline with respect to the total score (2.17; 95% CI [confidence interval], 1.13 to 3.22; p Total knee replacement confers significant intermediate and long-term benefits with respect to both disease-specific and generic health-related quality of life, especially pain and function, leading to positive patient satisfaction. Recommendations for necessary future studies are provided. Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence. Copyright © 2015 by The Journal of Bone and Joint Surgery, Incorporated.

  16. The Long-Term Game: An Analysis of the Life Expectancy of National Football League Players

    Directory of Open Access Journals (Sweden)

    Ruud Koning

    2014-03-01

    Full Text Available The National Football League (NFL has recently received significant negative media attention surrounding the safety of its players, revolving largely around the long term health risks of playing the sport. Recent premature deaths and instances of suicide associated with chronic traumatic encephalopathy and other football related injuries have brought the sport under increased scrutiny. By comparing mortality rates of the general population to mortality rates of players using publically available data from the 1970 and 1994 NFL seasons, we test whether participation in football is significantly harmful to the longevity of the players. We conclude that, in total, players in the NFL have lower mortality rates than the general population. However, there is evidence that line players have higher mortality rates than other players and that those who played more games have higher mortality rates than those who played fewer games.

  17. Resident challenges with daily life in Chinese long-term care facilities: A qualitative pilot study.

    Science.gov (United States)

    Song, Yuting; Scales, Kezia; Anderson, Ruth A; Wu, Bei; Corazzini, Kirsten N

    As traditional family-based care in China declines, the demand for residential care increases. Knowledge of residents' experiences with long-term care (LTC) facilities is essential to improving quality of care. This pilot study aimed to describe residents' experiences in LTC facilities, particularly as it related to physical function. Semi-structured open-ended interviews were conducted in two facilities with residents stratified by three functional levels (n = 5). Directed content analysis was guided by the Adaptive Leadership Framework. A two-cycle coding approach was used with a first-cycle descriptive coding and second-cycle dramaturgical coding. Interviews provided examples of challenges faced by residents in meeting their daily care needs. Five themes emerged: staff care, care from family members, physical environment, other residents in the facility, and personal strategies. Findings demonstrate the significance of organizational context for care quality and reveal foci for future research. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. Long Term Operation R and D to Investigate the Technical Basis for Life Extension and License Renewal Decisions

    International Nuclear Information System (INIS)

    Gaertner, John

    2012-01-01

    Establishing an improved technical basis for long term operation of existing plants is a nuclear industry priority. The Electric Power Research Institute (EPRI) has responded with a comprehensive Long Term Operation (LTO) Program addressing this need for existing nuclear power plants world-wide. The program supports both the business decisions necessary to achieve high performance operation and the licensing requirements for operation beyond 60 years. The program selects its R and D priorities in a structured and objective way with much industry input to provide useful results for decisions in the 2014 to 2019 time frame. The program is highly collaborative with U.S. Department of Energy (DOE) and with EPRI-member utilities. The R and D portfolio includes materials aging (metals, concrete, and cables), modernization of information and control technology, enhanced safety analysis, advanced fuel design, demonstration plant activities, life cycle management, and identification of aging management program need for subsequent license renewal. The program has focussed stakeholders world-wide on the technical issues of long term operation, and it is on-track to provide practical results for life extension and license renewal decisions. (author)

  19. A prospective analysis of long-term quality of life after permanent I-125 brachytherapy for localised prostate cancer

    International Nuclear Information System (INIS)

    Ash, Dan; Bottomley, David; Al-Qaisieh, Bashar; Carey, Brendan; Gould, Kath; Henry, Ann

    2007-01-01

    Background and purpose: To prospectively evaluate long-term urinary, bowel and sexual function after I-125 brachytherapy for localised prostate cancer using patient administered validated Quality of Life (QoL) instruments. Materials and methods: Between March 1995 and March 2004, 673 men underwent brachytherapy and recorded urinary symptoms prospectively using the International Prostate Symptom Score (IPSS). In addition, in a subgroup of 116 patients, the Expanded Prostate Cancer Index Composite (EPIC) was used to record QoL information on urinary, bowel and sexual function before treatment and at regular time intervals for at least two years. Results: Initially, there was a sharp rise in urinary symptoms which was most marked within the first three months. Scores then resolved slowly and returned to within one or two units of pre-treatment level at one year. Subsequently, there was no significant deterioration in urinary symptoms up to nine years following brachytherapy. Few had significant bowel symptoms. Sexual function deteriorated initially and then improved but failed to return to pre-treatment levels by two years. Patients requiring neo-adjuvant hormones experienced significantly more dysfunction. Conclusions: After an initial period of mild to moderate urinary symptoms prostate brachytherapy is well tolerated with relatively little deterioration in long-term quality of life. Long-term reduction in sexual function may be seen particularly in those requiring hormones

  20. A quality of life study in 20 adult long-term survivors of unrelated donor bone marrow transplantation.

    Science.gov (United States)

    Marks, D I; Gale, D J; Vedhara, K; Bird, J M

    1999-07-01

    There are few specific data available concerning quality of life (QOL) of survivors of unrelated donor bone marrow transplantation (UD-BMT). The procedure is expensive, difficult and is being employed increasingly yet we have little information concerning the QOL of survivors to justify this intervention. In this study, 20 long-term (>1 year post-BMT) survivors were studied with four self report questionnaires designed to assess quality of life, satisfaction with life, social support and employment status. Overall, satisfaction with life measures was above average but there was dissatisfaction with physical strength and appearance. The post-transplant employment data indicates that 60% of long-term survivors returned to full-time work and 15% to part-time work. Failure to return to work was not correlated with graft-versus-host disease (GVHD), relapse, age at or time since transplant. In general, there was a good correlation between the clinician's and patient's view of their health but the clinician's assessment of the patients mental health and energy was higher than the patients reported. Further research is required in the area of QOL post-UD-BMT. This will enable transplant physicians to counsel patients better pre-BMT and to evaluate fully the results achieved by different centres performing the procedure.

  1. Long-term quality of life assessment in patients with auricular prostheses

    NARCIS (Netherlands)

    Kievit, H.; Verhage-Damen, G.W.; Ingels, K.J.A.O.; Mylanus, E.A.M.; Hol, M.K.S.

    2013-01-01

    OBJECTIVE: To investigate the quality of life of people with an auricular prosthesis. METHODS: A retrospective case series study was conducted. Quality of life was evaluated by an open-ended question form and 3 questionnaires: the Glasgow Benefit Inventory, the Rosenberg Self-Esteem scale, and the

  2. Long-term impact of endometrial cancer diagnosis and treatment on health-related quality of life and cancer survivorship : Results from the randomized PORTEC-2 trial

    NARCIS (Netherlands)

    De Boer, Stephanie M.; Nout, Remi A.; Jurgenliemk-Schulz, Ina M.; Jobsen, Jan J; Lutgens, Ludy C.H.W.; Van Der Steen-Banasik, Elzbieta M.; Mens, Jan Willem M.; Slot, Annerie; Stenfert Kroese, Marika C.; Oerlemans, Simone; Putter, Hein; Verhoeven-Adema, Karen W.; Nijman, Hans W; Creutzberg, Carien L.

    2015-01-01

    Purpose: To evaluate the long-term health-related quality of life (HRQL) after external beam radiation therapy (EBRT) or vaginal brachytherapy (VBT) among PORTEC-2 trial patients, evaluate long-term bowel and bladder symptoms, and assess the impact of cancer on these endometrial cancer (EC)

  3. Long-term impact of endometrial cancer diagnosis and treatment on health-related quality of life and cancer survivorship : Results from the randomized PORTEC-2 trial

    NARCIS (Netherlands)

    de Boer, Stephanie M.; Nout, Remi A.; Jurgenliemk-Schulz, Ina M.; Jobsen, Jan J.; Lutgens, Ludy C. H. W.; van der Steen-Banasik, Elzbieta M.; Mens, Jan Willem M.; Slot, Annerie; Kroese, Marika C. Stenfert; Oerlemans, Simone; Putter, Hein; Verhoeven-Adema, Karen W.; Nijman, Hans W.; Creutzberg, Carien L.

    2015-01-01

    Purpose To evaluate the long-term health-related quality of life (HRQL) after external beam radiation therapy (EBRT) or vaginal brachytherapy (VBT) among PORTEC-2 trial patients, evaluate long-term bowel and bladder symptoms, and assess the impact of cancer on these endometrial cancer (EC)

  4. Long-Term Impact of Endometrial Cancer Diagnosis and Treatment on Health-Related Quality of Life and Cancer Survivorship : Results From the Randomized PORTEC-2 Trial

    NARCIS (Netherlands)

    de Boer, Stephanie M.; Nout, Remi A.; Jurgenliemk-Schulz, Ina M.; Jobsen, Jan J.; Lutgens, Ludy C. H. W.; van der Steen-Banasik, Elzbieta M.; Mens, Jan Willem M.; Slot, Annerie; Kroese, Marika C. Stenfert; Oerlemans, Simone; Putter, Hein; Verhoeven-Adema, Karen W.; Nijman, Hans W.; Creutzberg, Carien L.

    2015-01-01

    Purpose: To evaluate the long-term health-related quality of life (HRQL) after external beam radiation therapy (EBRT) or vaginal brachytherapy (VBT) among PORTEC-2 trial patients, evaluate long-term bowel and bladder symptoms, and assess the impact of cancer on these endometrial cancer (EC)

  5. Multi-Cultural Long Term Care Nurses’ Perceptions of Factors Influencing Patient Dignity at the End of Life

    Science.gov (United States)

    Periyakoil, Vyjeyanthi S.; Stevens, Marguerite; Kraemer, Helena

    2012-01-01

    The goal of this mixed-methods study was to characterize the perceptions of multi-cultural long-term care nurses about patient dignity at the end-of-life (EOL). The study was conducted in a large, urban long-term care (LTC) facility. The participants were forty-five long-term care nurses and 26 terminally ill nursing home patients. Nurses completed an open-ended interview about their perceptions of the concept of dying with dignity and the data were analyzed using grounded theory methods. Main themes identified as promoting patient dignity at the EOL included treating them with respect, helping them prepare for their EOL, promoting shared decision making and providing high quality tenor of care. The nurses’ cultural and religious backgrounds influenced their perceptions of what constitutes dignity-conserving care. Foreign-born nurses stressed the need for end-of-life rituals but this was strikingly absent in the statements of US-born nurses. Foreign-born Catholic nurses stated that the dying experience should not be altered using analgesics to relieve suffering or by attempts to hasten death by forgoing curative therapy or by other means. Both nurses and terminally ill patients completed the Dignity Card-sort Tool (DCT). A comparison of the LTC nurses cohort to the terminally ill patient responses on the DCT revealed that the nurses felt that patient dignity was eroded when her/his wishes were not carried out and when s/he is treated without respect. In contrast, dying LTC patients felt that poor medical care and loss of ability to choose care options to be the most important factors leading to erosion of dignity. PMID:23496266

  6. Depression, anxiety and quality of life in long-term survivors of malignant melanoma: a register-based cohort study.

    Directory of Open Access Journals (Sweden)

    Manfred E Beutel

    Full Text Available The purpose of the study was to determine anxiety and depression, quality of life, and their determinants in long-term survivors of malignant melanoma.In a state cancer registry a cohort of survivors of malignant melanoma was contacted via the physician registered. Of 1302 contactable patients, 689 (52.2% completed a questionnaire including the Patient Health Questionnaire with generalized anxiety (GAD-7 and depression (PHQ-9 and the EORTC Quality of Life Questionnaire (EORTC QLQ 30. Based on multiple regression analysis, predictors of quality of life and distress were identified. Comparison data were assessed in two waves of representative face-to-face household surveys of the adult German population.An average of 8.4 (5.7 to 12.2 years after diagnosis, distress was higher in women compared to men and in middle adulthood (vs. older patients. Symptoms were higher in women than in men, and there was a decline of functioning and increase of symptoms across the age range of both genders. Compared to the general population, there were slightly increased depression and anxiety (only women, but no impaired global quality of life. Yet, survivors evidenced functional decline and more physical symptoms. Distress and reduced quality of life were consistently predicted by lack of social support, fear of recurrence, pessimism and self-blame. Distress was increased by a family history of melanoma, and additional mental and somatic diseases.Overall, long-term survivors have adjusted well achieving a global quality of life comparable to the general population. Yet, compromised functional dimensions, physical symptoms and distress indicate the need for integrating psychooncological screening into oncological follow-up, which might be guided by predictors such as family history or social support. Further prospective study is needed to determine the course of adaptation to the disease and corroborate the risk factors identified.

  7. Numerical modelling of the long-term evolution of EDZ. Development of material models, implementation in finite-element codes, and validation

    International Nuclear Information System (INIS)

    Pudewills, A.

    2005-11-01

    Construction of deep underground structures disturbs the initial stress field in the surrounding rock. This effect can generate microcracks and alter the hydromechanical properties of the rock salt around the excavations. For the long-term performance of an underground repository in rock salt, the evolution of the 'Excavation Disturbed Zone' (EDZ) and the hydromechanical behaviour of this zone represent important issues with respect to the integrity of the geological and technical barriers. Within the framework of the NF-PRO project, WP 4.4, attention focuses on the mathematical modelling of the development and evolution of the EDZ in the rock near a disposal drift due to its relevance on the integrity of the geological and technical barriers. To perform this task, finite-element codes containing a set of time- and temperature-dependent constitutive models have been improved. A new viscoplastic constitutive model for rock salt that can describe the damage of the rock has been implemented in the finite-element codes available. The model parameters were evaluated based on experimental results. Additionally, the long-term evolution of the EDZ around a gallery in a salt mine at about 700 m below the surface was analysed and the numerical results were compared with in-situ measurements. The calculated room closure, stress distribution and the increase of rock permeability in the EDZ were compared with in-situ data, thus providing confidence in the model used. (orig.)

  8. The Long-Term Impact of Autoimmune Pancreatitis on Pancreatic Function, Quality of Life, and Life Expectancy

    NARCIS (Netherlands)

    J. Buijs (Jan); D.L. Cahen (Djuna); M. van Heerde (Marianne); Rauws, EA; L.J.M. De Buy Wenniger (Lucas J. Maillette); B.E. Hansen (Bettina); K. Biermann (Katharina); J. Verheij (Joanne); F.P. Vleggaar (Frank); M.A. Brink (Menno); U. Beuers (Ulrich); H.R. van Buuren (Henk); M.J. Bruno (Marco)

    2015-01-01

    textabstractObjective To evaluate the long-term outcome of autoimmune pancreatitis. Methods Patients with at least 2 years of follow-up were included. Information was collected regarding disease characteristics, treatment outcome, diagnosed malignancies, and mortality. In addition, pancreatic

  9. Physical activity enhances long-term quality of life in older adults: efficacy, esteem, and affective influences.

    Science.gov (United States)

    Elavsky, Steriani; McAuley, Edward; Motl, Robert W; Konopack, James F; Marquez, David X; Hu, Liang; Jerome, Gerald J; Diener, Ed

    2005-10-01

    Physical activity has been effective in enhancing quality of life (QOL) of older adults over relatively short periods of time. However, little is known about the long-term effects of physical activity and even less about the possible mediators of this relationship. We examined the mediating effects of psychological variables on the relationship between physical activity and global QOL (satisfaction with life) in older adults over a 4-year period. Participants (N = 174, M age = 66.7 years) completed a battery of psychosocial measures at 1 and 5 years following enrollment in a 6-month randomized controlled exercise trial. Panel analysis conducted within a covariance modeling framework indicated that physical activity was related to self-efficacy, physical self-esteem, and positive affect at 1 year, and in turn, greater levels of self-efficacy and positive affect were associated with higher levels of QOL. Analyses indicated that changes in physical activity over the 4-year period were related to increases in physical self-esteem and positive affect, but only positive affect directly influenced improvements in QOL. The findings lend support to the position that physical activity effects on QOL are in part mediated by intermediate psychological outcomes and that physical activity can have long-term effects on well-being.

  10. The health-related quality of life in long-term colorectal cancer survivors study: objectives, methods and patient sample.

    Science.gov (United States)

    Mohler, M Jane; Coons, Stephen Joel; Hornbrook, Mark C; Herrinton, Lisa J; Wendel, Christopher S; Grant, Marcia; Krouse, Robert S

    2008-07-01

    The objective of this paper is to describe the complex mixed-methods design of a study conducted to assess health-related quality of life (HRQOL) outcomes and ostomy-related obstacles and adjustments among long-term (>5 years) colorectal cancer (CRC) survivors with ostomies (cases) and without ostomies (controls). In addition, details are provided regarding the study sample and the psychometric properties of the quantitative data collection measures used. Subsequent manuscripts will present the study findings. The study design involved a cross-sectional mail survey for collecting quantitative data and focus groups for collecting qualitative data. The study subjects were individuals identified as long-term CRC survivors within a community-based health maintenance organization's enrolled population. Focus groups comprised of cases were conducted. The groups were divided by gender and HRQOL high and low quartile contrasts (based on the mail survey data). The modified City of Hope Quality of Life (mCOH-QOL)-Ostomy and SF-36v2 questionnaires were used in the mail survey. An abridged version of the mCOH-QOL-Ostomy was used for the control subjects. Focus groups explored ostomy-related barriers to self-care, adaptation methods/skills, and advice for others with an ostomy. The survey response rate was 52% (679/1308) and 34 subjects participated in focus groups. The internal consistency reliability estimates for the mCOH-QOL-Ostomy and SF-36v2 questionnaires were very acceptable for group comparisons. In addition, evidence supports the construct validity of the abridged version of the mCOH-QOL-Ostomy. Study limitations include potential non-response bias and limited minority participation. We were able to successfully recruit long-term CRC survivors into this study and the psychometric properties of the quantitative measures used were quite acceptable. Mixed-methods designs, such as the one used in this study, may be useful in identification and further elucidation of

  11. Combining garden therapy and supported employment - a method for preparing women on long-term sick leave for working life.

    Science.gov (United States)

    Lidén, Eva; Alstersjö, Karin; Gurné, Frida L; Fransson, Sandra; Bergbom, Ingegerd

    2016-06-01

    Women are overrepresented among the group people suffering from long-term illness. In addition to their illness, suffering long-term sick leave leads to economical restraints as well social distress. There are gaps in our understanding of the challenges these women face. There is also lack of knowledge about how these challenges can be effectively addressed in rehabilitation. This deficiency is problematic from an ethical, justice and a caring perspective. In this study, changes in health-related quality of life (HRQoL) among women on long-term sick leave were investigated during and after participating in a rehabilitation programme combining two validated methods, Garden Therapy and Supported Employment (SE). The study also discusses difficulties in realising research related to vulnerable under-privileged people. From a population of 329 women who had reported their interest to participate, 245 were randomised to the programme. Of these 144 accepted participation in the research project and of these 123 women accepted to answer the SF-36 questionnaire. The participants were between 21 and 62 years with poor physical and mental health. They had received public financial support from 10 years. The SF-36 measurement was carried out at baseline, after completion of Garden Therapy and after completion of SE. The results are based on data of respondents who participated at all the three occasions (n = 52). When comparing HRQoL baseline with the following occasions, the participants' General Health (GH), Vitality (VT), Social Functioning (SF) and mental health had improved significantly. The Four Leaf Clover (FLC) programme could be an appropriate method for reducing socially induced suffering. However, to conduct intervention studies where vulnerable persons are involved, it is off vital importance to consider whether the participants have the strength to complete the intervention. © 2015 Nordic College of Caring Science.

  12. Multicultural long-term care nurses’ perceptions of factors influencing patient dignity at the end of life.

    Science.gov (United States)

    Periyakoil, Vyjeyanthi S; Stevens, Marguerite; Kraemer, Helena

    2013-03-01

    The goal of this mixed-methods study was to characterize the perceptions of multicultural long-term care nurses about patient dignity at the end-of-life (EOL). The study was conducted in a large, urban, long-term care (LTC) facility. Participants were 45 long-term care nurses and 26 terminally ill nursing home residents. Nurses completed an openended interview about their perceptions of the concept of dying with dignity, and the data were analyzed using grounded theory methods. Main themes identified as promoting resident dignity at the EOL included treating them with respect, helping them prepare for the EOL, promoting shared decision-making, and providing high-quality care. The nurses’ cultural and religious backgrounds influenced their perceptions of what constitutes dignity-conserving care. Foreign-born nurses stressed the need for EOL rituals, but this was strikingly absent in the statements of U.S.-born nurses. Foreign-born Catholic nurses stated that the dying experience should not be altered using analgesics to relieve suffering or by attempts to hasten death by forgoing curative therapy or by other means. Nurses and terminally ill individuals completed the Dignity Card-sort Tool (DCT). A comparison of the DCT responses of the LTC nurses cohort with those of the terminally ill participants revealed that the nurses felt patient dignity was eroded when patient wishes were not followed and when they were treated without respect. In contrast, dying LTC residents felt that poor medical care and loss of ability to choose care options were the most important factors leading to erosion of dignity.

  13. Effect of the long-term care prevention project on the motor functions and daily life activities of the elderly.

    Science.gov (United States)

    Wada, Yoshihiro; Sakuraba, Keisyoku; Kubota, Atsushi

    2015-01-01

    [Purpose] The purpose of this study was to verify the effects of the long-term care prevention project and develop an effective program. [Subjects] A total of 81 elderly people (age, 79 ± 5.1 years; height, 149.2 ± 9.2 cm; weight, 54.2 ± 11.4 kg). [Methods] Grip, knee extension muscular strength, 10 m walking speed, and Timed Up and Go time were measured for evaluation of motor functions, and the "Locomo 25", a 25-question risk assessment questionnaire, was used as the judgment criterion for evaluation of daily life activities, with measurements being taken at the beginning of the project and after three months. [Results] In the motor functions evaluation, significant differences were observed in 10 m walking speed, Timed Up and Go time, and knee extension strength. In the daily life activities evaluation, scores for pain, rising movement, standing movement, indoor walking, outdoor walking, and fear of falling were significantly reduced. In addition, a significant correlation was also observed between motor functions and daily life activities. [Conclusion] The result of this study indicated that the long-term care prevention project is effective in maintaining or improving muscular strength and mitigating pain in the elderly and that it is an effective program for maintaining daily life activities. We were also able to show that it would be effective to develop programs with a low exercise intensity that can be performed on a continuing by the elderly.

  14. Genetic tools link long-term demographic and life-history traits of anemonefish to their anemone hosts

    KAUST Repository

    Salles, Océane C.

    2016-07-26

    The life-history traits and population dynamics of species are increasingly being attributed to the characteristics of their preferred habitats. While coral reef fish are often strongly associated with particular habitats, long-term studies establishing the demographic and life-history consequences of occupying different reef substrata are rare and no studies have monitored individuals in situ over their lifetime and determined the fate of their offspring. Here, we documented a quasi-turnover and local reproductive success for an entire population of orange clownfish (Amphiprion percula) from Kimbe Island, Papua New Guinea, by taking bi-annual samples of DNA over a 10-yr period (2003–2013). We compared demographic and life-history traits of individuals living on two host anemone species, Heteractis magnifica and Stichodactyla gigantea, including female size, adult continued presence (a proxy for relative longevity range), early post-settlement growth, the number of eggs per clutch and ‘local’ reproductive success (defined for each adult as the number of offspring returning to the natal population). Our results indicate that while the relative longevity of adults was similar on both host anemone species, females living in H. magnifica were larger than females in S. gigantea. However, despite females growing larger and producing more eggs on H. magnifica, we found that local reproductive success was significantly higher for clownfish living in S. gigantea. Life-history traits also exhibited local spatial variation, with higher local reproductive success recorded for adults living on S. gigantea on the eastern side of the island. Our findings support a ‘silver-spoon’ hypothesis that predicts individuals that are fortunate enough to recruit into good habitat and location will be rewarded with higher long-term reproductive success and will make a disproportionate contribution to population renewal. © 2016 Springer-Verlag Berlin Heidelberg

  15. Evaluation of residual life of material of power plant construction elements after long-term operation

    International Nuclear Information System (INIS)

    Osasyuk, V.V.

    1989-01-01

    Existing methods are analyzed for estimation of residual resource of elements of constructions, working in creep conditions. A suggested and experimentally verified new method of residual durability forecasting is described permitting the value of the supplementary resource to be specified according to the real state of the material after preoperation. Evaluation results are given for residual life of steam lines received by different methods and advantages of the technique proposed are shown. Reliability of the new technique is confirmed by steam line operation at thermal power plants

  16. Long-Term Survival, Quality of Life, and Quality-Adjusted Survival in Critically Ill Patients With Cancer.

    Science.gov (United States)

    Normilio-Silva, Karina; de Figueiredo, Adelaide Cristina; Pedroso-de-Lima, Antonio Carlos; Tunes-da-Silva, Gisela; Nunes da Silva, Adriana; Delgado Dias Levites, Andresa; de-Simone, Ana Tereza; Lopes Safra, Patrícia; Zancani, Roberta; Tonini, Paula Camilla; Vasconcelos de Andrade E Silva, Ulysses; Buosi Silva, Thiago; Martins Giorgi, Juliana; Eluf-Neto, José; Costa, Anderson; Abrahão Hajjar, Ludhmila; Biasi Cavalcanti, Alexandre

    2016-07-01

    To assess the long-term survival, health-related quality of life, and quality-adjusted life years of cancer patients admitted to ICUs. Prospective cohort. Two cancer specialized ICUs in Brazil. A total of 792 participants. None. The health-related quality of life before ICU admission; at 15 days; and at 3, 6, 12, and 18 months was assessed with the EQ-5D-3L. In addition, the vital status was assessed at 24 months. The mean age of the subjects was 61.6 ± 14.3 years, 42.5% were female subjects and half were admitted after elective surgery. The mean Simplified Acute Physiology Score 3 was 47.4 ± 15.6. Survival at 12 and 18 months was 42.4% and 38.1%, respectively. The mean EQ-5D-3L utility measure before admission to the ICU was 0.47 ± 0.43, at 15 days it was 0.41 ± 0.44, at 90 days 0.56 ± 0.42, at 6 months 0.60 ± 0.41, at 12 months 0.67 ± 0.35, and at 18 months 0.67 ± 0.35. The probabilities for attaining 12 and 18 months of quality-adjusted survival were 30.1% and 19.1%, respectively. There were statistically significant differences in survival time and quality-adjusted life years according to all assessed baseline characteristics (ICU admission after elective surgery, emergency surgery, or medical admission; Simplified Acute Physiology Score 3; cancer extension; cancer status; previous surgery; previous chemotherapy; previous radiotherapy; performance status; and previous health-related quality of life). Only the previous health-related quality of life and performance status were associated with the health-related quality of life during the 18-month follow-up. Long-term survival, health-related quality of life, and quality-adjusted life year expectancy of cancer patients admitted to the ICU are limited. Nevertheless, these clinical outcomes exhibit wide variability among patients and are associated with simple characteristics present at the time of ICU admission, which may help healthcare professionals estimate patients

  17. Long term impact of emotional, social and cognitive intelligence competencies and GMAT on career and life satisfaction and career success.

    Science.gov (United States)

    Amdurer, Emily; Boyatzis, Richard E; Saatcioglu, Argun; Smith, Melvin L; Taylor, Scott N

    2014-01-01

    Career scholars have called for a broader definition of career success by inviting greater exploration of its antecedents. While success in various jobs has been predicted by intelligence and in other studies by competencies, especially in management, long term impact of having intelligence and using competencies has not been examined. Even in collegiate outcome studies, few have examined the longer term impact on graduates' careers or lives. This study assesses the impact of demonstrated emotional, social, and cognitive intelligence competencies assessed at graduation and g measured through GMAT at entry from an MBA program on career and life satisfaction, and career success assessed 5 to 19 years after graduation. Using behavioral measures of competencies (i.e., as assessed by others), we found that emotional intelligence competencies predict career satisfaction and success. Adaptability had a positive impact, but influence had the opposite effect on these career measures and life satisfaction. Life satisfaction was negatively affected by achievement orientation and positively affected by teamwork. Current salary, length of marriage, and being younger at time of graduation positively affect all three measures of life and career satisfaction and career success. GMAT (as a measure of g) predicted life satisfaction and career success to a slight but significant degree in the final model analyzed. Meanwhile, being female and number of children positively affected life satisfaction but cognitive intelligence competencies negatively affected it, and in particular demonstrated systems thinking was negative.

  18. Long term impact of emotional, social and cognitive intelligence competencies and GMAT on career and life satisfaction and career success

    Science.gov (United States)

    Amdurer, Emily; Boyatzis, Richard E.; Saatcioglu, Argun; Smith, Melvin L.; Taylor, Scott N.

    2014-01-01

    Career scholars have called for a broader definition of career success by inviting greater exploration of its antecedents. While success in various jobs has been predicted by intelligence and in other studies by competencies, especially in management, long term impact of having intelligence and using competencies has not been examined. Even in collegiate outcome studies, few have examined the longer term impact on graduates' careers or lives. This study assesses the impact of demonstrated emotional, social, and cognitive intelligence competencies assessed at graduation and g measured through GMAT at entry from an MBA program on career and life satisfaction, and career success assessed 5 to 19 years after graduation. Using behavioral measures of competencies (i.e., as assessed by others), we found that emotional intelligence competencies predict career satisfaction and success. Adaptability had a positive impact, but influence had the opposite effect on these career measures and life satisfaction. Life satisfaction was negatively affected by achievement orientation and positively affected by teamwork. Current salary, length of marriage, and being younger at time of graduation positively affect all three measures of life and career satisfaction and career success. GMAT (as a measure of g) predicted life satisfaction and career success to a slight but significant degree in the final model analyzed. Meanwhile, being female and number of children positively affected life satisfaction but cognitive intelligence competencies negatively affected it, and in particular demonstrated systems thinking was negative. PMID:25566128

  19. Long Term Impact of Emotional, Social and Cognitive Intelligence Competencies and GMAT on Career and Life Satisfaction and Career Success

    Directory of Open Access Journals (Sweden)

    Emily eAmdurer

    2014-12-01

    Full Text Available ABSTRACTCareer scholars have called for a broader definition of career success by inviting greater exploration of its antecedents. While success in various jobs has been predicted by intelligence and in other studies by competencies, especially in management, long term impact of having intelligence and using competencies has not been examined. Even in collegiate outcome studies, few have examined the longer term impact on graduates’ careers or lives. This study assesses the impact of demonstrated emotional, social, and cognitive intelligence competencies assessed at graduation and g measured through GMAT at entry from an MBA program on career and life satisfaction, and career success assessed 5 to 19 years after graduation. Using behavioral measures of competencies (i.e., as assessed by others, we found that emotional intelligence competencies predict career satisfaction and success. Adaptability had a positive impact, but influence had the opposite effect on these career measures and life satisfaction. Life satisfaction was negatively affected by achievement orientation and positively affected by teamwork. Current salary, length of marriage, and being younger at time of graduation positively affect all three measures of life and career satisfaction and career success. GMAT (as a measure of g predicted life satisfaction and career success to a slight but significant degree in the final model analyzed. Meanwhile, being female and number of children positively affected life satisfaction but cognitive intelligence competencies negatively affected it, and in particular demonstrated systems thinking was negative.

  20. Learning turning points--in life with long-term illness--visualized with the help of the life-world philosophy.

    Science.gov (United States)

    Berglund, Mia M U

    2014-01-01

    A long-term illness is an occurrence that changes one's life and generates a need to learn how to live with it. This article is based on an empirical study of interviews on people living with different long-term illnesses. The results have shown that the learning process is a complex phenomenon interwoven with life as a whole. The essential meaning of learning to live with long-term illness concerns a movement toward a change of understanding of access to the world. In this movement, in which everyday lives as well as relationships with oneself and others are affected, a continual renegotiation is needed. Texts from existential/lifeworld philosopher, Heidegger and Gadamer, have been used to get a greater understanding of the empirical results. These texts have been analysed with particular focus on learning turning points and the importance of reflection. The results are highlighted under the following themes: Pursuit of balance-the aim of learning, The tense grip-the resistance to learning, To live more really-the possibilities of the learning, Distancing-the how of the learning, and The tense of the learning-the whole of the learning. In those learning turning points are present. Knowledge from this study has been used to make a didactic model designed to give caregivers a tool to support patients' learning. The didactic model is called: The challenge to take charge of life with a long-term illness.

  1. The role of the curriculum and other factors in determining the medium- to long-term attitude of the practicing dentist towards life-long learning.

    LENUS (Irish Health Repository)

    Polyzois, I

    2010-05-01

    To investigate the significance of the undergraduate dental curriculum on the medium- to long-term attitudes of the clinician to life-long learning, and to identify demographical and professional characteristics which may influence this attitude.

  2. Sleep quality and health-related quality of life among long-term survivors of (non-) Hodgkin lymphoma in Germany.

    Science.gov (United States)

    Hammersen, Friederike; Lewin, Philip; Gebauer, Judith; Kreitschmann-Andermahr, Ilonka; Brabant, Georg; Katalinic, Alexander; Waldmann, Annika

    2017-01-01

    This study investigated sleep quality and health-related quality of life (HRQOL) among long-term survivors of Hodgkin (HL) and non-Hodgkin lymphoma (NHL). The aim was to explore the impact of personal and health-related factors on sleep quality as well as associations between sleep quality and HRQOL. For the postal survey, participants with a minimum age of 18 years initially treated between 1998 and 2008 were recruited via the population-based cancer registry in Schleswig-Holstein, Northern Germany. Questionnaires included amongst others the Pittsburg Sleep Quality Index (PSQI) and the 36-Item Short Form Health Survey (SF-36v1). Descriptive and comparative statistics were performed. Additionally, a regression analysis was conducted to identify predictors of sleep quality. In total, we recruited 515 participants (398 NHL, 117 HL) with a mean age of 63.1 years. Approximately half of the survivors were classified as good sleepers. HRQOL scores differed between good and poor sleepers with lower scores in poor sleepers. In a prediction model, self-reported depression, exhaustion, higher age, inability to work, endocrinological disorders and female gender classified as predictors of sleep quality. This study highlights the impact of sleep quality on HRQOL in long-term survivors of NHL and HL. Thus, sleep quality should be routinely assessed during follow-up of cancer survivors with special attention to patients with potential risk factors.

  3. What to Do with a Second Chance in Life? Long-Term Experiences of Non-carriers of Huntington's Disease.

    Science.gov (United States)

    Winnberg, Elisabeth; Winnberg, Ulrika; Pohlkamp, Lilian; Hagberg, Anette

    2018-04-07

    Little is known about how people's lives are influenced when going from a 50% risk status of Huntington's disease (HD) to no risk after performing predictive testing. In this study, 20 interviews were conducted to explore the long-term (> 5 years) experiences after receiving predictive test results as a non-carrier of HD. The results showed a broad variety of both positive and negative reactions. The most prominent positive reaction reported was feelings of relief and gratitude, of not carrying the HD mutation for themselves and for their children. Also, the non-carrier status promoted in some individuals' significant life changes such as a wishing to have (more) children, pursuing a career or breaking up from an unhappy relationship. However, negative reactions on their psychological well-being were also described. Some had experienced psychological pressure of needing to do something extraordinary in their lives; others expressed feelings of guilt towards affected or untested siblings, resulting in sadness or clinical depression. The new genetic risk status could generate a need of re-orientation, a process that for some persons took several years to accomplish. The results of the present study show the importance of offering long-term post-result counselling for non-carriers in order to deal with the psychological consequences that may follow predictive testing.

  4. Overview of plant life management for long term operation in nuclear power plants

    International Nuclear Information System (INIS)

    Kang, K.S.; Vincze, P.; Bychkov, A.

    2014-01-01

    Many IAEA member states have given high priority to licensing their nuclear power plants to operate for terms longer than the time frame originally anticipated (generally 40 years). The task of managing plant ageing is assigned in most member states to an engineering specialty called 'plant life management' (PLiM) applying a systematic analysis methodology to System Structure Components (SSCs) ageing. In many countries, the safety performance of nuclear power plants is periodically assessed and characterized via the periodic safety review (PSR) process. Regulatory review and acceptance of PSRs constitutes for these countries the licensing requirement for continued operation of the plant to the following PSR cycle (usually 10 years). In the USA and in other countries operating US designed plants, instead of PSR process, a license renewal application (LRA) process is followed, which requires certain prerequisites such as ageing management programs, particularly for passive irreplaceable SSCs. Active components are normally addressed via the maintenance rule (MR) requirements and other established regulatory processes. A third group of member states have adopted a combined approach that incorporates elements of both the PSR process and selected LRA specific requirements, such as time limited ageing analysis. The article ends with some IAEA recommendations for the implementation of national PLiM programs

  5. DynEarthSol2D: An efficient unstructured finite element method to study long-term tectonic deformation

    KAUST Repository

    Choi, E.; Tan, E.; Lavier, L. L.; Calo, Victor M.

    2013-01-01

    Many tectonic problems require to treat the lithosphere as a compressible elastic material, which can also flow viscously or break in a brittle fashion depending on the stress level applied and the temperature conditions. We present a flexible methodology to address the resulting complex material response, which imposes severe challenges on the discretization and rheological models used. This robust, adaptive, two-dimensional, finite element method solves the momentum balance and the heat equation in Lagrangian form using unstructured meshes. An implementation of this methodology is released to the public with the publication of this paper and is named DynEarthSol2D (available at http://bitbucket.org/tan2/dynearthsol2). The solver uses contingent mesh adaptivity in places where shear strain is focused (localization) and a conservative mapping assisted by marker particles to preserve phase and facies boundaries during remeshing. We detail the solver and verify it in a number of benchmark problems against analytic and numerical solutions from the literature. These results allow us to verify and validate our software framework and show its improved performance by an order of magnitude compared against an earlier implementation of the Fast Lagrangian Analysis of Continua algorithm.

  6. DynEarthSol2D: An efficient unstructured finite element method to study long-term tectonic deformation

    KAUST Repository

    Choi, E.

    2013-05-01

    Many tectonic problems require to treat the lithosphere as a compressible elastic material, which can also flow viscously or break in a brittle fashion depending on the stress level applied and the temperature conditions. We present a flexible methodology to address the resulting complex material response, which imposes severe challenges on the discretization and rheological models used. This robust, adaptive, two-dimensional, finite element method solves the momentum balance and the heat equation in Lagrangian form using unstructured meshes. An implementation of this methodology is released to the public with the publication of this paper and is named DynEarthSol2D (available at http://bitbucket.org/tan2/dynearthsol2). The solver uses contingent mesh adaptivity in places where shear strain is focused (localization) and a conservative mapping assisted by marker particles to preserve phase and facies boundaries during remeshing. We detail the solver and verify it in a number of benchmark problems against analytic and numerical solutions from the literature. These results allow us to verify and validate our software framework and show its improved performance by an order of magnitude compared against an earlier implementation of the Fast Lagrangian Analysis of Continua algorithm.

  7. Evaluation of long-term creep-fatigue life of stainless steel weldment based on a microstructure degradation model

    International Nuclear Information System (INIS)

    Asayama, Tai; Hasebe, Shinichi

    1997-01-01

    This paper describes a newly developed analytical method of evaluation of creep-fatigue strength of stainless weld metals. Based on the observation that creep-fatigue crack initiates adjacent to the interface of sigma-phase/delta-ferrite and matrix, a mechanistic model which allows the evaluation of micro stress/strain concentration adjacent to the interface was developed. Fatigue and creep damage were evaluated using the model which describes the microstructure after exposed to high temperatures for a long time. Thus it was made possible to predict analytically the long-term creep-fatigue life of stainless steel metals whose microstructure is degraded as a result of high temperature service. (author)

  8. Quality of life long-term after body contouring surgery following bariatric surgery: sustained improvement after 7 years.

    Science.gov (United States)

    van der Beek, Eva S J; Geenen, Rinie; de Heer, Francine A G; van der Molen, Aebele B Mink; van Ramshorst, Bert

    2012-11-01

    Bariatric surgery for morbid obesity results in massive weight loss and improvement of health and quality of life. A downside of the major weight loss is the excess of overstretched skin, which may influence the patient's quality of life by causing functional and aesthetic problems. The purpose of the current study was to evaluate the patient's quality of life long-term after body contouring following bariatric surgery. Quality of life was measured with the Obesity Psychosocial State Questionnaire in 33 post-bariatric surgery patients 7.2 years (range, 3.2 to 13.3 years) after body contouring surgery. Data were compared with previous assessments 4.1 years (range, 0.7 to 9.2 years) after body contouring surgery of the quality of life at that time and before body contouring surgery. Compared with appraisals of quality of life before body contouring surgery, a significant, mostly moderate to large, sustained improvement of quality of life was observed in post-bariatric surgery patients 7.2 years after body contouring surgery in six of the seven psychosocial domains. A small deterioration occurred between 4.1- and 7.2-year follow-up on two of the seven domains except for the domain efficacy toward eating, which showed a significant improvement. At 7-year follow-up, 18 patients (55 percent) were satisfied with the result of body contouring surgery. This study indicates a sustained quality-of-life improvement in post-bariatric surgery patients after body contouring surgery. This suggests the importance of including reconstructive surgery as a component in the multidisciplinary approach in the surgical treatment of morbid obesity. Therapeutic, IV.

  9. Quality of life and physical activity in long-term (≥5 years post-diagnosis) colorectal cancer survivors - systematic review.

    Science.gov (United States)

    Eyl, Ruth Elisa; Xie, Kun; Koch-Gallenkamp, Lena; Brenner, Hermann; Arndt, Volker

    2018-06-01

    Due to the increasing number of long-term (≥5 years post diagnosis) colorectal cancer survivors, long-term quality of life of these patients is highly relevant. Several studies have reported a positive association between physical activity and quality of life in colorectal cancer survivors, however, so far no systematic review has been published which focuses on long-term colorectal cancer survivors. A systematic review was conducted using the databases PubMed, Web of Science, PsychINFO, and CINAHL. Studies which investigated associations between physical activity and quality of life in long-term colorectal cancer survivors were included. Ten articles based on seven studies were identified. Long-term colorectal cancer survivors who were physically active reported better quality of life than long-term survivors who were not physically active. Both, moderate to vigorous physical activity and lower levels like light physical activity were associated with higher quality of life. Most studies assessed the association between physical activity and quality of life cross-sectionally but one prospective study which measured physical activity and quality of life at three different points in time also found associations between physical activity and quality of life. The association between physical activity and quality of life seemed to be stronger among women than among men. The findings of this systematic review support an association between physical activity and quality of life in long-term colorectal cancer survivors. However, the evidence is limited as most studies were based on cross-sectional and observational design.

  10. Health-related quality of life among long-term rectal cancer survivors with an ostomy: manifestations by sex.

    Science.gov (United States)

    Krouse, Robert S; Herrinton, Lisa J; Grant, Marcia; Wendel, Christopher S; Green, Sylvan B; Mohler, M Jane; Baldwin, Carol M; McMullen, Carmit K; Rawl, Susan M; Matayoshi, Eric; Coons, Stephen Joel; Hornbrook, Mark C

    2009-10-01

    Intestinal stomas can pose significant challenges for long-term (> or = 5 years) rectal cancer (RC) survivors. Specifying common challenges and sociodemographic or clinical differences will further the development of tailored interventions to improve health-related quality of life (HRQOL). This was a matched cross-sectional study of long-term RC survivors conducted in three Kaiser Permanente regions. The mailed questionnaire included the modified City of Hope Quality of Life-Ostomy (mCOH-QOL-Ostomy) and Medical Outcomes Study 36-Item Short-Form Health Survey, version 2 (SF-36v2). Groups surveyed were permanent ostomates (cases) and those who did not require an ostomy (controls). RC survivors were matched on sex, age, and time since diagnosis. Comparisons between groups used regression analysis with adjustment for age, comorbidity score, history of radiation therapy, income, and work status. Response rate was 54% (491 of 909). Cases and controls had similar demographic characteristics. On the basis of the mCOH-QOL-Ostomy, both male and female cases had significantly worse social well-being compared with controls, while only female cases reported significantly worse overall HRQOL and psychological well-being. For younger females (ostomy had a greater impact on physical well-being compared with older females. Based on the SF-36v2, statistically significant and meaningful differences between female cases and controls were observed for seven of the eight scales and on the physical and mental component summary scores. Men and women report a different profile of challenges, suggesting the need for targeted or sex-specific interventions to improve HRQOL in this population. This may include focus on physical HRQOL for female ostomy survivors younger than age 75.

  11. Health-related quality of life and self-reported long-term conditions: a population-based survey

    Directory of Open Access Journals (Sweden)

    Ivan R. Zimmermann

    Full Text Available Objective: To estimate and compare the effect of self-reported long-term health conditions and sociodemographic factors on perceived health-related quality of life (HRQoL. Methods: A population-based survey of adults (18 to 65 years living in Brasilia, Brazil, was conducted in 2012. Descriptive and multivariate analyses using a Tobit model were performed with data on sociodemographic variables, self-reported conditions, and the European Quality of Life-5 Dimensions (EQ-5D health states, providing utility scores (preferred health state between 0 and 1 for HRQoL estimates. Results: The mean utility of 1,820 adults interviewed (mean age: 38.4±12.6 years was 0.883 (95% confidence interval [95%CI] 0.874-0.892, with 76.2% in the highest utility range (0.8 to 1.0. EQ-5D dimensions with moderate problems were pain/discomfort (33.8% and anxiety/depression (20.5%. Serious problems were reported by only 0.3% of the sample in the mobility and self-care domain and by 3.1% in the pain/discomfort domain. Multivariate analysis revealed reduced HRQoL in individuals with depression, diabetes, and hypertension. Living in satellite towns (outside the city core, belonging to a lower economic class, or not being formally employed were also associated with decreased HRQoL. Beta coefficients for these impacts ranged from -0.033 (not formally employed to -0.141 (depression, reflecting the strongest impact. Conclusion: Of the long-term health conditions studied, depression had the greatest impact on HRQoL. Social class, employment status, and place of residence also affected HRQoL.

  12. Life-long diseases need life-long treatment: long-term safety of ciclosporin in canine atopic dermatitis

    Science.gov (United States)

    Nuttall, Tim; Reece, Douglas; Roberts, Elizabeth

    2014-01-01

    Ciclosporin (Atopica; Novartis Animal Health) has been licensed for canine atopic dermatitis (AD) since 2002. Adverse events (AEs) have been reported in 55 per cent of 759 dogs in 15 clinical trials, but are rare in pharmacovigilance data (71.81 AEs/million capsules sold). Gastrointestinal reactions were most common, but were mild and rarely required intervention. Other AEs were rare (≤1 per cent in clinical trials; metabolism is not clinically significant for normal dogs. Concomitant treatment with most drugs is safe. Effects on cytochrome P450 and MDR1 P-glycoprotein activity may elevate plasma ciclosporin concentrations, but short-term changes are not clinically significant. Monitoring of complete blood counts, urinalysis or ciclosporin levels is not justified except with higher than recommended doses and/or long-term concurrent immunosuppressive drugs. Ciclosporin is not a contraindication for killed (including rabies) vaccines, but the licensed recommendation is that live vaccination is avoided during treatment. In conclusion, ciclosporin has a positive risk-benefit profile for the long-term management of canine AD. PMID:24682696

  13. A lonely life--A qualitative study of immigrant women on long-term sick leave in Norway.

    Science.gov (United States)

    Nortvedt, Line; Lohne, Vibeke; Kumar, Bernadette Nirmal; Hansen, Helle Ploug

    2016-02-01

    This study focuses on the everyday life of immigrant women with chronic pain on long-term sick leave in Norway. Research has shown that rehabilitation of immigrant women with chronic pain might be challenging both due to their lack of linguistic competence, due to lack of sufficient confidence/trust in their employers and in health personnel and lack of knowledge/skills among health care personnel in meeting immigrants' special needs. The objective of the study was to explore how immigrant women on long-term sick leave in Norway due to chronic pain experience their illness and their relationships at work and in the family. This article has a qualitative design, using participant observation and in-depth interviews. Participant observations were carried out in an outpatient clinic and qualitative interviews were conducted after the rehabilitation period. A hermeneutic approach was used to understand the meaning of the narrated text. All the authors participated in the discussion of the findings, and consensus was obtained for each identified theme. The research was conducted at an outpatient clinic at a rehabilitation hospital in the southern part of Norway. The clinic offers wide-ranging, specialized, multidisciplinary patient evaluations that last between 24 and 48h, followed by advice and/or treatment either individually or in a group, i.e. in a rehabilitation course. Participants (immigrant women) who had been referred to the outpatient clinic and to a rehabilitation course were recruited. Fourteen African and Asian women were observed in two rehabilitation courses, and eleven of them agreed to be interviewed once or twice (3). The interpretation revealed the following two main themes: 'Shut inside the home' and 'Rejected at the workplace'. Based on the women's experiences, a new understanding emerged of how being excluded or not feeling sufficiently needed, wanted or valued by colleagues, employers or even by family members rendered their daily lives

  14. Impact of Early-Life Exposures to Infections, Antibiotics, and Vaccines on Perinatal and Long-term Health and Disease

    Directory of Open Access Journals (Sweden)

    Steven L. Raymond

    2017-06-01

    Full Text Available Essentially, all neonates are exposed to infections, antibiotics, or vaccines early in their lives. This is especially true for those neonates born underweight or premature. In contrast to septic adults and children who are at an increased risk for subsequent infections, exposure to infection during the neonatal period is not associated with an increased risk of subsequent infection and may be paradoxically associated with reductions in late-onset sepsis (LOS in the most premature infants. Perinatal inflammation is also associated with a decreased incidence of asthma and atopy later in life. Conversely, septic neonates are at increased risk of impaired long-term neurodevelopment. While the positive effects of antibiotics in the setting of infection are irrefutable, prolonged administration of broad-spectrum, empiric antibiotics in neonates without documented infection is associated with increased risk of LOS, necrotizing enterocolitis, or death. Vaccines provide a unique opportunity to prevent infection-associated disease; unfortunately, vaccinations have been largely unsuccessful when administered in the first month of life with the exception of vaccines against hepatitis B and tuberculosis. Future vaccines will require the use of novel adjuvants to overcome this challenge. This review describes the influence of infections, antibiotics, and vaccines during the first days of life, as well as the influence on future health and disease. We will also discuss potential immunomodulating therapies, which may serve to train the preterm immune system and reduce subsequent infectious burden without subjecting neonates to the risks accompanied by virulent pathogens.

  15. Long-term Neurotoxic Effects of Early-life Exposure to Tetrachloroethylene-contaminated Drinking Water.

    Science.gov (United States)

    Aschengrau, Ann; Janulewicz, Patricia A; White, Roberta F; Vieira, Veronica M; Gallagher, Lisa G; Getz, Kelly D; Webster, Thomas F; Ozonoff, David M

    2016-01-01

    Tetrachloroethene (PCE) is a common environmental and occupational contaminant and an acknowledged neurotoxicant. From 1968 through 1983, widespread contamination of public drinking water supplies with PCE occurred in the Cape Cod region of Massachusetts. The source of the contamination was a vinyl liner applied to the inner surface of water distribution pipes. A retrospective cohort study (the Cape Cod Health Study) was undertaken to examine possible health consequences of early-life exposure to PCE-contaminated drinking water. This review describes the study methods and findings regarding the effects of prenatal and childhood exposure on neurologic outcomes during early adulthood, including vision, neuropsychological functioning, brain structure, risky behaviors, and mental illness. The review also describes the strengths and challenges of conducting population-based epidemiologic research in this unique setting. Participants were identified by cross-matching birth certificates and water system data. Information on health outcomes and confounding variables was collected from self-administered surveys (n = 1689), neuropsychological tests (n = 63), vision examinations (n = 63), and magnetic resonance imaging (n = 42). Early-life exposure to PCE was estimated using a leaching and transport model. The data analysis compared the occurrence of each health outcome among individuals with prenatal and early childhood PCE exposure to unexposed individuals while considering the effect of confounding variables. The study found evidence that early-life exposure to PCE-contaminated drinking water has long-term neurotoxic effects. The strongest associations were seen with illicit drug use, bipolar disorder, and post-traumatic stress disorder. Key strengths of the study were availability of historical data on affected water systems, a relatively high exposure prevalence and wide range of exposure levels, and little confounding. Challenges arose mainly from the historical

  16. Prognostic factors for long-term quality of life after adjuvant radiotherapy in women with endometrial cancer

    International Nuclear Information System (INIS)

    Foerster, Robert; Schnetzke, Lara; Arians, Nathalie; Rief, Harald; Debus, Juergen; Lindel, Katja; Bruckner, Thomas

    2016-01-01

    Adjuvant radiotherapy (RT) for endometrial cancer (EC) may affect patients' quality of life (QoL). There is a paucity of data on prognostic factors for long-term QoL and sexual functioning. This study aimed to investigate such factors and assess the role of the vaginal dilator (VD). QoL was assessed in 112 EC patients 6 years (median) after RT. QoL was compared to normative data, and the influence of age, tumor characteristics, lymphadenectomy, RT, and acute toxicities was assessed. VD use and its effect on subjective vaginal shortening/tightness was analyzed. QoL was reduced, particularly in younger patients. Vaginal brachytherapy only and intensity-modulated RT (IMRT) were associated with better global health status and reduced chronic gastrointestinal (GI) symptoms. Higher acute GI toxicity was associated with increased chronic GI symptoms, particularly diarrhea, and reduced role functioning. Higher acute urinary toxicity was associated with increased chronic urological symptoms, muscular/pelvic pain, and chronic GI symptoms, as well as with reduced emotional/social functioning and reduced global health status. Sexual interest/activity was increased despite vaginal dryness and dyspareunia. Sexual interest/activity increased with age. Only few, mainly younger patients used the VD. VD use >1 year was found in women with higher sexual interest/activity. Acute vaginal toxicity and chronic pain prevented VD use. Subjective vaginal shortening/tightness was not reduced in VD users. RT technique and acute toxicities are prognostic for the extent of chronic symptoms and long-term QoL. Sexuality is important even at a higher age. Few patients use the VD and a reduction of subjective vaginal shortening/tightness was not achieved. (orig.) [de

  17. Early-life sugar consumption has long-term negative effects on memory function in male rats.

    Science.gov (United States)

    Noble, Emily E; Hsu, Ted M; Liang, Joanna; Kanoski, Scott E

    2017-09-25

    Added dietary sugars contribute substantially to the diet of children and adolescents in the USA, and recent evidence suggests that consuming sugar-sweetened beverages (SSBs) during early life has deleterious effects on hippocampal-dependent memory function. Here, we test whether the effects of early-life sugar consumption on hippocampal function persist into adulthood when access to sugar is restricted to the juvenile/adolescent phase of development. Male rats were given ad libitum access to an 11% weight-by-volume sugar solution (made with high fructose corn syrup-55) throughout the adolescent phase of development (post-natal day (PN) 26-56). The control group received a second bottle of water instead, and both groups received ad libitum standard laboratory chow and water access throughout the study. At PN 56 sugar solutions were removed and at PN 175 rats were subjected to behavioral testing for hippocampal-dependent episodic contextual memory in the novel object in context (NOIC) task, for anxiety-like behavior in the Zero maze, and were given an intraperitoneal glucose tolerance test. Early-life exposure to SSBs conferred long-lasting impairments in hippocampal-dependent memory function later in life- yet had no effect on body weight, anxiety-like behavior, or glucose tolerance. A second experiment demonstrated that NOIC performance was impaired at PN 175 even when SSB access was limited to 2 hours daily from PN 26-56. Our data suggest that even modest SSB consumption throughout early life may have long-term negative consequences on memory function during adulthood.

  18. Long Term Financing of Infrastructure

    OpenAIRE

    Sinha, Sidharth

    2014-01-01

    Infrastructure projects, given their long life, require long term financing. The main sources of long term financings are insurance and pension funds who seek long term investments with low credit risk. However, in India household financial savings are mainly invested in bank deposits. Insurance and pension funds account for only a small percentage of household financial savings. In addition most infrastructure projects do not qualify for investment by insurance and pension funds because of t...

  19. Long-term effect of early-life stress from earthquake exposure on working memory in adulthood.

    Science.gov (United States)

    Li, Na; Wang, Yumei; Zhao, Xiaochuan; Gao, Yuanyuan; Song, Mei; Yu, Lulu; Wang, Lan; Li, Ning; Chen, Qianqian; Li, Yunpeng; Cai, Jiajia; Wang, Xueyi

    2015-01-01

    The present study aimed to investigate the long-term effect of 1976 Tangshan earthquake exposure in early life on performance of working memory in adulthood. A total of 907 study subjects born and raised in Tangshan were enrolled in this study. They were divided into three groups according to the dates of birth: infant exposure (3-12 months, n=274), prenatal exposure (n=269), and no exposure (born at least 1 year after the earthquake, n=364). The prenatal group was further divided into first, second, and third trimester subgroups based on the timing of exposure during pregnancy. Hopkins Verbal Learning Test-Revised and Brief Visuospatial Memory Test-Revised (BVMT-R) were used to measure the performance of working memory. Unconditional logistic regression analysis was used to analyze the influential factors for impaired working memory. The Hopkins Verbal Learning Test-Revised scores did not show significant difference across the three groups. Compared with no exposure group, the BVMT-R scores were slightly lower in the prenatal exposure group and markedly decreased in the infant exposure group. When the BVMT-R scores were analyzed in three subgroups, the results showed that the subjects whose mothers were exposed to earthquake in the second and third trimesters of pregnancy had significantly lower BVMT-R scores compared with those in the first trimester. Education level and early-life earthquake exposure were identified as independent risk factors for reduced performance of visuospatial memory indicated by lower BVMT-R scores. Infant exposure to earthquake-related stress impairs visuospatial memory in adulthood. Fetuses in the middle and late stages of development are more vulnerable to stress-induced damage that consequently results in impaired visuospatial memory. Education and early-life trauma can also influence the performance of working memory in adulthood.

  20. Assessment of long-term quality of life of esophageal carcinoma patients treated with continuous accelerated hyperfractionated and late-course accelerated hyperfractionated radiotherapy

    International Nuclear Information System (INIS)

    Wang Yang; He Shaoqin; Shi Xuehui; Jiang Kaida; Yao Weiqiang; Wang Ying

    2002-01-01

    Objective: To compare the long-term quality of life in esophageal carcinoma patients treated with continuous accelerated hyperfractionated (CAHF) and late-course accelerated hyperfractionated (LCAF) radiotherapy. Methods: Subjective and Objective Management Analysis (SOMA) scale, Symptom Checklist 90 (SCL-90) and Life Satisfaction Index A (LSIA) questionnaire were mailed to the long survivors in both CAHF and LCAF groups to assess the long-term quality of life including symptoms, psychological status and life satisfaction. Results: There was no significant difference between the two groups in the score of quality of life such as late radiation reaction, SCL-90 and LSI-A. Conclusions: 1. It is reasonable to assess the quality of life with these scales for esophageal carcinoma patients treated with radiotherapy, 2. Preliminary results demonstrate that there is no significant difference in long-term quality of life between the CAHF and LCAF radiotherapy groups, 3. Methods of evaluating the long-term quality of life for esophageal carcinoma patients treated with radiotherapy needs further investigation, preferably involving more patients and setting on control arm

  1. Long-term Course of Alzheimer Disease in Patients Treated According to the Dutch Dementia Guideline at a Memory Clinic A "Real-Life" Study

    NARCIS (Netherlands)

    Droogsma, Erika; van Asselt, Dieneke; van Steijn, Jolanda; Diekhuis, Marjolein; Veeger, Nic; De Deyn, Peter P.

    2016-01-01

    Introduction:There is little knowledge of the long-term course of Alzheimer disease (AD) in light of current pharmacological and nonpharmacological interventions provided in a real-life setting.Methods:The Frisian Alzheimer's Disease Cohort study is a real-life study of the course of AD in patients

  2. Physical activity and quality of life in long-term hospitalized patients with severe mental illness : A cross-sectional study

    NARCIS (Netherlands)

    Deenik, Jeroen; Kruisdijk, Frank; Tenback, Diederik; Braakman-Jansen, Annemarie; Taal, Erik; Hopman-Rock, Marijke; Beekman, Aartjan; Tak, Erwin; Hendriksen, Ingrid; van Harten, Peter

    2017-01-01

    Background: Increasing physical activity in patients with severe mental illness is believed to have positive effects on physical health, psychiatric symptoms and as well quality of life. Till now, little is known about the relationship between physical activity and quality of life in long-term

  3. Long-term health-related quality of life and psychological adjustment in children after haemolytic-uraemic syndrome.

    Science.gov (United States)

    Werner, Helene; Buder, Kathrin; Landolt, Markus A; Neuhaus, Thomas J; Laube, Guido F; Spartà, Giuseppina

    2017-05-01

    In children after haemolytic-uraemic syndrome (HUS), little is known about long-term health-related quality of life (HRQoL) and psychological adjustment as defined by behavioural problems, depressive symptoms and post-traumatic stress symptoms. Sixty-two paediatric patients with a history of HUS were included in this study. Medical data of the acute HUS episode were retrieved retrospectively from hospital records. Data on the clinical course at study investigation were assessed by clinical examination and laboratory evaluation. HRQoL and psychological adjustment data were measured by standardised, parent- and self-reported questionnaires. Haemolytic-uraemic syndrome was diagnosed at a mean of 6.5 years before the initiation of the study (standard deviation 2.9, range 0.1-15.7) years. Among the preschool children, parents reported that their child was less lively and energetic (HRQoL emotional dimension), while no increased behavioural problems were reported. In the school-age children, self- and proxy-reported HRQoL was well within or even above the norms, while increased total behavioural problems were found. The school-age children reported no increased depression scores. Also none of the children met the criteria for full or partial HUS-associated posttraumatic stress disorder. Healthcare providers should be particularly alert to behavioural problems in school-age children with a history of HUS and to lower HRQoL in preschool children.

  4. Sex differences in long-term quality of life after stroke: Influence of mood and functional status.

    Science.gov (United States)

    López Espuela, F; Portilla Cuenca, J C; Leno Díaz, C; Párraga Sánchez, J M; Gamez-Leyva, G; Casado Naranjo, I

    2017-12-19

    To evaluate long-term quality of life (QoL) in patients who have experienced a stroke and to analyse differences in QoL between sexes. We conducted a descriptive, cross-sectional, observational study to gather sociodemographic variables and risk factors; data were also obtained on QoL, mood, and functional status using validated scales. The study was approved by our centre's ethics committee. Our final sample included 124 patients; mean age was 71.30±11.99 years. In the QoL study, the EuroQol-5D dimensions in which participants presented most problems were anxiety/depression (66.7%) and pain/discomfort (62.2%). We found significant inter-sex differences in the dimensions of mobility and usual activities (P=.016 and P=.005, respectively). Women also achieved substantially poorer EuroQoL-5D index values than men (0.45±0.45 vs. 0.65±0.38; P=.013). QoL was found to be associated with dependence for the activities of daily living (r=0.326; P=.001) and depressed mood (r=-0.514; Pde Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

  5. Long-Term Benefits of Smoking Cessation on Gastroesophageal Reflux Disease and Health-Related Quality of Life.

    Directory of Open Access Journals (Sweden)

    Yukie Kohata

    Full Text Available Smoking is associated with gastroesophageal reflux disease (GERD. Varenicline, a nicotinic receptor partial agonist, is used to aid smoking cessation. The purpose of this study was to prospectively examine the long-term benefits of smoking cessation on GERD and health-related quality of life (HR-QOL.Patients treated with varenicline were asked to fill out a self-report questionnaire about their smoking habits, gastrointestinal symptoms, and HR-QOL before and 1 year after smoking cessation. The prevalence of GERD, frequency of symptoms, and HR-QOL scores were compared. We also investigated associations between clinical factors and newly-developed GERD.A total of 141 patients achieved smoking cessation (success group and 50 did not (failure group at 1 year after the treatment. The GERD improvement in the success group (43.9% was significantly higher than that in the failure group (18.2%. The frequency of reflux symptoms significantly decreased only in the success group. There were no significant associations between newly developed GERD and clinical factors including increased body mass index and successful smoking cessation. HR-QOL significantly improved only in the success group.Smoking cessation improved both GERD and HR-QOL. Smoking cessation should be recommended for GERD patients.

  6. Lessons from the use of a long-term energy model for consequential life cycle assessment: the BTL case

    International Nuclear Information System (INIS)

    Menten, Fabio; Tchung-Ming, Stephane; Lorne, Daphne; Bouvart, Frederique

    2013-11-01

    The main objective of this study is to develop a methodology adapted to the prospective environmental evaluation of actions in the energy sector. It describes how a bottom-up long-term energy model can be used in a life cycle assessment (LCA) framework. The proposed methodology is applied in a case study about the global warming impacts occurring as a consequence of the future production of synthetic diesel from biomass 'biomass to liquids' - BTL), a second generation biofuel, in France. The results show a high sensitivity of the system-wide GHG balance to (i) the policy context and to (ii) the economic environment. Both influence the substitutions occurring within the system due to the production of BTL. Under the specific conditions of this study, the consequences of introducing BTL are not clear-cut. Therefore, we focus on the lessons from the detailed analysis of the results more than in the precise-looking projections, illustrating how this type of models can be used for strategic planning (industry and policy makers). TIMES-type models allow a detailed description of the numerous technologies affected by BTL production and how these vary under different policy scenarios. Moreover, some recommendations are presented, which should contribute for a proper systematization of consequential and prospective LCA methodologies. We provide argumentation on how to define a functional unit and system boundaries that are better linked with the goal of the study. Other crucial methodological issues are also discussed: how to treat temporal aspects in such environmental evaluation and how to increase the consistency of life cycle assessments. (authors)

  7. Parental Perceptions of Quality of Life in Children on Long-Term Ventilation at Home as Compared to Enterostomy Tubes.

    Directory of Open Access Journals (Sweden)

    Brahim Redouane

    Full Text Available Health related quality of life (HRQL of children using medical technology at home is largely unknown. Our aim was to examine the HRQL in children on long-term ventilation at home (LTHV in comparison to a cohort using an enterostomy tube.Participants were divided into three groups: 1 LTHV without an enterostomy tube (LTHV cohort; 2 Enterostomy tube (GT cohort; 3 LTHV with an enterostomy tube (LTHV+GT cohort. Caregivers of children ≥ 5 years and followed at SickKids, Toronto, Canada, completed three questionnaires: Health Utilities Index 2/3 (HUI2/3, Caregiver Priorities Caregiver Health Index (CPCHILD, and the Paediatric Quality of Life Inventory (PedsQL. The primary outcome was the difference in utility (HUI2/3 scores between the cohorts.One hundred and nineteen children were enrolled; 47 in the LTHV cohort, 44 in the GT cohort, and 28 in the LTHV+GT cohort. In univariate analysis, HUI2 mean (SE scores were lowest for the GT cohort, 0.4 (0.04 followed by the LTHV+GT, 0.42 (0.05 and then the LTHV cohort, 0.7 (0.04, p = 0.001. A similar trend was seen for the HUI3 mean (SE scores: GT cohort, 0.1 (0.06, followed by the LTHV +GT cohort, 0.2 (0.08 and then the LTHV cohort, 0.5 (0.06, p = 0.0001. Technology cohort, nursing hours and the severity of health care needs predicted HRQL as measured by the HUI2/3.The HRQL of these children is low. Children on LTHV had higher HRQL than children using enterostomy tubes. Further work is needed to identify modifiable factors that can improve HRQL.

  8. Quality of life in long-term forensic psychiatric care: comparison of self-report and proxy assessments.

    Science.gov (United States)

    Schel, Sandra Helena Hendrika; Bouman, Yvonne Helena Alexandra; Bulten, Berend Hendrik

    2015-06-01

    To compare quality of life (QoL) ratings of long term forensic psychiatric care patients with the ratings of psychiatric nurses, in which the nurses indicate how they think the patient would answer. Agreement on QoL-scores according to the Forensic inpatient Quality of Life Questionnaire (FQL) was investigated for seventy- seven pairs of patients and psychiatric nurses from two forensic psychiatric long-care facilities where QoL is seen as an important treatment goal. This study also examined whether the amount of agreement was related to specific patient characteristics and characteristics of the patient- psychiatric nurse relationship. On group level, only small and mostly non-significant differences were found between patients' and psychiatric nurses' mean QoL scores. However, pairwise comparisons revealed poor agreement between patients' and nurses' QoL scores for half of the domains and moderate agreement on the other half of the domains, except for Leave, which was the only domain on which patients and their nurses had similar scores. Patient characteristics such as type of offence and type of psychopathology were negligibly related to the level of agreement. However, characteristics of the patient-nurse relationship such as age of the nurse and length of the patient-nurse relationship did influence the amount of consensus between patients' and proxies' QoL-scores significantly. Nurses were not sufficiently able to accurately estimate their patients' QoL experience and could probably benefit from a training aimed at assessing QoL of their patients and how to support their patients in optimizing their QoL themselves. Copyright © 2015 Elsevier Inc. All rights reserved.

  9. Antibiotic treatment of exacerbations of COPD in general practice: long-term impact on healthrelated quality of life

    Directory of Open Access Journals (Sweden)

    Marc Miravitlles

    2010-01-01

    exacerbations.Conclusions: In COPD outpatients, treatment of exacerbations with moxifloxacin had a more favorable long-term effect on quality of life than amoxicillin/clavulanate.Keywords: COPD, exacerbations, moxifloxacin, amoxicillin/clavulanate, quality of life, SGRQ

  10. ESTIMATION OF LONG-TERM INVESTMENT PROJECTS WITH ENERGY-EFFICIENT SOLUTIONS BASED ON LIFE CYCLE COSTS INDICATOR

    Directory of Open Access Journals (Sweden)

    Bazhenov Viktor Ivanovich

    2015-09-01

    Full Text Available The starting stage of the tender procedures in Russia with the participation of foreign suppliers dictates the feasibility of the developments for economical methods directed to comparison of technical solutions on the construction field. The article describes the example of practical Life Cycle Cost (LCC evaluations under respect of Present Value (PV determination. These create a possibility for investor to estimate long-term projects (indicated as 25 years as commercially profitable, taking into account inflation rate, interest rate, real discount rate (indicated as 5 %. For economic analysis air-blower station of WWTP was selected as a significant energy consumer. Technical variants for the comparison of blower types are: 1 - multistage without control, 2 - multistage with VFD control, 3 - single stage double vane control. The result of LCC estimation shows the last variant as most attractive or cost-effective for investments with economy of 17,2 % (variant 1 and 21,0 % (variant 2 under adopted duty conditions and evaluations of capital costs (Cic + Cin with annual expenditure related (Ce+Co+Cm. The adopted duty conditions include daily and seasonal fluctuations of air flow. This was the reason for the adopted energy consumption as, kW∙h: 2158 (variant 1,1743...2201 (variant 2, 1058...1951 (variant 3. The article refers to Europump guide tables in order to simplify sophisticated factors search (Cp /Cn, df, which can be useful for economical analyses in Russia. Example of evaluations connected with energy-efficient solutions is given, but this reference involves the use of materials for the cases with resource savings, such as all types of fuel. In conclusion follows the assent to use LCC indicator jointly with the method of determining discounted cash flows, that will satisfy the investor’s need for interest source due to technical and economical comparisons.

  11. Administrators' perspectives on end-of-life care for cancer patients in Japanese long-term care facilities.

    Science.gov (United States)

    Fukahori, Hiroki; Miyashita, Mitsunori; Morita, Tatsuya; Ichikawa, Takayuki; Akizuki, Nobuya; Akiyama, Miki; Shirahige, Yutaka; Eguchi, Kenji

    2009-10-01

    The purpose of this study was to clarify administrators' perspectives on availability of recommended strategies for end-of-life (EOL) care for cancer patients at long-term care (LTC) facilities in Japan. A cross-sectional survey was conducted with administrators at Japanese LTC facilities. Participants were surveyed about their facilities, reasons for hospitalization of cancer patients, and their perspectives on availability of and strategies for EOL care. The 97 responses were divided into medical facility (n = 24) and non-medical facility (n = 73) groups according to physician availability. The most frequent reasons for hospitalization were a sudden change in patient's condition (49.4%), lack of around-the-clock care (43.0%), and inability to palliate symptoms (41.0%). About 50% of administrators believed their facilities could provide EOL care if supported by palliative care experts. There was no significant difference between facility types (P = 0.635). Most administrators (81.2%) regarded unstable cancer patients as difficult to care for. However, many (68.4%) regarded opioids given orally as easy to administer, but regarded continuous subcutaneous infusion/central venous nutrition as difficult. Almost all administrators believed the most useful strategy was transferring patients to hospitals at the request of patients or family members (96.9%), followed by consultation with palliative care experts (88.5%). Although LTC facilities in Japan currently do not provide adequate EOL care for cancer patients, improvement might be possible with support by palliative care teams. Appropriate models are necessary for achieving a good death for cancer patients. Interventions based on these models are necessary for EOL care for cancer patients in LTC facilities.

  12. Long-term Shifting Patterns in Quality of Life After Distal Subtotal Gastrectomy: Preoperative- and Healthy-based Interpretations.

    Science.gov (United States)

    Lee, Seung Soo; Chung, Ho Young; Kwon, Ohkyoung; Yu, Wansik

    2015-06-01

    The study assessed long-term shifting patterns in quality of life (QoL) after distal subtotal gastrectomy relative to an estimated healthy population QoL (HPQoL), and compared them to shifting patterns interpreted in terms of a preoperative QoL baseline. QoL data from 127 gastric cancer patients who underwent open distal subtotal gastrectomy were obtained at the preoperative period and at 6, 12, 18, 24, and 36 months after surgery. QoL data obtained from 127 age- and sex-adjusted healthy individuals were used to estimate HPQoL. The study used the European Organization for Research and Treatment of Cancer (EORTC) QoL Questionnaire Core 30 (QLQ-C30) and a gastric cancer module (QLQ-STO22) to assess QoL. Comparisons were made between preoperative-based and healthy-based interpretations of longitudinal QoL shifting patterns. Among the persistently deteriorated QoL variables indicated by the preoperative-based interpretation (physical functioning, role functioning, cognitive functioning, nausea and vomiting, dyspnea, diarrhea, dysphagia, eating restrictions, dry mouth, and body image), eating restrictions and body image concerns were the only factors indicated by a healthy-based interpretation. In this interpretation, financial difficulties were evident at the preoperative period and persisted for at least 36 months. When preoperative QoL was used as a baseline, decreased QoL due to financial difficulties was not revealed. Persistent QoL deterioration after distal subtotal gastrectomy is primarily due to financial difficulties, eating restrictions, and body image concerns. Preoperative-based interpretation of postoperative QoL may exaggerate the persistency of reduced QoL and conceal on-going QoL deterioration after surgery.

  13. Multicenter evaluation of quality of life and patient satisfaction after breast reconstruction, a long-term retrospective study.

    Science.gov (United States)

    Ménez, T; Michot, A; Tamburino, S; Weigert, R; Pinsolle, V

    2018-04-01

    Breast reconstruction techniques are multiple and they should be chosen in order to improve women's satisfaction and well-being, thus obtaining a personalized treatment. This report's major purpose was to study, through the Breast-Q questionnaire, how the functional and aesthetic outcomes, as well as the complications, of the main autologous breast reconstruction techniques, can affect patients quality of life and well-being at long-term. The secondary purpose was to analyse, thus to identify, the independent factors characterizing the different reconstructive techniques, which may affect patients' satisfaction. Women who underwent autologous breast reconstruction through deep inferior epigastric artery perforator or Latissimus dorsi muscle flap from May 2006 to May 2013 were included. The assessment was based on the Breast-Q reconstruction questionnaire. All times of post-mastectomy reconstruction were concerned: immediate, delayed, after previous procedure failure or conversion to another reconstructive technique due to the patient's dissatisfaction. A total of 98 patients were included. Concerning patients satisfaction, the breast-Q score is highest in patients who underwent immediate breast reconstruction, while scores after delayed breast reconstruction, previous surgery failure or conversion to another technique are generally equivalent. Higher scores have been observed in patients who underwent reconstruction through autologous Latissimus dorsi compared to Latissimus dorsi with prosthetic implant reconstruction. The authors identified factors of higher patients' satisfaction, like absence of major complication and advanced patient's age, in order to personalize the surgical planning according to the patient's priorities. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  14. Effectiveness of psychological interventions to improve quality of life in people with long-term conditions: rapid systematic review of randomised controlled trials.

    Science.gov (United States)

    Anderson, Niall; Ozakinci, Gozde

    2018-03-27

    Long-term conditions may negatively impact multiple aspects of quality of life including physical functioning and mental wellbeing. The rapid systematic review aimed to examine the effectiveness of psychological interventions to improve quality of life in people with long-term conditions to inform future healthcare provision and research. EBSCOhost and OVID were used to search four databases (PsychInfo, PBSC, Medline and Embase). Relevant papers were systematically extracted by one researcher using the predefined inclusion/exclusion criteria based on titles, abstracts, and full texts. Randomized controlled trial psychological interventions conducted between 2006 and February 2016 to directly target and assess people with long-term conditions in order to improve quality of life were included. Interventions without long-term condition populations, psychological intervention and/or patient-assessed quality of life were excluded. From 2223 citations identified, 6 satisfied the inclusion/exclusion criteria. All 6 studies significantly improved at least one quality of life outcome immediately post-intervention. Significant quality of life improvements were maintained at 12-months follow-up in one out of two studies for each of the short- (0-3 months), medium- (3-12 months), and long-term (≥ 12 months) study duration categories. All 6 psychological intervention studies significantly improved at least one quality of life outcome immediately post-intervention, with three out of six studies maintaining effects up to 12-months post-intervention. Future studies should seek to assess the efficacy of tailored psychological interventions using different formats, durations and facilitators to supplement healthcare provision and practice.

  15. Long-term impact of childhood-onset type 1 diabetes on social life, quality of life and sexuality.

    Science.gov (United States)

    Mellerio, H; Guilmin-Crépon, S; Jacquin, P; Labéguerie, M; Lévy-Marchal, C; Alberti, C

    2015-12-01

    This study describes the socio-professional outcomes, health-related quality of life (HRQOL) and sexuality of adults with childhood-onset type 1 diabetes (T1D). The study participants (n=388), recruited from a nationwide registry (age: 28.5 ± 3.1 years; T1D duration: 17.0 ± 2.7 years), completed a questionnaire (198 items); the results were compared with the French general population using standardized incidence ratios (SIRs) and Z scores matched for age, gender and period with/without education levels and patterns of family life. Linear regression models also investigated correlates of SF-36 Physical (PCS) and Mental Composite Scores (MCS). Compared with the French general population, education levels of people with T1D were similar, with 68.6% having at least a high-school diploma or higher (SIR: 1.06, 95% CI: 0.93; 1.20), as were also their patterns of family life. Unemployment was higher in T1D women (15.3%, SIR: 1.50, 1.00; 2.05), but not in T1D men (8.6%, SIR: 0.96, 0.51; 1.57). Social discrimination was more common (SIR: 5.64, 4.64; 6.62), and frequency of daily alcohol consumption was higher (SIR: men, 3.34, 2.38; 4.54; women, 6.53, 4.57; 12.99). PCS and MCS were decreased moderately (mean ± SD: 52.0 ± 7.5; mean Z score: -0.2, 95% CI: -0.3; -0.1) and substantially (mean ± SD: 42.1 ± 12.4; mean Z score: -0.7, -0.8; -0.6), respectively. Fatigue and abandoning sports were predictive of a lower HRQOL. Both men and women were more frequently dissatisfied with their sex life. Prevalence of sexual problems was higher in women (SIR for: dysorgasmia, 1.91, 1.21-2.88; decreased/loss of desire: 2.11, 1.35-3.08), but similar in men. Participants with T1D-related complications had preserved social outcomes, but altered HRQOL. Young adults with T1D have satisfactory social participation. However, their higher alcohol consumption, lower MCS and frequent dissatisfaction with sexuality suggest a heavy impact of the disease on morale, especially in women. Improving the

  16. Degradation of Alloy 800 steam generator tubing and its long-term behaviour predictions for plant life management

    International Nuclear Information System (INIS)

    Lu, Y.C.; Tapping, R.L.; Pandey, M.D.

    2009-01-01

    results imply that Alloy 800 SG tubing may experience measurable aging after many years of service. Although these preliminary results require further confirmation, special attention should be paid to manage the SG tubing degradation in a proactive and predictable manner. Electric Power Research Institute (EPRI) and Dominion Engineering, Inc. (DEI) have developed probabilistic approaches using a degradation free lifetime Weibull distribution based on the OPEX of Alloy 600 SG tubing and a concept of materials improvement factors (MIFs) to 'predict' the long-term service behaviour of other SG tubing. In this paper, a new concept, 'corrosion stress cycle analysis' (CSCA) based on the concept of 'Fatigue Usage Factor' used in mechanical design, is proposed here as a guide for predictive and proactive SG life management. The CSCA approach assumes that an alloy can tolerate a certain number of corrosion stress cycles, i.e., excursions due to off-specification (assuming that the specifications are appropriate) chemistry conditions and SG transients etc. Using the in-service experience, the number of stress cycles that occurred in the history of a SG and in the future can be estimated and the Alloy 800 SG tubing long-term degradation can then be predicted. (author)

  17. Prognostic factors for long-term quality of life after adjuvant radiotherapy in women with endometrial cancer

    Energy Technology Data Exchange (ETDEWEB)

    Foerster, Robert; Schnetzke, Lara; Arians, Nathalie; Rief, Harald; Debus, Juergen; Lindel, Katja [University Hospital Heidelberg, Department of Radiation Oncology, Heidelberg (Germany); Bruckner, Thomas [University Hospital Heidelberg, Department of Medical Biometry, Heidelberg (Germany)

    2016-12-15

    Adjuvant radiotherapy (RT) for endometrial cancer (EC) may affect patients' quality of life (QoL). There is a paucity of data on prognostic factors for long-term QoL and sexual functioning. This study aimed to investigate such factors and assess the role of the vaginal dilator (VD). QoL was assessed in 112 EC patients 6 years (median) after RT. QoL was compared to normative data, and the influence of age, tumor characteristics, lymphadenectomy, RT, and acute toxicities was assessed. VD use and its effect on subjective vaginal shortening/tightness was analyzed. QoL was reduced, particularly in younger patients. Vaginal brachytherapy only and intensity-modulated RT (IMRT) were associated with better global health status and reduced chronic gastrointestinal (GI) symptoms. Higher acute GI toxicity was associated with increased chronic GI symptoms, particularly diarrhea, and reduced role functioning. Higher acute urinary toxicity was associated with increased chronic urological symptoms, muscular/pelvic pain, and chronic GI symptoms, as well as with reduced emotional/social functioning and reduced global health status. Sexual interest/activity was increased despite vaginal dryness and dyspareunia. Sexual interest/activity increased with age. Only few, mainly younger patients used the VD. VD use >1 year was found in women with higher sexual interest/activity. Acute vaginal toxicity and chronic pain prevented VD use. Subjective vaginal shortening/tightness was not reduced in VD users. RT technique and acute toxicities are prognostic for the extent of chronic symptoms and long-term QoL. Sexuality is important even at a higher age. Few patients use the VD and a reduction of subjective vaginal shortening/tightness was not achieved. (orig.) [German] Eine adjuvante Radiotherapie (RT) kann die Lebensqualitaet von Patientinnen mit Endometriumkarzinom (EC) beeinflussen. Daten zu prognostischen Faktoren fuer die langfristige Lebensqualitaet (QoL) und die Sexualfunktion sind

  18. Long-term use of cover crops and no-till shift soil microbial community life strategies in agricultural soil

    Science.gov (United States)

    Mitchell, Jeffrey; Scow, Kate

    2018-01-01

    Reducing tillage and growing cover crops, widely recommended practices for boosting soil health, have major impacts on soil communities. Surprisingly little is known about their impacts on soil microbial functional diversity, and especially so in irrigated Mediterranean ecosystems. In long-term experimental plots at the West Side Research and Extension Center in California’s Central Valley, we characterized soil microbial communities in the presence or absence of physical disturbance due to tillage, in the presence or absence of cover crops, and at three depths: 0–5, 5–15 and 15–30 cm. This characterization included qPCR for bacterial and archaeal abundances, DNA sequencing of the 16S rRNA gene, and phylogenetic estimation of two ecologically important microbial traits (rRNA gene copy number and genome size). Total (bacterial + archaeal) diversity was higher in no-till than standard till; diversity increased with depth in no-till but decreased with depth in standard till. Total bacterial numbers were higher in cover cropped plots at all depths, while no-till treatments showed higher numbers in 0–5 cm but lower numbers at lower depths compared to standard tillage. Trait estimates suggested that different farming practices and depths favored distinctly different microbial life strategies. Tillage in the absence of cover crops shifted microbial communities towards fast growing competitors, while no-till shifted them toward slow growing stress tolerators. Across all treatment combinations, increasing depth resulted in a shift towards stress tolerators. Cover crops shifted the communities towards ruderals–organisms with wider metabolic capacities and moderate rates of growth. Overall, our results are consistent with decreasing nutrient availability with soil depth and under no-till treatments, bursts of nutrient availability and niche homogenization under standard tillage, and increases in C supply and variety provided by cover crops. Understanding how

  19. Sexual life and fertility desire in long-term HIV serodiscordant couples in Addis Ababa, Ethiopia: a grounded theory study

    Directory of Open Access Journals (Sweden)

    Hailemariam Tewodros G

    2012-10-01

    Full Text Available Abstract Background Even though remarkable progress has been achieved, HIV/AIDS continues to be a major global health priority. HIV discordant relationship is one of the emerging issues in HIV prevention endeavour. In Ethiopia, very little is known about HIV-serodiscordant couples particularly how they manage their sexual relationship and fertility desire. Therefore, we conduct this study with the aim of exploring the experiences of HIV discordant couples about their sexual life, and fertility desire in the context of long-term relationships in Addis Ababa, Ethiopia. Methods A grounded theory approach was employed using in-depth interviews among 36 informants in ART/PMTCT centers of three public hospitals, a health center and one PLHIV association in Addis Ababa. Theoretical sampling was used to recruit 28 clients who lived in a discordant relationship and eight health care providers as key informants. Data collection and analysis were undertaken simultaneously using a constant comparison. The analysis was facilitated using OpenCode software. Results A grounded theory pertaining to sexual life and desire to have a child among HIV discordant couples emerged as “maintaining the relationship” as a core category. Couples pass through a social process of struggle to maintain their relationship. The causal conditions for couples to enter into the process of struggle to maintain their relationship were collectively categorized as “Entering in-to a transition” (knowing HIV serostatus and this includes mismatch of desire to have a child, controversy on safe sex versus desire to have a child, and undeniable change in sexual desire and practice through time were the features in entering into-transition. Then after the transition, couples engaged in certain actions/strategies that are categorized as “dealing with discordancy” such as entertaining partner’s interest by scarifying once self interest to maintain their relationship. Conclusions

  20. QUALITY-OF-LIFE IN A LONG-TERM MULTICENTER TRIAL IN CHRONIC NONSPECIFIC LUNG-DISEASE - ASSESSMENT AT BASE-LINE

    NARCIS (Netherlands)

    KAPTEIN, AA; BRAND, PLP; DEKKER, FW; KERSTJENS, HAM; POSTMA, DS; SLUITER, HJ

    1993-01-01

    Quality-of-life (QOL) in patients with respiratory illness is a topic of increasing interest to clinicians and researchers. In a multicentre trial, which studies the long-term effects of three medication regimens (beta-agonist plus either placebo, anti-cholinergic agent or corticosteroid, all by

  1. Long-term wine consumption is related to cardiovascular mortality and life expectancy independently of moderate alcohol intake: the Zutphen Study

    NARCIS (Netherlands)

    Streppel, M.T.; Ocke, M.C.; Boshuizen, H.C.; Kok, F.J.; Kromhout, D.

    2009-01-01

    Background: Light to moderate alcohol intake lowers the risk of cardiovascular mortality, but whether this protective effect can be attributed to a specific type of beverage remains unclear. Moreover, little is known about the effects of long-term alcohol intake on life expectancy. Methods: The

  2. Long-term health and quality-of-life consequences of mass screening for childhood celiac disease: A 10-year follow-up study

    NARCIS (Netherlands)

    Koppen, E.J. van; Schweizer, J.J.; Csizmadia, C.G.D.S.; Krom, Y.; Hylkema, H.B.; Geel, A.M. van; Koopman, H.M.; Verloove-Vanhorick, S.P.; Mearin, M.L.

    2009-01-01

    OBJECTIVE. Mass screening for celiac disease is controversial. The objective of this study was to determine whether detection of childhood celiac disease by mass screening improves long-term health status and health-related quality of life. METHODS.We conducted a prospective 10-year follow-up study

  3. Health-related quality of life and disease specific symptoms in long-term thyroid cancer survivors : A study from the population-based PROFILES registry

    NARCIS (Netherlands)

    Husson, O.; Haak, H.R.; Buffart, L.M.; Nieuwlaat, W.-A.; Oranje, W.A.; Mols, F.; Kuijpens, J.L.; Coebergh, J.W.W.; van de Poll-Franse, L.V.

    2013-01-01

    Background. Given the longevity of thyroid cancer patients, any impairment in health-related quality of life (HRQoL) during the follow-up period is of considerable concern. Therefore, the first aim of this study was to assess (thyroid cancer specific) HRQoL among long-term thyroid cancer survivors

  4. Recruiting long-term survivors of European Organisation for Research and Treatment of Cancer phase III clinical trials into quality of life studies : Challenges and opportunities

    NARCIS (Netherlands)

    van Leeuwen, M.L.; Efficace, F.; Fosså, S.D.; Bolla, M.; de Giorgi, U.; De Wit, R.; Holzner, B.; van de Poll-Franse, L.; White, J.; Collette, L.; Osanto, S.; Aaronson, N.K.; European Organisation for Research and Treatment of Cancer Quality of Life Group; Genito-Urinary Cancers Group, The

    2014-01-01

    Objectives In this pilot study we evaluated the feasibility of and methods for assessing the quality of life of long term survivors of European Organisation for Research and Treatment of Cancer (EORTC) phase III clinical trials. Here we report the results pertaining to the feasibility of conducting

  5. Recruiting long-term survivors of European Organisation for Research and Treatment of Cancer phase III clinical trials into quality of life studies: Challenges and opportunities

    NARCIS (Netherlands)

    van Leeuwen, M.; Efficace, F.; Fosså, S.D.; Bolla, M.; De Giorgi, U.; de Wit, R; Holzner, B.; van de Poll-Franse, L.V.; van Poppel, H.; White, J.; Collette, L.; Osanto, S.; Aaronson, N.K.

    2014-01-01

    Objectives: In this pilot study we evaluated the feasibility of and methods for assessing the quality of life of long term survivors of European Organisation for Research and Treatment of Cancer (EORTC) phase III clinical trials. Here we report the results pertaining to the feasibility of conducting

  6. Long-term exposure to anticholinergic and sedative drugs and cognitive and physical function in later life

    NARCIS (Netherlands)

    Wouters, H.; Hilmer, S.; Gnjidic, D.; Van Campen, J.; Teichert, M.; Van Der Meer, H.; Schaap, L.; Huisman, M.; Denig, P.; Lamoth, C.; Taxis, K.

    2017-01-01

    Introduction: Anticholinergic and sedative drugs from various therapeutic classes are frequently prescribed to older people. These drugs are known to impair cognitive and physical function in the short-term. However, long-term exposure to these drugs remains less examined. Methods: Data from the

  7. Long-Term Collections

    CERN Multimedia

    Staff Association

    2016-01-01

    45 years helping in developing countries! CERN personnel have been helping the least fortunate people on the planet since 1971. How? With the Long-Term Collections! Dear Colleagues, The Staff Association’s Long-Term Collections (LTC) Committee is delighted to share this important milestone in the life of our Laboratory with you. Indeed, whilst the name of CERN is known worldwide for scientific discoveries, it also shines in the many humanitarian projects which have been supported by the LTC since 1971. Several schools and clinics, far and wide, carry its logo... Over the past 45 years, 74 projects have been supported (9 of which are still ongoing). This all came from a group of colleagues who wanted to share a little of what life offered them here at CERN, in this haven of mutual understanding, peace and security, with those who were less fortunate elsewhere. Thus, the LTC were born... Since then, we have worked as a team to maintain the dream of these visionaries, with the help of regular donat...

  8. ISS Regenerative Life Support: Challenges and Success in the Quest for Long-Term Habitability in Space

    Science.gov (United States)

    Bazley, Jesse A.

    2011-01-01

    This presentation will discuss the International Space Station s (ISS) Regenerative Environmental Control and Life Support System (ECLSS) operations with discussion of the on-orbit lessons learned, specifically regarding the challenges that have been faced as the system has expanded with a growing ISS crew. Over the 10 year history of the ISS, there have been numerous challenges, failures, and triumphs in the quest to keep the crew alive and comfortable. Successful operation of the ECLSS not only requires maintenance of the hardware, but also management of the station resources in case of hardware failure or missed re-supply. This involves effective communication between the primary International Partners (NASA and Roskosmos) and the secondary partners (JAXA and ESA) in order to keep a reserve of the contingency consumables and allow for re-supply of failed hardware. The ISS ECLSS utilizes consumables storage for contingency usage as well as longer-term regenerative systems, which allow for conservation of the expensive resources brought up by re-supply vehicles. This long-term hardware, and the interactions with software, was a challenge for Systems Engineers when they were designed and require multiple operational workarounds in order to function continuously. On a day-to-day basis, the ECLSS provides big challenges to the on console controllers. Main challenges involve the utilization of the resources that have been brought up by the visiting vehicles prior to undocking, balance of contributions between the International Partners for both systems and resources, and maintaining balance between the many interdependent systems, which includes providing the resources they need when they need it. The current biggest challenge for ECLSS is the Regenerative ECLSS system, which continuously recycles urine and condensate water into drinking water and oxygen. These systems were brought to full functionality on STS-126 (ULF-2) mission. Through system failures and recovery

  9. [Computer cardiokymography. On its way to long-term noninvasive monitoring of cardiac performance in daly life].

    Science.gov (United States)

    Khaiutin, V M; Lukoshkova, E V; Sheroziia, G G

    2004-05-01

    stop veloergometry at lower loads, thus increasing the safety of the test. Since for large medical insurance companies very simple and inexpensive cardiokymograph are quite unprofitable, their commercially production in USA and in Germany has been stopped. However, the goal of cardiokymography: a real-time, beat-to-beat, long-term monitoring of cardiac function in daily life, remains the major factor determining the future of the method.

  10. Health-Related Quality of Life: Expanding a Conceptual Framework to Include Older Adults Who Receive Long-Term Services and Supports

    Science.gov (United States)

    Zubritsky, Cynthia; Abbott, Katherine M.; Hirschman, Karen B.; Bowles, Kathryn H.; Foust, Janice B.; Naylor, Mary D.

    2013-01-01

    For older adults receiving long-term services and supports (LTSS), health-related quality of life (HRQoL) has emerged as a critical construct to examine because of its focus on components of well-being, which are affected by progressive changes in health status, health care, and social support. HRQoL is a health-focused quality of life (QOL)…

  11. Comparison of quality of sleep, depression, and life satisfaction between older adults in nursing homes and long-term care hospitals in Korea.

    Science.gov (United States)

    Kim, Kon Hee; Hwang, Eun Hee

    2017-01-01

    The purpose of the present study was to identify the sleep quality, depression, and life satisfaction between nursing home and long-term care hospital residents. Data was collected through a structured questionnaire survey of 61 nursing home residents and 74 long-term care hospital residents. Descriptive statistics, t-test, χ 2 -test, anova, Pearson's correlation were used to analyze the data. The residents living in a nursing home showed higher subjective health status and sleep quality than long-term care hospital residents. Depression did not show a significant difference between them. However, there was a significant difference in depression score by subjective health status. Sleep quality and depression showed a significant negative correlation for both residents. In terms of depression and life satisfaction, nursing home residents showed a significant negative correlation, and long-term care hospital residents showed a significant positive correlation. These results show that environmental management is essential to enhance sleep quality, thus depression and subjective health status will be improved. Geriatr Gerontol Int 2017; 17: 142-149. © 2015 Japan Geriatrics Society.

  12. Effects of viewing ordered pictorial reminders on long-term memory in the first year of life

    OpenAIRE

    Carver, Leslie J.

    2011-01-01

    Previous research has shown that reminders can be effective for extending and enhancing a variety of kinds of memory in infants. We investigated the effects of viewing pictorial representations of actions that were included in imitation events used to measure long-term memory in young infants. Infants who saw the pictures of actions displayed in the order in which they comprised events showed evidence of memory for the events. Infants who saw the actions presented randomly did not. These resu...

  13. Long term impact of emotional, social and cognitive intelligence competencies and GMAT on career and life satisfaction and career success

    OpenAIRE

    Amdurer, Emily; Boyatzis, Richard E.; Saatcioglu, Argun; Smith, Melvin L.; Taylor, Scott N.

    2014-01-01

    ABSTRACTCareer scholars have called for a broader definition of career success by inviting greater exploration of its antecedents. While success in various jobs has been predicted by intelligence and in other studies by competencies, especially in management, long term impact of having intelligence and using competencies has not been examined. Even in collegiate outcome studies, few have examined the longer term impact on graduates’ careers or lives. This study assesses the impact of demonstr...

  14. What contributes to long-term quality of life in breast cancer patients who are undergoing surgery? Results of a multidimensional study.

    Science.gov (United States)

    Wittmann, Victoria; Látos, Melinda; Horváth, Zoltán; Simonka, Zsolt; Paszt, Attila; Lázár, György; Csabai, Márta

    2017-08-01

    This study aims to examine the key determinants of long-term quality of life in breast cancer patients who are undergoing surgery using a multidimensional approach and taking into account preoperative and post-operative psychological characteristics such as anxiety, depression, posttraumatic growth, body image, and physical activity as well as medical parameters. The study involved 63 breast cancer patients from the Department of Surgery at the University of Szeged. Assessments occurred 1 day before surgery as well as 3 days and 18 months after surgery using the Spielberger State and Trait Anxiety Inventory (STAI), Beck's Depression Inventory (BDI), Functional Assessment of Cancer Therapy-Breast Cancer Scale (FACT-B), Posttraumatic Growth Inventory (PTGI) and Breast Impact of Treatment Scale (BITS). Data relating to physical activity, medical parameters and sociodemographic characteristics were also collected. The level of depression did not change over time. State anxiety decreased 18 months after the surgery compared to before the surgery; however, there was a greater decrease immediately after the surgery and then anxiety increased again 18 months later. Trait anxiety was associated with quality of life, posttraumatic growth and body image. Posttraumatic growth and the level of depression were found to be possible contributing factors to the increase in long-term quality of life. The results show that the timely detection and proper management of psychological distress and the enhancement of posttraumatic growth are of great value, as they might be important contributing factors to long-term quality of life in breast cancer patients.

  15. Quality of Life and Gastrointestinal Symptoms in Long-Term Treated Dermatitis Herpetiformis Patients: A Cross-Sectional Study in Finland.

    Science.gov (United States)

    Pasternack, Camilla; Kaukinen, Katri; Kurppa, Kalle; Mäki, Markku; Collin, Pekka; Reunala, Timo; Huhtala, Heini; Salmi, Teea

    2015-12-01

    Dermatitis herpetiformis (DH) is a cutaneous manifestation of celiac disease. Both conditions are treated with a restrictive life-long gluten-free diet (GFD). Treated celiac disease patients have been shown to have more severe gastrointestinal symptoms and inferior quality of life compared with healthy controls, but evidence regarding quality of life in DH is lacking. The aim was to evaluate whether long-term GFD-treated DH patients suffer from persistent gastrointestinal symptoms and if they experience a drawdown in quality of life. Gastrointestinal symptoms and quality of life were assessed in 78 long-term GFD-treated DH patients using the validated Gastrointestinal Symptom Rating Scale, Psychological General Well-Being and Short Form 36 Health Survey questionnaires. The findings were compared with 110 healthy controls, population-based reference values and 371 treated celiac disease controls. The median age of the DH patients at the time of the study was 57 years, and 51 % were male. Significant differences in gastrointestinal symptoms or quality of life were not detected when treated DH patients were compared with healthy controls, but treated DH patients had less severe gastrointestinal symptoms and increased quality of life compared with celiac disease controls. Female DH patients had more severe gastrointestinal symptoms and reduced vitality compared with male DH patients. The presence of skin symptoms and the adherence to or duration of GFD did not have any influence on gastrointestinal symptoms or quality of life. We conclude that long-term GFD-treated DH patients do not suffer from the burden of dietary treatment and have a quality of life comparable to that of controls.

  16. Long-Term Quality of Life After Swallowing and Salivary-Sparing Chemo–Intensity Modulated Radiation Therapy in Survivors of Human Papillomavirus–Related Oropharyngeal Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Vainshtein, Jeffrey M. [Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan (United States); Moon, Dominic H. [University of Michigan Medical School, Ann Arbor, Michigan (United States); Feng, Felix Y. [Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan (United States); Chepeha, Douglas B. [Department of Otolaryngology—Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan (United States); Eisbruch, Avraham, E-mail: eisbruch@umich.edu [Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan (United States); Stenmark, Matthew H. [Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan (United States)

    2015-04-01

    Purpose: To evaluate long-term health-related quality of life (HRQOL) in 2 prospective studies of chemo–intensity modulated radiation therapy (chemo-IMRT) for oropharyngeal cancer (OPC). Methods and Materials: Of 93 patients with stage III/IV OPC treated on prospective studies of swallowing and salivary organ-sparing chemo-IMRT, 69 were eligible for long-term HRQOL assessment. Three validated patient-reported instruments, the Head and Neck QOL (HNQOL) questionnaire, the University of Washington quality of life (UWQOL) questionnaire, and the Xerostomia Questionnaire (XQ), previously administered from baseline through 2 years in the parent studies, were readministered at long-term follow-up, along with the Short-Form 36. Long-term changes in HRQOL from before treatment and 2 years were evaluated. Results: Forty patients (58%) with a median follow-up of 6.5 years participated, 39 of whom (97.5%) had confirmed human papillomavirus–positive OPC. Long term, no clinically significant worsening was detected in mean HRQOL scores compared with 2 years, with stable or improved HRQOL from before treatment in nearly all domains. “Moderate” or greater severity problems were uncommon, reported by 5% of patients for eating, 5% for swallowing, and 2.5% and 5% by HNQOL and UWQOL summary scores, respectively. Freedom from percutaneous endoscopic gastrostomy tube dependence and stricture dilation beyond 2 years was 97.5% and 95%, respectively. Eleven percent and 14% of patients reported “moderate” or “severe” long-term worsening in HNQOL Pain and Overall Bother domains, respectively, which were associated with mean dose to the cervical esophagus, larynx, and pharyngeal constrictors. Conclusions: At more than 6 years' median follow-up, OPC patients treated with swallowing and salivary organ-sparing chemo-IMRT reported stable or improved HRQOL in nearly all domains compared with both before treatment and 2-year follow-up. New late toxicity after 2 years was

  17. Rolls-Royce I and C long term support a dedicated solution to manage plant condition, optimize operating life and maximize plant value while improving safety

    International Nuclear Information System (INIS)

    Baillonmartos, F.

    2010-01-01

    Rolls-Royce supplied safety I and C equipment as Original Equipment Manufacturer (OEM) for 200 reactors in operation from 1970', including various technological steps (analog to digital hardware). The hardware scope covers various systems, either more than 500 hardware references, either more than 150000 parts in operation. Rolls-Royce contributes to life time extension ensuring system availability and reliability on long term basis by determining the optimum solution between different maintenance approaches: maintenance and repair with limited retrofit or major system retrofit. Based on Long Term Support (LTS) agreement with customers, Rolls-Royce commits to maintain the capability to manufacture, modify, repair, test, at board, rack and systems level over a long time period. This means finding solution to hardware ageing, technology evolution, skills and tools maintenance. This paper describes how Rolls-Royce has built a global process based on delivering a package of services and developing long term support engineering solutions and tools. Our main experience on EDF partnership will serve to illustrate Rolls-Royce I and C Long Term Support activity. (authors)

  18. Effects of viewing ordered pictorial reminders on long-term memory in the first year of life.

    Science.gov (United States)

    Carver, Leslie J

    2011-11-01

    Previous research has shown that reminders can be effective for extending and enhancing a variety of kinds of memory in infants. We investigated the effects of viewing pictorial representations of actions that were included in imitation events used to measure long-term memory in young infants. Infants who saw the pictures of actions displayed in the order in which they comprised events showed evidence of memory for the events. Infants who saw the actions presented randomly did not. These results suggest that pictures presented during the consolidation and storage phase of memory formation can be effective reminders of events for young infants.

  19. Long-term outcome and quality of life of patients treated in surgical intensive care: a comparison between sepsis and trauma

    OpenAIRE

    Korošec Jagodič, Helena; Jagodič, Klemen; Podbregar, Matej

    2006-01-01

    Introduction Our aim was to determine long-term survival and quality of life of patients admitted to a surgical intensive care unit (ICU) because of sepsis or trauma. Methods This was an observational study conducted in an 11-bed, closed surgical ICU at a 860-bed teaching general hospital over a 1-year period (January 2003 to December 2003). Patients were divided into two groups according to admission diagnoses: group 1 included patients with sepsis; and group 2 included patients with trauma ...

  20. Exploratory study of long-term health-related quality of life in patients with surgically treated primary parotid gland cancer.

    Science.gov (United States)

    Stenner, Markus; Beenen, Franziska; Hahn, Moritz; Koopmann, Mario; Weiss, Daniel; Hüttenbrink, Karl-Bernd

    2016-01-01

    Health-related quality of life (HRQOL) has received more and more attention as an outcome in cancer therapy. In this exploratory study, we assessed the long-term HRQOL among 77 surgically treated patients with parotid gland cancer. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30-questions (EORTC-QLQ-C30) and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 Head and Neck 35-questions (EORTC-QLQ-C30-H&N35) questionnaires were used in a cross-sectional design. The mean time-lag between initial diagnosis and completion of the questionnaire was 89.7 months. The HRQOL significantly increased with the time-lag to surgery and decreased with the patients' age. Factors with clinically significant effects in several areas of long-term HRQOL (ie, more than 4 scores) were age, type of neck dissection, preoperative facial nerve palsy, and postoperative radiation therapy. In parotid gland cancer surgery, factors, such as sex, age, type of surgery, facial nerve palsy, and radiation therapy, seem to be associated with clinically meaningful differences in long-term HRQOL scores. © 2015 Wiley Periodicals, Inc.

  1. Has long-term metal exposure induced changes in life history traits and genetic diversity of the enchytraeid worm Cognettia sphagnetorum (Vejd.)?

    International Nuclear Information System (INIS)

    Haimi, Jari; Knott, Karelyn Emily; Selonen, Salla; Laurikainen, Marjo

    2006-01-01

    We studied whether long-term metal exposure has affected life history traits, population growth patterns and genetic diversity of the asexual enchytraeid worm Cognettia sphagnetorum (Vejd.). Enchytraeids from metal contaminated and uncontaminated forest soil were compared by growing them individually in the laboratory and by following their population development in patchily Cu contaminated microcosms. Genetic differences between the two native populations were studied using allozyme electrophoresis. Individuals from the contaminated site had slower growth rate and they produced fewer fragments of larger size when compared to individuals from the uncontaminated site. In patchily Cu contaminated microcosms, C. sphagnetorum from the contaminated site had a slower population growth rate. Most alleles were shared by the two native populations, but there was greater diversity and more unique genotypes in the population living in the uncontaminated site. Overall, long-term exposure to metals has induced only slight changes in life history properties and clonal diversity of C. sphagnetorum. - Long-term exposure to metals caused only small changes in life histories of two populations of Cognettia sphagnetorum

  2. Dietary Reversal Ameliorates Short- and Long-Term Memory Deficits Induced by High-fat Diet Early in Life.

    Directory of Open Access Journals (Sweden)

    Catrina Sims-Robinson

    Full Text Available A high-fat diet (HFD, one of the major factors contributing to metabolic syndrome, which is associated with an increased risk of neurodegenerative diseases, leads to insulin resistance and cognitive impairment. It is not known whether these alterations are improved with dietary intervention. To investigate the long-term impact of a HFD on hippocampal insulin signaling and memory, C57BL6 mice were placed into one of three groups based on the diet: a standard diet (control, a HFD, or a HFD for 16 weeks and then the standard diet for 8 weeks (HF16. HFD-induced impairments in glucose tolerance and hippocampal insulin signaling occurred concurrently with deficits in both short- and long-term memory. Furthermore, these conditions were improved with dietary intervention; however, the HFD-induced decrease in insulin receptor expression in the hippocampus was not altered with dietary intervention. Our results demonstrate that memory deficits due to the consumption of a HFD at an early age are reversible.

  3. CHANGES IN QUALITY OF LIFE AFTER SHORT AND LONG TERM FOLLOW-UP OF ROUX-EN-Y GASTRIC BYPASS FOR MORBID OBESITY

    Directory of Open Access Journals (Sweden)

    Rafael M. LAURINO NETO

    2013-09-01

    Full Text Available Context It is unclear whether health-related quality of life (HRQL is sustained in a long-term follow-up of morbidly obese patients who underwent Roux-en-Y gastric bypass (RYGB. Objective This study aims to analyze the HRQL changes following RYGB in short and long-term follow-up. Methods We compared the health-related quality of life among three separate patient groups, using the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36. Group A - 50 preoperative morbidly obese patients; Group B - 50 RYGB patients 1-2 years post-surgery; Group C - 50 RYGB patients more than 7 years post-surgery. Results The groups were similar for gender, age and body mass index before surgery. We observed that physical functioning, social function, emotional role functioning and mental health scales did not vary between the three groups. The physical role functioning scale was unchanged in the short-term and decreased compared to the preoperative scale in the long-term follow-up. Bodily pain improved after the operation but returned to the initial level after 7 years. The vitality and general health perceptions improved after the operation and maintained these results after 7 years compared with the preoperative perceptions. Conclusions RYGB improved health-related quality of life in three SF-36 domains (bodily pain, general health perceptions and vitality in the short-term and two SF-36 domains (general health perceptions and vitality in the long-term.

  4. Long-Term Perspectives of Family Quality of Life Following Music Therapy With Young Children on the Autism Spectrum: A Phenomenological Study.

    Science.gov (United States)

    Thompson, Grace A

    2018-01-13

    Parents of children on the autism spectrum have consistently reported feeling uncertain in their parenting role, and desire more practical advice from service providers about how to support their child in the home. There is growing recognition of the need for interventions to provide support to the family as well as fostering child development outcomes. This study explores mothers' follow-up perspectives of family-centered music therapy (FCMT) four years after participating in a 16-week home-based program, and therefore provides a unique long-term viewpoint on FCMT outcomes. Eight mothers who previously participated in FCMT sessions with their young children on the autism spectrum were interviewed to explore their perception of any long-term outcomes. A descriptive phenomenological analysis revealed five global themes, including: improvement in mothers' confidence to engage their child; rare opportunities for mutual mother-child enjoyment; improved child social communication and quality of life; mothers' new understanding of the child's interests and strengths; and more opportunities for continuing the child's interest in music. Mothers perceived long-term benefits to social relationships within the family, leading to perceived enrichment in child and family quality of life following music therapy sessions. © American Music Therapy Association 2017. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  5. Early-life adversity-induced long-term epigenetic programming associated with early onset of chronic physical aggression: Studies in humans and animals.

    Science.gov (United States)

    Chistiakov, Dimitry A; Chekhonin, Vladimir P

    2017-06-05

    To examine whether chronic physical aggression (CPA) in adulthood can be epigenetically programmed early in life due to exposure to early-life adversity. Literature search of public databases such as PubMed/MEDLINE and Scopus. Children/adolescents susceptible for CPA and exposed to early-life abuse fail to efficiently cope with stress that in turn results in the development of CPA later in life. This phenomenon was observed in humans and animal models of aggression. The susceptibility to aggression is a complex trait that is regulated by the interaction between environmental and genetic factors. Epigenetic mechanisms mediate this interaction. Subjects exposed to stress early in life exhibited long-term epigenetic programming that can influence their behaviour in adulthood. This programming affects expression of many genes not only in the brain but also in other systems such as neuroendocrine and immune. The propensity to adult CPA behaviour in subjects experienced to early-life adversity is mediated by epigenetic programming that involves long-term systemic epigenetic alterations in a whole genome.

  6. Influencers on quality of life as reported by people living with dementia in long-term care: a descriptive exploratory approach.

    Science.gov (United States)

    Moyle, Wendy; Fetherstonhaugh, Deirdre; Greben, Melissa; Beattie, Elizabeth

    2015-04-23

    Over half of the residents in long-term care have a diagnosis of dementia. Maintaining quality of life is important, as there is no cure for dementia. Quality of life may be used as a benchmark for caregiving, and can help to enhance respect for the person with dementia and to improve care provision. The purpose of this study was to describe quality of life as reported by people living with dementia in long-term care in terms of the influencers of, as well as the strategies needed, to improve quality of life. A descriptive exploratory approach. A subsample of twelve residents across two Australian states from a national quantitative study on quality of life was interviewed. Data were analysed thematically from a realist perspective. The approach to the thematic analysis was inductive and data-driven. Three themes emerged in relation to influencers and strategies related to quality of life: (a) maintaining independence, (b) having something to do, and (c) the importance of social interaction. The findings highlight the importance of understanding individual resident needs and consideration of the complexity of living in large group living situations, in particular in regard to resident decision-making.

  7. Aging: Learning to Live a Finite Life.

    Science.gov (United States)

    Baars, Jan

    2017-10-01

    Although biodemographic research informs us that life expectancies have risen impressively during the last century, this has not led to much interest in these new horizons of aging. The instrumentalist culture of late modern societies, including its health cure system, has clearly difficulties to relate to the elusive but inevitable limitations of finite life. Moreover, as most people can be expected to survive into old age, thinking about finitude is easily postponed and reserved for those who are "really old." Indeed, a meaningful and realistic understanding of aging needs to include a confrontation with the finitude of life. Instead of reducing aging to the opposite or continuation of vital adulthood, it should be seen as something with a potentially broad and deep significance: a process of learning to live a finite life. As a contribution to this cultural repositioning of aging, the article presents a philosophical exploration of finitude and finite life. Among the discussed topics are the Stoic and Epicurean ways of living with death but also the necessity to expand the meaning of "finitude" beyond mortality. Aging is foremost a process of living through changes that are largely beyond our control although they require active responding. Next, individualistic or existentialist interpretations are criticized because finite lives presuppose a social world in which they emerge and on which they depend. Unfortunately, aging, the most important experiential source of knowledge about what it is to live a finite life, is neglected by the same culture that needs its wisdom. © The Author 2016. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  8. Happiness and life satisfaction prospectively predict self-rated health, physical health, and the presence of limiting, long-term health conditions.

    Science.gov (United States)

    Siahpush, Mohammad; Spittal, Matt; Singh, Gopal K

    2008-01-01

    To examine the effect of happiness and life satisfaction on health. Longitudinal data from waves 1 and 3, conducted in 2001 and 2004, respectively, of the Household Income and Labour Dynamics in Australia survey. Australia. A total of 9981 respondents aged 18 years and older. Outcomes were self-reported health; the absence of long-term, limiting health conditions; and physical health. Happiness was assessed with the following question: "During the past 4 weeks, have you been a happy person"? Life satisfaction was determined with the following question: "All things considered, how satisfied are you with your life"? We used multiple regression analysis to estimate odds ratios (ORs), beta coefficients (beta), and 95% confidence intervals (CIs) for the associations between baseline happiness or life satisfaction and health at wave 3. Baseline happiness and life satisfaction both were positively associated at wave 3 with excellent, very good, or good health (OR = 1.50, CI = 1.33-1.70, p < .0001; and OR = 1.62, CI = 1.27-2.08, p < .0001, respectively); with the absence of long-term, limiting health conditions (OR = 1.53, CI = 1.35-1.75, p < .0001; and OR = 1.51, CI = 1.25-1.82, p < .0001, respectively); and with higher physical health levels (beta = .99, CI = .60-1.39, p < .0001; and beta = .99, CI = .20-1.78, p < .0145, respectively). This study showed that happier people and those who were more satisfied with their lives at baseline reported better health (self-rated health; absence of limiting, long-term conditions; and physical health) at the 2-year follow-up when adjusted for baseline health and other relevant covariates.

  9. Life with a Gastric Band. Long-Term Outcomes of Laparoscopic Adjustable Gastric Banding-a Retrospective Study.

    Science.gov (United States)

    Kowalewski, Piotr K; Olszewski, Robert; Kwiatkowski, Andrzej; Gałązka-Świderek, Natalia; Cichoń, Krzysztof; Paśnik, Krzysztof

    2017-05-01

    Laparoscopic adjustable gastric banding (LAGB) is the third most popular bariatric procedure worldwide. Various authors present ambivalent long-term follow up results. We revised records of the patients who underwent LAGB between 2003 and 2006 along with history of additional check-ins. Patients with outdated details were tracked with the national health insurance database and social media (Facebook). An online survey was sent. The patients who did not have their band removed were included in this study. We calculated the percent total weight loss (%TWL) and percent excess weight loss (%EWL), along with changes in body mass index (ΔBMI). Satisfactory weight loss was set at >50% EWL (for BMI = 25 kg/m 2 ). Since eight patients gained weight, we decided to include negative values of %TWL, %EWL, and ΔBMI. One hundred seven patients underwent LAGB from 2003 to 2006. The mean follow-up time was 11.2 (±1.2) years. Eleven percent of patients were lost to follow up (n = 12). There was one perioperative death. Fifty-four of the patients (n = 57) had their band removed. Thirty-seven patients still have the band (39%) and were included in the study. The mean %EWL was 27% (-56-112%) and %TWL was 11% (-19-53%). Twelve patients achieved %EWL > 50% (32%). Thiry-two patients still suffer from obesity, with BMI over 30 kg/m 2 . Eight patients (22%) gained additional weight. Patients with %EWL > 50% suffered less from gastroesophageal reflux disease symptoms than those with EWL < 50% (p < 0.05). Out of 107 cases, only 11.2% of patients with gastric band (n = 12) achieved satisfactory %EWL. Twenty-two percent of patients regained their weight or even exceeded it. Overall results suggest that LAGB is not an effective bariatric procedure in long term observation.

  10. Long-Term Follow-Up in a Girl with Cystic Fibrosis and Diabetes Since the First Year of Life.

    Science.gov (United States)

    Fattorusso, Valentina; Casale, Alida; Raia, Valeria; Mozzillo, Enza; Franzese, Adriana

    2017-10-01

    Diabetes mellitus is the most common comorbidity in cystic fibrosis (CF). Recently, more attention has been paid to early glucose metabolism derangements (GMDs). The subject of this report is a female patient, affected by CF since 3 months of age. She presented with intermittent diabetes during early childhood. At the age of 10 years, oral glucose tolerance test (OGTT) was performed and showed glucose intolerance (IGT) status; glargine insulin therapy was started. At the age of 13 years, CF-related diabetes with fasting hyperglycemia occurred, so rapid insulin at meals was added. During the following year, clinical and nutritional status improved. Stable clinical conditions were observed in the following 3 years. This is the first case of very long-term follow-up concerning a CF patient with GMDs. Our case confirms the importance of paying attention to early GMDs in very young CF patients and seems to suggest that earlier therapy could ameliorate CF natural history.

  11. The Context of Religious and Spiritual Care at the End of Life in Long-term Care Facilities.

    Science.gov (United States)

    Hamilton, V Lee; Daaleman, Timothy P; Williams, Christianna S; Zimmerman, Sheryl

    2009-01-01

    Despite the increasing numbers of Americans who die in nursing homes (NHs) and residential care/assisted living (RC/AL) facilities, and the importance of religious and spiritual needs as one approaches death, little is known about how these needs are met for dying individuals in long-term care (LTC) institutional settings. This study compared receipt of religious and spiritual help in four types of LTC settings: NHs, smaller (facilities, traditional RC/AL facilities, and new-model RC/AL facilities. Data were also available for religious affiliation of the facilities, size, and provision of religious and hospice services. Controlling for such factors, the importance of religion/spirituality to the decedent was the strongest predictor of the decedent's receipt of spiritual help. In addition, new-model RC/AL facilities were significantly more likely to provide help for religious and spiritual needs of decedent residents than other RC/AL types, but did not differ significantly from NHs.

  12. Relationships between duplex findings and quality of life in long-term follow-up of patients treated for chronic venous disease.

    Science.gov (United States)

    Huang, Ying; Gloviczki, Peter

    2016-03-01

    Relationships between duplex findings and data on health-related quality of life (QoL) to assess long-term results of treatment of varicose veins and chronic venous insufficiency (CVI) are not well known. The goal of this review was to correlate duplex findings and QoL assessments in clinical studies with long-term follow-up. A review of the English language literature on PUBMED revealed 17 clinical studies, including 9 randomized controlled trials (RCTs), 6 prospective, and 2 retrospective studies that included patients with at least 5-year follow-up after endovenous laser ablation (EVLA), radiofrequency ablation (RFA), ultrasound-guided foam sclerotherapy (UGFS), and traditional superficial venous surgery. At 5 years, great saphenous vein (GSV) occlusion rate on duplex ultrasound ranged from 66% to 82% for EVLA, from 62% to 92% for RFA, from 41% to 58% for UGFS and from 54% to 85% for surgery. Freedom from GSV reflux rates were 82% and 84%, respectively for EVLA and surgery, and ranged between 84% and 95% for RFA. Significant improvements were observed in several domains of generic QoL and in most domains of venous disease-specific QoL, irrespective of the treatment. In at least one RCT, CIVIQ scores correlated well with abnormal duplex findings in patients who underwent treatment with UGFS. In another RCT, long-term AVVQ was significantly better after surgery as compared with UGFS similar to results of duplex findings. Analysis of the available literature confirmed that all four techniques were effective in the abolishment of reflux or obliteration of the GSV. Moreover, well-designed RCTs with large sample size are needed to produce robust long-term data on clinical outcome after treatment of varicose veins and CVI and to better understand the relationships between duplex-derived data and QoL assessments. © The Author(s) 2016.

  13. Health-related quality of life of young adults with Turner syndrome following a long-term randomized controlled trial of recombinant human growth hormone

    Directory of Open Access Journals (Sweden)

    Van Vliet Guy

    2011-05-01

    Full Text Available Abstract Background There are limited long-term randomized controlled trials of growth hormone (GH supplementation to adult height and few published reports of the health-related quality of life (HRQOL following treatment. The present follow-up study of young adults from a long-term controlled trial of GH treatment in patients with Turner syndrome (TS yielded data to examine whether GH supplementation resulted in a higher HRQOL (either due to taller stature or from the knowledge that active treatment and not placebo had been received or alternatively a lower HRQOL (due to medicalization from years of injections. Methods The original trial randomized 154 Canadian girls with TS aged 7-13 years from 13 centres to receive either long-term GH injections at the pharmacologic dose of 0.3 mg/kg/week or to receive no injections; estrogen prescription for induction of puberty was standardized. Patients were eligible for the follow-up study if they were at least 16 years old at the time of follow-up. The instrument used to study HRQOL was the SF-36, summarized into physical and mental component scales (PCS and MCS; higher scores indicate better HRQOL. Results Thirty-four of the 48 eligible participants (71% consented to participate; data were missing for one patient. Both groups (GH and no treatment had normal HRQOL at this post-treatment assessment. The GH group had a (mean ± SD PCS score of 56 ± 5; the untreated group 58 ± 4; mean score for 16-24 year old females in the general population 53.5 ± 6.9. The GH group had a mean MCS score of 52 ± 6; the untreated group 49 ± 13; mean score for 16-24 year old females in the general population 49.6 ± 9.8. Secondary analyses showed no relationship between HRQOL and height. Conclusions We found no benefit or adverse effect on HRQOL either from receiving or not receiving growth hormone injections in a long-term randomized controlled trial, confirming larger observational studies. We suggest that it remains

  14. Early Life Arsenic Exposure and Acute and Long-term Responses to Influenza A Infection in Mice

    OpenAIRE

    Ramsey, Kathryn A.; Foong, Rachel E.; Sly, Peter D.; Larcombe, Alexander N.; Zosky, Graeme R.

    2013-01-01

    Background: Arsenic is a significant global environmental health problem. Exposure to arsenic in early life has been shown to increase the rate of respiratory infections during infancy, reduce childhood lung function, and increase the rates of bronchiectasis in early adulthood. Objective: We aimed to determine if early life exposure to arsenic exacerbates the response to early life influenza infection in mice. Methods: C57BL/6 mice were exposed to arsenic in utero and throughout postnatal lif...

  15. Physical activity and quality of life in long-term hospitalized patients with severe mental illness: a cross-sectional study.

    Science.gov (United States)

    Deenik, Jeroen; Kruisdijk, Frank; Tenback, Diederik; Braakman-Jansen, Annemarie; Taal, Erik; Hopman-Rock, Marijke; Beekman, Aartjan; Tak, Erwin; Hendriksen, Ingrid; van Harten, Peter

    2017-08-18

    Increasing physical activity in patients with severe mental illness is believed to have positive effects on physical health, psychiatric symptoms and as well quality of life. Till now, little is known about the relationship between physical activity and quality of life in long-term hospitalized patients with severe mental illness and knowledge of the determinants of behavioural change is lacking. The purpose of this study was to elucidate the relationship between objectively measured physical activity and quality of life, and explore modifiable psychological determinants of change in physical activity in long-term hospitalized patients with severe mental illness. In 184 inpatients, physical activity was measured using an accelerometer (ActiGraph GTX+). Quality of life was assessed by EuroQol-5D and WHOQol-Bref. Attitude and perceived self-efficacy towards physical activity were collected using the Physical Activity Enjoyment Scale and the Multidimensional Self Efficacy Questionnaire, respectively. Patient and disease characteristics were derived retrospectively from electronic patient records. Associations and potential predictors were analysed using hierarchical regression. Physical activity was positively related with and a predictor of all quality of life outcomes except on the environmental domain, independent of patient and disease characteristics. However, non-linear relationships showed that most improvement in quality of life lies in the change from sedentary to light activity. Attitude and self-efficacy were not related to physical activity. Physical activity is positively associated with quality of life, especially for patients in the lower spectrum of physical activity. An association between attitude and self-efficacy and physical activity was absent. Therefore, results suggest the need of alternative, more integrated and (peer-)supported interventions to structurally improve physical activity in this inpatient population. Slight changes from sedentary

  16. Introduction: Long term prediction

    International Nuclear Information System (INIS)

    Beranger, G.

    2003-01-01

    Making a decision upon the right choice of a material appropriate to a given application should be based on taking into account several parameters as follows: cost, standards, regulations, safety, recycling, chemical properties, supplying, transformation, forming, assembly, mechanical and physical properties as well as the behaviour in practical conditions. Data taken from a private communication (J.H.Davidson) are reproduced presenting the life time range of materials from a couple of minutes to half a million hours corresponding to applications from missile technology up to high-temperature nuclear reactors or steam turbines. In the case of deep storage of nuclear waste the time required is completely different from these values since we have to ensure the integrity of the storage system for several thousand years. The vitrified nuclear wastes should be stored in metallic canisters made of iron and carbon steels, stainless steels, copper and copper alloys, nickel alloys or titanium alloys. Some of these materials are passivating metals, i.e. they develop a thin protective film, 2 or 3 nm thick - the so-called passive films. These films prevent general corrosion of the metal in a large range of chemical condition of the environment. In some specific condition, localized corrosion such as the phenomenon of pitting, occurs. Consequently, it is absolutely necessary to determine these chemical condition and their stability in time to understand the behavior of a given material. In other words the corrosion system is constituted by the complex material/surface/medium. For high level nuclear wastes the main features for resolving problem are concerned with: geological disposal; deep storage in clay; waste metallic canister; backfill mixture (clay-gypsum) or concrete; long term behavior; data needed for modelling and for predicting; choice of appropriate solution among several metallic candidates. The analysis of the complex material/surface/medium is of great importance

  17. LONG-TERM THERAPY WITH INDAPAMIDE IN ELDERLY AND SENILE PATIENTS WITH HYPERTENSION: CARDIORENOPROTECTIVE EFFECTS AND INFLUENCE ON QUALITY OF LIFE

    Directory of Open Access Journals (Sweden)

    M. E. Statsenko

    2009-01-01

    Full Text Available Aim. To estimate cardiorenoprotective effect of 12-month therapy by indapamide in elderly and senile patients with arterial hypertension (HT and its influence on quality of life.Material and methods. 40 elderly and senile patients with HT were examined. 70% of patients received monotherapy by indapamide 2,5 mg once daily and 30% of patients were treated with indapamide and lisinopril combination. Duration of observation was 12 months. Ambulatory blood pressure (BP monitoring, echocardiography, plasma lipid profile, glycemia and uricemia levels and potassium serum level was evaluated initially and after 12 months of therapy. Glomerular filtration rate and albuminuria as well as patient quality of life also was evaluated.Results. Target BP level was reached in all patients during 12 month therapy. Reduction of average 24-hour, day and night BP, BP load, rate of morning BP rising was observed. Negative influence on BP variability was not found. Improvement of daily BP profile also was found. The indapamide reduced left ventricle mass, improved renal function, vessel resistance and quality of life. Negative influence of long-term therapy with indapamide on lipid, glucose, purine metabolism and serum potassium level was not observed.Conclusion. Indapamide is an effective antihypertensive drug for long-term treatment of elderly and senile patients with HT of 1-2 degree.

  18. The Long-term Impact of Early Life Pain On Adult Responses to Anxiety and Stress: Historical Perspectives and Empirical Evidence

    Science.gov (United States)

    Victoria, Nicole C.; Murphy, Anne Z.

    2016-01-01

    Approximately 1 in 6 infants are born prematurely each year. Typically, these infants spend 25 days in the Neonatal Intensive Care Unit (NICU) where they experience 10–18 painful and inflammatory procedures each day. Remarkably, pre-emptive analgesics and/or anesthesia are administered less than 25% of the time. Unalleviated pain during the perinatal period is associated with permanent decreases in pain sensitivity, blunted cortisol responses and high rates of neuropsychiatric disorders. To date, the mechanism(s) by which these long-term changes in stress and pain behavior occur, and whether such alterations can be prevented by appropriate analgesia at the time of insult, remains unclear. Work in our lab using a rodent model of early life pain suggests that inflammatory pain experienced on the day of birth blunts adult responses to stress- and pain-provoking stimuli, and dysregulates the hypothalamic pituitary adrenal (HPA) axis in part through a permanent upregulation in central endogenous opioid tone. This review focuses on the long-term impact of neonatal inflammatory pain on adult anxiety- and stress-related responses, and underlying neuroanatomical changes in the context of endogenous pain control and the HPA axis. These two systems are in a state of exaggerated developmental plasticity early in postnatal life, and work in concert to respond to noxious or aversive stimuli. We present empirical evidence from animal and clinical studies, and discuss historical perspectives underlying the lack of analgesia/anesthetic use for early life pain in the modern NICU. PMID:26210872

  19. Long-term collections

    CERN Multimedia

    Collectes à long terme

    2007-01-01

    The Committee of the Long Term Collections (CLT) asks for your attention for the following message from a young Peruvian scientist, following the earthquake which devastated part of her country a month ago.

  20. Long-Term Impact of Endometrial Cancer Diagnosis and Treatment on Health-Related Quality of Life and Cancer Survivorship: Results From the Randomized PORTEC-2 Trial

    International Nuclear Information System (INIS)

    Boer, Stephanie M. de; Nout, Remi A.; Jürgenliemk-Schulz, Ina M.; Jobsen, Jan J.; Lutgens, Ludy C.H.W.; Steen-Banasik, Elzbieta M. van der; Mens, Jan Willem M.; Slot, Annerie; Stenfert Kroese, Marika C.; Oerlemans, Simone; Putter, Hein; Verhoeven-Adema, Karen W.; Nijman, Hans W.; Creutzberg, Carien L.

    2015-01-01

    Purpose: To evaluate the long-term health-related quality of life (HRQL) after external beam radiation therapy (EBRT) or vaginal brachytherapy (VBT) among PORTEC-2 trial patients, evaluate long-term bowel and bladder symptoms, and assess the impact of cancer on these endometrial cancer (EC) survivors. Patients and Methods: In the PORTEC-2 trial, 427 patients with stage I high–intermediate-risk EC were randomly allocated to EBRT or VBT. The 7- and 10-year HRQL questionnaires consisted of EORTC QLQ-C30; subscales for bowel and bladder symptoms; the Impact of Cancer Questionnaire; and 14 questions on comorbidities, walking aids, and incontinence pads. Analysis was done using linear mixed models for subscales and (ordinal) logistic regression with random effects for single items. A two-sided P value <.01 was considered statistically significant. Results: Longitudinal HRQL analysis showed persisting higher rates of bowel symptoms with EBRT, without significant differences in global health or any of the functioning scales. At 7 years, clinically relevant fecal leakage was reported by 10.6% in the EBRT group, versus 1.8% for VBT (P=.03), diarrhea by 8.4% versus 0.9% (P=.04), limitations due to bowel symptoms by 10.5% versus 1.8% (P=.001), and bowel urgency by 23.3% versus 6.6% (P<.001). Urinary urgency was reported by 39.3% of EBRT patients, 25.5% for VBT, P=.05. No difference in sexual activity was seen between treatment arms. Long-term impact of cancer scores was higher among the patients who had an EC recurrence or second cancer. Conclusions: More than 7 years after treatment, EBRT patients reported more bowel symptoms with impact on daily activities, and a trend for more urinary symptoms, without impact on overall quality of life or difference in cancer survivorship issues.

  1. Long-Term Impact of Endometrial Cancer Diagnosis and Treatment on Health-Related Quality of Life and Cancer Survivorship: Results From the Randomized PORTEC-2 Trial

    Energy Technology Data Exchange (ETDEWEB)

    Boer, Stephanie M. de, E-mail: s.m.de_boer.ONCO@lumc.nl [Department of Radiation Oncology, Leiden University Medical Center, Leiden (Netherlands); Nout, Remi A. [Department of Radiation Oncology, Leiden University Medical Center, Leiden (Netherlands); Jürgenliemk-Schulz, Ina M. [Department of Radiation Oncology, University Medical Center Utrecht, Utrecht (Netherlands); Jobsen, Jan J. [Department of Radiotherapy, Medisch Spectrum Twente, Enschede (Netherlands); Lutgens, Ludy C.H.W. [Department of Radiation Oncology (MAASTRO), University Medical Centre Maastricht (Netherlands); Steen-Banasik, Elzbieta M. van der [Arnhem Radiotherapy Institute (ARTI), Arnhem (Netherlands); Mens, Jan Willem M. [Department of Radiation Oncology, Erasmus MC-Daniel den Hoed Cancer Center, Rotterdam (Netherlands); Slot, Annerie [Radiotherapy Institute Friesland, Leeuwarden (Netherlands); Stenfert Kroese, Marika C. [Department of Radiation Oncology, Radiotherapy Group Deventer, Deventer (Netherlands); Oerlemans, Simone [Research Department, Netherlands Comprehensive Cancer Organization, Eindhoven (Netherlands); Center of Research on Psychology in Somatic Diseases, Tilburg University, Tilburg (Netherlands); Putter, Hein [Department of Medical Statistics, Leiden University Medical Center, Leiden (Netherlands); Verhoeven-Adema, Karen W. [Comprehensive Cancer Center The Netherlands-West, Leiden (Netherlands); Nijman, Hans W. [Department of Gynecologic Oncology, University Medical Center Groningen, Groningen (Netherlands); Creutzberg, Carien L. [Department of Radiation Oncology, Leiden University Medical Center, Leiden (Netherlands)

    2015-11-15

    Purpose: To evaluate the long-term health-related quality of life (HRQL) after external beam radiation therapy (EBRT) or vaginal brachytherapy (VBT) among PORTEC-2 trial patients, evaluate long-term bowel and bladder symptoms, and assess the impact of cancer on these endometrial cancer (EC) survivors. Patients and Methods: In the PORTEC-2 trial, 427 patients with stage I high–intermediate-risk EC were randomly allocated to EBRT or VBT. The 7- and 10-year HRQL questionnaires consisted of EORTC QLQ-C30; subscales for bowel and bladder symptoms; the Impact of Cancer Questionnaire; and 14 questions on comorbidities, walking aids, and incontinence pads. Analysis was done using linear mixed models for subscales and (ordinal) logistic regression with random effects for single items. A two-sided P value <.01 was considered statistically significant. Results: Longitudinal HRQL analysis showed persisting higher rates of bowel symptoms with EBRT, without significant differences in global health or any of the functioning scales. At 7 years, clinically relevant fecal leakage was reported by 10.6% in the EBRT group, versus 1.8% for VBT (P=.03), diarrhea by 8.4% versus 0.9% (P=.04), limitations due to bowel symptoms by 10.5% versus 1.8% (P=.001), and bowel urgency by 23.3% versus 6.6% (P<.001). Urinary urgency was reported by 39.3% of EBRT patients, 25.5% for VBT, P=.05. No difference in sexual activity was seen between treatment arms. Long-term impact of cancer scores was higher among the patients who had an EC recurrence or second cancer. Conclusions: More than 7 years after treatment, EBRT patients reported more bowel symptoms with impact on daily activities, and a trend for more urinary symptoms, without impact on overall quality of life or difference in cancer survivorship issues.

  2. 'The challenge to take charge of life with long-term illness': nurses' experiences of supporting patients' learning with the didactic model.

    Science.gov (United States)

    Andersson, Susanne; Svanström, Rune; Ek, Kristina; Rosén, Helena; Berglund, Mia

    2015-12-01

    The aim of this implementation study is to describe nurses' experiences of supporting patient learning using the model called 'The challenge to take charge of life with long-term illness'. Supporting patient learning for those suffering from a long-term illness is a complex art in nursing. Genuine learning occurs at a deep and existential level. If the patient's resistance to illness can be challenged and reflected upon, the patient may take charge of his/her life. The project lasted for 2 years and was initiated by a former patient on an assisted haemodialysis ward and involved 14 registered nurses. The project began with a session to review patients' learning and the didactic model. Monthly reflective meetings and group supervisions were held that focused on the nurses' experiences of supporting patient learning. Notes were written during these reflective meetings and group sessions. Data collected from interviews, notes and written stories were subjected to phenomenological analysis. Three aspects of nurses' experiences of the learning support approach were assessed: To have the courage to listen sincerely, a movement from providing information to supporting learning, and to let the patient indicate the direction. The approach resulted in an increased focus on genuine dialogue and the courage to encourage patients to take charge of their health process. The changes in nurses' approach to learning support reveal that they shift from providing information on the disease, illness and treatment to strengthening and supporting the patient in making decisions and taking responsibility. For nurses, the change entails accepting the patient's goals and regarding their own role as supportive rather than controlling. The didactic model and involved supervision contributed to the change in the nurses' approach. The didactic model might be useful in caring for persons with long-term illness, making the care more person-centred and enhancing the patient's self-care ability.

  3. The role of socioeconomic factors in Black-White health inequities across the life course: Point-in-time measures, long-term exposures, and differential health returns.

    Science.gov (United States)

    Boen, Courtney

    2016-12-01

    Research links Black-White health disparities to racial differences in socioeconomic status (SES), but understanding of the role of SES in racial health gaps has been restricted by reliance on static measures of health and socioeconomic well-being that mask the dynamic quality of these processes and ignore the racialized nature of the SES-health connection. Utilizing twenty-three years of longitudinal data from the Panel Study of Income Dynamics (1984-2007), this study uses multilevel growth curve models to examine how multiple dimensions of socioeconomic well-being-including long-term economic history and differential returns to SES-contribute to the life course patterning of Black-White health disparities across two critical markers of well-being: body mass index (N = 9057) and self-rated health (N = 11,329). Findings indicate that long-term SES exerts a significant influence on both body mass index and self-rated health, net of point-in-time measures, and that Black-White health gaps are smallest in models that adjust for both long-term and current SES. I also find that Blacks and Whites receive differential health returns to increases in SES, which suggests that other factors-such as neighborhood segregation and exposure racial discrimination-may restrict Blacks from converting increases in SES into health improvements in the same way as Whites. Together, these processes contribute to the life course patterning of Black-White health gaps and raise concerns about previous misestimation of the role of SES in racial health disparities. Copyright © 2016 Elsevier Ltd. All rights reserved.

  4. Intensity-Modulated Radiotherapy is Associated With Improved Global Quality of Life Among Long-term Survivors of Head-and-Neck Cancer

    International Nuclear Information System (INIS)

    Chen, Allen M.; Farwell, D. Gregory; Luu, Quang; Vazquez, Esther G.; Lau, Derick H.; Purdy, James A.

    2012-01-01

    Purpose: To compare the long-term quality of life among patients treated with and without intensity-modulated radiotherapy (IMRT) for head-and-neck cancer. Methods and Materials: University of Washington Quality of Life instrument scores were reviewed for 155 patients previously treated with radiation therapy for locally advanced head-and-neck cancer. All patients were disease free and had at least 2 years of follow-up. Eighty-four patients (54%) were treated with IMRT. The remaining 71 patients (46%) were treated with three-dimensional conformal radiotherapy (3D CRT) by use of initial opposed lateral fields matched to a low anterior neck field. Results: The mean global quality of life scores were 67.5 and 80.1 for the IMRT patients at 1 and 2 years, respectively, compared with 55.4 and 57.0 for the 3D CRT patients, respectively (p < 0.001). At 1 year after the completion of radiation therapy, the proportion of patients who rated their global quality of life as “very good” or “outstanding” was 51% and 41% among patients treated by IMRT and 3DCRT, respectively (p = 0.11). At 2 years, the corresponding percentages increased to 73% and 49%, respectively (p < 0.001). On multivariate analysis accounting for sex, age, radiation intent (definitive vs. postoperative), radiation dose, T stage, primary site, use of concurrent chemotherapy, and neck dissection, the use of IMRT was the only variable independently associated with improved quality of life (p = 0.01). Conclusion: The early quality of life improvements associated with IMRT not only are maintained but apparently become more magnified over time. These data provide powerful evidence attesting to the long-term benefits of IMRT for head-and-neck cancer.

  5. How to Establish a Bioregenerative Life Support System for Long-Term Crewed Missions to the Moon or Mars.

    Science.gov (United States)

    Fu, Yuming; Li, Leyuan; Xie, Beizhen; Dong, Chen; Wang, Mingjuan; Jia, Boyang; Shao, Lingzhi; Dong, Yingying; Deng, Shengda; Liu, Hui; Liu, Guanghui; Liu, Bojie; Hu, Dawei; Liu, Hong

    2016-12-01

    To conduct crewed simulation experiments of bioregenerative life support systems on the ground is a critical step for human life support in deep-space exploration. An artificial closed ecosystem named Lunar Palace 1 was built through integrating efficient higher plant cultivation, animal protein production, urine nitrogen recycling, and bioconversion of solid waste. Subsequently, a 105-day, multicrew, closed integrative bioregenerative life support systems experiment in Lunar Palace 1 was carried out from February through May 2014. The results show that environmental conditions as well as the gas balance between O 2 and CO 2 in the system were well maintained during the 105-day experiment. A total of 21 plant species in this system kept a harmonious coexistent relationship, and 20.5% nitrogen recovery from urine, 41% solid waste degradation, and a small amount of insect in situ production were achieved. During the 105-day experiment, oxygen and water were recycled, and 55% of the food was regenerated. Key Words: Bioregenerative life support systems (BLSS)-Space agriculture-Space life support-Waste recycle-Water recycle. Astrobiology 16, 925-936.

  6. Assessment of Shelf-Life Ability of Apples cv. ‘Auksis’ after Long-term Storage Under Different Conditions

    OpenAIRE

    Juhņeviča-Radenkova Karina; Radenkovs Vitalijs

    2016-01-01

    The objective of the current research was to ascertain the shelf-life ability of apple ‘Auksis’ after 6 months of cold storage under different conditions. The effect of storage conditions such as: cold storage under normal atmosphere (NA), 1-methylcyclopropene (1-MCP) + cold storage, and ultra-low oxygen (ULO)-controlled atmosphere (CA) [2.0% CO2 and 1.0% O2 (ULO1) and 2.5% CO2 and 1.5% O2 (ULO2)] on the quality of apples during shelf-life was evaluated. Apple fruits immediately after cold st...

  7. Association of social network and social support with health-related quality of life and fatigue in long-term survivors of Hodgkin lymphoma.

    Science.gov (United States)

    Soares, A; Biasoli, I; Scheliga, A; Baptista, R L; Brabo, E P; Morais, J C; Werneck, G L; Spector, N

    2013-08-01

    As the number of survivors of Hodgkin's lymphoma (HL) increases, there has been a growing interest in long-term treatment-related side effects and their impact on the quality of life (QoL). The aim of this study was to assess the association of social network and social support with the QoL and fatigue among long-term HL survivors. A total of 200 HL survivors were included. The generic Short Form-12 (SF-12) questionnaire, the QoL cancer survivor's questionnaire (QOL-CS), and the Multidimensional Fatigue Inventory were used to assess QoL and fatigue. Social network and social support were evaluated with the Social Support Survey. Social network and all social support measures were favorably associated with two or more SF-12 scales, mainly with physical functioning and the mental health scales. Social network and social support dimensions were also associated with better QOL-CS scores. Affective support, informational support, positive interaction, and emotional support were associated with less fatigue. Both social network and social support are associated with better QoL and lower levels of fatigue in HL survivors. This information may be useful to health professionals and community organizations in implementing effective interventions to improve these patients' quality of life.

  8. Societal consequences of falls in the older population: Injuries, healthcare costs, and long-term reduced quality of life

    NARCIS (Netherlands)

    K.A. Hartholt (Klaas); E.F. van Beeck (Ed); S. Polinder (Suzanne); N. van der Velde (Nathalie); E.M.M. van Lieshout (Esther); M.J.M. Panneman (Martien); T.J.M. van der Cammen (Tischa); P. Patka (Peter)

    2011-01-01

    textabstractBACKGROUND:: Fall incidents are a major cause of morbidity and mortality in older adults. The aim of this cohort study was to determine the incidence, costs, and quality of life for fall-related injuries in the older Dutch population presenting at the emergency department. METHODS:: Data

  9. The long-term effect of a population-based life-style intervention on smoking and alcohol consumption

    DEFF Research Database (Denmark)

    Baumann, Sophie; Toft, Ulla Marie Nørgaard; Aadahl, Mette

    2015-01-01

    AIMS: To examine whether improvements in smoking and alcohol consumption throughout the 5-year course of a population-based multi-factorial life-style intervention were sustained 5 years after its discontinuation. DESIGN: Population-based randomized controlled trial. SETTING: Suburbs of Copenhage...

  10. Long-term effects of pallidal or subthalamic deep brain stimulation on quality of life in Parkinson's disease

    NARCIS (Netherlands)

    Volkmann, Jens; Albanese, Alberto; Kulisevsky, Jaime; Tornqvist, Aana-Lena; Houeto, Jean-Luc; Pidoux, Bernard; Bonnet, Anne-Marie; Mendes, Alexandre; Benabid, Alim-Louis; Fraix, Valerie; van Blercom, Nadege; Xie, Jing; Obeso, José; Rodriguez-Oroz, Maria Cruz; Guridi, Jurge; Schnitzler, Alfons; Timmermann, Lars; Gironell, Alexandre A.; Molet, Juan; Pascual-Sedano, Benta; Rehncrona, Stig; Moro, Elena; Lang, Anthony C.; Lozano, Andres M.; Bentivoglio, Anna Rita; Scerrati, Massimo; Contarino, Maria Fiorella; Romito, Luigi; Janssens, Marc; Agid, Yves

    2009-01-01

    We assessed the effects of deep brain stimulation of the subthalamic nucleus (STN-DBS) or internal pallidum (GPi-DBS) on health-related quality of life (HrQoL) in patients with advanced Parkinson's disease participating in a previously reported multicenter trial. Sickness Impact Profile (SIP)

  11. Assessment of Shelf-Life Ability of Apples cv. ‘Auksis’ after Long-term Storage Under Different Conditions

    Directory of Open Access Journals (Sweden)

    Juhņeviča-Radenkova Karina

    2016-12-01

    Full Text Available The objective of the current research was to ascertain the shelf-life ability of apple ‘Auksis’ after 6 months of cold storage under different conditions. The effect of storage conditions such as: cold storage under normal atmosphere (NA, 1-methylcyclopropene (1-MCP + cold storage, and ultra-low oxygen (ULO-controlled atmosphere (CA [2.0% CO2 and 1.0% O2 (ULO1 and 2.5% CO2 and 1.5% O2 (ULO2] on the quality of apples during shelf-life was evaluated. Apple fruits immediately after cold storage and after 25 days of maintaining at market condition had been evaluated. The physical (firmness, weight losses, chemical (total soluble solids and acid contents, and sensory (aroma, taste, acidity, sweetness, juiciness, and color characteristics of apples had been evaluated after 5, 10, 15, 20, and 25 days to ascertain maximal shelf-life. Results from sensory evaluation indicated that apples treated with 1-MCP and stored at NA were characterized with distinctive aroma, whereas apples stored under CA were poor in sweetness and had remarkable acidity and juiciness. Apples that were stored in cold had pronounced aroma and color but without taste. Based on the evaluation by panelist, maximum shelf-life of apples that were kept under cold storage and ULO1 was 15 days, whereas that of apples that had been treated with 1-MCP and stored at NA and those stored in ULO2 was 25 days.

  12. Evaluation of long-term results and quality of life in patients who underwent rib fixation with titanium devices after trauma.

    Science.gov (United States)

    Billè, Andrea; Okiror, Lawrence; Campbell, Aideen; Simons, Jason; Routledge, Tom

    2013-06-01

    To describe the long-term results, quality of life and chronic pain after chest wall fixation for traumatic rib fracture using a quality of life (QOL) score and a numeric pain score. Retrospective analysis of 10 consecutive patients who underwent surgery for rib fractures after trauma and reconstruction between October 2010 and March 2012. Chest rib fractures were fixed with titanium clips and bars or titanium plates and screws through a posterolateral thoracotomy. Pain was assessed with a numeric pain scale 0-10 and quality of life (QOL) with the EORTC questionnaire QLQ-C30. There were 5 males and 5 females. The median age was 58 years (range 21-80). There were no postoperative deaths. The only postoperative complication observed was a contralateral pleural effusion requiring drainage. Median length of stay of the drain and median length of hospital stay were 2 days (range 0-8) and 4 days (range 1-42 days), respectively. The average follow-up period of operatively managed patients was 14 months (range 8-23.5 months). Seven patients scored the pain as 0, one as 1 (mild), one as 4 (moderate) and one as 8 (severe). Only two patients are taking occasionally pain killers. Only one patient presents severe limitation in his life scoring his QOL as poor. Titanium devices (clips and bars; screws and plates) are effective and safe for repair of rib fractures and showed good long-term results in terms of pain and quality of life after the operation.

  13. Quality of Life and Sexual Function Benefits of Long-Term Testosterone Treatment: Longitudinal Results From the Registry of Hypogonadism in Men (RHYME).

    Science.gov (United States)

    Rosen, Raymond C; Wu, Frederick; Behre, Hermann M; Porst, Hartmut; Meuleman, Eric J H; Maggi, Mario; Romero-Otero, Javier; Martinez-Salamanca, Juan I; Jones, Thomas Hugh; Debruyne, Frans M J; Kurth, Karl-Heinz; Hackett, Geoff I; Quinton, Richard; Stroberg, Peter; Reisman, Yacov; Pescatori, Edoardo S; Morales, Antonio; Bassas, Lluis; Cruz, Natalio; Cunningham, Glenn R; Wheaton, Olivia A

    2017-09-01

    The benefits and risks of long-term testosterone administration have been a topic of much scientific and regulatory interest in recent years. To assess long-term quality of life (QOL) and sexual function benefits of testosterone replacement therapy (TRT) prospectively in a diverse, multinational cohort of men with hypogonadism. A multinational patient registry was used to assess long-term changes associated with TRT in middle-age and older men with hypogonadism. Comprehensive evaluations were conducted at 6, 12, 24, and 36 months after enrollment into the registry. QOL and sexual function were evaluated by validated measures, including the Aging Males' Symptom (AMS) Scale and the International Index of Erectile Function (IIEF). A total of 999 previously untreated men with hypogonadism were enrolled at 25 European centers, 750 of whom received TRT at at least one visit during the period of observation. Patients on TRT reported rapid and sustained improvements in QOL, with fewer sexual, psychological, and somatic symptoms. Modest improvements in QOL and sexual function, including erectile function, also were noted in RHYME patients not on TRT, although treated patients showed consistently greater benefit over time in all symptom domains compared with untreated patients. AMS total scores for patients on TRT were 32.8 (95% confidence interval = 31.3-34.4) compared with 36.6 (95% confidence interval = 34.8-38.5) for untreated patients (P treatment. The major strengths are the large, diverse patient population being treated in multidisciplinary clinical settings. The major limitation is the frequency of switching from one formulation to another. Overall, we confirmed the broad and sustained benefits of TRT across major QOL dimensions, including sexual, somatic, and psychological health, which were sustained over 36 months in our treatment cohort. Rosen RC, Wu F, Behre H, et al. Quality of Life and Sexual Function Benefits Effects of Long-Term Testosterone Treatment

  14. Positive and negative early life experiences differentially modulate long term survival and amyloid protein levels in a mouse model of Alzheimer's disease.

    Science.gov (United States)

    Lesuis, Sylvie L; Maurin, Herve; Borghgraef, Peter; Lucassen, Paul J; Van Leuven, Fred; Krugers, Harm J

    2016-06-28

    Stress has been implicated as a risk factor for the severity and progression of sporadic Alzheimer's disease (AD). Early life experiences determine stress responsivity in later life, and modulate age-dependent cognitive decline. Therefore, we examined whether early life experiences influence AD outcome in a bigenic mouse model which progressively develops combined tau and amyloid pathology (biAT mice).Mice were subjected to either early life stress (ELS) or to 'positive' early handling (EH) postnatally (from day 2 to 9). In biAT mice, ELS significantly compromised long term survival, in contrast to EH which increased life expectancy. In 4 month old mice, ELS-reared biAT mice displayed increased hippocampal Aβ levels, while these levels were reduced in EH-reared biAT mice. No effects of ELS or EH were observed on the brain levels of APP, protein tau, or PSD-95. Dendritic morphology was moderately affected after ELS and EH in the amygdala and medial prefrontal cortex, while object recognition memory and open field performance were not affected. We conclude that despite the strong transgenic background, early life experiences significantly modulate the life expectancy of biAT mice. Parallel changes in hippocampal Aβ levels were evident, without affecting cognition of young adult biAT mice.

  15. Quality of life and self-esteem in patients submitted to surgical treatment of skin carcinomas: long-term results.

    Science.gov (United States)

    Maciel, Paula Curitiba; Veiga-Filho, Joel; Carvalho, Marcelo Prado; Fonseca, Fernando Elias Martins; Ferreira, Lydia Masako; Veiga, Daniela Francescato

    2014-01-01

    Cancer is a multifactorial disease and skin carcinomas are the most common type of cancer. Assessing quality of life and self-esteem outcomes in skin cancer patients is important because these are indicators of the results of the treatment, translating how patients face their lives and their personal relationships. To assess the late impact of the surgical treatment of head and/or neck skin carcinomas on quality of life and self-esteem of the patients. Fifty patients with head or neck skin carcinomas were enrolled. Their age ranged between 30 and 75 years, 27 were men and 23 were women. Patients were assessed with regard to quality of life and self-esteem, preoperatively and five years postoperatively. Validated instruments were used: the MOS 36-item Short-form Health Survey (SF-36) and the Rosenberg Self-esteem/EPM-UNIFESP Scale. The Wilcoxon signed-rank test was used for the statistical analysis. Twenty-two patients completed the five-year follow-up, 54.5% women and 45.5% men. Compared to the preoperative assessment, patients had an improvement in mental health (p=0.011) and in self-esteem (p=0.002). There was no statistical difference with regard to the other domains of the SF-36. Patients submitted to surgical treatment of skin carcinoma improved mental health and self-esteem in the late postsurgical testing.

  16. Thirty years after Chernobyl: Long-term determination of 137Cs effective half-life in the lichen Stereocaulon vesuvianum.

    Science.gov (United States)

    Savino, F; Pugliese, M; Quarto, M; Adamo, P; Loffredo, F; De Cicco, F; Roca, V

    2017-06-01

    It has been widely shown that nuclear fallout includes substances, which accumulate in organisms such as crustaceans, fish, mushrooms and lichens, helping to evaluate the activity concentration of contaminants accumulated on a long time. In this context, radiocaesium deposited in soil following the Chernobyl accident on 26 April 1986 is known to have remained persistently available for plant uptake in many areas of Europe. Studies on the lichen Stereocaulon vesuvianum show the plant's high capacity to retain radionuclides from the substrate and the air. After the Chernobyl accident, starting from September 1986, at the Radioactivity Laboratory (LaRa) of the University of Naples Federico II, four monitoring campaigns to evaluate the activity concentration of four isotopes of the two elements caesium and ruthenium ( 134 Cs, 137 Cs, 103 Ru and 106 Ru) were carried out until 1999. This study allowed the effective half-life of 134 Cs and 137 Cs to be estimated. Twenty-eight years after the accident, in December 2014, a further sampling was carried out; only 137 Cs was revealed beyond the detection limits, measuring activity concentrations ranging from 20 to 40 Bq/kg, while the other radionuclides were no longer observed due to their shorter half-life. The last sampling allowed more precise determination of the effective half-life of 137 Cs (6.2 ± 0.1 year), due to the larger dataset on a large time period. Copyright © 2017 Elsevier Ltd. All rights reserved.

  17. Older adults benefit from music training early in life: biological evidence for long-term training-driven plasticity.

    Science.gov (United States)

    White-Schwoch, Travis; Woodruff Carr, Kali; Anderson, Samira; Strait, Dana L; Kraus, Nina

    2013-11-06

    Aging results in pervasive declines in nervous system function. In the auditory system, these declines include neural timing delays in response to fast-changing speech elements; this causes older adults to experience difficulty understanding speech, especially in challenging listening environments. These age-related declines are not inevitable, however: older adults with a lifetime of music training do not exhibit neural timing delays. Yet many people play an instrument for a few years without making a lifelong commitment. Here, we examined neural timing in a group of human older adults who had nominal amounts of music training early in life, but who had not played an instrument for decades. We found that a moderate amount (4-14 years) of music training early in life is associated with faster neural timing in response to speech later in life, long after training stopped (>40 years). We suggest that early music training sets the stage for subsequent interactions with sound. These experiences may interact over time to sustain sharpened neural processing in central auditory nuclei well into older age.

  18. Quality of life and self-esteem in patients submitted to surgical treatment of skin carcinomas: long-term results*

    Science.gov (United States)

    Maciel, Paula Curitiba; Veiga-Filho, Joel; de Carvalho, Marcelo Prado; Fonseca, Fernando Elias Martins; Ferreira, Lydia Masako; Veiga, Daniela Francescato

    2014-01-01

    BACKGROUND Cancer is a multifactorial disease and skin carcinomas are the most common type of cancer. Assessing quality of life and self-esteem outcomes in skin cancer patients is important because these are indicators of the results of the treatment, translating how patients face their lives and their personal relationships. OBJECTIVE To assess the late impact of the surgical treatment of head and/or neck skin carcinomas on quality of life and self-esteem of the patients. METHODS Fifty patients with head or neck skin carcinomas were enrolled. Their age ranged between 30 and 75 years, 27 were men and 23 were women. Patients were assessed with regard to quality of life and self-esteem, preoperatively and five years postoperatively. Validated instruments were used: the MOS 36-item Short-form Health Survey (SF-36) and the Rosenberg Self-esteem/EPM-UNIFESP Scale. The Wilcoxon signed-rank test was used for the statistical analysis. RESULTS Twenty-two patients completed the five-year follow-up, 54.5% women and 45.5% men. Compared to the preoperative assessment, patients had an improvement in mental health (p=0.011) and in self-esteem (p=0.002). There was no statistical difference with regard to the other domains of the SF-36. CONCLUSION Patients submitted to surgical treatment of skin carcinoma improved mental health and self-esteem in the late postsurgical testing. PMID:25054746

  19. The long-term life cycle private and external costs of high coal usage in the US

    International Nuclear Information System (INIS)

    Bergerson, Joule; Lave, Lester

    2007-01-01

    Using four times as much coal in 2050 for electricity production need not degrade air quality or increase greenhouse gas emissions. Current SO x and NO x emissions from the power sector could be reduced from 12 to less than 1 and from 5 to 2 million tons annually, respectively, using advanced technology. While direct CO 2 emissions from new power plants could be reduced by over 87%, life cycle emissions could increase by over 25% due to the additional coal that is required to be mined and transported to compensate for the energy penalty of the carbon capture and storage technology. Strict environmental controls push capital costs of pulverized coal (PC) and integrated coal gasification combined cycle (IGCC) plants to $1500-1700/kW and $1600-2000/kW, respectively. Adding carbon capture and storage (CCS) increases costs to $2400-2700/kW and $2100-3000/kW (2005 dollars), respectively. Adding CCS reduces the 40-43% efficiency of the ultra-supercritical PC plant to 31-34%; adding CCS reduces the 32-38% efficiency of the GE IGCC plant to 27-33%. For IGCC, PC, and natural gas combined cycle (NGCC) plants, the carbon dioxide tax would have to be $53, $74, and $61, respectively, to make electricity from a plant with CCS cheaper. Capturing and storing 90% of the CO 2 emissions increases life cycle costs from 5.4 to 11.6 cents/kWh. This analysis shows that 90% CCS removal efficiency, although being a large improvement over current electricity generation emissions, results in life cycle emissions that are large enough that additional effort is required to achieve significant economy-wide reductions in the US for this large increase in electricity generation using either coal or natural gas

  20. Long-term outcome and quality of life of patients treated in surgical intensive care: a comparison between sepsis and trauma.

    Science.gov (United States)

    Korosec Jagodic, Helena; Jagodic, Klemen; Podbregar, Matej

    2006-01-01

    Our aim was to determine long-term survival and quality of life of patients admitted to a surgical intensive care unit (ICU) because of sepsis or trauma. This was an observational study conducted in an 11-bed, closed surgical ICU at a 860-bed teaching general hospital over a 1-year period (January 2003 to December 2003). Patients were divided into two groups according to admission diagnoses: group 1 included patients with sepsis; and group 2 included patients with trauma (polytrauma, multiple trauma, head injury, or spinal injury). Quality of life was assessed after 2 years following ICU admission using the EuroQol 5D questionnaire. A total of 164 patients (98 trauma patients and 66 patients with sepsis) were included in the study. Trauma patients were younger than patients with sepsis (53 +/- 21 years versus 64 +/- 13 years; P Trauma patients stayed longer on the general ward (35 +/- 44 days versus 17 +/- 24 days; P trauma group (surgical ICU survival: 60% versus 74%; in-hospital survival: 42% versus 62%; post-hospital survival: 78% versus 92%; cumulative 2-year survival: 33% versus 57%; P quality of life in all five dimensions of the EuroQol 5D between groups: 60% of patients had signs of depression, almost 60% had problems in usual activities and 56% had pain. Patients with sepsis treated in a surgical ICU have higher short-term and long-term mortality than do trauma patients. However, quality of life is reduced to the same level in both groups.

  1. Jumping combined exercise programs reduce fall risk and improve balance and life quality of elderly people who live in a long-term care facility.

    Science.gov (United States)

    Cakar, E; Dincer, U; Kiralp, M Z; Cakar, D B; Durmus, O; Kilac, H; Soydan, F C; Sevinc, S; Alper, C

    2010-03-01

    The objective of this study was to determine whether regular combined exercise program, which consists strength, stretching and aerobic exercises and additional jumping training, improve balance, fall risk, quality of life and depression status of older people living in a residential care. A total of 168 residents who live in a long term care facility were screened. The trial began with 78 eligible participants and they were randomly grouped as combined exercises program (COM) group that includes stretching, strength and aerobic exercises, and COM plus jumping (COMpJ) group. 66 of the participants finished the trial. The groups were convened three times a week for six weeks. Each group had a warm-up, effective training and a cooling down periods. The total exercising time was no longer than 45 minutes in each group. Berg balance test and Biodex Balance System for the assessment of the dynamic balance and fall risk, short form 36 (SF 36) for the health related quality of life and Geriatric Depression Scale (GDS) for evaluation of the depression status were used. The balance improvement and fall risk reduction were observed in both of the groups at the end of the trial; however, the improvements were statistically better in jumping combined group. Also health related quality of life improved in both groups. Regular group exercise in a long term care facility have several beneficial effects on the elderly residents in regard to balance improvement, fall risk reduction and quality of life. The addition of jumping to strength, stretching and aerobic exercises provides important contributions to balance improvement and fall risk reduction.

  2. Modified Pfannenstiel Open Approach as an Alternative to Laparoscopic Total Proctocolectomy and IPAA: Comparison of Short- and Long-term Outcomes and Quality of Life.

    Science.gov (United States)

    Duraes, Leonardo C; Schroeder, Destiny A; Dietz, David W

    2018-05-01

    A laparoscopic approach to total proctocolectomy with IPAA has been suggested to have better short-term outcomes and cosmesis, whereas open surgery by midline incision may result in shorter operative times. We hypothesized that a modified Pfannenstiel open approach would combine the advantages of both techniques. The purpose of this study was to compare outcomes of open total proctocolectomy with IPAA using a modified Pfannenstiel incision versus those following the laparoscopic approach. This was a retrospective study comparing patients submitted to open IPAA using modified Pfannenstiel incision versus laparoscopy from 1998 to 2014. The study was conducted at a high-volume tertiary referral center. Among 1275 patients, 119 patients underwent the laparoscopic approach and 33 underwent the modified Pfannenstiel approach. Short- and long-term outcomes were evaluated, and quality-of-life questionnaires were assessed. Patients who underwent the modified Pfannenstiel approach were younger, more often women, and had lower BMI and ASA classification compared with those who underwent laparoscopy. Surgical time was lower in Pfannenstiel, and no difference was observed in length of hospital stay. No difference was observed in postoperative complications, pouch failure rate, or quality of life. Patients were then matched 1:1 by diagnosis, sex, age (±5 y) and BMI (±5 kg/m). The Pfannenstiel approach still had a shorter surgical time. No difference was observed in the length of hospital stay, complications, pouch failure, or quality of life. In long-term follow-up, pouchitis symptoms occurred more frequently in Pfannenstiel (mean follow-up = 7.3 y), and seepage was more frequently observed in the laparoscopy group (mean follow-up = 4.2 y). These differences were not observed in matched patients. The study was limited by its retrospective design and inherent selection bias. The modified Pfannenstiel approach provides equivalent short- and long-term outcomes and similar

  3. Quality of life after surgical treatment of coarctation in long-term follow-up (CoAFU): Predictive value of clinical variables.

    Science.gov (United States)

    Bambul Heck, Pinar; Pabst von Ohain, Jelena; Kaemmerer, Harald; Ewert, Peter; Hager, Alfred

    2018-01-01

    We sought to analyze the quality of life and the predictive value of clinical variables from previous follow-up study in patients late after surgical treatment of aortic coarctation on the quality of life. All patients, who have participated in the prospective cross-sectional COALA Study in 2000 with a structural clinical investigation including blood pressure measurement and symptom-limited exercise test were contacted for the health-related quality of life questionnaire SF-36 from January 2013 through December 2014. From 273 eligible patients, we received data from 135 patients, 9 of them died during the follow-up time at the median age of 46years (range 30-64years). Seventy-four patients did not participate in the study, other 64 patients moved to remote or unknown areas and could not be contacted. Quality of life was good in the fields of physical role and pain. However, patients reported a significant impairment in general health and in health transition, depending on the age. Arterial hypertension and variables from echocardiography or exercise testing from the COALA study were not predictive on functional health status. Quality of life in patients late after aortic coarctation repair is fairly good compared with healthy controls. Impairments in general health and health transition depend mainly on age, can be explained due to numerous comorbidities and reinterventions in long-term. The predictive value of the commonly assessed clinical variables on quality of life is limited. Copyright © 2017. Published by Elsevier B.V.

  4. Long-term treatment of ADHD with stimulants: A large observational study of real-life patients

    DEFF Research Database (Denmark)

    Powell, Shelagh G.; Thomsen, Per Hove; Frydenberg, Morten

    2011-01-01

    : The diversity of ADHD patients was evident from the comorbidity, age at start, comedication, and treatment needs over time. Dosages corresponded to guidelines in most patients, but some needed higher dosages or got along on lower dosages for long periods. Age at start and comorbidity influenced dosage......, and dosage was associated to differential outcome groups. Conclusion: The study findings underscored the diversity of ADHD patients and that individual factors should be taken into account when tailoring individual treatment schedules. Findings further showed that stimulant dosages are dynamic over time......Objective: To evaluate 410 real-life patients treated with stimulants and assessed systematically over several years. Method: Naturalistic observational study. A database was compiled on the basis of a review of the medical charts of patients attending a specialized ADHD clinic. Results...

  5. Environmental Life Cycle Assessment of long-term organic rice production in a Subtropical area of China

    DEFF Research Database (Denmark)

    Xueqing, He; Qiao, Yuhui; Liang, Long

    2018-01-01

    a considerable environmental impact and changing from conventional to organic rice cultivation might therefore have a potentially great impact. Meanwhile, it takes time for the organic farming systems to reach a new steady state after conversion to organic. Thus, the environmental profile of the organic products...... will change over time and it is therefore important to examine whether the difference to conventional will be reduced (and disappear) or be increased over time. The aim of the present study was therefore to assess the environmental impact of organic rice production 5 (OR5), 10 (OR10) and 15 (OR15) years since...... conversion and compare it to conventional rice (CR) in subtropical China. The life cycle assessment (LCA) method was used to assess environmental impact of rice production systems with regard to nine environmental impact categories: Non-renewable Energy Depletion (NED), Water Depletion (WD), Land Occupation...

  6. Long-term morbidity and quality of life in patients with localized prostate cancer undergoing definitive radiotherapy or radical prostatectomy

    International Nuclear Information System (INIS)

    Lilleby, Wolfgang; Fossaa, Sophie D.; Waehre, Haakon R.; Olsen, Dag Rune

    1999-01-01

    Purpose: To assess morbidity, side effects, and quality of life (QoL) in patients treated for localized prostate cancer with curative aim. Methods and Materials: This descriptive cross-sectional study comprises 154 patients who had undergone definitive radiotherapy (RAD) and 108 patients with radical prostatectomy (PRECT) at the Norwegian Radium Hospital during 1987-1995. At least 1 year after treatment the patients completed several questionnaires assessing quality of life (European Organization for Research and Treatment of Cancer QLQ-C30 instrument [EORTC QLQ-C30]), lower urinary tract symptoms (LUTS): International Prostate Symptom Score (IPSS), or sexuality (selected questions from the Psychosocial Adjustment to Illness Scale [PAIS]). Urinary incontinence and bowel distress were evaluated by ad hoc constructed questionnaires. A control group (OBS) consisted of 38 patients following the watch-and-wait policy. Results: Twenty percent of the patients from the RAD Group had moderate (14%) or severe (6%) LUTS as compared to 12% in the PRECT group. However, 35% of men from the latter group reported moderate to severe urinary incontinence. 'Overall' sexuality was moderately or severely impaired in 71% of the PRECT and 50% of the RAD patients. In the former group high age was correlated with erectile impotency (p 1 year after definitive radiotherapy or radical prostatectomy with no difference as compared to the age-matched normal population. Clinicians should be aware of the fact that general QoL dimensions (physical function, emotional function, fatigue) are as a rule of greater significance for QoL than sexuality and lower urinary tract symptoms

  7. Long-term outcome of elderly patients requiring intensive care admission for abdominal pathologies: survival and quality of life.

    Science.gov (United States)

    Merlani, P; Chenaud, C; Mariotti, N; Ricou, B

    2007-05-01

    Medical developments have allowed the management of patients aged over 70 years with severe abdominal pathologies requiring intensive care unit (ICU) admission. These patients require enhanced life support and present a high ICU mortality. We investigated the outcome and quality of life (QOL) of elderly patients 2 years after their ICU stay for abdominal pathologies. Patients aged 70 years or over with abdominal pathologies, admitted to our ICU over a period of 2 years, were included. Two years following their ICU stay, a letter informed the patients about the present study. Consent to participate was obtained by telephone. QOL was assessed by the Euro-QOL and Short Form-36 questionnaires. Other patient-centered outcomes were evaluated. Overall, 2780 patients were admitted to the ICU during the study period; 141 (5%) patients were eligible; 112 of the 141 (79%) survived their ICU stay, 95 (67%) survived their hospital stay and 52 (37%) were alive 2 years after their ICU stay; 36 of the 52 survivors (69%) answered the questionnaire. Their QOL 2 years after their ICU stay was decreased in comparison with an age-matched population. Eighty-one per cent of patients lived at home and 57% were totally independent. They perceived their ICU stay as positive and 75% stated that they would agree to go through intensive care again. Factors associated with 2-year survival were the absence of co-morbidity, absence of malignancy and a lower Simplified Acute Physiology II score on ICU admission. A high mortality rate and a decrease in QOL were observed in elderly patients with severe abdominal pathologies. Nonetheless, these patients were able to adapt well to their physical disabilities.

  8. Value Retention, Service Life, Use Intensity and Long-Term Productivity of Wood Chippers as Obtained from Contractor Records

    Directory of Open Access Journals (Sweden)

    Raffaele Spinelli

    2017-12-01

    Full Text Available Acknowledging the absence of up-to-date empirical data on the value retention, service life and annual use of chipping machinery, in 2017 the authors surveyed the records kept by 50 contractors offering biomass chipping services. The machine fleet and operations in this survey could be taken as representative for most of Europe, where the biomass sector is well established and is facing further expansion. Data collection included the whole chipping unit, comprised of chipper, carrier and loader. Manually-fed units were excluded from the survey. The data pointed at a service life up to and exceeding 10,000 h and 10 years, which relieved any concerns about poor durability. Value retention was good, and may exceed that of other mainstream forestry equipment. Engine power was the main explanatory variable in any models to predict purchase price and productivity. The effect of this variable could explain most of the variability (>80% in the purchase price and productivity data. Results also pointed at the essential equivalence in price and productivity between PTO-driven (i.e., tractor powered and independent-engine chippers, once differences in engine power are accounted for. However, the distribution of purchase price between different components of the chipping unit was different between the two unit types, with the chipper accounting for a larger proportion of the total investment in independent-engine units. Machine power was also different, with most PTO-driven units being significantly smaller than independent-engine units, due to the limitations of existing tractors. Furthermore, half of the carriers assigned to a PTO-driven unit were subject to flexible use, i.e., they were not solely used for chipping work.

  9. Life History theory hypotheses on child growth: Potential implications for short and long-term child growth, development and health.

    Science.gov (United States)

    Said-Mohamed, Rihlat; Pettifor, John M; Norris, Shane A

    2018-01-01

    Life history theory integrates ecological, physiological, and molecular layers within an evolutionary framework to understand organisms' strategies to optimize survival and reproduction. Two life history hypotheses and their implications for child growth, development, and health (illustrated in the South African context) are reviewed here. One hypothesis suggests that there is an energy trade-off between linear growth and brain growth. Undernutrition in infancy and childhood may trigger adaptive physiological mechanisms prioritizing the brain at the expense of body growth. Another hypothesis is that the period from conception to infancy is a critical window of developmental plasticity of linear growth, the duration of which may vary between and within populations. The transition from infancy to childhood may mark the end of a critical window of opportunity for improving child growth. Both hypotheses emphasize the developmental plasticity of linear growth and the potential determinants of growth variability (including the role of parent-offspring conflict in maternal resources allocation). Implications of these hypotheses in populations with high burdens of undernutrition and infections are discussed. In South Africa, HIV/AIDS during pregnancy (associated with adverse birth outcomes, short duration of breastfeeding, and social consequences) may lead to a shortened window of developmental plasticity of growth. Furthermore, undernutrition and infectious diseases in children living in South Africa, a country undergoing a rapid nutrition transition, may have adverse consequences on individuals' cognitive abilities and risks of cardio-metabolic diseases. Studies are needed to identify physiological mechanisms underlying energy allocation between biological functions and their potential impacts on health. © 2017 Wiley Periodicals, Inc.

  10. Long-Term Quality of Life and Pregnancy Outcomes of Differentiated Thyroid Cancer Survivors Treated by Total Thyroidectomy and I131 during Adolescence and Young Adulthood

    Directory of Open Access Journals (Sweden)

    Melanie Metallo

    2016-01-01

    Full Text Available Introduction. Differentiated thyroid cancer (DTC is rare and confers good prognosis. Long-term health related quality of life (HRQoL and pregnancy outcomes are not well known in subjects treated during adolescence and young adulthood. Methods. Cross-sectional analysis of HRQoL and global self-esteem, using SF-36 and ISP-25 surveys, and of pregnancy outcomes in female survivors of DTC treated by total thyroidectomy and I131 before age of 25 years. Results. Forty-five of 61 patients (74% responded to the survey. Cumulative I131 activity was ≤3.85 GBq in 18 subjects and >3.85 GBq in 27 subjects. Mean time from diagnosis was 7.6 ± 5.2 years for the group ≤ 3.85 GBq versus 16.9 ± 11.6 years for the group > 3.85 GBq (P 3.85 GBq and 10 in patients from the group ≤ 3.85 GBq. Frequency of miscarriages was of 17% (group > 3.85 GBq and 10% (group ≤ 3.85 GBq with 9 and 24 live births, respectively. No congenital malformations or first year mortality was noted. Conclusion. Long-term HRQoL, global self-esteem, and pregnancy outcomes are not affected in young female survivors of DTC.

  11. Long-term effects of antibiotics, norfloxacin, and sulfamethoxazole, in a partial life-cycle study with zebrafish (Danio rerio): effects on growth, development, and reproduction.

    Science.gov (United States)

    Yan, Zhenhua; Lu, Guanghua; Ye, Qiuxia; Liu, Jianchao

    2016-09-01

    A partial life-cycle study with zebrafish (Danio rerio) was conducted to evaluate the long-term effects of antibiotics, norfloxacin (NOR) and sulfamethoxazole (SMX). A series of bio-endpoints correlated to the growth, development, and reproduction was assessed. The results showed that the body weight and the condition factor were depressed by SMX at 200 μg/L during the growth period. Meanwhile, the activities of metabolic enzyme (ethoxyresorufin O-deethylase, EROD) and antioxidant enzymes (superoxide dismutase, SOD and catalase, CAT) were stimulated in all cases. The consequences of parental exposure to antibiotics for the next generation were also examined. The egg production of parents were depressed by the 200 μg/L NOR and SMX alone or in combination. Similarly, decreased hatching, survival, and enhanced development abnormality of the next generation also occurred after parental exposure to SMX at the highest concentration. The heartbeat however was not altered in all cases. Furthermore, there was no significant difference in the bio-endpoints between the combined and individual treatment in most cases, with the exception of lower EROD activity and egg production in the co-treatment. The results suggest that long-term exposure to NOR and SMX at environmentally relevant concentrations, individually and in a mixture, may not significantly pose a threat to the growth, development, and reproduction of zebrafish, and an adverse effect may be expected at high concentration.

  12. Comparison of Different Disease-Specific Health-Related Quality of Life Measurements in Patients with Long-Term Noninvasive Ventilation

    Directory of Open Access Journals (Sweden)

    Toru Oga

    2017-01-01

    Full Text Available Background. Two disease-specific questionnaires have been developed to assess health-related quality of life (HRQL in patients with chronic respiratory failure: the Severe Respiratory Insufficiency (SRI Questionnaire and the Maugeri Respiratory Failure (MRF Questionnaire. We aimed to compare the characteristics of the SRI, MRF-26, and St. George’s Respiratory Questionnaire (SGRQ for use in patients with home noninvasive ventilation (NIV. Methods. Fifty-six outpatients receiving long-term NIV were recruited and underwent assessments of pulmonary function, arterial blood gas, HRQL, dyspnea, and psychological status. Results. Correlations of the SRI and MRF-26 with the SGRQ were modest. While pulmonary function was weakly related to only some domains of the SRI and MRF-26, the modified Medical Research Council (mMRC dyspnea scale and Hospital Anxiety and Depression Scale (HADS were significantly related to all domains of the SRI and MRF-26. Multiple regression analyses showed that HADS depression and mMRC accounted for 34% and 27% of the variance in the SRI, 24% and 37% in the MRF-26, and 17% and 46% in the SGRQ, respectively. Conclusions. The SRI and MRF-26 were reliable questionnaires for patients receiving long-term NIV. Dyspnea and psychological status were their main common determinants. The SRI covers more psychological health impairments than the MRF. This trial is registered with ClinicalTrials.gov Identifier: NCT00905476.

  13. Long-Term Effects of Haematopoietic Stem Cell Transplantation after Pediatric Cancer: A Qualitative Analysis of Life Experiences and Adaptation Strategies

    Directory of Open Access Journals (Sweden)

    Magali Lahaye

    2017-05-01

    Full Text Available Haematopoietic stem cell transplantation (HSCT improves the survival rate of children and adolescents with malignant and non-malignant conditions; however, the physical, psychological and social burden of such a procedure is considerable both during and after treatment. The present qualitative study investigated the long-term effects of HSCT after pediatric cancer. Thirty adolescent and young adult (AYA survivors (Mage = 23.61 years, SD = 5.21 participated in individual interviews and were invited to speak about their life experiences following their treatment and strategies they use to deal with their past medical experiences and the long-term sequelae. Our results showed the presence of ongoing physical and psychosocial consequences of their past illness and its treatments with wide ranging psychosocial impacts, such as affected self-image, social withdrawal, sense of lack of choice, and need for specific attention. Different strategies were reported to overcome these consequences, such as talking about illness, giving a sense to their past medical experiences, and developing meaningful social relationships. Clinical and research implications are also discussed.

  14. Abandoned to the strains of daily life: a qualitative study of the long-term experiences in partners to persons after a mild to moderate stroke.

    Science.gov (United States)

    Ytterberg, Charlotte; von Koch, Lena; Erikson, Anette

    2017-11-13

    To describe the experiences of everyday life over 6 years after stroke, from the perspectives of partners to persons after stroke. Semi structured individual interviews were conducted with seven partners to persons who had had stroke. The interviews were recorded and then transcribed verbatim. The participants comprised two men and five women aged 60-82 years. The data were collected and analysed using a grounded theory approach. One core category Living in strained everyday circumstances and three categories Feelings of anxiety, Living a demanding day to day life, and Adjusting to a changed role emerged from the analysis. The participants had developed strategies and new ways to boost their energy level in order to find the strength needed for their everyday life. This study shows that the everyday lives of partners to people who have had a stroke are characterised by feelings of strain and anxiety and that they need possibilities for different kinds of long-term support. Our findings may contribute to increased knowledge among health workers and increased readiness to offer support or referral to other meeting places such as peer support groups. Implications for rehabilitation The everyday lives of partners to people who have had a stroke are characterised by feelings of strain and anxiety. Partners to people who have had a stroke need possibilities for different kinds of long-term support. Possibilities for relief among partners to persons after stroke may be organised for example within the municipality or by patient organisations and other voluntary networks such as peer support groups.

  15. Open-label study on the long-term efficacy, safety, and impact on quality of life of OROS hydromorphone ER in patients with chronic low back pain.

    Science.gov (United States)

    Wallace, Mark; Thipphawong, John

    2010-10-01

    To investigate the efficacy, safety, and impact on quality of life of long-term administration of OROS hydromorphone ER (8-128mg) in patients with chronic low back pain. A total of 113 adults with chronic low back pain who completed a 6-week open-label study were enrolled in this 6-month extension study. The primary end point was the daily pain relief rating obtained during monthly study visits. Secondary end points included Investigator and Patient Global Evaluations, Brief Pain Inventory scores obtained at monthly study visits, and quality-of-life measures (Medical Outcomes Study Questionnaire and 36-Item Short-Form Health Survey score) obtained at monthly intervals. Mean±SD change from baseline in pain relief with OROS hydromorphone ER for the Month 6 visit was 0.9±2.55 (P=0.0007) and for the last assessment of the extension study was 0.9±2.53 (P=0.0002). At the Month 6 visit, 81.3% of investigators and 71.0% of patients rated their satisfaction of pain relief with OROS hydromorphone ER treatment as good, very good, or excellent. Changes on the 36-item Short Form Health Survey, a quality-of-life measure, were statistically significant for the physical composite scores for all extension phase time points, including Month 6 (2.1±5.34; Psleep disturbances. Adverse events included gastrointestinal and central nervous system symptoms. The results support the long-term use of OROS hydromorphone ER in managing chronic moderate to severe low back pain. Wiley Periodicals, Inc.

  16. Health-related quality of life of young people with long-term illnesses before and after transfer from child to adult healthcare.

    Science.gov (United States)

    While, A E; Heery, E; Sheehan, A M; Coyne, I

    2017-01-01

    The numbers of children with long-term illnesses surviving into adulthood and transferring from child to adult services has increased dramatically in the last 30 years. This study aimed to examine health-related quality of life pre- and post-transfer from child to adult healthcare for young people with three long-term illnesses. A total of 217 young people with cystic fibrosis, congenital heart defects or diabetes attending child and adult hospital services in Dublin, Ireland completed a questionnaire survey. Multiple linear regression was used to identify predictors of five dimensions of health-related quality of life pre- and post-transfer. Post-transfer young people with congenital heart disease and diabetes reported significantly lower physical well-being than their pre-transfer counterparts. Pre-transfer young people with cystic fibrosis reported significantly lower physical well-being than those with diabetes, but there was no significant difference post-transfer. Pre-transfer females reported lower scores than males on the Psychological Well-being and Autonomy and Parent Relation dimensions; however, these differences disappeared post-transfer. Higher maternal overprotection scores were associated with significantly lower scores on the Psychological Well-being, Autonomy and Parent Relation, and Social Support and Peers dimensions, regardless of transfer status. Disease group, gender and maternal overprotection were predictors of health-related quality of life pre- and post-transfer from child to adult healthcare. Transition programmes should promote self-management and discourage parental overprotection. © 2016 John Wiley & Sons Ltd.

  17. Radical cystectomy with orthotopic neobladder for invasive bladder cancer: a critical analysis of long term oncological, functional and quality of life results

    Directory of Open Access Journals (Sweden)

    Arnulf Stenzl

    2010-10-01

    Full Text Available PURPOSE: Analyze current knowledge and practice regarding tumor-related cystectomy with subsequent orthotopic neobladder both in male and female patients. DESIGN, SETTING, AND PARTICIPANTS: Evaluate literature predominantly from the last decade dealing with long-term experience in large numbers of patients with an orthotopic neobladder following cystectomy. Oncological outcome specific to an orthotopic neobladder, functional aspects such as urinary continence, renal function, sexual activity and other quality of life issues are elucidated. RESULTS: Local pelvic recurrences after urothelial bladder cancer occur in 7-12%. Urethral second primary tumors in male and female patients in contemporary series with bladder substitution are 4-6% and 1.4 o 4%, respectively. Upper tract recurrences vary between 2.4-17%. Complications regarding the upper urinary tract have dramatically diminished due to simplified forms of upper tract protection as well as a more refined technique of ureterointestinal anastomosis. Depending on the technique ureteroileal stenosis was lately reported to lie between 2.7 to 3.8%. Renal function remained stable in 96% after a mean follow-up of up to 5 years. Radical cystectomy in carefully selected patients has stood the test of time by providing adequate long-term survival and low local recurrence rates. Orthotopic bladder substitution does not compromise oncological outcome, yields excellent functional results, is cost effective compared to other types of urinary diversion, may improve quality of life and should therefore be the diversion of choice both in men and women. Chronological age is generally not a contraindication for cystectomy, but for orthotopic urinary diversion, tumor extent, functional pelvic floor deficits and general life expectancy are limiting factors.

  18. Evaluation of the Quality of Life in Adult Cancer Survivors (QLACS scale for long-term cancer survivors in a sample of breast cancer survivors

    Directory of Open Access Journals (Sweden)

    Foley Kristie

    2006-12-01

    Full Text Available Abstract Background This paper evaluates psychometric properties of a recently developed measure focusing on the health-related quality of life (HRQL of long-term cancer survivors, the Quality of Life in Adult Survivors scale (QLACS, in a sample of breast cancer survivors. This represents an important area of study, given the large number of breast cancer patients surviving many years post diagnosis. Methods Analyses are based on an 8-year follow-up of a sample of breast cancer survivors who participated in an earlier study conducted in 1995. Participants were re-contacted in 2003 and those who were reachable and agreed to participate (n = 94 were surveyed using a variety of measures including the QLACS. Additional follow-up surveys were conducted 2 weeks and one year later. Psychometric tests of the QLACS included test-retest reliability, concurrent and retrospective validity, and responsiveness. Results The QLACS domain and summary scores showed good test-retest reliability (all test-retest correlations were above .7 and high internal consistency. The Generic Summary Score showed convergent validity with other measures designed to assess generic HRQL. The Cancer-Specific Summary score exhibited divergent validity with generic HRQL measures, but not a cancer-related specific measure. The QLACS Cancer-Specific Summary Score demonstrated satisfactory predictive validity for factors that were previously shown to be correlated with HRQL. The QLACS generally demonstrated a high level of responsiveness to life changes. Conclusion The QLACS may serve as a useful measure for assessing HRQL among long-term breast cancer survivors that are not otherwise captured by generic measures or those specifically designed for newly diagnosed patients.

  19. The long-term impact of early life pain on adult responses to anxiety and stress: Historical perspectives and empirical evidence.

    Science.gov (United States)

    Victoria, Nicole C; Murphy, Anne Z

    2016-01-01

    Approximately 1 in 6 infants are born prematurely each year. Typically, these infants spend 25 days in the Neonatal Intensive Care Unit (NICU) where they experience 10-18 painful and inflammatory procedures each day. Remarkably, pre-emptive analgesics and/or anesthesia are administered less than 25% of the time. Unalleviated pain during the perinatal period is associated with permanent decreases in pain sensitivity, blunted cortisol responses and high rates of neuropsychiatric disorders. To date, the mechanism(s) by which these long-term changes in stress and pain behavior occur, and whether such alterations can be prevented by appropriate analgesia at the time of insult, remains unclear. Work in our lab using a rodent model of early life pain suggests that inflammatory pain experienced on the day of birth blunts adult responses to stress- and pain-provoking stimuli, and dysregulates the hypothalamic pituitary adrenal (HPA) axis in part through a permanent upregulation in central endogenous opioid tone. This review focuses on the long-term impact of neonatal inflammatory pain on adult anxiety- and stress-related responses, and underlying neuroanatomical changes in the context of endogenous pain control and the HPA axis. These two systems are in a state of exaggerated developmental plasticity early in postnatal life, and work in concert to respond to noxious or aversive stimuli. We present empirical evidence from animal and clinical studies, and discuss historical perspectives underlying the lack of analgesia/anesthetic use for early life pain in the modern NICU. Copyright © 2015 Elsevier Inc. All rights reserved.

  20. Long-term results and quality of life of patients undergoing sequential surgical treatment for severe acute pancreatitis complicated by infected pancreatic necrosis.

    Science.gov (United States)

    Cinquepalmi, Lorenza; Boni, Luigi; Dionigi, Gianlorenzo; Rovera, Francesca; Diurni, Mario; Benevento, Angelo; Dionigi, Renzo

    2006-01-01

    Infected pancreatic necrosis (IPN) is one of the most severe complications of acute pancreatitis (AP). Sequential surgical debridement represents one of the most effective treatments in terms of morbidity and mortality. The aim of this paper is to describe the quality of life and long-term results (e.g., nutritional, muscular, and pancreatic function) of patients treated by sequential necrosectomy at the Department of Surgery of the University of Insubria (Varese, Italy). Data were collected on patients undergoing sequential surgical debridement as treatment for IPN. The severity of AP was evaluated using the Ranson criteria, the Acute Physiology and Chronic Health Evaluation (APACHE II) Score, and the Sepsis Score, as well as the extent of necrosis. The surgical approach was through a midline or subcostal laparotomy, followed by exploration of the peritoneal cavity, wide debridement, and peritoneal lavage. The abdomen was either left open or closed partially with a surgical zipper, with multiple re-laparotomies scheduled until debridement of necrotic tissue was complete. The long-term evaluation focused on late morbidity, performance status, and abdominal wall function. In the majority of patients (68%), mixed flora were isolated. Pseudomonas aeruginosa was the microorganism identified most commonly (59%), often associated with Candida albicans or C. glabrata. The mean total hospital stay was 71+/-38 days (range 13-146 days), of which 24+/-19 days (range 0-66 days) were in the intensive care unit. Eight patients died, the deaths being caused by multiple organ dysfunction syndrome in seven patients and hemorrhage from the splenic artery in one. Normal exocrine and endocrine pancreatic function was observed in 28 patients (88%). At discharge, four patients had steatorrhea, which was temporary. Eight patients (23%) developed pancreatic pseudocysts, and in six, cystogastostomy was performed. Most patients (29/32, 91%) developed a post-operative hernia, but only five

  1. Long-Term Collections

    CERN Multimedia

    Comité des collectes à long terme

    2011-01-01

    It is the time of the year when our fireman colleagues go around the laboratory for their traditional calendars sale. A part of the money of the sales will be donated in favour of the long-term collections. We hope that you will welcome them warmly.

  2. Long-term changes in the quality of life of patients with rheumatoid arthritis treated with biological therapies.

    Science.gov (United States)

    Ortega-Valín, Luis; Mayorga-Bajo, Isabel; Prieto-Fernández, Carolina; Del Pozo-Ruiz, Javier; Gutiérrez-Gutiérrez, Esperanza; Pérez-Sandoval, Trinidad

    2017-02-27

    To analyze the changes in health-related quality of life (HRQoL) of patients with rheumatoid arthritis (RA) treated with biological therapies. Observational prospective study performed from October 2006 to May 2011. The inclusion criteria were adult patients, diagnosed with RA, treated for at least one year with anti-tumor necrosis factor therapy (infliximab or etanercept), who had not received other biological treatments previously. A total of 41 patients who completed the study undertook the specific and validated questionnaire QoL-RA Scale 3 times: E1 (September 2006-February 2007), E2 (April 2008-January 2009) and E3 (July 2010- May 2011). Data analysis was conducted using Epi-Info version 3.3 2004 for Windows® and Excel 2007; mean comparisons were evaluated by Student's t-test and the relationship between the 3 outcomes for each patient by lineal regression. Overall results show a downward trend which was not statistically significant: 7.09 (standard deviation [SD]=1.15) in E1; 6.90 (SD=1.60) in E2; and 6.52 (SD=1.59) in E3. Items with higher scores were those related to psychosocial aspects (help from family, interaction with family and friends), whereas the physical dimension was valued more poorly (physical ability, arthritis pain, arthritis). Between E2 and E3 there was a significant increase in help from family (P=.0008), whereas level of tension (P=.0119) and mood (P=.0451) decreased significantly. In all, HRQoL reported by patients is good and has remained unchanged after approximately 6 years of study. The stability of HRQoL is probably partly attributable to treatment. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

  3. Symptom Severity and Quality of Life Among Long-term Colorectal Cancer Survivors Compared With Matched Control Subjects: A Population-Based Study.

    Science.gov (United States)

    Hart, Tae L; Charles, Susan T; Gunaratne, Mekhala; Baxter, Nancy N; Cotterchio, Michelle; Cohen, Zane; Gallinger, Steven

    2018-03-01

    Data are lacking regarding physical functioning, psychological well-being, and quality of life among colorectal cancer survivors >10 years postdiagnosis. The purpose of this study was to examine self-reported physical functioning, quality of life, and psychological well-being in long-term colorectal cancer survivors compared with age- and sex-matched unaffected control subjects. Participants completed a cross-sectional survey. The colorectal cancer survivors and unaffected control subjects were recruited from the Ontario Familial Colorectal Cancer Registry. A population-based sample of colorectal cancer survivors (N = 296) and their age- and sex-matched unaffected control subjects (N = 255) were included. Survivors were, on average, 15 years postdiagnosis. Quality of life was measured with the Functional Assessment of Cancer Therapy-General scale, bowel dysfunction with the Memorial Sloan-Kettering Cancer Center scale, urinary dysfunction with the International Consultation on Incontinence Questionnaire-Short Form, fatigue with the Functional Assessment of Chronic Illness Therapy-Fatigue scale, and depression with the Center for Epidemiologic Studies-Depression scale. In linear mixed-model analyses adjusting for income, education, race, and comorbid medical conditions, survivors reported good emotional, functional, physical, and overall quality of life, comparable to control subjects. Fatigue and urinary functioning did not differ significantly between survivors and control subjects. Survivors reported significantly higher social quality of life and lower depression compared with unaffected control subjects. The only area where survivors reported significantly worse deficits was in bowel dysfunction, but the magnitude of differences was relatively small. Generalizability is limited by moderately low participation rates. Findings are likely biased toward healthy participants. No baseline assessment was available to examine change in outcomes over time. Long-term

  4. Effects of long-term multicomponent exercise on health-related quality of life in older adults with type 2 diabetes: evidence from a cohort study.

    Science.gov (United States)

    Baptista, Liliana C; Dias, Gonçalo; Souza, Nelba R; Veríssimo, Manuel T; Martins, Raul A

    2017-08-01

    To establish the effect of a long-term multicomponent exercise (LTMEX) intervention (24 months) on health-related quality of life (HRQoL), in older adults with type 2 diabetes (T2D). This longitudinal retrospective cohort study analyzes the effects of a supervised LTMEX program on HRQoL in older adults with T2D (n = 279). Participants underwent one of two conditions: LTMEX (n = 241) trained three times per week; and unchanged lifestyle-the control group (CO; n = 38). Participants completed baseline, and 2-year follow-up evaluations including the Short Form Health Survey 36 (SF-36), anthropometric, hemodynamic components, and cardiorespiratory fitness (VO 2 peak). LTMEX improves HRQoL, specifically physical functioning (P health (P health (MH; P older adults with T2D, and also anthropometric, hemodynamic profile, and cardiorespiratory fitness.

  5. CARDIORENAL RELATIONS AND QUALITY OF LIFE IN ELDERLY PATIENTS WITH CHRONIC HEART FAILURE IN LONG TERM THERAPY WITH CARVEDILOL AND BISOPROLOL

    Directory of Open Access Journals (Sweden)

    M. A. Statsenko

    2005-01-01

    Full Text Available Aim. To compare effects of long term therapy with сarvedilol and bisoprolol on heart and renal functions, heart rate variability (HRV and quality of life in elderly patients with chronic heart failure (CHF.Material and methods. We examined 40 patients aged 60-75 years on the 15-30 day after myocardial infarction complicated with CHF. All the patients taking basic therapy with enalapril, aspirin, simvastatin and diuretics were randomized to either bisoprolol (n=20 or сarvedilol (n=20 therapy group. The average daily doses were 5,7+0,8 mg for and 32,6+3,4 mg for carvedilol. The duration of the observation period was 12 months. Cardiac morphofunctional parameters, HRV, renal function and quality of life were determined at baseline, after 12 weeks and at the end of the study.Results. Complex therapy of CHF including both beta-blockers resulted in clinical improvement, increase in myocardial contractility. However, carvedilol group showed more pronounced increase in ejection fraction in comparison with bisoprolol group, 8,97% and 5,14%, respectively. Local contractility index decreased significantly only in carvedilol group by 29,9% (p<0,05. Carvedilol demonstrated more significant nephroprotective effects: glomerular filtration rate increased by 32,2%, renal functional reserve restored in 70% of patients. Tubular reabsorbtion, sodium clearance and excretion also increased in carvedilol group. After 12 month of treatment microalbuminuria reduced in both groups of patients, but more significant in carvedilol group. Carvedilol provided more strong blocking effect on sympathetic part of autonomic nervous system according to HRV data.Conclusion. In elderly patients with CHF long term therapy with both carvedilol and bisoprolol provided with improvement in clinical conditions and renal function, increased in HRV and was well tolerated. However, carvedilol compared with bisoprolol showed more significant beneficial effects on cardiac morphofunctional

  6. Impaired quality of life in patients with treated acromegaly despite long-term biochemically stable disease: Results from a 5-years prospective study.

    Science.gov (United States)

    Kyriakakis, Nikolaos; Lynch, Julie; Gilbey, Stephen G; Webb, Susan M; Murray, Robert D

    2017-06-01

    Patients with acromegaly demonstrate impaired quality of life (QoL), but data on long-term QoL changes in treated acromegaly are limited. This study evaluates and identifies factors that influence QoL in patients with long-term biochemical remission. The study consists of a cross-sectional arm comparing QoL between patients with treated and controlled acromegaly and healthy controls; and a longitudinal arm assessing QoL changes in patients with biochemically stable disease during 5.7±0.6 years of follow-up. A total of 58 patients and 116 matched controls were recruited for the cross-sectional arm; 28 patients completed the longitudinal arm. Three generic questionnaires (Psychological General Well-Being Schedule [PGWBS], 36-item Short-Form [SF-36], EuroQoL [EQ-5D]) and the disease-specific acromegaly QoL questionnaire (AcroQoL) were applied. Quality of life assessment was performed 11.6±8.2 years following diagnosis and treatment of acromegaly. Patients with treated acromegaly had lower QoL scores compared with controls in all questionnaires with the exception of the PGWBS "Anxiety" subscale. The AcroQoL "Appearance" subscale and the "Physical Function" subscales of the remaining questionnaires were the most underscored domains. No difference in the total and subscale scores of all questionnaires was observed between baseline and follow-up, with the exception of the SF-36 "Physical Function," where a decline was found (58.5±24.7% vs 43.1±31.1%; P=.002). However, after adjusting for covariates, no significant change in any of the QoL scores was seen. Duration of IGF-1/GH control was positively correlated with QoL scores in most questionnaires at baseline, whereas use of GH lowering therapy at the time of QoL assessment was a negative predictive factor of QoL. Patients with biochemically controlled acromegaly demonstrate impaired QoL, which persists despite long-term disease control. This primarily consists of impaired physical function and secondly of impaired

  7. Evaluation of long term health-related quality of life in extensive burns: a 12-year experience in a burn center.

    Science.gov (United States)

    Xie, Bing; Xiao, Shi-chu; Zhu, Shi-hui; Xia, Zhao-fan

    2012-05-01

    We sought to evaluate the long term health-related quality of life (HRQOL) in patients survived severely extensive burn and identify their clinical predicting factors correlated with HRQOL. A cross-sectional study was conducted in 20 patients survived more than 2 years with extensive burn involving ≥70% total body surface area (TBSA) between 1997 and 2009 in a burn center in Shanghai. Short Form-36 Medical Outcomes Survey (SF-36), Brief Version of Burn Specific Health Scale (BSHS-B) and Michigan Hand Outcome Questionnaire (MHQ) were used for the present evaluation. SF-36 scores were compared with a healthy Chinese population, and linear correlation analysis was performed to screen the clinical relating factors predicting physical and mental component summary (PCS and MCS) scores from SF-36. HRQOL scores from SF-36 were significantly lower in the domains of physical functioning, role limitations due to physical problems, pain, social functioning and role limitations due to emotional problems compared with population norms. Multiple linear regression analysis demonstrated that only return to work (RTW) predicted improved PCS. While age at injury, facial burns, skin grafting and length of hospital stay were correlated with MCS. Work, body image and heat sensitivity obtained the lowest BSHS-B scores in all 9 domains. Improvements of HRQOL could still be seen in BSHS-B scores in domains of simple abilities, hand function, work and affect even after a quite long interval between burns and testing. Hand function of extensive burn patients obtained relatively poor MHQ scores, especially in those without RTW. Patients with extensive burns have a poorer quality of life compared with that of general population. Relatively poor physical and psychological problems still exist even after a long period. Meanwhile, a trend of gradual improvements was noted. This information will aid clinicians in decision-making of comprehensive systematic regimens for long term rehabilitation

  8. International evaluation of the psychometrics of health-related quality of life questionnaires for use among long-term survivors of testicular and prostate cancer.

    Science.gov (United States)

    van Leeuwen, Marieke; Kieffer, Jacobien M; Efficace, Fabio; Fosså, Sophie D; Bolla, Michel; Collette, Laurence; Colombel, Marc; De Giorgi, Ugo; Holzner, Bernhard; van de Poll-Franse, Lonneke V; van Poppel, Hendrik; White, Jeff; de Wit, Ronald; Osanto, Susanne; Aaronson, Neil K

    2017-05-11

    Understanding of the physical, functional and psychosocial health problems and needs of cancer survivors requires cross-national and cross-cultural standardization of health-related quality of life (HRQoL) questionnaires that capture the full range of issues relevant to cancer survivors. To our knowledge, only one study has investigated in a comprehensive way whether a questionnaire used to evaluate HRQoL in cancer patients under active treatment is also reliable and valid when used among (long-term) cancer survivors. In this study we evaluated, in an international context, the psychometrics of HRQoL questionnaires for use among long-term, disease-free, survivors of testicular and prostate cancer. In this cross-sectional study, we recruited long-term survivors of testicular and prostate cancer from Northern and Southern Europe and from the United Kingdom who had participated in two phase III EORTC clinical trials. Participants completed the SF-36 Health Survey, the EORTC QLQ-C30 questionnaire, the QLQ-PR25 (for prostate cancer) or the QLQ-TC26 (for testicular cancer) questionnaires, and the Impact of Cancer questionnaire. Testicular cancer survivors also completed subscales from the Nordic Questionnaire for Monitoring the Age Diverse Workforce. Two hundred forty-two men (66% response rate) were recruited into the study. The average time since treatment was more than 10 years. Overall, there were few missing questionnaire data, although scales related to sexuality, satisfaction with care and relationship concerns of men without partners were missing in more than 10% of cases. Debriefing showed that in general the questionnaires were accepted well. Many of the survivors scored at the upper extremes of the questionnaires, resulting in floor and ceiling effects in 64% of the scales. All of the questionnaires investigated met the threshold of 0.70 for group level reliability, with the exception of the QLQ-TC26 (mean reliability .64) and the QLQ-PR25 (mean reliability

  9. Long-term disease-specific and cognitive quality of life after intensity-modulated radiation therapy: a cross-sectional survey of nasopharyngeal carcinoma survivors

    International Nuclear Information System (INIS)

    Kiang, Alan; Weinberg, Vivian K.; Cheung, Ka Ho Nicholas; Shugard, Erin; Chen, Josephine; Quivey, Jeanne M.; Yom, Sue S.

    2016-01-01

    There is a lack of data on quality of life in long-term survivors of nasopharyngeal carcinoma (NPC) who have been treated with intensity-modulated radiation therapy (IMRT). We characterized long-term disease-specific and cognitive QoL in NPC survivors after IMRT. We conducted a cross-sectional study of surviving patients diagnosed and treated for NPC at our center with curative-intent IMRT, with or without chemotherapy. Patients who were deceased, still undergoing treatment, with known recurrent disease, or treated with RT modality other than IMRT were excluded. QoL was measured by FACT-NP and FACT-Cog. Between May and November 2013, 44 patients completed cognitive (FACT-Cog), general (FACT-G), and NPC-specific (NPCS) QoL assessments. Patients were categorized into 4 cohorts based on duration since IMRT (≤2.5, >2.5–6, >6–10, and >10–16 years). There was no significant difference in age (p = 0.20) or stage ((I/II vs III/IV: p = 0.78) among the cohorts. The 4 cohorts differed overall for all QoL measures (ANOVA: p < 0.02 for each), due to improved scores >2.5–6 years post-IMRT compared with ≤2.5 years post-IMRT (post hoc tests: p ≤ 0.04 for each). No differences were observed between >2.5–6 and >6–10 years post-IMRT, but lower mean FACT-Cog and NPCS scores were observed for >10 years compared to >2.5–6 years post-IMRT (post hoc: p < 0.05 for each). All QoL measures were low during the initial recovery period (≤2.5 years) and were higher by 6 years post-IMRT. At >10 years post-IMRT, lower scores were observed in the domains of NPC-specific and cognitive QoL. Survivors of NPC, even if treated with IMRT, are at risk for detriment in domain-specific QoL measures at very long-term follow-up

  10. Quality of life in women undergoing urinary diversion for bladder cancer: results of a multicenter study among long-term disease-free survivors.

    Science.gov (United States)

    Gacci, Mauro; Saleh, Omar; Cai, Tommaso; Gore, John L; D'Elia, Carolina; Minervini, Andrea; Masieri, Lorenzo; Giannessi, Claudia; Lanciotti, Michele; Varca, Virginia; Simonato, Alchiede; Serni, Sergio; Carmignani, Giorgio; Carini, Marco

    2013-03-12

    Women undergoing radical cystectomy (RC) and urinary diversion for bladder cancer experience substantial limitations in health-related quality of life (HRQOL). However, the level of discomfort caused by different urinary diversion has been never evaluated in long term survivors. The aim of this multicenter study is to evaluate differences in HRQOL among recurrence-free women undergoing cutaneous ureterostomy (CUS), Bricker's ileal conduit (BK-IC) and Orthotopic neobladder VIP (ONB-VIP) in disease-free females treated with radical cystectomy (RC), with long-term follow up (mean 60.1 months; range 36-122 months). All consecutively treated female patients from two urological institutions who underwent RC and urinary diversion from January 2000 to December 2008, with no evidence of tumor recurrence at a minimum follow up of 36 months, were included. Patients received the European Organisation for Research and Treatment of Cancer (EORTC) generic (QLQ-C30) and bladder cancer-specific instruments (QLQ-BLM30) and the Functional Assessment of Cancer Therapy for Bladder Cancer (FACT-BL). Clinical data and questionnaire results were analyzed in order to evaluate the HRQOL differences among diversion groups. We identified 37 females (median age: 68, range 45-82 years), including 12 status-post CUS, 16 who underwent BK-IC, and 9 who underwent ONB-VIP. Most were healthy (24/37 with no comorbidities, 4/37 Charlson 1-2, 9/37 Charlson 3 or greater - we didn't considered bladder cancer in Charlson evaluation because bladder cancer was the main inclusion criteria). Women undergoing CUS endorsed worse FACT-BL scores compared with BK-IC and ONB-VIP patients, worse HRQOL regarding physical and emotional well-being (p=0.008 and p=0.02, respectively), and a trend toward worse EORTC QLQ-C30 scores for appetite loss and fatigue (p=0.05 for both). In our study long-term disease-free females treated with CUS endorsed worse HRQOL compared with women who underwent BK-IC or ONB-VIP, mostly due

  11. Role of cardiac biomarkers (troponin I and CK-MB as predictors of quality of life and long-term outcome after cardiac surgery

    Directory of Open Access Journals (Sweden)

    Bignami Elena

    2009-01-01

    Full Text Available Perioperative and postoperative morbidity and mortality associated with cardiac surgery affect both the outcome and quality of life. Markers such as troponin effectively predict short-term outcome. In a prospective cohort study in a University Hospital we assessed the role of cardiac biomarkers, also as predictors of long-term outcome and life quality after cardiac surgery with a three-year follow-up after conventional heart surgery. Patients were interviewed via phone calls with a structured questionnaire examining general health, functional status, activities of daily living, perception of life quality and need for hospital readmission. Descriptive statistics and multivariate analysis were performed. Out of 252 consecutive patients, 8 (3.2% died at the three years follow up: 7 for cardiac complications and 1 for cancer. Thirty-six patients (13.5% had hospital readmission for cardiac causes (mostly for atrial fibrillation or other arrhythmias (9.3%, but none needed cardiac surgical reintervention; 21 patients (7.9% were hospitalised for non-cardiac causes. No limitation in function activities of daily living was reported by most patients (94%, 92% perceived their general health as excellent, very good or good and none considered it insufficient; 80% were NYHA I, 17% NYHA II, 3% NYHA III and none NYHA IV. Multivariate analysis indicated preoperative treatment with digitalis or nitrates, and postoperative cardiac biomarkers release was independently associated to death. Elevated cardiac biomarker release and length of hospital stay were the only postoperative independent predictors of death in this study.

  12. Long-term health, well-being, life satisfaction, and attitudes toward parenthood in men diagnosed as infertile: challenges to gender stereotypes and implications for practice.

    Science.gov (United States)

    Fisher, Jane R W; Baker, Gordon H W; Hammarberg, Karin

    2010-07-01

    To investigate attitudes toward parenthood, long-term life satisfaction, and health and well-being in men diagnosed as infertile. A cross-sectional survey of a cohort of men 5 years after diagnosis of infertility. The andrology clinic at the Royal Women's Hospital Reproductive Services, Melbourne Australia. All men diagnosed at this center as infertile in 2001 and 2002. None. Attitudes to parenthood (Meaning of Parenthood), quality of intimate relationship (Intimate Bonds Measure), personality characteristics (Vulnerable Personality Style Questionnaire), life satisfaction (Satisfaction with Life Scale), and self-rated physical health (Physical Component Summary of SF-12 [PCS-12]) and relationship with mental health (Mental Component Summary of SF12 [MCS-12]). A total of 112 (41%) of 276 men completed the survey. Of these, 96% had pursued infertility treatment and 87% had become fathers. Only 10% thought that fertility confirmed by fatherhood reflected masculinity, and 84% desired parenthood as much as their partners did. When all other factors were controlled for, men who had not become fathers had poorer mental health (MCS-12 score = 43.9 +/- 9.9) than those who were fathers (MCS-12 score = 49.25 +/- 8.7). Clinical practice should not presume that infertile men conflate fertility and masculinity, are less distressed than women about the potential loss of parenthood, or adjust more readily to childlessness, which appear to be inaccurate but widespread stereotypes. Copyright 2010 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  13. Inequalities in long term health-related quality of life between partnered and not partnered breast cancer survivors through the mediation effect of social support.

    Science.gov (United States)

    Leung, Janni; Smith, Michelle D; McLaughlin, Deirdre

    2016-10-01

    To compare long-term quality of life outcomes by marital status among women living with breast cancer, and to test the mediation effects of social support as an underlying factor. Data are drawn from 1996 to 2010 of the Australian Longitudinal Study on Women's Health. The sample included 505 women with breast cancer with six years of follow-up data. Social support was measured by the Medical Outcomes Study Social Support Survey (MOS-SSS). Physical and mental health-related quality of life (HRQOL) was measured using the Short-Form Health Survey (SF-36). Breast cancer survivors who did not have a partner, compared to those who had a partner, had significantly lower levels of social support, which was associated with poorer HRQOL. Social support mediated the relationship between not having a partner and poorer HRQOL. Results were consistent after taken into consideration socio-demographic characteristics, which included age, highest level of education, country of birth, and area of residence. Women recovering from breast cancer who do not have partners have poorer physical and mental HRQOL, than those with partners, with a lack of social support as an underlying inequality. Partners of breast cancer survivors are importance sources in the provision of social support to help them maintain well-being and quality of life. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  14. Use of the long-term quality of life assessment in the decision to indicate surgery in patients with chronic rhinosinusitis.

    Science.gov (United States)

    Marambaia, Pablo Pinillos; Lima, Manuela Garcia; Macario, Hélder; Gomes, Amaury de Machado; Gomes, Leonado Marques; Marambaia, Melina Pinillos; Santos, Otávio Marambaia Dos

    2018-04-22

    Quality-of-life questionnaires have been used to support decision-making in patients with chronic rhinosinusitis in the past decade. The choice of treatment in practice, however, also considers the patient's decision. To assess the long-term quality of life of patients with chronic rhinosinusitis who decided to avoid surgery. This is a prospective longitudinal study with a group of patients with chronic rhinosinusitis, with and without indication for surgery, with application of the questionnaire SNOT-22 in two periods: between 2011 and 2012 and between June and August 2016, via email. Data were collected from 42 patients, of which 13 presented indications for surgery and 29 were not indicated for surgery. The average quality of life score was 42.1 (±16.4) in the group with an indication for surgery and 40.6 (±23.4) in the group without this indication, p=0.84. All the patients were assessed by a single doctor with blinding in relation to the initial score. No differences were detected between the groups. The impact of the chronic rhinosinusitis was reduced even among the patients with the indication for surgery. Both groups scored over 40. This study can help predict the impact of the chronic rhinosinusitis over time and better adjust expectations with non-surgical treatment. Copyright © 2018 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

  15. Mode of Delivery and Long-Term Health-Related Quality-of-Life Outcomes: A Prospective Population-Based Study.

    Science.gov (United States)

    Petrou, Stavros; Kim, Sung Wook; McParland, Penny; Boyle, Elaine M

    2017-06-01

    Relatively little is known about the effects of mode of delivery on long-term health-related quality-of-life outcomes. Furthermore, no previous study has expressed these outcomes in preference-based (utility) metrics. The study population comprised 2,161 mothers recruited from a prospective population-based study in the East Midlands of England encompassing live births and stillbirths between 32 +0 and 36 +6 weeks' gestation and a sample of term-born controls. Perinatal data were extracted from the mothers' maternity records. Health-related quality-of-life outcomes were assessed at 12 months postpartum, using the EuroQol Five Dimensions (EQ-5D) measure with responses to the EQ-5D descriptive system converted into health utility scores. Descriptive statistics and multivariable analyses were used to estimate the relationship between the mode of delivery and health-related quality-of-life outcomes. The overall health-related quality-of-life profile of the women in the study cohort mirrored that of the English adult population as revealed by national health surveys. A significantly higher proportion of women delivering by cesarean delivery reported some, moderate, severe, or extreme pain or discomfort at 12 months postpartum than women undergoing spontaneous vaginal delivery. Multivariable analyses, using the Ordinary Least Squares estimator revealed that, after controlling for maternal sociodemographic characteristics, cesarean delivery without maternal or fetal compromise was associated with a significant EQ-5D utility decrement in comparison to spontaneous vaginal delivery among all women (-0.026; p = 0.038) and among mothers of term-born infants (-0.062; p quality of life in comparison to spontaneous vaginal delivery. Further longitudinal studies are needed to understand the magnitude, trajectory, and underpinning mechanisms of health-related quality-of-life outcomes following different modes of delivery. © 2016 Wiley Periodicals, Inc.

  16. Human factor observations of the Biosphere 2, 1991-1993, closed life support human experiment and its application to a long-term manned mission to Mars.

    Science.gov (United States)

    Alling, Abigail; Nelson, Mark; Silverstone, Sally; Van Thillo, Mark

    2002-01-01

    Human factors are a key component to the success of long-term space missions such as those necessitated by the human exploration of Mars and the development of bioregenerative and eventually self-sufficient life support systems for permanent space outposts. Observations by participants living inside the 1991-1993 Biosphere 2 closed system experiment provide the following insights. (1) Crew members should be involved in the design and construction of their life support systems to gain maximum knowledge about the systems. (2) Individuals living in closed life support systems should expect a process of physiological and psychological adaptation to their new environment. (3) Far from simply being a workplace, the participants in such extended missions will discover the importance of creating a cohesive and satisfying life style. (4) The crew will be dependent on the use of varied crops to create satisfying cuisine, a social life with sufficient outlets of expression such as art and music, and to have down-time from purely task-driven work. (5) The success of the Biosphere 2 first 2-year mission suggests that crews with high cultural diversity, high commitment to task, and work democracy principles for individual responsibility may increase the probability of both mission success and personal satisfaction. (6) Remaining challenges are many, including the need for far more comprehensive real-time modeling and information systems (a "cybersphere") operating to provide real-time data necessary for decision-making in a complex life support system. (7) And, the aim will be to create a noosphere, or sphere of intelligence, where the people and their living systems are in sustainable balance.

  17. Differences in symptoms, functioning, and quality of life between women on long-term sick-leave with musculoskeletal pain with and without concomitant depression

    Directory of Open Access Journals (Sweden)

    Schüldt Ekholm K

    2011-08-01

    Full Text Available Gunilla Brodda Jansen1,2, Jürgen Linder3, Kristina Schüldt Ekholm4,5, Jan Ekholm2,41Department of Pain Management, Capio St Göran’s Hospital, 2Department of Clinical Sciences, Division of Rehabilitation Medicine, Karolinska Institutet, Danderyd Hospital, 3Diagnostic Centre, Division of Psychiatry, Department of Clinical Neuroscience, Karolinska Institutet, 4Stockholm Rehabilitation Medicine University Clinic, Danderyd Hospital; 5Section of Rehabilitation Science, Department of Health Sciences, Mid Sweden University, Campus Östersund, SwedenObjective: The aim was to describe the differences in symptoms, functioning and quality of life between women on long-term sick-leave due to protracted musculoskeletal pain with and without concomitant depression.Design: Descriptive and comparisons with/without comorbid depression.Methods: 332 female patients were examined by three specialist physicians in psychiatry, orthopedic surgery, and rehabilitation medicine and assigned to four groups according to the ICD-10 diagnoses: low back/joint disorders (LBJ, n = 150, myalgia (M, n = 43, fibromyalgia (FM, n = 87, or depression without somatic pain diagnosis (DE, n = 52.Results: Patients with somatic pain conditions LBJ, M, or FM showed more activity-related difficulties if concomitant depression was present during the activities ‘focusing attention’, ‘making decisions’, and ‘undertaking a single task’; and in the domains ‘energy level’, ‘memory functions’, ‘emotional functions’, and ‘optimism/pessimism’. Patients with FM and concomitant depression perceived higher pain intensity than patients in group DE. No statistically significant differences in physically related activities were noted between each of the somatic pain conditions with and without coexisting depression. FM patients with coexisting depression reported fewer painful sites on their pain drawings compared with FM-patients without depression. Patients with LBJ or FM

  18. 3. International Conference on Nuclear Power Plant Life Management (PLiM) for Long Term Operations (LTO). Keynotes, papers, presentations, posters

    International Nuclear Information System (INIS)

    2012-01-01

    The world's fleet of nuclear power plants is, on average, more than 20 years old. Even though the design life of a nuclear power plant is typically 30-40 years, many plants will operate in excess of their design lives, provided that nuclear power plant engineers demonstrate by analysis, equipment and system upgrades, increased vigilance, testing and ageing management that the plant will operate safely. In the operation of nuclear power plants, safety should always be the prime consideration. Plant operators and regulators must always ensure that plant safety is maintained and, where possible, enhanced during its operating lifetime. Nuclear power plant life management (PLiM) has gained increased attention over the past decade, and effective ageing management of systems, structures and components (SSCs) is a key element in PLiM for the safe and reliable long term operation of nuclear power plants. A PLiM programme is an effective tool that allows an operator to safely and cost effectively manage ageing effects in SSCs for long term operation (LTO). A PLiM programme helps facilitate decisions concerning when and how to repair, replace or modify SSCs in an economically optimized way, while assuring that a high level of safety is maintained. The option for extended nuclear power plant operation has been recognized by operators and regulators alike, as evidenced in the number of licence renewal programmes that are being developed by Member States. After the severe accident at the Fukushima Daiichi nuclear power plant, the safe operation of nuclear power plants has become even more important; not only in terms of technical or ageing issues, but also in terms of management system and qualified workforce related issues. Application of an integrated management system and structured workforce planning are needed throughout the plant life in order to ensure effective plant organization and management. The IAEA organized the first and second International Conference on Nuclear

  19. Experiences of long-term home care as an informal caregiver to a spouse: gendered meanings in everyday life for female carers.

    Science.gov (United States)

    Eriksson, Henrik; Sandberg, Jonas; Hellström, Ingrid

    2013-05-01

    In this article, we explore the gender aspects of long-term caregiving from the perspective of women providing home care for a spouse suffering from dementia. One of the most common circumstances in which a woman gradually steps into a long-term caregiver role at home involves caring for a spouse suffering from dementia. Little attention has been paid to examining the experiences and motivations of such caregivers from a feminist perspective. Twelve women, all of whom were informal caregivers to a partner suffering from dementia, were interviewed on the following themes: the home, their partner's disease, everyday life, their relationship and autonomy. The results of these interviews were analysed in relation to gender identity and social power structures using a feminist perspective. The findings of this study show that the informants frequently reflected on their caregiving activities in terms of both general and heteronormative expectations. The results suggest that the process of heteropolarisation in these cases can be an understood as a consequence of both the spouse's illness and the resulting caring duties. Also, the results suggest that the act of caring leads to introspections concerning perceived 'shortcomings' as a caregiver. Finally, the results indicate that it is important to recognise when the need for support in day-to-day caring is downplayed. Women view their caregiving role and responsibilities as paramount; their other duties, including caring for themselves, are deemed less important. We stress that the intense commitment and responsibilities that women experience in their day-to-day caring must be acknowledged and that it is important for healthcare professionals to find mechanisms for providing choices for female caregivers without neglecting their moral concerns. Female carers face difficulties in always living up to gendered standards and this need to be considered when evaluating policies and practices for family carers. © 2012 Blackwell

  20. Factors influencing long-term quality of life and depression in German liver transplant recipients: a single-centre cross-sectional study.

    Science.gov (United States)

    Zahn, Alexandra; Seubert, Lisa; Jünger, Jana; Schellberg, Dieter; Weiss, Karl Heinz; Schemmer, Peter; Stremmel, Wolfgang; Sauer, Peter; Gotthardt, Daniel Nils

    2013-06-26

    Health-related quality of life (HRQOL) following orthotopic liver transplantation (OLT) has become increasingly important. Therefore, we aimed to identify factors affecting HRQOL after OLT. This cross-sectional, single-centre study surveyed 281 OLT patients. Survey tools included the Short Form (SF-36) Health Survey, the Patient Health Questionnaire 9 (PHQ9), and a self-designed employment questionnaire. Patient medical records were reviewed. Participants included 187 men (mean age at OLT: 50 [± 11; 13-69] years). Primary indications for OLT were viral hepatitis (28%), alcoholic liver disease (35%), cholestatic liver disease (11%), and others (26%). Follow-up ranged from 2 to 136 months. Clinical factors associated with improved HRQOL were age ≤ 45 years at OLT and current MELD score <=≤ 13. Time after OLT and indication for transplantation affected SF-36 HRQOL. SF-36 physical component summary scales plateaued at 3-years post-OLT and then stabilized. For the SF-36 HRQOL, scores were the lowest in all domains for OLT recipients transplanted for chronic viral hepatitis and for unemployed patients, whereas sex and number of transplantations showed no significant differences. The PHQ9 results showed that depression was significantly more frequent among patients with current MELD score ≥ 13 or impaired liver function and those transplanted for chronic viral hepatitis or unemployed patients. Age and sex did not influence PHQ9 results. Medical and psychosocial support is crucial for long-term HRQOL after OLT. Developing multidisciplinary interventions to address issues such as employment, age, MELD score, and liver function may improve long-term HRQOL in these patients.

  1. The effect, moderators, and mediators of resistance and aerobic exercise on health-related quality of life in older long-term survivors of prostate cancer.

    Science.gov (United States)

    Buffart, Laurien M; Newton, Robert U; Chinapaw, Mai J; Taaffe, Dennis R; Spry, Nigel A; Denham, James W; Joseph, David J; Lamb, David S; Brug, Johannes; Galvão, Daniel A

    2015-08-15

    The current study examined effects, moderators (for whom), and mediators (working mechanisms) of 12 months of exercise on health-related quality of life (HRQoL) in older long-term survivors of prostate cancer. In total, 100 men aged 71.7 years (standard deviation, 6.4 years) were randomly assigned to 6 months of supervised aerobic and resistance exercise followed by 6 months of a home-based exercise maintenance program (EX group) or printed education material regarding physical activity for 12 months (PA group). Assessments took place at baseline and after 6 and 12 months. Generalized estimating equations were used to study the effects of EX versus PA on HRQoL at 6 and 12 months, adjusting for baseline HRQoL. The authors examined potential sociodemographic and clinical moderators by adding interaction terms, and potential physical and psychological mediators using the product-of-coefficients test. At 6 months, significant beneficial effects were found for global QoL, physical function, and social function in the EX group compared with the PA group. For physical function, beneficial effects were sustained at 12 months. Moderation analyses demonstrated larger effects of EX versus PA for patients who were married, started exercising sooner after their diagnosis, and previously used bisphosphonates. Changes in lower body functional performance significantly mediated the effect of EX on global QoL, physical function, and social function. No mediating effects on HRQoL were found for aerobic fitness, physical activity, fatigue, distress, or falls self-efficacy. Aerobic and resistance exercise appears to have beneficial effects on HRQoL among older, long-term survivors of prostate cancer. Effects were moderated by marital status, time since diagnosis, and use of bisphosphonates, and were mediated by lower body functional performance. © 2015 American Cancer Society.

  2. Long term radioactive waste management

    International Nuclear Information System (INIS)

    Lavie, J.M.

    1984-01-01

    In France, waste management, a sensitive issue in term of public opinion, is developing quickly, and due to twenty years of experience, is now reaching maturity. With the launching of the French nuclear programme, the use of radioactive sources in radiotherapy and industry, waste management has become an industrial activity. Waste management is an integrated system dealing with the wastes from their production to the long term disposal, including their identification, sortage, treatment, packaging, collection and transport. This system aims at guaranteing the protection of present and future populations with an available technology. In regard to their long term management, and the design of disposals, radioactive wastes are divided in three categories. This classification takes into account the different radioisotopes contained, their half life and their total activity. Presently short-lived wastes are stored in the shallowland disposal of the ''Centre de la Manche''. Set up within the French Atomic Energy Commission (CEA), the National Agency for waste management (ANDRA) is responsible within the framework of legislative and regulatory provisions for long term waste management in France [fr

  3. Effect of inpatient rehabilitation on quality of life and exercise capacity in long-term lung transplant survivors: a prospective, randomized study.

    Science.gov (United States)

    Ihle, Franziska; Neurohr, Claus; Huppmann, Patrick; Zimmermann, Gregor; Leuchte, Hanno; Baumgartner, Rainer; Kenn, Klaus; Sczepanski, Bernd; Hatz, Rudolf; Czerner, Stephan; Frey, Lorenz; Ueberfuhr, Peter; Bittmann, Iris; Behr, Jürgen

    2011-08-01

    The purpose of this study was to examine the effect of an inpatient rehabilitation program on health-related quality of life (HRQOL) and exercise capacity (EC) in long-term (>1 year after lung transplantation) survivors (LTSs) in comparison to a control group (CG). Sixty LTSs, 4.5 ± 3.2 years after lung transplantation (LTx), were randomly assigned to two equally sized groups that were stratified for gender and underlying disease. Thirty LTSs (age 49 ± 13 years, 13 male and 17 females, 19 double LTxs, 7 BOS Stage ≥ 1) attended an inpatient rehabilitation program (intervention group, IG) for 23 ± 5 days. The CG (age 50 ± 12 years, 13 males and 17 females, 20 double LTxs, 2 BOS Stage ≥ 1) received medical standard therapy (physiotherapy). Patients were evaluated by cardiopulmonary exercise testing, 6-minute walk test (6MWT), SF-36, SGRQ and the Quality of Life Profile for Chronic Diseases questionnaire before and after (18 ± 3 days) the program. The groups were statistically indistinguishable in terms of clinical data. Each treatment group significantly improved their sub-maximal EC (6MWT: IG, 493 ± 90 m vs 538 ± 90 m, p exercise tolerance in LTS. Our study results did not demonstrate a significant benefit of an inpatient over an outpatient exercise program. Copyright © 2011 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.

  4. Long-term Course of Alzheimer Disease in Patients Treated According to the Dutch Dementia Guideline at a Memory Clinic: A "Real-Life" Study.

    Science.gov (United States)

    Droogsma, Erika; van Asselt, Dieneke; van Steijn, Jolanda; Diekhuis, Marjolein; Veeger, Nic; De Deyn, Peter P

    2016-01-01

    There is little knowledge of the long-term course of Alzheimer disease (AD) in light of current pharmacological and nonpharmacological interventions provided in a "real-life" setting. The Frisian Alzheimer's Disease Cohort study is a "real-life" study of the course of AD in patients (n=576) treated with pharmacological (ie, cholinesterase inhibitors) and nonpharmacological (ie, case management, respite care) interventions. Disease course was described by changes in cognition (Mini Mental State Examination, clock-drawing test) and number of types of professional care applying a repeated-measures analysis using a marginal model (population-based average model). In addition, behavioral and psychological symptoms, and proportions of nursing home admissions and deaths were investigated. During 3.5 years, the average Mini Mental State Examination decreased from 22.24 to 18.91, the clock-drawing test score increased from 3.38 to 4.05, the number of types of professional care increased from 0.85 to 2.64, and the patients with behavioral and psychological symptoms increased from 29.0% to 70.2%. The proportion of patients admitted to a nursing home was 40.8% and 41.0% died. Cognition and behaviour of AD patients deteriorated accompanied with an increase in care-dependency during 3.5 years. Nevertheless, compared with the precholinesterase inhibitor era, current pharmacological and nonpharmacological interventions appear to slow cognitive decline, which emphasizes that they seem to have a favorable effect.

  5. Long term effect (more than five years) of intrathecal baclofen on impairment, disability, and quality of life in patients with severe spasticity of spinal origin

    NARCIS (Netherlands)

    Zahavi, A; Geertzen, JHB; Middel, B; Staal, M; Rietman, JS

    2004-01-01

    Objectives: To evaluate long term change in impairment, disability, and health related functional status in patients with severe spasticity who received intrathecal baclofen. Methods: A long term ( more than five years) observational longitudinal follow up study assessing 21 patients who received

  6. Long-term follow-up indicates unimpaired oral health-related quality of life for people having shortened dental arches

    NARCIS (Netherlands)

    Gerritsen, A.E.; Witter, D.J.; Creugers, N.H.J.

    2017-01-01

    OBJECTIVES: To assess and analyse OHRQoL of people with shortened dental arches (SDA) in a long-term cohort study. METHODS: All participants of a long-term cohort study on SDA who were still attending the university dental clinic and still had an SDA (SDA group) with 3-5 posterior occluding pairs

  7. The long-term impact of early life poverty on orbitofrontal cortex volume in adulthood: results from a prospective study over 25 years.

    Science.gov (United States)

    Holz, Nathalie E; Boecker, Regina; Hohm, Erika; Zohsel, Katrin; Buchmann, Arlette F; Blomeyer, Dorothea; Jennen-Steinmetz, Christine; Baumeister, Sarah; Hohmann, Sarah; Wolf, Isabella; Plichta, Michael M; Esser, Günter; Schmidt, Martin; Meyer-Lindenberg, Andreas; Banaschewski, Tobias; Brandeis, Daniel; Laucht, Manfred

    2015-03-01

    Converging evidence has highlighted the association between poverty and conduct disorder (CD) without specifying neurobiological pathways. Neuroimaging research has emphasized structural and functional alterations in the orbitofrontal cortex (OFC) as one key mechanism underlying this disorder. The present study aimed to clarify the long-term influence of early poverty on OFC volume and its association with CD symptoms in healthy participants of an epidemiological cohort study followed since birth. At age 25 years, voxel-based morphometry was applied to study brain volume differences. Poverty (0=non-exposed (N=134), 1=exposed (N=33)) and smoking during pregnancy were determined using a standardized parent interview, and information on maternal responsiveness was derived from videotaped mother-infant interactions at the age of 3 months. CD symptoms were assessed by diagnostic interview from 8 to 19 years of age. Information on life stress was acquired at each assessment and childhood maltreatment was measured using retrospective self-report at the age of 23 years. Analyses were adjusted for sex, parental psychopathology and delinquency, obstetric adversity, parental education, and current poverty. Individuals exposed to early life poverty exhibited a lower OFC volume. Moreover, we replicated previous findings of increased CD symptoms as a consequence of childhood poverty. This effect proved statistically mediated by OFC volume and exposure to life stress and smoking during pregnancy, but not by childhood maltreatment and maternal responsiveness. These findings underline the importance of studying the impact of early life adversity on brain alterations and highlight the need for programs to decrease income-related disparities.

  8. The long-term mortality impact of combined job strain and family circumstances: A life course analysis of working American mothers.

    Science.gov (United States)

    Sabbath, Erika L; Mejía-Guevara, Iván; Noelke, Clemens; Berkman, Lisa F

    2015-12-01

    Work stress and family composition have been separately linked with later-life mortality among working women, but it is not known how combinations of these exposures impact mortality, particularly when exposure is assessed cumulatively over the life course. We tested whether, among US women, lifelong work stress and lifelong family circumstances would jointly predict mortality risk. We studied formerly working mothers in the US Health and Retirement Study (HRS) born 1924-1957 (n = 7352). We used sequence analysis to determine five prototypical trajectories of marriage and parenthood in our sample. Using detailed information on occupation and industry of each woman's longest-held job, we assigned each respondent a score for job control and job demands. We calculated age-standardized mortality rates by combined job demands, job control, and family status, then modeled hazard ratios for death based on family constellation, job control tertiles, and their combination. Married women who had children later in life had the lowest mortality risks (93/1000). The highest-risk family clusters were characterized by spells of single motherhood (132/1000). Generally, we observed linear relationships between job control and mortality hazard within each family trajectory. But while mortality risk was high for all long-term single mothers, we did not observe a job control-mortality gradient in this group. The highest-mortality subgroup was previously married women who became single mothers later in life and had low job control (HR 1.91, 95% CI 1.38,2.63). Studies of associations between psychosocial work characteristics and health might consider heterogeneity of effects by family circumstances. Worksite interventions simultaneously considering both work and family characteristics may be most effective in reducing health risks. Copyright © 2015 Elsevier Ltd. All rights reserved.

  9. Long-Term Collection

    CERN Multimedia

    Staff Association

    2016-01-01

    Dear Colleagues, As previously announced in Echo (No. 254), your delegates took action to draw attention to the projects of the Long-Term Collections (LTC), the humanitarian body of the CERN Staff Association. On Tuesday, 11 October, at noon, small Z-Cards were widely distributed at the entrances of CERN restaurants and we thank you all for your interest. We hope to have achieved an important part of our goal, which was to inform you, convince you and find new supporters among you. We will find out in the next few days! An exhibition of the LTC was also set up in the Main Building for the entire week. The Staff Association wants to celebrate the occasion of the Long-Term Collection’s 45th anniversary at CERN because, ever since 1971, CERN personnel have showed great support in helping the least fortunate people on the planet in a variety of ways according to their needs. On a regular basis, joint fundraising appeals are made with the Directorate to help the victims of natural disasters around th...

  10. Collectes à long terme

    CERN Multimedia

    Collectes à long terme

    2014-01-01

    En cette fin d’année 2014 qui approche à grands pas, le Comité des Collectes à Long Terme remercie chaleureusement ses fidèles donatrices et donateurs réguliers pour leurs contributions à nos actions en faveur des plus démunis de notre planète. C’est très important, pour notre Comité, de pouvoir compter sur l’appui assidu que vous nous apportez. Depuis plus de 40 ans maintenant, le modèle des CLT est basé principalement sur des actions à long terme (soit une aide pendant 4-5 ans par projet, mais plus parfois selon les circonstances), et sa planification demande une grande régularité de ses soutiens financiers. Grand MERCI à vous ! D’autres dons nous parviennent au cours de l’année, et ils sont aussi les bienvenus. En particulier, nous tenons à remercier...

  11. Staff preparedness for providing palliative and end-of-life care in long-term care homes: Instrument development and validation.

    Science.gov (United States)

    Chan, Helen Yl; Chun, Gloria Km; Man, C W; Leung, Edward Mf

    2018-05-01

    Although much attention has been on integrating the palliative care approach into services of long-term care homes for older people living with frailty and progressive diseases, little is known about the staff preparedness for these new initiatives. The present study aimed to develop and test the psychometric properties of an instrument for measuring care home staff preparedness in providing palliative and end-of-life care. A 16-item instrument, covering perceived knowledge, skill and psychological readiness, was developed. A total of 247 staff members of different ranks from four care homes participated in the study. Exploratory factor analysis using the principal component analysis extraction method with varimax rotation was carried out for initial validation. Known group comparison was carried out to examine its discriminant validity. Reliability of the instrument was assessed based on test-retest reliability of a subsample of 20 participants and the Cronbach's alpha of the items. Exploratory factor analysis showed that the instrument yielded a three-factor solution, which cumulatively accounted for 68.5% of the total variance. Three subscales, namely, willingness, capability and resilience, showed high internal consistency and test-retest reliability. It also showed good discriminant validity between staff members of professional and non-professional groups. This is a brief, valid and reliable scale for measuring care home staff preparedness for providing palliative and end-of-life care. It can be used to identify their concerns and training needs in providing palliative and end-of-life care, and as an outcome measure to evaluate the effects of interventional studies for capacity building in this regard. Geriatr Gerontol Int 2018; 18: 745-749. © 2018 Japan Geriatrics Society.

  12. A urine-fuelled soil-based bioregenerative life support system for long-term and long-distance manned space missions

    Science.gov (United States)

    Maggi, Federico; Tang, Fiona H. M.; Pallud, Céline; Gu, Chuanhui

    2018-05-01

    A soil-based cropping unit fuelled with human urine for long-term manned space missions was investigated with the aim to analyze whether a closed-loop nutrient cycle from human liquid wastes was achievable. Its ecohydrology and biogeochemistry were analysed in microgravity with the use of an advanced computational tool. Urine from the crew was used to supply primary (N, P, and K) and secondary (S, Ca and Mg) nutrients to wheat and soybean plants in the controlled cropping unit. Breakdown of urine compounds into primary and secondary nutrients as well as byproduct gases, adsorbed, and uptake fractions were tracked over a period of 20 years. Results suggested that human urine could satisfy the demand of at least 3 to 4 out of 6 nutrients with an offset in pH and salinity tolerable by plants. It was therefore inferred that a urine-fuelled life support system can introduce a number of advantages including: (1) recycling of liquids wastes and production of food; (2) forgiveness of neglect as compared to engineered electro-mechanical systems that may fail under unexpected or unplanned conditions; and (3) reduction of supply and waste loads during space missions.

  13. Long-Term Social Reintegration Outcomes for Burn Survivors With and Without Peer Support Attendance: A Life Impact Burn Recovery Evaluation (LIBRE) Study.

    Science.gov (United States)

    Grieve, Brian; Shapiro, Gabriel D; Wibbenmeyer, Lucy; Acton, Amy; Lee, Austin; Marino, Molly; Jette, Alan; Schneider, Jeffrey C; Kazis, Lewis E; Ryan, Colleen M

    2017-10-31

    To examine differences in long-term social reintegration outcomes for burn survivors with and without peer support attendance. Cross-sectional survey. Community-dwelling burn survivors. Burn survivors (N=601) aged ≥18 years with injuries to ≥5% total body surface area (TBSA) or burns to critical areas (hands, feet, face, or genitals). Not applicable. The Life Impact Burn Recovery Evaluation Profile was used to examine the following previously validated 6 scale scores of social participation: Family and Friends, Social Interactions, Social Activities, Work and Employment, Romantic Relationships, and Sexual Relationships. Burn support group attendance was reported by 330 (55%) of 596 respondents who responded to this item. Attendees had larger burn size (43.4%±23.6% vs 36.8%±23.4% TBSA burned, P10 years from injury (50% vs 42.5%, Preintegration in burn survivors. This cross-sectional study prompts further exploration into the potential benefits of peer support groups on burn recovery with future intervention studies. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  14. Long term health-related quality of life after burns is strongly dependent on pre-existing disease and psychosocial issues and less due to the burn itself.

    Science.gov (United States)

    Orwelius, L; Willebrand, M; Gerdin, B; Ekselius, L; Fredrikson, M; Sjöberg, F

    2013-03-01

    Health-related quality of life (HRQoL) is reduced after a burn, and is affected by coexisting conditions. The aims of the investigation were to examine and describe effects of coexisting disease on HRQoL, and to quantify the proportion of burned people whose HRQoL was below that of a reference group matched for age, gender, and coexisting conditions. A nationwide study covering 9 years and examined HRQoL 12 and 24 months after the burn with the SF-36 questionnaire. The reference group was from the referral area of one of the hospitals. The HRQoL of the burned patients was below that of the reference group mainly in the mental dimensions, and only single patients were affected in the physical dimensions. The factor that significantly affected most HRQoL dimensions (n=6) after the burn was unemployment, whereas only smaller effects could be attributed directly to the burn. Poor HRQoL was recorded for only a small number of patients, and the decline were mostly in the mental dimensions when compared with a group adjusted for age, gender, and coexisting conditions. Factors other than the burn itself, such as mainly unemployment and pre-existing disease, were most important for the long term HRQoL experience in these patients. Copyright © 2012 Elsevier Ltd and ISBI. All rights reserved.

  15. Measuring Family Members’ Satisfaction with End-of-Life Care in Long-Term Care: Adaptation of the CANHELP Lite Questionnaire

    Directory of Open Access Journals (Sweden)

    Shevaun Nadin

    2017-01-01

    Full Text Available Rationale. Improving end-of-life care (EOLC in long-term care (LTC homes requires quality measurement tools that assess families’ satisfaction with care. This research adapted and pilot-tested an EOLC satisfaction measure (Canadian Health Care Evaluation Project (CANHELP Lite Questionnaire for use in LTC to measure families’ perceptions of the EOLC experience and to be self-administered. Methods and Results. Phase 1. A literature review identified key domains of satisfaction with EOLC in LTC, and original survey items were assessed for inclusiveness and relevance. Items were modified, and one item was added. Phase 2. The revised questionnaire was administered to 118 LTC family members and cognitive interviews were conducted. Further modifications were made including reformatting to be self-administered. Phase 3. The new instrument was pilot-tested with 134 family members. Importance ratings indicated good content and face validity. Cronbach’s alpha coefficients (range: .88–.94 indicated internal consistency. Conclusion. This research adapted and pilot-tested the CANHELP for use in LTC. This paper introduces the new, valid, internally consistent, self-administered tool (CANHELP Lite Family Caregiver LTC that can be used to measure families’ perceptions of and satisfaction with EOLC. Future research should further validate the instrument and test its usefulness for quality improvement and care planning.

  16. C.E.B.A.S., a closed equilibrated biological aquatic system as a possible precursor for a long-term life support system?

    Science.gov (United States)

    Blüm, V.

    C.E.B.A.S.-AQUARACK is a long-term multi-generation experimental device for aquatic organisms which is disposed for utlizitation in a space station. It results from the basic idea of a space aquarium for maintaining aquatic animals for longer periods integrated in a AQUARACK which consists of a modular animal holding tank, a semi-biological/physical water recycling system and an electronical control unit. The basic idea to replace a part of the water recycling system by a continuous culture of unicellular algae primarily leads to a second system for experiments with algae, a botanical AQUARACK consisting of an algal reactor, a water recycling and the electronical control unit. The combination of the zoological part, and the botanical part with a common control system in the AQUARACK, however, results in a ``Closed Equilibrated Biological Aquatic System'' (C.E.B.A.S.) representing an closed artificial ecosystem. Although this is disposed primarily as an experimental device for basic zoological, botanical and interdisciplinary research it opens the theoretical possibility to adapt it for combined production of animal and plant biomass on ground or in space. The paper explains the basic conception of the hardware construction of the zoological part of the system, the corresponding scientific frame program including the choice of the experimental animals and gives some selected examples of the hardware-related resrearch. It furtheron discusses the practical and economical relevance of the system in the development of a controlled aquatical life support system in general.

  17. The relationship between chronic pain and health-related quality of life in long-term social assistance recipients in Norway.

    Science.gov (United States)

    Løyland, Borghild; Miaskowski, Christine; Paul, Steven M; Dahl, Espen; Rustøen, Tone

    2010-12-01

    The purposes of this study were to compare the health-related quality of life (HRQOL) of long-term social assistance recipients (LTRs) with and without chronic pain and determine the effect of select demographic, social, pain, alcohol, and illicit drug use characteristics on the physical and mental components of their HRQOL. In this cross-sectional study, which is part of a larger study that evaluated the health and functional abilities of LTRs in Norway, 405 LTRs of which 178 had chronic pain were recruited from 14 of 433 municipalities. LTRs with chronic pain were older (P < .001), more often married (P = .002), feeling more lonely, (P = .048), and had more problems with alcohol (P = .035). The final regression model explained 41.2% (P < .001) of the variance in PCS scores and 32.2% (P < .001) of the variance in MCS scores. Being in chronic pain (29.7%), being older (4.7%), and never married (2%) predicted worse PCS scores. Feeling lonely (11.9%), having problems with illicit drug use (5.9%), and being in chronic pain (2.9%) predicted worse MCS scores. LTRs with chronic pain rated both the physical and mental components of HRQOL lower than LTRs without chronic pain. The MCS score in both groups was negatively effected.

  18. An optimized cask technology for conditioning, transportation and long term interim storage of 'End of Life' nuclear waste

    International Nuclear Information System (INIS)

    Lefort-Mary, Florence; Clement, Gilles; Lamouroux, Christine; Dumont, Bruno

    2016-01-01

    When preparing for the decommissioning of a nuclear facility, during its 'end of life' management and while performing the actual dismantling operations, one has to consider a large diversity of nuclear waste in term of types, volumes and activities. Customers are frequently faced with the obligation to undertake multiple and costly waste management operations including handling, reconditioning or re-transferring from one package to another, for example when moving from on-site storage to transportation. To address this issue, a new - highly flexible - cask system named TN R MW is being developed. This cask has a total weight of 10 T and is compliant with the 2012 IAEA regulations. It is developed on a flexible concept basis, adaptable to the various nuclear needs, including: from IP2 to B(U) / B(U)F; on-site/ international transportation; long term interim storage. Licensing and manufacturing of number of items of this TN R MW family is underway. (authors)

  19. Long-term follow-up on health-related quality of life in major depressive disorder: a 2-year European cohort study.

    Science.gov (United States)

    Saragoussi, Delphine; Christensen, Michael Cronquist; Hammer-Helmich, Lene; Rive, Benoît; Touya, Maëlys; Haro, Josep Maria

    2018-01-01

    Major depressive disorder (MDD) is associated with significant impairments in health-related quality of life (HRQoL) and everyday functioning. This cohort study investigated the long-term development of HRQoL in patients with MDD and its association with patient characteristics, including depressive symptom severity and cognitive symptoms. The Prospective Epidemiological Research on Functioning Outcomes Related to Major depressive disorder (PERFORM) study was a longitudinal cohort study conducted in 1,159 outpatients aged 18-65 years with MDD in France, Germany, Spain, Sweden, and the UK. The patients were either initiating antidepressant monotherapy or undergoing their first switch of antidepressant. HRQoL was assessed using the Medical Outcomes Study Short-Form 12-item Health Survey (SF-12) up to month 12 and the EuroQol Five Dimensions questionnaire up to month 24 (UK only). Depressive symptom severity was assessed up to month 24 by the patient-reported Patient Health Questionnaire and cognitive symptoms by the Perceived Deficit Questionnaire. Multivariate analyses were performed to identify patient characteristics associated with HRQoL. Mental HRQoL was severely impaired at baseline versus normative data (mean [SD] SF-12 mental component summary [MCS], 26.5 [9.2]); mean (SD) physical component summary (PCS) total score was 45.2 (12.1). SF-12 MCS improved over 12 months of follow-up (38.7 [11.6] at month 12), while SF-12 PCS remained stable (45.3 [11.1]). At each assessment time point, there was a clear pattern of lower SF-12 MCS and PCS total score in patients experiencing greater cognitive problems. The mean EuroQol Five Dimensions questionnaire utility index score generally decreased (i.e., worsened) with increasing severity of cognitive and depressive symptoms at all time points up to 24 months. Multivariate analyses identified both depression severity and cognitive symptoms as strongly and significantly associated with poor HRQoL. These findings highlight

  20. The roles of herbal remedies in survival and quality of life among long-term breast cancer survivors - results of a prospective study

    Directory of Open Access Journals (Sweden)

    Sullivan-Halley Jane

    2011-06-01

    Full Text Available Abstract Background Few data exist on survival or health-related quality of life (QOL related to herbal remedy use among long-term breast cancer survivors. The objective of this report is to examine whether herbal remedy use is associated with survival or the health-related QOL of these long-term breast cancer survivors. Methods In 1999-2000, we collected the information of herbal remedy use and QOL during a telephone interview with 371 Los Angeles Non-Hispanic/Hispanic white women who had survived more than 10 years after breast cancer diagnosis. QOL was measured using the Medical Outcomes Study Short Form-36 (SF-36 questionnaire. Patients were followed for mortality from the baseline interview through 2007. 299 surviving patients completed a second telephone interview on QOL in 2002-2004. We used multivariable Cox proportional hazards methods to estimate relative risks (RR and 95% confidence intervals (CI for mortality and applied multivariable linear regression models to compare average SF-36 change scores (follow-up - baseline between herbal remedy users and non-users. Results Fifty-nine percent of participants were herbal remedy users at baseline. The most commonly used herbal remedies were echinacea, herbal teas, and ginko biloba. Herbal remedy use was associated with non-statistically significant increases in the risks for all-cause (44 deaths, RR = 1.28, 95% CI = 0.62-2.64 and breast cancer (33 deaths, RR = 1.78, 95% CI = 0.72-4.40 mortality. Both herbal remedy users' and non-users' mental component summary scores on the SF-36 increased similarly from the first survey to the second survey (P = 0.16, but herbal remedy users' physical component summary scores decreased more than those of non-users (-5.7 vs. -3.2, P = 0.02. Conclusions Our data provide some evidence that herbal remedy use is associated with poorer survival and a poorer physical component score for health-related QOL among women who have survived breast cancer for at least

  1. The long term impact of cataract surgery on quality of life, activities and poverty: results from a six year longitudinal study in Bangladesh and the Philippines.

    Directory of Open Access Journals (Sweden)

    Lisa Danquah

    Full Text Available BACKGROUND: Cataract surgery has been shown to improve quality of life and household economy in the short term. However, it is unclear whether these benefits are sustained over time. This study aims to assess the six year impact of cataract surgery on health related quality of life (HRQoL, daily activities and economic poverty in Bangladesh and The Philippines. METHODS AND FINDINGS: This was a longitudinal study. At baseline people aged ≥50 years with visual impairment due to cataract ('cases' and age-, sex-matched controls without visual impairment were interviewed about vision specific and generic HRQoL, daily activities and economic indicators (household per capita expenditure, assets and self-rated wealth. Cases were offered free or subsidised cataract surgery. Cases and controls were re-interviewed approximately one and six years later. At baseline across the two countries there were 455 cases and 443 controls. Fifty percent of cases attended for surgery. Response rates at six years were 47% for operated cases and 53% for controls. At baseline cases had poorer health and vision related QoL, were less likely to undertake productive activities, more likely to receive assistance with activities and were poorer compared to controls (p<0.05. One year after surgery there were significant increases in HRQoL, participation and time spent in productive activities and per capita expenditure and reduction in assistance with activities so that the operated cases were similar to controls. These increases were still evident after six years with the exception that time spent on productive activities decreased among both cases and controls. CONCLUSION: Cataract causing visual loss is associated with reduced HRQoL and economic poverty among older adults in low-income countries. Cataract surgery improves the HRQoL of the individual and economy of the household. The findings of this study suggest these benefits are sustained in the long term.

  2. Long-term stability of morphine, codeine, and 6-acetylmorphine in real-life whole blood samples, stored at -20°C.

    Science.gov (United States)

    Høiseth, Gudrun; Fjeld, Bente; Burns, Margrete Larsen; Strand, Dag Helge; Vindenes, Vigdis

    2014-06-01

    Stability of drugs during storage is important in forensic toxicology. For the analytes detected after intake of heroin (6-acetylmorphine (6-AM), morphine and codeine), long-time stability in real life whole blood samples are studied in only a small number of cases. Whole blood post mortem (n=37) and whole blood samples from living persons (n=22) containing morphine and codeine as well as 6-AM in blood or urine were selected. All cases represented intake of heroin. All samples contained fluoride and were initially analysed and stored in normal conditions (-20°C) for 4-9 years. All samples were then reanalysed using the same analytical methods and the results were compared. For samples from living persons, the median change in concentration was -3.7% for morphine and -5.3% for codeine. For post mortem samples, the median change in concentration was -12% for morphine and -11% for codeine. Both for samples from living persons and post mortem samples, the decrease in the concentrations from the original analysis to reanalysis were statistically significant for morphine and codeine. Regarding 6-AM, all living samples were negative at reanalysis. For post mortem samples, four cases still tested positive for 6-AM at reanalysis with a median change in the concentrations of -81%. There was no significant change in the morphine to codeine concentration ratios neither for living nor post mortem samples. This study showed that in real life whole blood samples, the concentrations of morphine and codeine are relatively stable during long-term storage at -20°C. 6-AM on the other hand, shows a considerable decrease in concentrations that is important to consider when interpreting results from reanalyses of forensic cases. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  3. Functional limitation and health-related quality of life, and associated factors among long term stroke survivors in a Malaysian community.

    Science.gov (United States)

    Nor Azlin, M N; Aziz, N A; Saperi, B S; Aljunid, S M

    2016-12-01

    this study aimed to evaluate function and quality of life (QoL) and associated factors among long term stroke survivors in the Malaysian community. A cross-sectional study was conducted involving stroke survivors living in the community at two or more years post-stroke. Eligible participants with the diagnosis of stroke were identified from 2005-2010 case mix database of a tertiary hospital. the patients' medical records were analysed and data on demographic and clinical profiles were collected. telephone interviews were conducted to assess existing stroke-related impairments, comorbidities, stroke recurrences, current level of function and QoL, with the usage of rivermead mobility index (rMI), barthel index (bI) and stroke specific quality of life scale (ssQOL). A total of 203 stroke survivors; mean age 64.5 (standard Deviation(sD) 12.2) years, 45.3% males, stroke duration 44.7 (sD 13.8) months completed the interviews. Mean rMI was 11.7 (sD 3.4) and bI was 89.8 (sD 19.8). Forty three percent and 99% had difficulty in ascending/descending stairs and fast walking, respectively. Up to 20% had limitations in most of the bI subsets. Mean ssQOL was 207.6 (sD 37.2), with domains mostly affected were 'energy' and 'social role'. Function and QOL were both influenced by age (p<0.01) and stroke related impairments (p<0.05), but not by co-morbidities or stroke recurrence. QoL and function (both mobility and ADL) were strongly positively correlated with each other (p<0.01). It was observed that functional limitations especially mobility, remains post-stroke major problem and were attributed mainly to stroke-related impairments.

  4. Promising Long-Term Health-Related Quality of Life After High-Dose-Rate Brachytherapy Boost for Localized Prostate Cancer

    International Nuclear Information System (INIS)

    Wahlgren, Thomas; Nilsson, Sten; Lennernaes, Bo; Brandberg, Yvonne

    2007-01-01

    Purpose: To explore the long-term general and disease-specific health-related quality of life (HRQOL) >5 years after combined radiotherapy for localized prostate cancer, including a high-dose-rate brachytherapy boost and hormonal deprivation therapy. Methods and Materials: Of 196 eligible patients with localized prostate cancer (Stage T1-T3a) consecutively treated with curative radiotherapy at our institution between June 1998 and August 2000, 182 (93%) completed the European Organization for Research and Treatment of Cancer Quality of Life questionnaires QLQ-C30 and QLQ-PR25, including specific questions on fecal incontinence >5 years after treatment in September 2005. A comparison with age-matched normative data was done, as well as a longitudinal analysis using HRQOL data from a previous study. Results: The analysis included 158 nonrecurrent patients. Comparisons made with normative data showed that physical and role functioning were significantly better statistically and social functioning was significantly worse. Diarrhea and sleep disturbances were more pronounced and pain less pronounced than in a normal male population. The longitudinal analysis of disease-specific HRQOL showed that urinary urgency and erectile problems persisted 5 years after treatment, and nocturia and hormonally dependent symptoms had declined significantly, with a statistically significant difference. Fecal incontinence was recognized by 25% of patients, of whom 80% considered it a minor problem. Conclusion: More than 5 years after combined radiotherapy, irritative urinary problems and erectile dysfunction remain concerns, although severe bowel disturbance and fecal incontinence seem to be minor problems. Longitudinally, a decline mainly in hormonally dependent symptoms was seen. Minor differences in general HRQOL compared with normative data were observed, possibly including 'response shift' effects

  5. Effect of long-term non-invasive ventilation on quality of life and cardiac function of children's neuromuscular disorders with chronic respiratory failure: a clinical trial

    Directory of Open Access Journals (Sweden)

    Saeed Sadr

    2018-04-01

    Full Text Available Background: Use of long-term non-invasive positive pressure ventilation is increasing greatly worldwide in children with chronic respiratory failure (CRF of all ages. This treatment requires delivery of ventilation through a non-invasive interface. Cardiac function in majority of these children is impaired. The aim of this study was to assess the effect of institution of non-invasive ventilation (NIV on quality of life (QOL and cardiac function in children with CRF related to neuromuscular disorders. Methods: Information obtained from all of the children under 16 years old with CRF due to neuromuscular disorders who were on NIV for at least six months and that were referred to Mofid children's hospital, Tehran, Iran between September 1, 2013, to September 1, 2017.Based on previous studies they were assessed from the year prior to starting NIV and annually thereafter. Data obtained included diagnosis, pulmonary function test, echocardiographic data, length of hospitalizations, and health care costs. Patients and parents completed questionnaires assessing QOL with NIV and recalling QOL one year before commencing NIV. All results were recorded in information forms and data were analyzed with chi square and entered in SPSS 21. Results: Follow-up ranged from 6 to 36 months (median 18. Before and after NIV hospitalization rates (P<0.001, PICU admission (P<0.001 and health care costs decreased respectively. QOL remained stable after NIV despite disease progression (P<0.001. Systolic pulmonary arterial pressure (P=0.009 is diminished. Symptoms of daytime sleepiness (P<0.001 and headache (P<0.001 improved after initiation of NIV. Conclusions: This study revealed that use of NIV results in a reduction in PAH without adverse effects on quality of life and pulmonary function.

  6. Nurses' Experiences of End-of-life Care in Long-term Care Hospitals in Japan: Balancing Improving the Quality of Life and Sustaining the Lives of Patients Dying at Hospitals

    Directory of Open Access Journals (Sweden)

    Ryo Odachi, RN, MA

    2017-09-01

    Full Text Available Summary: Purpose: In Japan, about 80% of deaths occur in hospitals, especially long-term care beds. The purpose of this study was to clarify the nursing practices used for such older patients at the end-of-life stage in long-termcare wards via the modified grounded theory approach (M-GTA. Methods: Data were obtained through semi-structured interviews of nineteen nurses working in cooperating long-term care wards, acute care wards, or hospice services (to allow for constant comparison between these types of wards in western Japan in 2014. We analyzed the transcribed data using M-GTA. Results: The core category that emerged from the analysis was “Balancing enhancement of patients' daily life quality and life-sustaining care in the face of uncertainty about the patients' character.” Eleven categories emerged, such as Seeking older patients' character with their family, Supporting families' decision making, Rebuilding patients' daily life in the ward, and Sustaining patients' life span through medical care. Conclusions: Nurses experienced uncertainty about the care needs of older patients, the ethical problems of Enhancing the patients' QOL by using risky care, and the evaluation criteria used to judge their own nursing care after the patients' death. All nurses had the goal of ensuring a natural death for all patients. Nurses' acceptance and evaluation of their own care was critically influenced by the patient's family's responses to their care after patients' death. Further research is necessary to develop evaluation criteria and educational programs for end-of-life nursing care of older adults. Keywords: terminal care, aged, long-term care, qualitative research

  7. Long-term follow-up study and long-term care of childhood cancer survivors

    Directory of Open Access Journals (Sweden)

    Hyeon Jin Park

    2010-04-01

    Full Text Available The number of long-term survivors is increasing in the western countries due to remarkable improvements in the treatment of childhood cancer. The long-term complications of childhood cancer survivors in these countries were brought to light by the childhood cancer survivor studies. In Korea, the 5-year survival rate of childhood cancer patients is approaching 70%; therefore, it is extremely important to undertake similar long-term follow-up studies and comprehensive long-term care for our population. On the basis of the experiences of childhood cancer survivorship care of the western countries and the current Korean status of childhood cancer survivors, long-term follow-up study and long-term care systems need to be established in Korea in the near future. This system might contribute to the improvement of the quality of life of childhood cancer survivors through effective intervention strategies.

  8. Trauma in adolescents causes long-term marked deficits in quality of life: adolescent children do not recover preinjury quality of life or function up to two years postinjury compared to national norms.

    Science.gov (United States)

    Holbrook, Troy Lisa; Hoyt, David B; Coimbra, Raul; Potenza, Bruce; Sise, Michael J; Sack, Dan I; Anderson, John P

    2007-03-01

    Injury is a leading cause of death and preventable morbidity in adolescents. Little is known about long-term quality of life (QoL) outcomes in injured adolescents. The objectives of the present report are to describe long-term QoL outcomes and compare posttrauma QoL to national norms for QoL in uninjured adolescents from the National Health Interview Survey (NHIS). In all, 401 trauma patients aged 12 to 19 years were enrolled in the study. Enrollment criteria excluded spinal cord injury. QoL after trauma was measured using the Quality of Well-being (QWB) scale, a sensitive and well-validated functional index (range: 0 = death to 1.000 = optimum functioning). Patient outcomes were assessed at discharge, and 3, 6, 12, 18, and 24 months after discharge. NHIS data were based on 3 survey years and represent a population-based U.S. national random sample of uninjured adolescents. Major trauma in adolescents was associated with significant and marked deficits in QoL throughout the 24-month follow-up period, compared with NHIS norms for this age group. Compared with NHIS norms for QoL in uninjured adolescents aged 12 to 19 years (N = 81,216,835; QWB mean = 0.876), injured adolescents after major trauma had striking and significant QoL deficits beginning at 3-month follow-up (QWB mean = 0.694, p or=15 years) and female sex. Other significant risk factors for poor QoL outcomes were perceived threat to life, pedestrian struck mechanism, and Injury Severity Scores >16. Major trauma in adolescents is associated with significant and marked deficits in long-term QoL outcomes, compared with U.S. norms for healthy adolescents. Early identification and treatment of risk factors for poor long-term QoL outcomes must become an integral component of trauma care in mature trauma care systems.

  9. Long-Term Symbolic Learning

    National Research Council Canada - National Science Library

    Kennedy, William G; Trafton, J. G

    2007-01-01

    What are the characteristics of long-term learning? We investigated the characteristics of long-term, symbolic learning using the Soar and ACT-R cognitive architectures running cognitive models of two simple tasks...

  10. Differences in impact of long term caregiving for mentally ill older adults on the daily life of informal caregivers: a qualitative study.

    Science.gov (United States)

    Zegwaard, Marian I; Aartsen, Marja J; Grypdonck, Mieke Hf; Cuijpers, Pim

    2013-03-27

    Owing to the policy of extramuralization of care in most Western countries older people with severe mental illness have to rely more and more on informal caregivers for daily care. Caregivers themselves are often aged, and although caregiving implies an impact on daily life that exceeds the boundaries of usual informal care, the impact differs across caregivers. Some caregivers seem to suffer more than others, and the differences cannot be fully understood by factors currently known to exacerbate the burden of caregiving. In order to help caregivers reduce the impact of caregiving it is important to gain a deeper understanding of factors influencing the burden and its impact on the caregiver's life. With this in mind, the aim of the study is to explore and understand differences in the impact of long-term caregiving on the quality of life of caregivers who look after older adults with severe mental illness. A qualitative, associative, inductive strategy and continuous simultaneous coding were used to interpret the data of 19 semi-structured interviews. We identified an underlying psychological factor "perceived freedom of choice" which explains the gross differences in impact, leading to a definition of two main types of caregivers. Depending on how people perceive freedom of choice to provide care, the consequences of caregiving can be characterized as a process of gain (type 1) or loss (type 2). Four influential factors deepen the impact of caregiving for the type 2 caregivers, and two subtypes are identified for this category. Consequences of caregiving are most readily seen in a deteriorating quality of the relationship with the care recipient and in the psychosocial well-being of the caregiver. The concept of freedom of choice adds to our understanding of the differences and explains the variation in impact on the caregivers' life. The type 1 caregiver generally experiences gain whereas type 2 generally experiences loss, which puts the latter group typically

  11. LONG TERM COLLECTIONS

    CERN Multimedia

    STAFF ASSOCIATION

    2010-01-01

    ACKNOWLEDGMENTS The Long-Term Collections (CLT) committee would like to warmly thank its faithful donors who, year after year, support our actions all over the world. Without you, all this would not be possible. We would like to thank, in particular, the CERN Firemen’s Association who donated 5000 CHF in the spring thanks to the sale of their traditional calendar, and the generosity of the CERN community. A huge thank you to the firemen for their devotion to our cause. And thank you to all those who have opened their door, their heart, and their purses! Similarly, we warmly thank the CERN Yoga Club once again for its wonderful donation of 2000 CHF we recently received. We would also like to tell you that all our projects are running well. Just to remind you, we are currently supporting the activities of the «Réflexe-Partage» Association in Mali; the training centre of «Education et Développement» in Abomey, Benin; and the orphanage and ...

  12. Significant long-term, but not short-term, hippocampal-dependent memory impairment in adult rats exposed to alcohol in early postnatal life.

    Science.gov (United States)

    Goodfellow, Molly J; Lindquist, Derick H

    2014-09-01

    In rodents, ethanol exposure in early postnatal life is known to induce structural and functional impairments throughout the brain, including the hippocampus. Herein, rat pups were administered one of three ethanol doses over postnatal days (PD) 4-9, a period of brain development comparable to the third trimester of human pregnancy. As adults, control and ethanol rats were trained and tested in a variant of hippocampal-dependent one-trial context fear conditioning. In Experiment 1, subjects were placed into a novel context and presented with an immediate footshock (i.e., within ∼8 sec). When re-exposed to the same context 24 hr later low levels of conditioned freezing were observed. Context pre-exposure 24 hr prior to the immediate shock reversed the deficit in sham-intubated and unintubated control rats, enhancing freezing behavior during the context retention test. Even with context pre-exposure, however, significant dose-dependent reductions in contextual freezing were seen in ethanol rats. In Experiment 2, the interval between context pre-exposure and the immediate shock was shortened to 2 hr, in addition to the standard 24 hr. Ethanol rats trained with the 2 hr, but not 24 hr, interval displayed retention test freezing levels roughly equal to controls. Results suggest the ethanol rats can encode a short-term context memory and associate it with the aversive footshock 2 hr later. In the 24 hr ethanol rats the short-term context memory is poorly transferred or consolidated into long-term memory, we propose, impeding the memory's subsequent retrieval and association with shock. © 2014 Wiley Periodicals, Inc.

  13. Long-term effects of peer victimization on social outcomes through the fourth decade of life in individuals born at normal or extremely low birthweight.

    Science.gov (United States)

    Day, Kimberly L; Van Lieshout, Ryan J; Vaillancourt, Tracy; Saigal, Saroj; Boyle, Michael H; Schmidt, Louis A

    2017-09-01

    Exposure to early adversity is known to have deleterious effects on brain-behaviour relations across the lifespan and across a range of domains. Here, we tested a cumulative risk hypothesis of adult social functioning and health outcomes in the fourth decade of life, using the oldest known longitudinally followed cohort of survivors of extremely low birthweight (ELBW; 2,500 g) participants. In the combined sample, peer victimization was associated with lower likelihood of having children and household income, poorer family functioning and self-esteem, more loneliness and chronic health conditions, less social support, and increased likelihood for contact with police. Moderation analyses indicated that among ELBW survivors, compared to their NBW counterparts, victimization was more strongly associated with being convicted of a crime and with having chronic health conditions. These findings highlight the negative long-term impact of peer victimization on all children and that some outcomes may be differentially affected by prenatal and early post-natal environments. Statement of contribution What is already known on this subject Exposure to early adversity has deleterious effects on brain-behaviour relations across the lifespan. Extremely premature children have higher rates of exposure to adversities, including peer victimization. Peer victimization is associated with adverse outcomes in adulthood in those born at term. What does this study add? Victimization negatively impacts the social outcomes of those born extremely premature and at term into adulthood. Associations appear to be affected by individual differences in prenatal and early post-natal environments. Intervention is crucial when peer victimization occurs in children at risk, as well as those typically developing. © 2016 The British Psychological Society.

  14. Do interventions with staff in long-term residential facilities improve quality of care or quality for life people with dementia? A systematic review of the evidence.

    Science.gov (United States)

    Bird, Mike; Anderson, Katrina; MacPherson, Sarah; Blair, Annaliese

    2016-12-01

    Common sense suggests and research indicates relationships between staff factors in residential dementia care and quality of life (QOL) for residents, with poor care increasing suffering. However, we do not have a coherent picture of which staff interventions have an impact on quality of care (QOC) or resident QOL. A comprehensive search of 20 years' peer-reviewed literature using Medline, PsycINFO, Embase, PubMed, CINAHL, and the Cochrane, Campbell Collaboration identified 4,760 studies meriting full text review. Forty-six met the inclusion criteria, namely interventions in long-term facilities helping staff develop their capacity to provide better care and/or QOL for residents with dementia. Thirty-five other papers comprised an associated predictor review. Conclusions from these limited data are further compromised because nine studies failed to measure effects on residents and only half assessed effects after the project team withdrew. Of these, excellent studies produced change over the medium (3-4 months) or longer term, including reduction in challenging behavior and restraint use but this applied only to a minority. A number of studies failed to measure effects on QOC, limiting conclusions about mechanisms underlying change. In general, level of intervention required depended on the target. For outcomes like restraint use, structured education sessions with some support appear adequate. Programs to reduce pain require more support. For complicated issues like challenging behavior and increasing co-operation in showering, detailed, supportive, on-site interventions are required. Improvements in restraint and staff/resident interactions were the most promising findings. (Review registration number: PROSPERO 2014:CRD42014015224).

  15. The association of long-term treatment-related side effects with cancer-specific and general quality of life among prostate cancer survivors.

    Science.gov (United States)

    Davis, Kimberly M; Kelly, Scott P; Luta, George; Tomko, Catherine; Miller, Anthony B; Taylor, Kathryn L

    2014-08-01

    To examine the association between treatment-related side effects and cancer-specific and general quality of life (QOL) among long-term prostate cancer survivors. Within the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial, we conducted telephone interviews with prostate cancer survivors (N = 518) who were 5-10 years after diagnosis. We assessed demographic and clinical information, sexual, urinary, and bowel treatment-related side effects (Expanded Prostate Cancer Index Composite), cancer-specific QOL (Functional Assessment of Cancer Therapy--total score), and general QOL (the Medical Outcomes Study Short Form 12's physical and mental subscales). Participants were aged 74.6 years on average, primarily White (88.4%), and married (81.7%). Pearson correlation coefficients between the 3 treatment-related side effect domains (urinary, sexual, and bowel) and QOL ranged between 0.14 and 0.42 (P functioning and greater bowel side effects were independently associated with poorer cancer-specific QOL (P functions were also associated with poorer general QOL on the Medical Outcomes Study Short Form 12's physical component summary and mental component summary (P side effects demonstrated the strongest association with all QOL outcomes. Treatment-related side effects persisted for up to 10 years after diagnosis and continued to be associated with men's QOL. These results suggest that each of the treatment-related side effects was independently associated with cancer-specific QOL. Compared with the other Expanded Prostate Cancer Index Composite domains, bowel side effects had the strongest association with cancer-specific and general QOL. These associations emphasize the tremendous impact that bowel side effects continue to have for men many years after their initial diagnosis. Copyright © 2014. Published by Elsevier Inc.

  16. Radiation Doses to Structures Within and Adjacent to the Larynx are Correlated With Long-Term Diet- and Speech-Related Quality of Life

    International Nuclear Information System (INIS)

    Dornfeld, Ken; Simmons, Joel R.; Karnell, Lucy; Karnell, Michael; Funk, Gerry; Yao Min; Wacha, Judith; Zimmerman, Bridget; Buatti, John M.

    2007-01-01

    Purpose: To test the hypothesis that radiation dose to key sites in the upper aerodigestive tract is associated with long-term functional outcome after (chemo)radiotherapy for head-and-neck cancers. Methods and Materials: This study examined the outcome for 27 patients treated with intensity-modulated radiotherapy for definitive management of their head-and-neck cancer who were disease free for at least 1 year after treatment. Head-and-neck cancer-specific quality of life (QoL) was assessed before treatment and at 1 year after treatment. Type of diet tolerated, presence of a feeding tube, and degree of weight loss 1 year after treatment were also used as outcome measures. Radiation doses delivered to various points along the upper aerodigestive tract, including base of tongue, lateral pharyngeal walls, and laryngeal structures, were determined from each treatment plan. Radiation doses for each of these points were tested for correlation with outcome measures. Results: Higher doses delivered to the aryepiglottic folds, false vocal cords, and lateral pharyngeal walls near the false cords correlated with a more restrictive diet, and higher doses to the aryepiglottic folds correlated with greater weight loss (p < 0.05) 1 year after therapy. Better posttreatment speech QoL scores were associated with lower doses delivered to structures within and surrounding the larynx. Conclusion: Our data show an inverse relationship between radiation dose delivered to laryngeal structures and speech and diet and QoL outcomes after definitive (chemo)radiation treatment. These findings suggest that efforts to deliver lower doses to laryngeal structures may improve outcomes after definitive (chemo)radiation therapy

  17. Evaluating long term forecasts

    Energy Technology Data Exchange (ETDEWEB)

    Lady, George M. [Department of Economics, College of Liberal Arts, Temple University, Philadelphia, PA 19122 (United States)

    2010-03-15

    The U.S. Department of Energy's Energy Information Administration (EIA), and its predecessor organizations, has published projections of U.S. energy production, consumption, distribution and prices annually for over 30 years. A natural issue to raise in evaluating the projections is an assessment of their accuracy compared to eventual outcomes. A related issue is the determination of the sources of 'error' in the projections that are due to differences between the actual versus realized values of the associated assumptions. One way to do this would be to run the computer-based model from which the projections are derived at the time the projected values are realized, using actual rather than assumed values for model assumptions; and, compare these results to the original projections. For long term forecasts, this approach would require that the model's software and hardware configuration be archived and available for many years, possibly decades, into the future. Such archival creates many practical problems; and, in general, it is not being done. This paper reports on an alternative approach for evaluating the projections. In the alternative approach, the model is run many times for cases in which important assumptions are changed individually and in combinations. A database is assembled from the solutions and a regression analysis is conducted for each important projected variable with the associated assumptions chosen as exogenous variables. When actual data are eventually available, the regression results are then used to estimate the sources of the differences in the projections of the endogenous variables compared to their eventual outcomes. The results presented here are for residential and commercial sector natural gas and electricity consumption. (author)

  18. Long-term pain prevalence and health-related quality of life outcomes for patients enrolled in a ketamine versus morphine for prehospital traumatic pain randomised controlled trial.

    Science.gov (United States)

    Jennings, Paul A; Cameron, Peter; Bernard, Stephen; Walker, Tony; Jolley, Damien; Fitzgerald, Mark; Masci, Kevin

    2014-10-01

    Improved early pain control may affect the longer-term prevalence of persistent pain. In a previous randomised, controlled trial, we found that the administration of ketamine on hospital arrival decreased pain scores to a greater extent than morphine alone in patients with prehospital traumatic pain. In this follow-up study, we sought to determine the prevalence of persistent pain and whether there were differences in patients who received ketamine or morphine. This study was a long-term follow-up study of the prehospital, prospective, randomised, controlled, open-label study comparing ketamine with morphine in patients with trauma and a verbal pain score of >5 after 5 mg intravenous morphine. Patients were followed-up by telephone 6-12 months after enrollment, and a questionnaire including the SF-36 (V.2) health-related quality of life survey and the Verbal Numerical Rating Scale for pain was administered. A total of 97/135 (72%) patients were able to be followed-up 6-12 months after enrollment between July 2008 and July 2010. Overall, 44/97 (45%) participants reported persistent pain related to their injury, with 3/97 (3%) reporting persistent severe pain. The prevalence of persistent pain was the same between study groups (22/50 (44%) for the ketamine group vs 22/47 (46%) for the morphine group). There was no difference in the SF-36 scores between study arms. There is a high incidence of persistent pain after traumatic injury, even in patients with relatively minor severity of injury. Although decreased pain scores at hospital arrival are achieved with ketamine compared with morphine, this difference does not affect the prevalence of persistent pain or health-related quality of life 6 months after injury. Further larger studies are required to confirm this finding. Australian and New Zealand Clinical Trials Registry (ACTRN12607000441415). Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go

  19. Comparative study of mental health and quality of life in long term refugees and host populations in Oru-Ijebu, Southwest Nigeria

    Science.gov (United States)

    2012-01-01

    Background Refugees as “People Living in Highly Stressful Situation” are particularly vulnerable to mental ill-health as a result of the trauma experienced pre- and post-migration. The lack of information on the mental health disparities of refugees and non-refugees in West Africa is what this study aimed to bridge. A cross-sectional study design was employed using a cluster sampling technique. Interviewer-administered structured questionnaires consisting of the Mini-International Neuropsychiatric Interview (MINI), WHO quality of life (WHOQOL-BREF) and the Community Quality of Life (CQoL) were used for data collection. Data were analyzed with SPSS version 17. Logistic regression analysis was used to determine the predictors of mental health status and QoL. Results Respondents consisted of 444(45.7%) refugees and 527(54.3%) non-refugees. Two-thirds 292 (66%) of the refugees were Liberians. Mean age: refugees - 34.8 ± 12.8 years versus non-refugees - 33.3 ± 8.1 years (p refugees were married, most 468(88.8%) of the native population were not (p refugees had polygamous marriages, lived in poorer type of accommodation and had no formal education compared to the non-refugees (p refugees (p Refugees were three times more likely than non-refugees to have poor mental health [OR: 3.43; 95%CI: 1.83-6.40]. Overall, being currently ill tripled the odds of mental ill health [OR: 2.73; 95%CI: 1.98-3.77]. Unskilled workers [OR: 2.78; 95%CI: 1.68-4.60], skilled workers [OR: 2.98; 95%CI: 2.03-4.38] and the unemployed [OR: 1.94; 95%CI: 1.29-2.92] had two or more times the odds of poor mental health compared to professionals. Conclusions QoL and occupational status were the major threats to the mental health of the refugees. Results of this study point to the need for continued attention to not only the healthcare needs but the welfare, housing, employment and overall QoL to support the long-term mental health of refugees and non-refugee populations alike

  20. Comparative study of mental health and quality of life in long-term refugees and host populations in Oru-Ijebu, Southwest Nigeria.

    Science.gov (United States)

    Akinyemi, Oluwaseun O; Owoaje, Eme T; Ige, Olusimbo K; Popoola, Oluwafemi A

    2012-07-31

    Refugees as "People Living in Highly Stressful Situation" are particularly vulnerable to mental ill-health as a result of the trauma experienced pre- and post-migration. The lack of information on the mental health disparities of refugees and non-refugees in West Africa is what this study aimed to bridge. A cross-sectional study design was employed using a cluster sampling technique. Interviewer-administered structured questionnaires consisting of the Mini-International Neuropsychiatric Interview (MINI), WHO quality of life (WHOQOL-BREF) and the Community Quality of Life (CQoL) were used for data collection. Data were analyzed with SPSS version 17. Logistic regression analysis was used to determine the predictors of mental health status and QoL. Respondents consisted of 444(45.7%) refugees and 527(54.3%) non-refugees. Two-thirds 292 (66%) of the refugees were Liberians. Mean age: refugees--34.8 ± 12.8 years versus non-refugees--33.3 ± 8.1 years (p refugees were married, most 468(88.8%) of the native population were not (p refugees had polygamous marriages, lived in poorer type of accommodation and had no formal education compared to the non-refugees (p refugees (p Refugees were three times more likely than non-refugees to have poor mental health [OR: 3.43; 95% CI: 1.83-6.40]. Overall, being currently ill tripled the odds of mental ill health [OR: 2.73; 95% CI: 1.98-3.77]. Unskilled workers [OR: 2.78; 95% CI: 1.68-4.60], skilled workers [OR: 2.98; 95% CI: 2.03-4.38] and the unemployed [OR: 1.94; 95% CI: 1.29-2.92] had two or more times the odds of poor mental health compared to professionals. QoL and occupational status were the major threats to the mental health of the refugees. Results of this study point to the need for continued attention to not only the healthcare needs but the welfare, housing, employment and overall QoL to support the long-term mental health of refugees and non-refugee populations alike.

  1. Positive deviance control-case life history: a method to develop grounded hypotheses about successful long-term avoidance of infection

    Directory of Open Access Journals (Sweden)

    Sandoval Milagros

    2008-03-01

    Full Text Available Abstract Background Prevalence rates for long-term injection drug users in some localities surpass 60% for HIV and 80% for HCV. We describe methods for developing grounded hypotheses about how some injectors avoid infection with either virus. Methods Subjects: 25 drug injectors who have injected drugs 8 – 15 years in New York City. 17 remain without antibody to either HIV or HCV; 3 are double-positives; and 5 are positive for HCV but not HIV. "Staying Safe" methodology compares serostatus groups using detailed biographical timelines and narratives; and information about how subjects maintain access to physical resources and social support; their strategies and tactics to remain safe; how they handle problems of addiction and demands by drug dealers and other drug users; and how their behaviors and strategies do or do not become socially-embedded practices. Grounded theory and life-history analysis techniques compare and contrast doubly-uninfected with those infected with both viruses or only with HCV. Results Themes and initial hypotheses emerging from analyses included two master hypotheses that, if confirmed, should help shape preventive interventions: 1 Staying uninfected is not simply a question of social structure or social position. It involves agency by drug injectors, including sustained hard work and adaptation to changing circumstances. 2 Multiple intentionalities contribute to remaining uninfected. These conscious goals include balancing one's need for drugs and one's income; developing ways to avoid drug withdrawal sickness; avoiding situations where other drug users importune you to share drugs; and avoiding HIV (and perhaps HCV infection. Thus, focusing on a single goal in prevention might be sub-optimal. Other hypotheses specify mechanisms of enacting these intentionalities. One example is finding ways to avoid extreme social ostracism. Conclusion We have identified strategies and tactics that some doubly-uninfected IDUs have

  2. Long-Term Outcome and Quality of Life of Patients With Endometrial Carcinoma Treated With or Without Pelvic Radiotherapy in the Post Operative Radiation Therapy in Endometrial Carcinoma 1 (PORTEC-1) Trial

    NARCIS (Netherlands)

    Nout, Remi A.; van de Poll-Franse, Lonneke V.; Lybeert, Marnix L. M.; Warlam-Rodenhuis, Carla C.; Jobsen, Jan J.; Mens, Jan Willem M.; Lutgens, Ludy C. H. W.; Pras, Betty; van Putten, Wim L. J.; Creutzberg, Carien L.

    2011-01-01

    Purpose To determine the long-term outcome and health-related quality of life (HRQL) of patients with endometrial carcinoma (EC) treated with or without pelvic radiotherapy in the Post Operative Radiation Therapy in Endometrial Carcinoma 1 (PORTEC-1) trial. Patients and Methods Between 1990 and

  3. Report from the Rockefellar Foundation Sponsored International Workshop on reducing mortality and improving quality of life in long-term survivors of Hodgkin's disease: July 9-16, 2003, Bellagio, Italy

    DEFF Research Database (Denmark)

    Mauch, Peter; Ng, Andrea; Aleman, Berthe

    2005-01-01

    A workshop, sponsored by the Rockefellar Foundation, was held between 9 to 16 July, 2003 to devise strategies to reduce mortality and improve quality of life of long-term survivors of Hodgkin's disease. Participants were selected for their clinical and research background on late effects after Ho...

  4. Long-term effects of spinal cord stimulation on angina symptoms and quality of life in patients with refractory angina pectoris--results from the European Angina Registry Link Study (EARL)

    DEFF Research Database (Denmark)

    Andréll, P; Yu, W; Gersbach, P

    2010-01-01

    To assess the long-term effect of spinal cord stimulation (SCS) on angina symptoms and quality of life in patients with refractory angina pectoris defined as severe angina due to coronary artery disease resistant to conventional pharmacological therapy and/or revascularisation....

  5. Work-Related Demands and Life Satisfaction: The Effects of Engagement and Disengagement among Employed and Long-Term Unemployed People

    Science.gov (United States)

    Korner, Astrid; Reitzle, Matthias; Silbereisen, Rainer K.

    2012-01-01

    Social change has accentuated various demands in people's work lives including, for instance, fears of being laid off, anticipated or experienced difficulties in finding a new and/or appropriate job or a lack of security in career planning. The present study on N=1751 employed, short-term unemployed, and long-term (greater than 12 months)…

  6. The relationship between morbidity after axillary surgery and long-term quality of life in breast cancer patients: the role of anxiety

    NARCIS (Netherlands)

    Aerts, P. D. M.; de Vries, J.; van der Steeg, A. F. W.; Roukema, J. A.

    2011-01-01

    Although arm/shoulder morbidity after sentinel lymph node biopsy (SLNB) and/or axillary lymph node dissection (ALND) has been studied before, information is lacking concerning self-imposed restrictions in activities and long-term consequences of both surgical procedures in relationship to quality of

  7. Long-term air pollution exposure, genome-wide DNA methylation and lung function in the LifeLines cohort study.

    Science.gov (United States)

    BACKGROUND: Long-term air pollution exposure is negatively associated with lung function, yet the mechanisms underlying this association are not·­ fully clear.Differential DNA methylation may explain this association. OBJECTIVES: Our main aim was to study the associati...

  8. The long-term effect of a-ketoglutarate, given early in postnatal life, on both growth and various bone parameters in pigs

    DEFF Research Database (Denmark)

    Andersen, Ninette Kieme; Tatara, M.R.; Krupski, W.

    2008-01-01

    The long-term effect of a-ketoglutarate (AKG) given for 21-24 days post-partum, on the skeleton of commercial pigs, was investigated. In experiment A, 12 pigs were given AKG [0.1 g/kg of body weight (b.w.) per day per os], while 12 controls were administered vehicle. At day 169, the left and right...

  9. Short and long-term quality of life after reconstruction of bladder exstrophy in infancy: preliminary results of the QUALEX (QUAlity of Life of bladder EXstrophy) study.

    Science.gov (United States)

    Jochault-Ritz, Sandy; Mercier, Mariette; Aubert, Didier

    2010-08-01

    The aim of the study was to assess quality of life (QOL) of patients born with bladder exstrophy (BE) and reconstructed during early childhood in 7 French university hospitals (QUALEX study: QUAlity of Life of bladder EXstrophy). Patients from 6 to 42 years old answered self-administered Short-Form 36 (SF-36), VSP-A (Vécu et Santé Perçue de l'Adolescent), VSP-AE (Vécu et Santé Perçue de l'Enfant), AUQUIE (AUto-QUestionnaire Imagé de l'Enfant), and general questionnaires about functional and socioeconomic data. Dimension scores were compared between adults and adolescents using SF-36 and adolescents and children using VSP-AE. Scores were also compared to the general French population. Among the 134 eligible patients, 36 adults, 18 adolescents, and 17 children answered the questionnaire. There was no difference between responders and nonresponders in reconstruction criteria. Continence was achieved in 77% of adults, 65% of adolescents, and 12% of children. Adolescent QOL was globally superior to adults and children. Adult QOL was globally lower than the general population except on the physical dimension. Children's QOL was also globally lower than the general population except for relations with family and school work. Adolescents' scores on SF-36 were superior to the general population but lower on half of the dimensions with VSP-AE. Patients presenting with reconstructed BE have impaired QOL, and functional results seem to be the most likely predictive factor of health-related QOL score. Copyright 2010 Elsevier Inc. All rights reserved.

  10. Sheet GT3-2. General approach of life phases on a long term for uranium mining residues storages and comparison with other storages

    International Nuclear Information System (INIS)

    2009-01-01

    This document aims at specifying the short term, middle term and long term boundaries for a sustainable management and rehabilitated ancient uranium mining sites and of uranium mining residue storage sites. It presents a general overview of site evolution in time, and then, more precisely, the different functions (rehabilitation management, corrective actions, control and monitoring, and so on) and equipment (confinement works, measurement system) at stake in the management of these sites and the control of their impacts. Functions and equipment implemented on such a site, as well as time scales corresponding to different approaches are compared with those of other types of storage. The peculiarity of ancient uranium mining sites and its implications in terms of management on a long term are discussed

  11. Finite element reliability analysis of fatigue life

    International Nuclear Information System (INIS)

    Harkness, H.H.; Belytschko, T.; Liu, W.K.

    1992-01-01

    Fatigue reliability is addressed by the first-order reliability method combined with a finite element method. Two-dimensional finite element models of components with cracks in mode I are considered with crack growth treated by the Paris law. Probability density functions of the variables affecting fatigue are proposed to reflect a setting where nondestructive evaluation is used, and the Rosenblatt transformation is employed to treat non-Gaussian random variables. Comparisons of the first-order reliability results and Monte Carlo simulations suggest that the accuracy of the first-order reliability method is quite good in this setting. Results show that the upper portion of the initial crack length probability density function is crucial to reliability, which suggests that if nondestructive evaluation is used, the probability of detection curve plays a key role in reliability. (orig.)

  12. Long-term urethral catheterisation.

    Science.gov (United States)

    Turner, Bruce; Dickens, Nicola

    This article discusses long-term urethral catheterisation, focusing on the relevant anatomy and physiology, indications for the procedure, catheter selection and catheter care. It is important that nurses have a good working knowledge of long-term catheterisation as the need for this intervention will increase with the rise in chronic health conditions and the ageing population.

  13. Long-term usability

    International Nuclear Information System (INIS)

    Holmgren, M.

    1998-01-01

    Longitudinal studies of the usability of a computer based system for process control has been performed. The whole life-cycle of one system has been of interest, as the problems are varying over time. Repeated measurements of the operators' experiences of this system have been made during 15 years. Of main interest have been the advantages/ disadvantages of computer based system for process control compared with conventional instrumentation. The results showed among other things that (1) computer based systems made it easier to control the process and increased security (2) age differences could be explained by other factors (3 ) expectations before the installation may influence the attitudes and use of equipment for quite some time In some questions the attitudes changed over time while in others they were quite stable, for example, in questions concerning preference for type of equipment. What do operators appreciate in a computer based system for process control? About 300 operators were asked about that. The main factor seems to include a reliable system with valid information that functions during disturbances. Hopefully new systems are designed with that in mind. (author)

  14. Pituitary diseases : long-term psychological consequences

    NARCIS (Netherlands)

    Tiemensma, Jitske

    2012-01-01

    Nowadays, pituitary adenomas can be appropriately treated, but patients continue to report impaired quality of life (QoL) despite long-term remission or cure. In patients with Cushing’s disease, Cushing’s syndrome or acromegaly, doctors should be aware of subtle cognitive impairments and the

  15. Long term complications of diabetes

    Science.gov (United States)

    ... medlineplus.gov/ency/patientinstructions/000327.htm Long-term complications of diabetes To use the sharing features on this page, ... other tests. All these may help you keep complications of diabetes away. You will need to check your blood ...

  16. [Long-term psychiatric hospitalizations].

    Science.gov (United States)

    Plancke, L; Amariei, A

    2017-02-01

    Long-term hospitalizations in psychiatry raise the question of desocialisation of the patients and the inherent costs. Individual indicators were extracted from a medical administrative database containing full-time psychiatric hospitalizations for the period 2011-2013 of people over 16 years old living in the French region of Nord-Pas-de-Calais. We calculated the proportion of people who had experienced a hospitalization with a duration of 292 days or more during the study period. A bivariate analysis was conducted, then ecological data (level of health-care offer, the deprivation index and the size of the municipalities of residence) were included into a multilevel regression model in order to identify the factors significantly related to variability of long-term hospitalization rates. Among hospitalized individuals in psychiatry, 2.6% had had at least one hospitalization of 292 days or more during the observation period; the number of days in long-term hospitalization represented 22.5% of the total of days of full-time hospitalization in psychiatry. The bivariate analysis revealed that seniority in the psychiatric system was strongly correlated with long hospitalization rates. In the multivariate analysis, the individual indicators the most related to an increased risk of long-term hospitalization were: total lack of autonomy (OR=9.0; 95% CI: 6.7-12.2; P<001); diagnoses of psychological development disorders (OR=9.7; CI95%: 4.5-20.6; P<.001); mental retardation (OR=4.5; CI95%: 2.5-8.2; P<.001): schizophrenia (OR=3.0; CI95%: 1.7-5.2; P<.001); compulsory hospitalization (OR=1.7; CI95%: 1.4-2.1; P<.001); having experienced therapeutic isolation (OR=1.8; CI95%: 1.5-2.1; P<.001). Variations of long-term hospitalization rates depending on the type of establishment were very high, but the density of hospital beds or intensity of ambulatory activity services were not significantly linked to long-term hospitalization. The inhabitants of small urban units had

  17. THE LIS STUDY (LYUBERTSY STUDY ON MORTALITY RATE IN PATIENTS AFTER ACUTE MYOCARDIAL INFARCTION. EVALUATION OF DRUG THERAPY. PART 2. INFLUENCE OF PREVIOUS DRUG TREATMENT ON LONG-TERM LIFE PROGNOSIS

    Directory of Open Access Journals (Sweden)

    S. Yu. Martsevich

    2015-12-01

    Full Text Available Aim. To evaluate drug therapy received by patients who had survived acute myocardial infarction (AMI in the framework of the AMI register (the “LIS” study and estimate this therapy influence on long-term outcomes of the disease. Material and methods. The total of 961 patients of 1133 enrolled in the “LIS” study , were discharged from hospital. 191 patients had died during follow-up. 632 patients (who had survived and consented to visit out-patient clinic underwent repeated examination (median of follow-up 1.6 [1.0; 2.4] years. Data about treatment before and during AMI were received from patient’s charts; data about treatment after AMI were obtained from out-patient medical records. Results. Before reference AMI only a small number of the patients received the main drug groups (antiplatelet agents, β-blockers, ACE inhibitors, statins, at that ACE inhibitors were prescribed more often than the others. Use of β-blockers and ACE inhibitors before reference AMI significantly improved long-term life prognosis [relative risk (RR 0.70 and 0.66, respectively]. Rate of the main drug groups prescribed in hospital was rather high with the exception of thrombolytics (less than 10%. Thrombolytics, β-blockers and antiplatelet agents prescribed in hospital significantly improved long-term life prognosis of patients (RR 0.42, 0.65 and 0.58 respectively. At the second visit (according to data of out-patient medical records rate of antiplatelet agents, ACE inhibitors, β-blockers and statins prescription exceeded 60%. Conclusion. Very low prevalence of adequate drug therapy preceding AMI determines high mortality rate among survived acute stage of myocardial infarction patients in long-term period.

  18. Long-term prospective longitudinal evaluation of emotional distress and quality of life in cervical cancer patients who remained disease-free 2-years from diagnosis.

    Science.gov (United States)

    Mantegna, Giovanna; Petrillo, Marco; Fuoco, Gilda; Venditti, Laura; Terzano, Serena; Anchora, Luigi Pedone; Scambia, Giovanni; Ferrandina, Gabriella

    2013-03-18

    A long-term prospective assessment of QoL in cervical cancer patients is still lacking. Here, we provide the first 2-years prospective, longitudinal study evaluating emotional distress and QoL in early stage (ECC) and locally advanced (LACC) cervical cancer patients who remained disease-free 2-years from diagnosis. The questionnaires: Hospital Anxiety and Depression Scale (HADS), Global Health Status items of EORTC QLQ-C30 (GHS), and EORTC QLQ-CX24 (CX24) have been administered by a dedicated team of psycho-oncologists, administered at baseline, and after 3, 6, 12 and 24 months from surgery The Generalized Linear Model for repeated measure was used to analyze modifications of QoL measures over time. In both groups, an early reduction of the percentage of patients with anxiety levels ≥11 was observed at the 3-month evaluation (ECC: 25.7% at baseline Vs 14.7% after 3 months, p value=0.001; LACC: 22.2% at baseline Vs 15.4% after 3 months, p value=0.001). Despite this favorable trend, after 2 years from diagnosis, 11.9% of ECC and 15.6% of LACC patients still showed an anxiety score ≥11. No significant changes over time were observed in term of Depression levels. Focusing on QoL issues, mean GHS and Sexual Activity scores showed an improvement over time in both groups compared to baseline (GHS: 5.7% difference for ECC, p value=0.001, and 11.0% in LACC, p value=0.001; SXA: 13.9% difference for ECC, p value=0.001; and 6.1% in LACC, p value=0.008). On the other hand, Body Image mean scores were significantly impaired by chemoradiation administration in LACC patients, without long-term recovery (7.5% difference, p value=0.001). Finally, in both groups, lymphedema (LY) and menopausal symptoms (MS) showed an early worsening which persisted 2-year after surgery (LY: 19.5% difference for ECC, p value=0.014, and 27.3% in LACC, p value=0.001; MS: 14.4% difference for ECC, p value=0.004, and 16.0% in LACC, p value=0.002). Despite a significant improvement over time, elevated

  19. Positive and negative early life experiences differentially modulate long term survival and amyloid protein levels in a mouse model of Alzheimer’s disease

    NARCIS (Netherlands)

    Lesuis, S.L.; Maurin, H.; Borghgraef, P.; Lucassen, P.J.; Van Leuven, F.; Krugers, H.J.

    2016-01-01

    Stress has been implicated as a risk factor for the severity and progression of sporadic Alzheimer's disease (AD). Early life experiences determine stress responsivity in later life, and modulate age-dependent cognitive decline. Therefore, we examined whether early life experiences influence AD

  20. Finite life time effects in the coherent exciton transfer

    International Nuclear Information System (INIS)

    Barvik, I.; Herman, P.

    1992-04-01

    The paper addresses a specific problem in the exciton transfer in molecular aggregates, namely the influence of the finite life time effects, on the memory functions entering the Generalized Master Equation (GME) which connect different sites of the system. 7 refs, 2 figs

  1. The Sources of Life Chances: Does Education, Class Category, Occupation, or Short-Term Earnings Predict 20-Year Long-Term Earnings?

    Directory of Open Access Journals (Sweden)

    ChangHwan Kim

    2018-03-01

    Full Text Available In sociological studies of economic stratification and intergenerational mobility, occupation has long been presumed to reflect lifetime earnings better than do short-term earnings. However, few studies have actually tested this critical assumption. In this study, we investigate the cross-sectional determinants of 20-year accumulated earnings using data that match respondents in the Survey of Income and Program Participation to their longitudinal earnings records based on administrative tax information from 1990 to 2009. Fit statistics of regression models are estimated to assess the predictive power of various proxy variables, including occupation, education, and short-term earnings, on cumulative earnings over the 20-year time period. Contrary to the popular assumption in sociology, our results find that cross-sectional earnings have greater predictive power on long-term earnings than occupation-based class classifications, including three-digit detailed occupations for both men and women. The model based on educational attainment, including field of study, has slightly better fit than models based on one-digit occupation or the Erikson, Goldthorpe, and Portocarero class scheme. We discuss the theoretical implications of these findings for the sociology of stratification and intergenerational mobility.

  2. Ultimate disposal of radioactive waste - Long-term safe containment. Also a contribution to giving concrete shape to our reponsibility towards the life of future generations

    International Nuclear Information System (INIS)

    Naeser, H.W.; Oberpottkamp, U.

    1995-01-01

    A fundamental issue arising in connection with the plan approval procedure for the construction and operation of radwaste repositories is the question whether the documentation submitted in evidence of appropriate precaution being taken according to the state of the art in science and technology to prevent damage to the population and the environment, is to include evidence that the precautions envisaged and their efficiency can be maintained by the operator over a prolonged period of time. The opinion of the authors is that demanding such evidence of long-term safe containment of hazardous waste is in agreement with Art. 20 a GG (German Constitution) and is to be given for the full period of time that is accessible to assessment and computation using the state-of-the-art means and technology, yielding reliable scientific results void of any data of a speculative nature. Computed evidence is to be submitted for this period of time in compliance with the means and principles given in section 45 StrlSchV (Radiation Protection Ordinance). The article thus is a contribution to giving more concrete shape to the responsibility towards future generations. (orig.) [de

  3. Long-term effects of glucocorticoids on function, quality of life, and survival in patients with Duchenne muscular dystrophy: a prospective cohort study.

    Science.gov (United States)

    McDonald, Craig M; Henricson, Erik K; Abresch, Richard T; Duong, Tina; Joyce, Nanette C; Hu, Fengming; Clemens, Paula R; Hoffman, Eric P; Cnaan, Avital; Gordish-Dressman, Heather

    2018-02-03

    Glucocorticoid treatment is recommended as a standard of care in Duchenne muscular dystrophy; however, few studies have assessed the long-term benefits of this treatment. We examined the long-term effects of glucocorticoids on milestone-related disease progression across the lifespan and survival in patients with Duchenne muscular dystrophy. For this prospective cohort study, we enrolled male patients aged 2-28 years with Duchenne muscular dystrophy at 20 centres in nine countries. Patients were followed up for 10 years. We compared no glucocorticoid treatment or cumulative treatment duration of less than 1 month versus treatment of 1 year or longer with regard to progression of nine disease-related and clinically meaningful mobility and upper limb milestones. We used Kaplan-Meier analyses to compare glucocorticoid treatment groups for time to stand from supine of 5 s or longer and 10 s or longer, and loss of stand from supine, four-stair climb, ambulation, full overhead reach, hand-to-mouth function, and hand function. Risk of death was also assessed. This study is registered with ClinicalTrials.gov, number NCT00468832. 440 patients were enrolled during two recruitment periods (2006-09 and 2012-16). Time to all disease progression milestone events was significantly longer in patients treated with glucocorticoids for 1 year or longer than in patients treated for less than 1 month or never treated (log-rank p<0·0001). Glucocorticoid treatment for 1 year or longer was associated with increased median age at loss of mobility milestones by 2·1-4·4 years and upper limb milestones by 2·8-8·0 years compared with treatment for less than 1 month. Deflazacort was associated with increased median age at loss of three milestones by 2·1-2·7 years in comparison with prednisone or prednisolone (log-rank p<0·012). 45 patients died during the 10-year follow-up. 39 (87%) of these deaths were attributable to Duchenne-related causes in patients with known duration of

  4. Long-term clinical and quality of life outcomes after stenting of femoropopliteal artery stenosis: 3-year results from the STROLL study.

    Science.gov (United States)

    Bunte, Matthew C; Cohen, David J; Jaff, Michael R; Gray, William A; Magnuson, Elizabeth A; Li, Haiyan; Feiring, Andrew; Cioppi, Marco; Hibbard, Robert; Gray, Bruce; Khatib, Yazan; Jessup, David; Patarca, Roberto; Du, Jing; Stoll, Hans-Peter; Massaro, Joe; Safley, David M

    2018-03-09

    To evaluate the clinical and health status outcomes of patients undergoing superficial femoral artery (SFA) revascularization using the Shape Memory Alloy Recoverable Technology (S.M.A.R.T.®) nitinol self-expanding stent through 3 years of follow-up. Limited long-term data are available describing the durability of benefits after femoropopliteal revascularization. In a multicenter, prospective, core-lab adjudicated study, 250 subjects with de novo or restenotic femoropopliteal arterial lesions were treated with the S.M.A.R.T.® stent. The primary endpoint of target vessel patency, a composite of ultrasound-assessed patency and freedom from clinically driven target lesion revascularization (TLR), was evaluated through 3 years. Secondary endpoints included stent fracture and health status. Health status was measured using generic and disease-specific instruments, including the Peripheral Artery Questionnaire (PAQ). At 3-year follow-up, Kaplan-Meier estimated target vessel patency was 72.7%, freedom from clinically driven TLR was 78.5%, and the incidence of stent fracture was 3.6%. The PAQ summary score was markedly impaired at baseline (mean 37.3 ± 19.6 points) and improved substantially at 1 month (mean change from baseline of 31.4 points, 95% CI: 28.5-34.3; P PAQ were largely preserved through 3 years of follow-up (mean change from baseline, 28.0 points, 95% CI: 24.3-31.7; P < 0.0001). In patients undergoing revascularization for moderately complex SFA disease, use of the self-expanding S.M.A.R.T® stent was associated with a high rate of target vessel patency through 3 years and led to substantial and sustained health status benefits. © 2018 Wiley Periodicals, Inc.

  5. Quasi-experimental evaluation of a multifaceted intervention to improve quality of end-of-life care and quality of dying for patients with advanced dementia in long-term care institutions.

    Science.gov (United States)

    Verreault, René; Arcand, Marcel; Misson, Lucie; Durand, Pierre J; Kroger, Edeltraut; Aubin, Michèle; Savoie, Maryse; Hadjistavropoulos, Thomas; Kaasalainen, Sharon; Bédard, Annick; Grégoire, Annie; Carmichael, Pierre-Hughes

    2018-03-01

    Improvement in the quality of end-of-life care for advanced dementia is increasingly recognized as a priority in palliative care. To evaluate the impact of a multidimensional intervention to improve quality of care and quality of dying in advanced dementia in long-term care facilities. Quasi-experimental study with the intervention taking place in two long-term care facilities versus usual care in two others over a 1-year period. The intervention had five components: (1) training program to physicians and nursing staff, (2) clinical monitoring of pain using an observational pain scale, (3) implementation of a regular mouth care routine, (4) early and systematic communication with families about end-of-life care issues with provision of an information booklet, and (5) involvement of a nurse facilitator to implement and monitor the intervention. Quality of care was assessed with the Family Perception of Care Scale. The Symptom Management for End-of-Life Care in Dementia and the Comfort Assessment in Dying scales were used to assess the quality of dying. A total of 193 residents with advanced dementia and their close family members were included (97 in the intervention group and 96 in the usual care group). The Family Perception of Care score was significantly higher in the intervention group than in the usual care group (157.3 vs 149.1; p = 0.04). The Comfort Assessment and Symptom Management scores were also significantly higher in the intervention group. Our multidimensional intervention in long-term care facilities for patients with terminal dementia resulted in improved quality of care and quality of dying when compared to usual care.

  6. The effect of detecting undetected common mental disorders on psychological distress and quality of life in long-term sickness absence

    DEFF Research Database (Denmark)

    Søgaard, Hans Jørgen; Bech, Per

    2010-01-01

    The burden imposed by common mental disorders on individuals and society calls for interventions aimed at reducing psychological distress and improving quality of life.......The burden imposed by common mental disorders on individuals and society calls for interventions aimed at reducing psychological distress and improving quality of life....

  7. The effect of detecting undetected common mental disorders on psychological distress and quality of life in long-term sickness absence: a randomised controlled trial

    DEFF Research Database (Denmark)

    Søgaard, Hans Jørgen; Bech, Per

    2010-01-01

    The burden imposed by common mental disorders on individuals and society calls for interventions aimed at reducing psychological distress and improving quality of life.......The burden imposed by common mental disorders on individuals and society calls for interventions aimed at reducing psychological distress and improving quality of life....

  8. Long-term quality of life in patients with rectal cancer treated with preoperative (chemo)-radiotherapy within a randomized trial

    International Nuclear Information System (INIS)

    Tiv, M.; Puyraveau, M.; Mercier, M.; Bosset, J.F.; Puyraveau, M.; Mineur, L.; Calais, G.; Maingon, P.; Bardet, E.; Mercier, M.; Bosset, J.F.

    2010-01-01

    Purpose: Few studies have evaluated the quality of life (QoL) of patients with rectal cancer. This report describes the quality of life of French patients who entered the 22921 EORTC trial that investigated the role and place of chemotherapy (CT) added to preoperative radiotherapy (preop-RT). Patients and Methods: Patients without recurrences were evaluated with EORTC QLQ-C30 and QLQ-CR38 questionnaires, after a median time of 4.6 years from randomization. Results: All the scores of QLQ-C30 functions were high, from 78 up to 88, with those of global health quality of life scale (GHQL) status being 73. The mean scores of symptoms were low except for diarrhea. For QLQ-CR38, the mean scores for 'body image' and 'future perspective' were high at 79.6 and 69.7 respectively. The scores for 'sexual functioning' and 'enjoyment' were low. Men had more sexual problems than females (62.5 vs 25 mean scores respectively). Chemotherapy was associated with more diarrhea complaints, lower 'role', lower 'social functioning' and lower global health quality of life scale. Conclusion: The overall quality of life of patients with rectal cancer is quite good 4.6 years after the beginning preoperative treatments. However, adding chemotherapy to preoperative radiotherapy has a negative effect on diarrhea complaints and some quality of life dimensions. (authors)

  9. Nuclear Energy, Long Term Requirements

    International Nuclear Information System (INIS)

    Knapp, V.

    2006-01-01

    There are serious warnings about depletion of oil and gas and even more serious warnings about dangers of climate change caused by emission of carbon dioxide. Should developed countries be called to replace CO2 emitting energy sources as soon as possible, and the time available may not be longer then few decades, can nuclear energy answer the call and what are the requirements? Assuming optimistic contribution of renewable energy sources, can nuclear energy expand to several times present level in order to replace large part of fossil fuels use? Paper considers intermediate and long-term requirements. Future of nuclear power depends on satisfactory answers on several questions. First group of questions are those important for near and intermediate future. They deal with economics and safety of nuclear power stations in the first place. On the same time scale a generally accepted concept for radioactive waste disposal is also required. All these issues are in the focus of present research and development. Safer and more economical reactors are targets of international efforts in Generation IV and INPRO projects, but aiming further ahead these innovative projects are also addressing issues such as waste reduction and proliferation resistance. However, even assuming successful technical development of these projects, and there is no reason to doubt it, long term and large-scale nuclear power use is thereby not yet secured. If nuclear power is to play an essential role in the long-term future energy production and in reduction of CO2 emission, than several additional questions must be replied. These questions will deal with long-term nuclear fuel sufficiency, with necessary contribution of nuclear power in sectors of transport and industrial processes and with nuclear proliferation safety. This last issue is more political then technical, thus sometimes neglected by nuclear engineers, yet it will have essential role for the long-term prospects of nuclear power. The

  10. Analysing long term discursive processes

    DEFF Research Database (Denmark)

    Horsbøl, Anders

    which extend beyond the single interaction, for instance negotiations or planning processes, seems to have played a less important role, with studies such as Iedema 2001 and Wodak 2000 as exceptions. These long term processes, however, are central to the constitution and workings of organizations......What do timescales - the notion that processes take place or can be viewed within a shorter or longer temporal range (Lemke 2005) - mean for the analysis of discourse? What are the methodological consequences of analyzing discourse at different timescales? It may be argued that discourse analysis...... in general has favored either the analysis of short term processes such as interviews, discussions, and lessons, or the analysis of non-processual entities such as (multimodal) texts, arguments, discursive repertoires, and discourses (in a Foucaultian sense). In contrast, analysis of long term processes...

  11. Comparing long term energy scenarios

    International Nuclear Information System (INIS)

    Cumo, M.; Simbolotti, G.

    2001-01-01

    Major projection studies by international organizations and senior analysts have been compared with reference to individual key parameters (population, energy demand/supply, resources, technology, emissions and global warming) to understand trends and implications of the different scenarios. Then, looking at the long term (i.e., 2050 and beyond), parameters and trends have been compared together to understand and quantify whether and when possible crisis or market turbulence might occur due to shortage of resources or environmental problems [it

  12. Differences in impact of long term caregiving for mentally ill older adults on the daily life of informal caregivers: a qualitative study

    NARCIS (Netherlands)

    Zegwaard, M.I.; Aartsen, M.J.; Grypdonck, M.H.F.; Cuijpers, P.

    2013-01-01

    Background: Owing to the policy of extramuralization of care in most Western countries older people with severe mental illness have to rely more and more on informal caregivers for daily care. Caregivers themselves are often aged, and although caregiving implies an impact on daily life that exceeds

  13. Life-history traits and habitat preferences of colonizing plant species in long-term spontaneous succession in abandoned gravel-sand pits

    Czech Academy of Sciences Publication Activity Database

    Řehounková, Klára; Prach, Karel

    2010-01-01

    Roč. 11, č. 1 (2010), s. 45-53 ISSN 1439-1791 R&D Projects: GA AV ČR IAA600050702 Institutional research plan: CEZ:AV0Z60050516 Keywords : life-histories * vegetation * success ion Subject RIV: EF - Botanics Impact factor: 2.199, year: 2010

  14. Long term follow-up of health-related quality of life in young adults born very preterm or with a very low birth weight

    NARCIS (Netherlands)

    Verrips, Gijsbert; Brouwer, Leonoor; Vogels, Ton; Taal, Erik; Drossaert, Constance H.C.; Feeny, David; Verheijden, Marieke; Verloove-Vanhorick, Pauline

    2012-01-01

    Background The purpose was, first, to evaluate changes in health-related quality of life (HRQL) in a cohort of very low birth weight (VLBW; <1500 g.) or very preterm (< 32 weeks of gestation) children between ages 14 and 19, and second, to identify correlates of HRQL at age 19. Methods HRQL was

  15. Hybrid lithium-ion capacitor with LiFePO4/AC composite cathode - Long term cycle life study, rate effect and charge sharing analysis

    Science.gov (United States)

    Shellikeri, A.; Yturriaga, S.; Zheng, J. S.; Cao, W.; Hagen, M.; Read, J. A.; Jow, T. R.; Zheng, J. P.

    2018-07-01

    Energy storage devices, which can combine the advantages of lithium-ion battery with that of electric double layer capacitor, are of prime interest. Recently, composite cathodes, which combine a battery material with capacitor material, have shown promise in enhancing life cycle and energy/power performances. Lithium-ion capacitor (LIC), with unique charge storage mechanism of combining a pre-lithiated battery anode with a capacitor cathode, is one such device which has the potential to synergistically incorporate the composite cathode to enhance capacity and cycle life. We report here a hybrid LIC consisting of a lithium iron phosphate (LiFePO4-LFP)/Activated Carbon composite cathode in combination with a hard carbon anode, by integrating the cycle life and capacity enhancing strategies of a dry method of electrode fabrication, anode pre-lithiation and a 3:1 anode to cathode capacity ratio, demonstrating a long cycle life, while elaborating on the charge sharing between the faradaic and non-faradaic mechanism in the battery and capacitor materials, respectively in the composite cathode. An excellent cell capacity retention of 94% (1000 cycles at 1C) and 92% (100,000 cycles at 60C) were demonstrated, while retaining 78% (over 6000 cycles at 2.7C) and 67% (over 70,000 cycles at 43C) of the LFP capacity in the composite cathode.

  16. Long-Term Health-Related Quality of Life in German Patients with Juvenile Idiopathic Arthritis in Comparison to German General Population

    OpenAIRE

    Barth, Swaantje; Haas, Johannes-Peter; Schlichtiger, Jenny; Molz, Johannes; Bisdorff, Betty; Michels, Hartmut; Hügle, Boris; Radon, Katja

    2016-01-01

    Objective Aims of the study were to investigate health-related quality of life (HRQOL) in adult patients with former diagnosis of Juvenile Idiopathic Arthritis (JIA), to compare their HRQOL with the general population and to identify factors related to a poor outcome. Methods In 2012, a cross-sectional survey was performed by mailing a questionnaire to a large cohort of former and current patients of the German Centre for Rheumatology in Children and Adolescents. Only adult patients (?18 year...

  17. Differences in impact of long term caregiving for mentally ill older adults on the daily life of informal caregivers: a qualitative study

    OpenAIRE

    Zegwaard, Marian I; Aartsen, Marja J; Grypdonck, Mieke HF; Cuijpers, Pim

    2013-01-01

    Background: Owing to the policy of extramuralization of care in most Western countries older people with severe mental illness have to rely more and more on informal caregivers for daily care. Caregivers themselves are often aged, and although caregiving implies an impact on daily life that exceeds the boundaries of usual informal care, the impact differs across caregivers. Some caregivers seem to suffer more than others, and the differences cannot be fully understood by factors currently kno...

  18. Sustained safety and efficacy of extended-shelf-life {sup 90}Y glass microspheres: long-term follow-up in a 134-patient cohort

    Energy Technology Data Exchange (ETDEWEB)

    Lewandowski, Robert J.; Minocha, Jeet; Memon, Khairuddin; Riaz, Ahsun; Gates, Vanessa L.; Ryu, Robert K.; Sato, Kent T.; Omary, Reed; Salem, Riad [Northwestern University, Department of Radiology, Chicago, IL (United States)

    2014-03-15

    To validate our initial pilot study and confirm sustained safety and tumor response of extended-shelf-life {sup 90}Y glass microspheres. We hypothesized that for the same planned tissue dose, the increase in number of glass microspheres (decayed to the second week of their allowable shelf-life) administered for the same absorbed dose would result in better tumor distribution of the microspheres without causing additional adverse events. Between June 2007 and January 2010, 134 patients underwent radioembolization with extended-shelf-life {sup 90}Y glass microspheres; data from 84 new patients were combined with data from our 50-patient pilot study cohort. Baseline and follow-up imaging and laboratory data were obtained 1 and 3 months after therapy and every 3 months thereafter. Clinical and biochemical toxicities were prospectively captured and categorized according to the Common Terminology Criteria. Response in the index lesion was assessed using WHO and EASL guidelines. The mean delivered radiation dose was 123 Gy to the target liver tissue. The mean increase in number of microspheres with this approach compared to standard {sup 90}Y glass microsphere dosimetry was 103 %, corresponding to an increase from 3.84 to 7.78 million microspheres. Clinical toxicities included fatigue (89 patients, 66 %), abdominal pain (49 patients, 36.6 %), and nausea/vomiting (25 patients, 18.7 %). Grade 3/4 bilirubin toxicity was seen in three patients (2 %). Two (1 %) of the initial 50-patient cohort showed gastroduodenal ulcers; gastroduodenal ulcers were not seen in any of the subsequent 84 patients. According to WHO and EASL guidelines, response rates were 48 % and 57 %, respectively, and 21 % demonstrated a complete EASL response. This study showed sustained safety and efficacy of extended-shelf-life {sup 90}Y glass microspheres in a larger, 134-patient cohort. The increase in number of microspheres administered theoretically resulted in better tumor distribution of the

  19. Long-Term Survival and Improved Quality of Life following Multiple Repeat Gamma Knife Radiosurgeries for Recurrent Glioblastoma Multiforme: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Erik W. Larson

    2013-01-01

    Full Text Available The management of glioblastoma multiforme (GBM is in most cases complex and must be specifically tailored to the needs of the patient with the goals of extended survival and improved quality of life. Despite advancements in therapy, treatment outcomes remain almost universally poor. Salvage treatment options for the recurrence of the disease is an area of intense study. The following case highlights the utility of Gamma Knife Radiosurgery (GKRS as a salvage treatment. In this clinical situation, three sequential GKRS treatments led to prolonged survival (beyond four years after diagnosis and improved quality of life in a patient who was unable to receive further chemotherapy regimens and was unwilling to undergo further aggressive resection. To date, there have been few reports of three or more sequential GKRS treatment sessions utilized as salvage therapy for recurrent GBM in patients who can no longer tolerate chemotherapy. This report provides evidence that aggressive local treatment with GKRS at the time of recurrence may be appropriate, depending on a patient’s individual clinical situation, and can lead to prolonged survival and improved quality of life.

  20. Reproduction impairment and endocrine disruption in female zebrafish after long-term exposure to MC-LR: A life cycle assessment

    International Nuclear Information System (INIS)

    Hou, Jie; Li, Li; Wu, Ning; Su, Yujing; Lin, Wang; Li, Guangyu; Gu, Zemao

    2016-01-01

    Microcystin-LR (MC-LR) has been found to cause reproductive and developmental impairments as well as to disrupt sex hormone homeostasis of fish during acute and sub-chronic toxic experiments. However, fish in natural environments are continuously exposed to MC-LR throughout their entire life cycle as opposed to short-term exposure. Here, we tested the hypothesis that the mechanism by which MC-LR harms female fish reproduction and development within natural water bodies is through interference of the reproductive endocrine system. In the present study, zebrafish hatchlings (5 d post-fertilization) were exposed to 0, 0.3, 3 and 30 μg/L MC-LR for 90 d until reaching sexual maturity. Female zebrafish were selected, and the changes in growth and developmental indicators, ovarian ultrastructure as well as the levels of gonadal steroid hormones and vitellogenin (VTG) were examined along with the transcription of related genes in the hypothalamic–pituitary–gonadal–liver axis (HPGL-axis). The results showed for the first time, a life cycle exposure to MC-LR caused growth inhibition, decreased ovary weight and ovarian ultra-pathological lesions. Decreased ovarian testosterone levels indicated that MC-LR disrupted sex steroid hormone balance. Significantly up-regulated transcription of brain FSHβ and LHβ along with ovarian ERα, FSHR and LHR suggested positive feedback regulation in the HPGL-axis was induced as a compensatory mechanism for MC-LR damage. It was also noted that ovarian VTG content and hepatic ERα and VTG1 expression were all down-regulated, which might be responsible for reduced vitellus storage noted in our histological observations. Our findings indicate that a life cycle exposure to MC-LR impairs the development and reproduction of female zebrafish by disrupting the transcription of related HPGL-axis genes, suggesting that MC-LR has potential adverse effects on fish reproduction and thus population dynamics in MCs-contaminated aquatic

  1. Immediate and long-term relationship between severe maternal morbidity and health-related quality of life: a prospective double cohort comparison study

    Directory of Open Access Journals (Sweden)

    Mohd Noor Norhayati

    2016-08-01

    Full Text Available Abstract Background Given the growing interest in severe maternal morbidity (SMM, the need to assess its effects on quality of life is pressing. The objective of this study was to compare the quality of life scores between women with and without SMM at 1-month and 6-month postpartum in Kelantan, Malaysia. Methods A prospective double cohort study design was applied at two tertiary referral hospitals over a 6-month period. The study population included all postpartum women who delivered in 2014. Postpartum women with and without SMM were selected as the exposed and non-exposed groups, respectively. For each exposed case identified, a non-exposed case with a similar mode of delivery was selected. The main outcome measures used were scores from the Short Form-12 Health Survey (SF-12. Results The study measured 145 exposed and 187 non-exposed women. The group-time interaction of the repeated measure analysis of variance (RM ANOVA showed no significant difference in the mean overall SF-12 physical component summary score changes (P = 0.534 between women with and without SMM. Similarly, the group-time interaction of the RM ANOVA showed no significant difference in the mean overall SF-12 mental component summary score changes (P = 0.674 between women with and without SMM. However, women with SMM scored significantly lower on a general health perceptions subscale at 1-month (P = 0.031, role limitations due to physical health subscale at 6-month (P = 0.019, vitality subscale at 1-month (P = 0.007 and 6-month (P = 0.008, and role limitations due to emotional problems subscales at 6-month (P = 0.008. Conclusions Women with severe maternal morbidity demonstrated comparable quality of life during the 6-month postpartum period compared to women without severe maternal morbidity.

  2. Early life stress induces long-term changes in limbic areas of a teleost fish: the role of catecholamine systems in stress coping

    DEFF Research Database (Denmark)

    Vindas, Marco A.; Fokos, Stefanos; Pavlidis, Michail

    2018-01-01

    Early life stress (ELS) shapes the way individuals cope with future situations. Animals use cognitive flexibility to cope with their ever-changing environment and this is mainly processed in forebrain areas. We investigated the performance of juvenile gilthead seabream, previously subjected...... of post-stress response in the β2 adrenergic receptor expression and a downregulation in bdnf in the Dm3 of ELS fish, which together indicate an allostatic overload in their stress coping ability. ELS fish showed higher neuronal activity (cfos) post-acute stress in the hippocampus homologue (Dlv...

  3. Health-related quality of life--from the perspective of mothers and fathers of adult children suffering from long-term mental disorders.

    Science.gov (United States)

    Johansson, Anita; Ewertzon, Mats; Andershed, Birgitta; Anderzen-Carlsson, Agneta; Nasic, Salmir; Ahlin, Arne

    2015-06-01

    There is a lack of studies on mothers' and fathers' experiences of Health-Related Quality of Life (HRQOL) associated with caregiving of adult children suffering from mental disorder. A cross-sectional study was therefore carried out with 108 mothers and 43 fathers. Data were collected by means of the Short Form Health Survey (SF-36), the Hospital Anxiety and Depression Scale (HADS), the Family Involvement and Alienation Questionnaire (FIAQ) and the Burden Assessment Scale (BAS). Mothers' HRQOL was affected more than fathers' and lower compared to Swedish age related norms. HRQOL was predominantly related to ratings on HADS and BAS. Copyright © 2015 Elsevier Inc. All rights reserved.

  4. The immediate and long-term effects of exercise and patient education on physical, functional, and quality-of-life outcome measures after single-level lumbar microdiscectomy: a randomized controlled trial protocol.

    Science.gov (United States)

    Selkowitz, David M; Kulig, Kornelia; Poppert, Elizabeth M; Flanagan, Sean P; Matthews, Ndidiamaka D; Beneck, George J; Popovich, John M; Lona, Jose R; Yamada, Kimiko A; Burke, Wendy S; Ervin, Carolyn; Powers, Christopher M

    2006-08-25

    Low back pain remains a costly quality-of-life-related health problem. Microdiscectomy is often the surgical procedure of choice for a symptomatic, single-level, lumbar disc herniation in younger and middle-aged adults. The question of whether a post-microdiscectomy exercise program enhances function, quality of life, and disability status has not been systematically explored. Thus, the overall purpose of this study is to assess immediate and long-term outcomes of an exercise program, developed at University of Southern California (USC), targeting the trunk and lower extremities (USC Spine Exercise Program) for persons who have undergone a single-level microdiscectomy for the first time. One hundred individuals between the ages of 18 and 60 who consent to undergo lumbar microdiscectomy will be recruited to participate in this study. Subjects will be randomly assigned to one of two groups: 1) one session of back care education, or 2) a back care education session followed by the 12-week USC Spine Exercise Program. The outcome examiners (evaluators), as well as the data managers, will be blinded to group allocation. Education will consist of a one-hour "one-on-one" session with the intervention therapist, guided by an educational booklet specifically designed for post-microdiscectomy care. This session will occur four to six weeks after surgery. The USC Spine Exercise Program consists of two parts: back extensor strength and endurance, and mat and upright therapeutic exercises. This exercise program is goal-oriented, performance-based, and periodized. It will begin two to three days after the education session, and will occur three times a week for 12 weeks. Primary outcome measures include the Oswestry Disability Questionnaire, Roland-Morris Disability Questionnaire, SF-36 quality of life assessment, Subjective Quality of Life Scale, 50-foot Walk, Repeated Sit-to-Stand, and a modified Sorensen test. The outcome measures in the study will be assessed before and after

  5. Long-term course of opioid addiction.

    Science.gov (United States)

    Hser, Yih-Ing; Evans, Elizabeth; Grella, Christine; Ling, Walter; Anglin, Douglas

    2015-01-01

    Opioid addiction is associated with excess mortality, morbidities, and other adverse conditions. Guided by a life-course framework, we review the literature on the long-term course of opioid addiction in terms of use trajectories, transitions, and turning points, as well as other factors that facilitate recovery from addiction. Most long-term follow-up studies are based on heroin addicts recruited from treatment settings (mostly methadone maintenance treatment), many of whom are referred by the criminal justice system. Cumulative evidence indicates that opioid addiction is a chronic disorder with frequent relapses. Longer treatment retention is associated with a greater likelihood of abstinence, whereas incarceration is negatively related to subsequent abstinence. Over the long term, the mortality rate of opioid addicts (overdose being the most common cause) is about 6 to 20 times greater than that of the general population; among those who remain alive, the prevalence of stable abstinence from opioid use is low (less than 30% after 10-30 years of observation), and many continue to use alcohol and other drugs after ceasing to use opioids. Histories of sexual or physical abuse and comorbid mental disorders are associated with the persistence of opioid use, whereas family and social support, as well as employment, facilitates recovery. Maintaining opioid abstinence for at least five years substantially increases the likelihood of future stable abstinence. Recent advances in pharmacological treatment options (buprenorphine and naltrexone) include depot formulations offering longer duration of medication; their impact on the long-term course of opioid addiction remains to be assessed.

  6. Long-term effect of the self-management comprehensive coping strategy program on quality of life in patients with breast cancer treated with high-dose chemotherapy.

    Science.gov (United States)

    Gaston-Johansson, Fannie; Fall-Dickson, Jane M; Nanda, Joy P; Sarenmalm, Elisabeth Kenne; Browall, Maria; Goldstein, Nancy

    2013-03-01

    This study aims to examine the effectiveness of a self-management multimodal comprehensive coping strategy program (CCSP) on quality of life (QOL) among breast cancer patients 1 year after treatment. Patients (n = 110) with stage II, III, or IV breast cancer scheduled to receive high dose chemotherapy and autologous hematopoietic stem cell transplantation were randomized to either CCSP treatment or control group. The CCSP intervention was taught 2 week before hospital admission with reinforcement at specified times during treatment and 3 months after discharge. The CCSP components included educational information, cognitive restructuring, coping skills enhancement, and relaxation with guided imagery. Instruments administered at baseline included the following: Quality of Life Index-Cancer Version (QOLI-CV), State-Trait Anxiety Inventory, Beck Depression Inventory, and Coping Strategies Questionnaire. At 1-year follow-up, patients (n = 73) completed and returned the follow-up QOLI-CV. Patients were mainly ≥ 40 years of age, married, Caucasian, and diagnosed with advanced breast cancer. A model measuring effectiveness of CCSP on QOL (total and subscale) at 1-year follow-up showed that the CCSP group (n = 38) had significant improvement in overall QOL (p psychological/spiritual well-being (p psychological (51%) and sleep problems (60%). The CCSP improved QOL for patients at 1-year follow-up. Patients overwhelmingly reported that CCSP was beneficial. The CCSP as an effective coping intervention has potential as a self-management program for breast cancer survivors. Copyright © 2012 John Wiley & Sons, Ltd.

  7. The partial mediation effect of satisfaction with social support and coping effectiveness on health-related quality of life and perceived stress long-term after heart transplantation

    Directory of Open Access Journals (Sweden)

    White-Williams C

    2014-12-01

    Full Text Available Connie White-Williams,1 Kathleen L Grady,2 Pariya Fazeli,1 Susan Myers,1 Linda Moneyham,3 Karen Meneses,3 Bruce Rybarczyk4 1University of Alabama Medical Center, Birmingham, AL, USA; 2Division of Cardiac Surgery, Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA; 3School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA; 4Department of Psychology, Clinical Psychology Program, Virginia Commonwealth University, Richmond, VA, USA Abstract: The purpose of this research was to examine whether satisfaction with social support and coping effectiveness mediate the relationship between stress and health-related quality of life (HRQOL 5 years after heart transplantation. Data were collected from 212 heart transplant patients (80% male, 92% white, mean age 59.9 years at four United States sites using the Heart Transplant Stressor Scale, Social Support Index, Jalowiec Coping Scale, and Quality of Life Index. Using Baron and Kenny's approach, a series of regression equations for mediation revealed that both satisfaction with social support and coping partially mediated the relationship between perceived stress and HRQOL. Understanding the relationships of social support, stress, and coping on patients' HRQOL is important for the development of interventions to provide optimal patient care. Keywords: heart transplantation, social support, coping, stress, mediation

  8. Long-term Consequences of Childhood Bullying in Adults who Stutter: Social Anxiety, Fear of Negative Evaluation, Self-esteem, and Satisfaction with Life.

    Science.gov (United States)

    Blood, Gordon W; Blood, Ingrid M

    2016-12-01

    Psychosocial disorders have been reported in adults who stutter, especially social anxiety disorder. Social anxiety has been linked to childhood victimization. It is possible that recalled childhood victimization could be linked to psychosocial problems reported in some adults who stutter. Participants were 36 adults who stutter and 36 adults who do not stutter (mean age=21.9 years). The Retrospective Bullying Questionnaire was completed for primary school, secondary school and university environments for physical, verbal, relational and cyber bullying. Participants were categorized into one of five groups (bully, victim, bully-victim, bystander and uninvolved) based ontheir responses. Participants completed four psychosocial scales: social interaction anxiety, fear of negative evaluation, self-esteem and satisfaction with life scales. The two groups differed with adults who stutter having higher social interaction anxiety, fear of negative evaluation and satisfaction with life. Analyses of variance revealed that victims had the highest scores among both groups on all four scales. Adults who recalled being victimized during childhood were more likely, regardless of whether they stutter or did not stutter, to have poorer psychosocial scale scores. These results show the lingering effects of childhood victimization, common in some children who stutter, may contribute to the reported psychosocial problems in adulthood. The need for early intervention for children who are bullied and future research with larger samples is warranted. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. Long-term independent brain-computer interface home use improves quality of life of a patient in the locked-in state: a case study.

    Science.gov (United States)

    Holz, Elisa Mira; Botrel, Loic; Kaufmann, Tobias; Kübler, Andrea

    2015-03-01

    Despite intense brain-computer interface (BCI) research for >2 decades, BCIs have hardly been established at patients' homes. The current study aimed at demonstrating expert independent BCI home use by a patient in the locked-in state and the effect it has on quality of life. In this case study, the P300 BCI-controlled application Brain Painting was facilitated and installed at the patient's home. Family and caregivers were trained in setting up the BCI system. After every BCI session, the end user indicated subjective level of control, loss of control, level of exhaustion, satisfaction, frustration, and enjoyment. To monitor BCI home use, evaluation data of every session were automatically sent and stored on a remote server. Satisfaction with the BCI as an assistive device and subjective workload was indicated by the patient. In accordance with the user-centered design, usability of the BCI was evaluated in terms of its effectiveness, efficiency, and satisfaction. The influence of the BCI on quality of life of the end user was assessed. At the patient's home. A 73-year-old patient with amyotrophic lateral sclerosis in the locked-in state. Not applicable. The BCI has been used by the patient independent of experts for >14 months. The patient painted in about 200 BCI sessions (1-3 times per week) with a mean painting duration of 81.86 minutes (SD=52.15, maximum: 230.41). BCI improved quality of life of the patient. In most of the BCI sessions the end user's satisfaction was high (mean=7.4, SD=3.24; range, 0-10). Dissatisfaction occurred mostly because of technical problems at the beginning of the study or varying BCI control. The subjective workload was moderate (mean=40.61; range, 0-100). The end user was highy satisfied with all components of the BCI (mean 4.42-5.0; range, 1-5). A perfect match between the user and the BCI technology was achieved (mean: 4.8; range, 1-5). Brain Painting had a positive impact on the patient's life on all three dimensions: competence

  10. Reproduction impairment and endocrine disruption in female zebrafish after long-term exposure to MC-LR: A life cycle assessment.

    Science.gov (United States)

    Hou, Jie; Li, Li; Wu, Ning; Su, Yujing; Lin, Wang; Li, Guangyu; Gu, Zemao

    2016-01-01

    Microcystin-LR (MC-LR) has been found to cause reproductive and developmental impairments as well as to disrupt sex hormone homeostasis of fish during acute and sub-chronic toxic experiments. However, fish in natural environments are continuously exposed to MC-LR throughout their entire life cycle as opposed to short-term exposure. Here, we tested the hypothesis that the mechanism by which MC-LR harms female fish reproduction and development within natural water bodies is through interference of the reproductive endocrine system. In the present study, zebrafish hatchlings (5 d post-fertilization) were exposed to 0, 0.3, 3 and 30 μg/L MC-LR for 90 d until reaching sexual maturity. Female zebrafish were selected, and the changes in growth and developmental indicators, ovarian ultrastructure as well as the levels of gonadal steroid hormones and vitellogenin (VTG) were examined along with the transcription of related genes in the hypothalamic-pituitary-gonadal-liver axis (HPGL-axis). The results showed for the first time, a life cycle exposure to MC-LR caused growth inhibition, decreased ovary weight and ovarian ultra-pathological lesions. Decreased ovarian testosterone levels indicated that MC-LR disrupted sex steroid hormone balance. Significantly up-regulated transcription of brain FSHβ and LHβ along with ovarian ERα, FSHR and LHR suggested positive feedback regulation in the HPGL-axis was induced as a compensatory mechanism for MC-LR damage. It was also noted that ovarian VTG content and hepatic ERα and VTG1 expression were all down-regulated, which might be responsible for reduced vitellus storage noted in our histological observations. Our findings indicate that a life cycle exposure to MC-LR impairs the development and reproduction of female zebrafish by disrupting the transcription of related HPGL-axis genes, suggesting that MC-LR has potential adverse effects on fish reproduction and thus population dynamics in MCs-contaminated aquatic environment

  11. A modelling study for long-term life prediction of carbon steel overpack for geological isolation of High-Level Radioactive Waste

    International Nuclear Information System (INIS)

    Taniguchi, Naoki; Honda, Akira; Ishikawa, Hirohisa

    1996-01-01

    Current plans for the geological disposal of High-Level Radioactive Waste (HLW) in Japan include metal overpacks which contain HLW. Overpacks may be required to remain intact for more than several hundred years in order to provide containment of radio nuclides. The main factor limiting the performance of overpacks is considered to be corrosion by groundwater. Carbon steel is one of the candidate material for overpacks. A mathematical model for life prediction of carbon steel overpack has been developed based on corrosion mechanism. General corrosion and localized corrosion are considered because these are likely to initiate in repository conditions. In general corrosion model, the reduction of oxygen and water are considered as cathodic reaction. In localized corrosion model, we have constructed a model which predict the period for localized corrosion based on oxygen transport in bentonite. We also developed a model which predict the propagation rate of localized corrosion that is based on mass balance within the corroding cavity. (author)

  12. Assessment of costs related to the implementation of management solutions on the long term for high and medium level long life radioactive wastes. ANDRA's proposition

    International Nuclear Information System (INIS)

    2014-10-01

    This huge document contains several volumes which propose detailed costing of the various parts of the Cigeo project after sketch studies (this project deals with the deep geological storage of high and medium level long life radioactive wastes). It notably states the various hypotheses regarding the inventory of radioactive wastes, the waste supply prediction, and works closure. This cost assessment takes the different project stages into account and a cost update. Various aspects are thus assessed, some related to investments (design studies, preliminary works, construction of the various installations, renewal of equipment during exploitation, installation dismantling and works closure, insurance, commissioning authority and engineering subcontracting), to exploitation (production and maintenance, support, activities related to safety, radiation protection and control of the environment, operating costs, utilities, storage containers, insurance), and to other expenses (tax, research and development, technological tests, control after closure)

  13. The long-term effects of a life-prolonging heat treatment on the Drosophila melanogaster transcriptome suggest that heat shock proteins extend lifespan

    DEFF Research Database (Denmark)

    Sarup, Pernille Merete; Sørensen, Peter; Loeschcke, Volker

    2014-01-01

    Heat-induced hormesis, i.e. the beneficial effect of mild heat-induced stress, increases the average lifespan of many organisms. This effect, which depends on the heat shock factor, decreases the log mortality rate weeks after the stress has ceased. To identify candidate genes that mediate......-treated flies. Several hsp70 probe sets were up-regulated 1.7–2-fold in the mildly stressed flies weeks after the last heat treatment (P shock protein, Hsp70, is reported to return to normal levels of expression shortly after heat stress. We...... conclude that the heat shock response, and Hsp70 in particular, may be central to the heat-induced increase in the average lifespan in flies that are exposed to mild heat stress early in life....

  14. Long-term biodosimetry Redux

    International Nuclear Information System (INIS)

    Simon, Steven L.; Bouville, Andre

    2016-01-01

    This paper revisits and reiterates the needs, purposes and requirements of bio-dosimetric assays for long-term dose and health risk assessments. While the most crucial need for bio-dosimetric assays is to guide medical response for radiation accidents, the value of such techniques for improving our understanding of radiation health risk by supporting epidemiological (long-term health risk) studies is significant. As new cohorts of exposed persons are identified and new health risk studies are undertaken with the hopes that studying the exposed will result in a deeper understanding of radiation risk, the value of reliable dose reconstruction is underscored. The ultimate application of biodosimetry in long-term health risk studies would be to completely replace model-based dose reconstruction-a complex suite of methods for retrospectively estimating dose that is commonly fraught with large uncertainties due to the absence of important exposure-related information, as well as imperfect models. While biodosimetry could potentially supplant model-based doses, there are numerous limitations of presently available techniques that constrain their widespread application in health risk research, including limited ability to assess doses received far in the past, high cost, great inter-individual variability, invasiveness, higher than preferred detection limits and the inability to assess internal dose (for the most part). These limitations prevent the extensive application of biodosimetry to large cohorts and should be considered a challenge to researchers to develop new and more flexible techniques that meet the demands of long-term health risk research. Events in recent years, e.g. the Fukushima reactor accident and the increased threat of nuclear terrorism, underscore that any event that results in significant radiation exposures of a group of people will also produce a much larger population, exposed at lower levels, but that likewise needs (or demands) an exposure

  15. Reliability and validity of a survey to measure bowel function and quality of life in long-term rectal cancer survivors.

    Science.gov (United States)

    Wendel, Christopher S; Grant, Marcia; Herrinton, Lisa; Temple, Larissa K F; Hornbrook, Mark C; McMullen, Carmit K; Bulkley, Joanna E; Altschuler, Andrea; Krouse, Robert S

    2014-12-01

    Examination of reliability and validity of a specialized health-related quality of life questionnaire for rectal cancer (RC) survivors (≥5 years post-diagnosis). We mailed 1,063 Kaiser Permanente (KP) RC survivors (313 ostomy and 750 anastomosis) a questionnaire containing the Modified City of Hope Quality of Life-Ostomy (mCOH-QOL-O), SF-12v2, Duke-UNC Functional Social Support Questionnaire (FSSQ), and Memorial Sloan-Kettering Cancer Center Bowel Function Index (BFI). We adapted certain BFI items for use by subjects with intestinal ostomies. We evaluated reliability for all instruments with inter-item correlations and Cronbach's alpha. We assessed construct validity only for the BFI in the ostomy group, because such use has not been reported. The overall response rate was 60.5 % (577 respondents/953 eligible). Compared with non-responders, participants were on average 2 years younger and more likely non-Hispanic white, resided in educationally non-deprived areas, and had KP membership through a group. The mCOH-QOL-O, SF-12, and FSSQ were found to be highly reliable for RC survivors. In the ostomy group, BFI Urgency/Soilage and Dietary subscales were found to be reliable, but Frequency was not. Factor analysis supported the construct of Urgency/Soilage and Dietary subscales in the ostomy group, although one item had a moderate correlation with all three factors. The BFI also demonstrated good concurrent validity with other instruments in the ostomy group. With possible exception of the BFI Frequency subscale in populations with ostomies, components of our survey can be used for the entire population of RC survivors, no matter whether they received anastomosis or ostomy.

  16. Evaluating the long-term consequences of air pollution in early life: geographical correlations between coal consumption in 1951/1952 and current mortality in England and Wales.

    Science.gov (United States)

    Phillips, David I W; Osmond, Clive; Southall, Humphrey; Aucott, Paula; Jones, Alexander; Holgate, Stephen T

    2018-04-27

    To evaluate associations between early life air pollution and subsequent mortality. Geographical study. Local government districts within England and Wales. Routinely collected geographical data on the use of coal and related solid fuels in 1951-1952 were used as an index of air pollution. We evaluated the relationship between these data and both all-cause and disease-specific mortality among men and women aged 35-74 years in local government districts between 1993 and 2012. Domestic (household) coal consumption had the most powerful associations with mortality. There were strong correlations between domestic coal use and all-cause mortality (relative risk per SD increase in fuel use 1.124, 95% CI 1.123 to 1.126), and respiratory (1.238, 95% CI 1.234 to 1.242), cardiovascular (1.138, 95% CI 1.136 to 1.140) and cancer mortality (1.073, 95% CI 1.071 to 1.075). These effects persisted after adjustment for socioeconomic indicators in 1951, current socioeconomic indicators and current pollution levels. Coal was the major cause of pollution in the UK until the Clean Air Act of 1956 led to a rapid decline in consumption. These data suggest that coal-based pollution, experienced over 60 years ago in early life, affects human health now by increasing mortality from a wide variety of diseases. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  17. Long term stability of power systems

    Energy Technology Data Exchange (ETDEWEB)

    Kundur, P; Gao, B [Powertech Labs. Inc., Surrey, BC (Canada)

    1994-12-31

    Power system long term stability is still a developing subject. In this paper we provide our perspectives and experiences related to long term stability. The paper begins with the description of the nature of the long term stability problem, followed by the discussion of issues related to the modeling and solution techniques of tools for long term stability analysis. Cases studies are presented to illustrate the voltage stability aspect and plant dynamics aspect of long term stability. (author) 20 refs., 11 figs.

  18. Long-term health-related quality of life after pancreatic resection for malignancy in patients with and without severe postoperative complications.

    Science.gov (United States)

    Heerkens, Hanne D; van Berkel, Lisanne; Tseng, Dorine S J; Monninkhof, Evelyn M; van Santvoort, Hjalmar C; Hagendoorn, Jeroen; Borel Rinkes, Inne H M; Lips, Irene M; Intven, Martijn; Molenaar, I Quintus

    2018-02-01

    Surgery for pancreatic cancer yields significant morbidity and mortality risks and survival is limited. Therefore, the influence of complications on quality of life (QoL) after pancreatic surgery is important. This study compares QoL in patients with and without severe complications after surgery for pancreatic (pre-)malignancy. This prospective cohort study scored complications after pancreatic surgery according to the Clavien-Dindo system and the definitions of the International Study Group of Pancreatic Surgery. QoL was measured by the RAND36 questionnaire, the European Organization for Research and Treatment of Cancer core questionnaire (QLQ-C30) and the pancreas specific QLQ-PAN26. QoL in patients with severe complications was compared with QoL in patients with no or mild complications over a period of 12 months. Analysis was performed with linear mixed models for repeated measurements. Between March 2012 and July 2016, 137 patients were included. Sixty-eight patients (50%) had at least 1 severe complication. There were no statistically significant and clinically relevant differences between both groups in QoL up to 12 months after surgery. In this study, no differences in QoL between patients with and without severe postoperative complications were encountered during the first 12 months after surgery for pancreatic (pre-)malignancy. http://www.clinicaltrials.gov Identifier: NCT02175992. Copyright © 2017 International Hepato-Pancreato-Biliary Association Inc. Published by Elsevier Ltd. All rights reserved.

  19. Health-related quality of life and occurrence of intestinal side effects after pelvic radiotherapy - evaluation of long-term effects of diagnosis and treatment

    International Nuclear Information System (INIS)

    Bye, A.; Trope, C.; Loge, J.H.; Hjermstad, M.; Kaasa, S.

    2000-01-01

    Health-related quality of life (HRQOL) and occurrence of late intestinal side effects were assessed 3-4 years after pelvic radiotherapy for carcinoma of the endometrium and cervix. During 1988-1990, 143 women were included in a clinical trial to evaluate the effect of a low fat, low lactose diet on radiation-induced diarrhoea. Of 94 survivors, 79 (84%) answered the request. HRQOL was assessed by the EORTC QLQ-C36 and compared with population-based norms. The women scored lower than the general population on role functioning (81.5 versus 90.6 (p < 0.01)) and higher on diarrhoea (23.8 versus 9.5 (p < 0.01)). Compared with pre-treatment conditions, an increase in cases with pain in the lower back, hips and thighs was seen. Substantial pain and diarrhoea were associated with deterioration in HRQOL. In conclusion, few treatment and/or disease-related effects were detected 3-4 years after radiotherapy, with the exception of increased bowel frequency and pain in the lower back, hips and thighs

  20. A Comparison of the Long-term Health Related Quality of Life and Handicap of Stroke Patients in Mainland China and Hong Kong

    Directory of Open Access Journals (Sweden)

    T Kwok

    2010-01-01

    Full Text Available Purpose To compare health related quality of life (HRQOL and handicap of stroke survivors in Hong Kong (HK and Chengdu (CD in Mainland China. Method Fifty-four pairs of first ever stroke patients in CD and in HK matched by age, sex and Modified Barthel Index (MBI were interviewed using a structured questionnaire at 16–36 months after stroke. HRQOL and handicap outcomes were evaluated by the Chinese version of the Short-Form Health Survey (SF-36 and London Handicap Scale (LHS respectively. Results Compared to stroke patients in CD, HK subjects reported significantly greater handicap, especially in the occupation domain. HK subjects also had significantly lower HRQOL Z scores in domains of role limitations due to emotional or physical problems, and bodily pain. CD subjects had more social support, but had more difficulties in meeting medical costs, and were less likely to have regular medical follow-up and dysphagia symptom. After adjusting for social and health related factors, the site differences in handicap and the role limitation (physical domain of SF36 became insignificant. Conclusions CD stroke survivors had better scores in HRQOL and fewer handicaps than their counterparts in HK, because of social and health related factors.

  1. Long-term benefits of exercising on quality of life and fatigue in multiple sclerosis patients with mild disability: a pilot study.

    Science.gov (United States)

    McCullagh, Ruth; Fitzgerald, Anthony P; Murphy, Raymond P; Cooke, Grace

    2008-03-01

    To determine if exercise benefits patients with multiple sclerosis. Randomized controlled trial. Participants exercised at home and also attended exercise classes held in a hospital physiotherapy gym. Thirty patients, diagnosed and independently mobile, were recruited in the Dublin area. For three months, classes were held twice-weekly and participants exercised independently once-weekly. The control group was monitored monthly and management remained unchanged. Measurements were taken at baseline, three and six months. The Modified Fatigue Impact Scale (MFIS), Multiple Sclerosis Impact Scale-29 (MSIS-29) and Functional Assessment of Multiple Sclerosis (FAMS) were used to measure fatigue and quality of life (QOL). Heart rate (HR) and the Borg's Rating of Perceived Exertion (RPE) were recorded during an incremental exercise test. The change from baseline scores between groups was compared using the Mann-Whitney U-test. Twenty-four participants completed the programme (n = 12 in each group). Based on the change in scores at three months, the exercise group had significantly greater improvements in exercise capacity (HR: -14 [-18.5, -2.5] versus 0.5 [-4, 5.5], P= 0.009), QOL (FAMS: 23 [9.5, 42.5] versus -3.5 [-16, 5], P=0.006) and fatigue (MFIS: -13 [-20, -3] versus 1 [-4, 4.5], P=0.02). At six months, the difference in change scores remained significant for FAMS (19 [14, 31] versus -4.5 [-25, 8], P=0.002) and MFIS (-8.5 [-19.5, -1] versus 0.5 [-2.5, 6.5], P=0.02) only. A three-month exercise programme improved participants' exercise capacity, QOL and fatigue, with the improvements in QOL and fatigue lasting beyond the programme.

  2. Long-Term Health-Related Quality of Life in German Patients with Juvenile Idiopathic Arthritis in Comparison to German General Population.

    Directory of Open Access Journals (Sweden)

    Swaantje Barth

    Full Text Available Aims of the study were to investigate health-related quality of life (HRQOL in adult patients with former diagnosis of Juvenile Idiopathic Arthritis (JIA, to compare their HRQOL with the general population and to identify factors related to a poor outcome.In 2012, a cross-sectional survey was performed by mailing a questionnaire to a large cohort of former and current patients of the German Centre for Rheumatology in Children and Adolescents. Only adult patients (≥18 years with a diagnosis compatible with JIA were included (n = 2592; response 66%. The questionnaire included information about HRQOL (EQ5D, disease-related questions and socio-demographics. Prevalence and 95% confidence intervals (CI of problems with mobility, self-care, usual activities, pain and anxiety/depression were standardized to the German general population. Factors associated with low HRQOL in JIA patients were identified using logistic regression models.Sixty-two percent of the study population was female; age range was 18-73 years. In all dimensions, JIA patients reported statistically significantly more problems than the general population with largest differences in the pain dimension (JIA patients 56%; 95%CI 55-58%; general population 28%; 26-29% and the anxiety/depression dimension (28%; 27-29% vs. 4%; 4-5%. Lower HRQOL in JIA patients was associated with female sex, older age, lower level of education, still being under rheumatic treatment and disability.HRQOL in adult JIA patients is considerably lower than in the general population. As this cohort includes historic patients the new therapeutic schemes available today are expected to improve HRQOL in future.

  3. Long-Term Health-Related Quality of Life in German Patients with Juvenile Idiopathic Arthritis in Comparison to German General Population.

    Science.gov (United States)

    Barth, Swaantje; Haas, Johannes-Peter; Schlichtiger, Jenny; Molz, Johannes; Bisdorff, Betty; Michels, Hartmut; Hügle, Boris; Radon, Katja

    2016-01-01

    Aims of the study were to investigate health-related quality of life (HRQOL) in adult patients with former diagnosis of Juvenile Idiopathic Arthritis (JIA), to compare their HRQOL with the general population and to identify factors related to a poor outcome. In 2012, a cross-sectional survey was performed by mailing a questionnaire to a large cohort of former and current patients of the German Centre for Rheumatology in Children and Adolescents. Only adult patients (≥18 years) with a diagnosis compatible with JIA were included (n = 2592; response 66%). The questionnaire included information about HRQOL (EQ5D), disease-related questions and socio-demographics. Prevalence and 95% confidence intervals (CI) of problems with mobility, self-care, usual activities, pain and anxiety/depression were standardized to the German general population. Factors associated with low HRQOL in JIA patients were identified using logistic regression models. Sixty-two percent of the study population was female; age range was 18-73 years. In all dimensions, JIA patients reported statistically significantly more problems than the general population with largest differences in the pain dimension (JIA patients 56%; 95%CI 55-58%; general population 28%; 26-29%) and the anxiety/depression dimension (28%; 27-29% vs. 4%; 4-5%). Lower HRQOL in JIA patients was associated with female sex, older age, lower level of education, still being under rheumatic treatment and disability. HRQOL in adult JIA patients is considerably lower than in the general population. As this cohort includes historic patients the new therapeutic schemes available today are expected to improve HRQOL in future.

  4. Long-term impact of childhood disadvantage on late-life functional decline among older Japanese: Results from the JAGES prospective cohort study.

    Science.gov (United States)

    Murayama, Hiroshi; Fujiwara, Takeo; Tani, Yukako; Amemiya, Airi; Matsuyama, Yusuke; Nagamine, Yuiko; Kondo, Katsunori

    2017-09-11

    Increasing evidence suggests an impact of childhood disadvantage on late-life functional impairment in Western countries. However, the processes by which childhood disadvantage affects functional capacity are influenced by several factors unique to particular societies. We examined the impact of childhood disadvantage on functional decline among older Japanese, using a large-scale prospective cohort study. Data came from surveys conducted in 2010 and 2013 as part of the Japan Gerontological Evaluation Study (JAGES), a nationwide cohort study targeting community-dwelling people aged 65 years and over. Childhood disadvantage included subjective childhood socioeconomic status (SES), body height and educational level. The sample was stratified by age at baseline (65-69 y, 70-74 y, 75-79 y, and ≥ 80 y). A total of 11,601 respondents were analyzed. In the 65-69 y group, lower childhood SES was associated with functional decline, but this association was mediated by adult SES. In contrast, childhood SES was independently associated with functional decline in the older cohort. In the 75-79 y group, lower childhood SES was associated with functional decline. However, in the ≥ 80 y group, people with higher childhood SES were more likely to experience functional decline. Shorter height was associated with functional decline in the 70-74 y group. Higher education was related to functional decline in all age groups except the ≥ 80 y group. These findings suggest that childhood disadvantage affects functional decline, but its effect varies by age cohort. The mechanisms underlying the association between childhood disadvantage and functional decline may be influenced by social and historical context. © The Author 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  5. Temperature affects long-term productivity and quality attributes of day-neutral strawberry for a space life-support system

    Science.gov (United States)

    Massa, Gioia D.; Chase, Elaine; Santini, Judith B.; Mitchell, Cary A.

    2015-04-01

    Strawberry (Fragaria x ananassa L.) is a promising candidate crop for space life-support systems with desirable sensory quality and health attributes. Day-neutral cultivars such as 'Seascape' are adaptable to a range of photoperiods, including short days that would save considerable energy for crop lighting without reductions in productivity or yield. Since photoperiod and temperature interact to affect strawberry growth and development, several diurnal temperature regimes were tested under a short photoperiod of 10 h per day for effects on yield and quality attributes of 'Seascape' strawberry during production cycles longer than 270 days. The coolest day/night temperature regime, 16°/8 °C, tended to produce smaller numbers of larger fruit than did the intermediate temperature range of 18°/10 °C or the warmest regime, 20°/12 °C, both of which produced similar larger numbers of smaller fruit. The intermediate temperature regime produced the highest total fresh mass of berries over an entire production cycle. Independent experiments examined either organoleptic or physicochemical quality attributes. Organoleptic evaluation indicated that fruit grown under the coolest temperature regime tended to score the highest for both hedonic preference and descriptive evaluation of sensory attributes related to sweetness, texture, aftertaste, and overall approval. The physicochemical quality attributes Brix, pH, and sugar/acid ratio were highest for fruits harvested from the coolest temperature regime and lower for those from the warmer temperature regimes. The cool-regime fruits also were lowest in titratable acidity. The yield parameters fruit number and size oscillated over the course of a production cycle, with a gradual decline in fruit size under all three temperature regimes. Brix and titratable acidity both decreased over time for all three temperature treatments, but sugar/acid ratio remained highest for the cool temperature regime over the entire production

  6. Long-term major adverse cardiovascular events and quality of life after coronary angiography in elderly patients with acute coronary syndrome.

    Science.gov (United States)

    Sigurjonsdottir, R; Barywani, S; Albertsson, P; Fu, M

    2016-11-01

    Although the elderly comprise the majority of acute coronary syndrome (ACS) patients, limited data exist on major adverse cardiovascular events (MACEs) and quality of life (QoL). To study MACEs and QoL prospectively in ACS patients >70years referred for coronary angiography. A prospective observational study that included ACS patients >70years undergoing coronary angiography. The outcomes were MACEs and QoL 3years after inclusion. MACEs were defined as death, recurrent ACS, new-onset of heart failure and repeated revascularization by coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI). A QoL questionnaire was completed by the patients along with a physical examination and a personal interview at the 3-year follow-up. Multivariate analysis was performed to identify the predictors for MACEs. In total, 138 patients (mean age 78.8±3.8years) with ACS were included in the study. Mean follow-up was 1196±296days. In all, 42% of the patients had MACEs and 25% had post-ACS heart failure. The mortality rate was 11%. After adjusting for significant cardiovascular risk factors, the following factors were significantly associated with MACEs: Age, high-sensitive troponin T (hsTNT), use of diuretics and reduced left ventricular ejection fraction (LVEF). Furthermore, the QoL evaluated with SF-36 in survivors from ACS at the end of study was similar to the QoL in an age-matched healthy Swedish population. In this prospective study on elderly ACS patients MACEs still occurred in 42% of the cases (despite low mortality and good QoL), with post-ACS heart failure as the most important event. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  7. Impact of External Beam Adjuvant Radiotherapy on Health-Related Quality of Life for Long-Term Survivors of Endometrial Adenocarcinoma: A Population-Based Study

    International Nuclear Information System (INIS)

    Poll-Franse, Lonneke V. van de; Mols, Floortje; Essink-Bot, Marie-Louise; Haartsen, Joke E.; Vingerhoets, Ad J.J.M.; Lybeert, Marnix L.M.; Berg, Hetty A. van den; Coebergh, Jan Willem W.

    2007-01-01

    Purpose: To compare the health-related quality of life (HRQOL) among 5-10-year survivors of Stage I-II endometrial (adeno-)carcinoma (EC) treated with surgery alone or surgery with external beam adjuvant radiotherapy (EBRT) and an age-matched norm population. Methods and Materials: A population-based, cross-sectional survey was conducted by the Eindhoven Cancer Registry. All patients were included who had been diagnosed with EC between 1994 and 1998 (n = 462). Information from the questionnaires returned was linked to data from the Eindhoven Cancer Registry on patient, tumor, and treatment characteristics. Results: Responses were received from 75% of the patients. The analyses were restricted to women with Stage I-II disease at diagnosis, treated with either surgery alone or surgery with adjuvant EBRT, and without recurrent disease or new primary malignancies (n = 264). The patients who had received adjuvant EBRT (n = 80) had had a significantly higher tumor stage and grade at diagnosis (p < 0.0001) and a longer mean time since diagnosis (p = 0.04). Age, number of comorbid diseases, current marital status, nulliparity, education, and occupation were similar for both treatment groups. On multivariate analyses, adjuvant EBRT was independently and negatively associated with the vitality and physical and social well-being scale scores. The HRQOL scores of both treatment groups, however, were similar to those of an age-matched norm population. Conclusion: In general, the HRQOL of EC survivors is good. EC survivors treated with surgery alone had a better HRQOL than women treated with surgery and adjuvant EBRT, although for both groups, the HRQOL was in the range of the norm population

  8. Long-term Outcomes and Quality of Life of 186 Patients With Primary Parotid Carcinoma Treated With Surgery and Radiotherapy at the Daniel den Hoed Cancer Center

    Energy Technology Data Exchange (ETDEWEB)

    Al-Mamgani, Abrahim, E-mail: a.al-mamgani@erasmusmc.nl [Department of Radiation Oncology, Erasmus Medical Center-Daniel den Hoed Cancer Center, Rotterdam (Netherlands); Rooij, Peter van [Department of Biostatistics, Erasmus Medical Center-Daniel den Hoed Cancer Center, Rotterdam (Netherlands); Verduijn, Gerda M. [Department of Radiation Oncology, Erasmus Medical Center-Daniel den Hoed Cancer Center, Rotterdam (Netherlands); Meeuwis, Cees A. [Department of Otorhinolaryngology, Erasmus Medical Center-Daniel den Hoed Cancer Center, Rotterdam (Netherlands); Levendag, Peter C. [Department of Radiation Oncology, Erasmus Medical Center-Daniel den Hoed Cancer Center, Rotterdam (Netherlands)

    2012-09-01

    Purpose: To assess the outcomes, toxicity, and quality of life (QOL) of patients with primary parotid carcinoma treated with surgery and postoperative radiotherapy at the Daniel den Hoed Cancer Center. Methods and Materials: Between 1995 and 2010, 186 patients with parotid carcinoma were treated with parotidectomy with or without neck dissection, followed by radiotherapy. Elective nodal irradiation (ENI) was applied to high-risk, node-negative disease. End points were locoregional control (LRC), disease-free survival (DFS), cause-specific survival (CSS), and overall survival (OS), late toxicity, and QOL. Results: After a median follow-up of 58 months (range, 4-172 months), the 5-year Kaplan-Meier estimates for LRC, DFS, CSS, and OS were 89%, 83%, 80%, and 68%, respectively. Forty-five events were reported: 24 distant metastases (DM) and 21 locoregional failures (LRF). Event-free survival rates by histological types were 89%, 78%, 76%, 74%, and 70% for acinic cell, mucoepidermoid, adenoid cystic, adenocarcinoma, and squamous cell carcinoma, respectively. More LRF were reported in patients with squamous cell and high-grade mucoepidermoid carcinoma (21% and 19%, respectively) than in patients with other histological types (p = 0.04) and more DM in patients with adenoid cystic and adenocarcinoma (20% and 19%, respectively) than in patients with other types (p = 0.03). None of the high-risk node-negative patients who received ENI developed regional failure. On multivariate analysis, T stage, N stage, grade, and presence of perineural invasion and facial paralysis correlated significantly with DFS. The 5-year cumulative incidence of grade {>=}2 late toxicity was 8%. QOL scores deteriorate during and shortly after treatment but returned in almost all scales to baseline scores within 6 months. Conclusions: Of the entire group, surgery and postoperative radiotherapy resulted in excellent outcomes with minimal side effects and preservation of good QOL scores. However, in

  9. Long-term Outcomes and Quality of Life of 186 Patients With Primary Parotid Carcinoma Treated With Surgery and Radiotherapy at the Daniel den Hoed Cancer Center

    International Nuclear Information System (INIS)

    Al-Mamgani, Abrahim; Rooij, Peter van; Verduijn, Gerda M.; Meeuwis, Cees A.; Levendag, Peter C.

    2012-01-01

    Purpose: To assess the outcomes, toxicity, and quality of life (QOL) of patients with primary parotid carcinoma treated with surgery and postoperative radiotherapy at the Daniel den Hoed Cancer Center. Methods and Materials: Between 1995 and 2010, 186 patients with parotid carcinoma were treated with parotidectomy with or without neck dissection, followed by radiotherapy. Elective nodal irradiation (ENI) was applied to high-risk, node-negative disease. End points were locoregional control (LRC), disease-free survival (DFS), cause-specific survival (CSS), and overall survival (OS), late toxicity, and QOL. Results: After a median follow-up of 58 months (range, 4–172 months), the 5-year Kaplan-Meier estimates for LRC, DFS, CSS, and OS were 89%, 83%, 80%, and 68%, respectively. Forty-five events were reported: 24 distant metastases (DM) and 21 locoregional failures (LRF). Event-free survival rates by histological types were 89%, 78%, 76%, 74%, and 70% for acinic cell, mucoepidermoid, adenoid cystic, adenocarcinoma, and squamous cell carcinoma, respectively. More LRF were reported in patients with squamous cell and high-grade mucoepidermoid carcinoma (21% and 19%, respectively) than in patients with other histological types (p = 0.04) and more DM in patients with adenoid cystic and adenocarcinoma (20% and 19%, respectively) than in patients with other types (p = 0.03). None of the high-risk node-negative patients who received ENI developed regional failure. On multivariate analysis, T stage, N stage, grade, and presence of perineural invasion and facial paralysis correlated significantly with DFS. The 5-year cumulative incidence of grade ≥2 late toxicity was 8%. QOL scores deteriorate during and shortly after treatment but returned in almost all scales to baseline scores within 6 months. Conclusions: Of the entire group, surgery and postoperative radiotherapy resulted in excellent outcomes with minimal side effects and preservation of good QOL scores. However, in

  10. Estimated disability-adjusted life years averted by long-term provision of long acting contraceptive methods in a Brazilian clinic.

    Science.gov (United States)

    Bahamondes, Luis; Bottura, Bruna F; Bahamondes, M Valeria; Gonçalves, Mayara P; Correia, Vinicius M; Espejo-Arce, Ximena; Sousa, Maria H; Monteiro, Ilza; Fernandes, Arlete

    2014-10-10

    What is the contribution of the provision, at no cost for users, of long acting reversible contraceptive methods (LARC; copper intrauterine device [IUD], the levonorgestrel-releasing intrauterine system [LNG-IUS], contraceptive implants and depot-medroxyprogesterone [DMPA] injection) towards the disability-adjusted life years (DALY) averted through a Brazilian university-based clinic established over 30 years ago. Over the last 10 years of evaluation, provision of LARC methods and DMPA by the clinic are estimated to have contributed to DALY averted by between 37 and 60 maternal deaths, 315-424 child mortalities, 634-853 combined maternal morbidity and mortality and child mortality, and 1056-1412 unsafe abortions averted. LARC methods are associated with a high contraceptive effectiveness when compared with contraceptive methods which need frequent attention; perhaps because LARC methods are independent of individual or couple compliance. However, in general previous studies have evaluated contraceptive methods during clinical studies over a short period of time, or not more than 10 years. Furthermore, information regarding the estimation of the DALY averted is scarce. We reviewed 50 004 medical charts from women who consulted for the first time looking for a contraceptive method over the period from 2 January 1980 through 31 December 2012. Women who consulted at the Department of Obstetrics and Gynaecology, University of Campinas, Brazil were new users and users switching contraceptive, including the copper IUD (n = 13 826), the LNG-IUS (n = 1525), implants (n = 277) and DMPA (n = 9387). Estimation of the DALY averted included maternal morbidity and mortality, child mortality and unsafe abortions averted. We obtained 29 416 contraceptive segments of use including 25 009 contraceptive segments of use from 20 821 new users or switchers to any LARC method or DMPA with at least 1 year of follow-up. The mean (± SD) age of the women at first consultation ranged from 25

  11. Feasibility, reliability, and validity of the Pediatric Quality of Life Inventory ™ generic core scales, cancer module, and multidimensional fatigue scale in long-term adult survivors of pediatric cancer.

    Science.gov (United States)

    Robert, Rhonda S; Paxton, Raheem J; Palla, Shana L; Yang, Grace; Askins, Martha A; Joy, Shaini E; Ater, Joann L

    2012-10-01

    Most health-related quality of life assessments are designed for either children or adults and have not been evaluated for adolescent and young adult survivors of pediatric cancer. The objective of this study was to examine the feasibility, reliability, and validity of the Pediatric Quality of Life Inventory (PedsQL ™ Generic Core Scales, Cancer Module, and Multidimensional Fatigue Scale in adult survivors of pediatric cancer. Adult survivors (n = 64; Mean age 35 year old; >2 years after treatment) completed the PedsQL™ Generic Core Scales, Cancer Module, and Multidimensional Fatigue Scale. Feasibility was examined with floor and ceiling effects; and internal consistency was determined by Cronbach's coefficient alpha calculations. Inter-factor correlations were also assessed. Significant ceiling effects were observed for the scales of social function, nausea, procedural anxiety, treatment anxiety, and communication. Internal consistency for all subscales was within the recommended ranges (α ≥ 0.70). Moderate to strong correlations between most Cancer Module and Generic Core Scales (r = 0.25 to r = 0.76) and between the Multidimensional Fatigue Scale and Generic Core Scales (r = 0.37 to r = 0.73). The PedsQL™ Generic Core Scales, Cancer Module, and Multidimensional Fatigue Scale appear to be feasible for an older population of pediatric cancer survivors; however, some of the Cancer Module Scales (nausea, procedural/treatment anxiety, and communication) were deemed not relevant for long-term survivors. More information is needed to determine whether the issues addressed by these modules are meaningful to long-term adult survivors of pediatric cancers. Copyright © 2012 Wiley Periodicals, Inc.

  12. Navigating Long-Term Care

    Directory of Open Access Journals (Sweden)

    James D. Holt MD

    2017-03-01

    Full Text Available Americans over age 65 constitute a larger percentage of the population each year: from 14% in 2010 (40 million elderly to possibly 20% in 2030 (70 million elderly. In 2015, an estimated 66 million people provided care to the ill, disabled, and elderly in the United States. In 2000, according to the Centers for Disease Control and Prevention (CDC, 15 million Americans used some form of long-term care: adult day care, home health, nursing home, or hospice. In all, 13% of people over 85 years old, compared with 1% of those ages 65 to 74, live in nursing homes in the United States. Transitions of care, among these various levels of care, are common: Nursing home to hospital transfer, one of the best-studied transitions, occurs in more than 25% of nursing home residents per year. This article follows one patient through several levels of care.

  13. Short and long-term effects of supervised versus unsupervised exercise training on health-related quality of life and functional outcomes following lung cancer surgery - a randomized controlled trial.

    Science.gov (United States)

    Brocki, Barbara Cristina; Andreasen, Jane; Nielsen, Lene Rodkjaer; Nekrasas, Vytautas; Gorst-Rasmussen, Anders; Westerdahl, Elisabeth

    2014-01-01

    Surgical resection enhances long-term survival after lung cancer, but survivors face functional deficits and report on poor quality of life long time after surgery. This study evaluated short and long-term effects of supervised group exercise training on health-related quality of life and physical performance in patients, who were radically operated for lung cancer. A randomized, assessor-blinded, controlled trial was performed on 78 patients undergoing lung cancer surgery. The intervention group (IG, n=41) participated in supervised out-patient exercise training sessions, one hour once a week for ten weeks. The sessions were based on aerobic exercises with target intensity of 60-80% of work capacity, resistance training and dyspnoea management. The control group (CG, n=37) received one individual instruction in exercise training. Measurements consisted of: health-related quality of life (SF36), six minute walk test (6MWT) and lung function (spirometry), assessed three weeks after surgery and after four and twelve months. Both groups were comparable at baseline on demographic characteristic and outcome values. We found a statistically significant effect after four months in the bodily pain domain of SF36, with an estimated mean difference (EMD) of 15.3 (95% CI:4 to 26.6, p=0.01) and a trend in favour of the intervention for role physical functioning (EMD 12.04, 95% CI: -1 to 25.1, p=0.07) and physical component summary (EMD 3.76, 95% CI:-0.1 to 7.6, p=0.06). At 12 months, the tendency was reversed, with the CG presenting overall slightly better measures. We found no effect of the intervention on 6MWT or lung volumes at any time-point. Supervised compared to unsupervised exercise training resulted in no improvement in health-related quality of life, except for the bodily pain domain, four months after lung cancer surgery. No effects of the intervention were found for any outcome after one year. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  14. Preclinical rodent toxicity studies for long term use of ceftriaxone

    Directory of Open Access Journals (Sweden)

    Elena Ratti

    2015-01-01

    Ceftriaxone showed rapid absorption with half-life values ranging between 1 and 1.5 h. Additionally, there was no evidence of accumulation and a virtually complete elimination by 16 h after the last dose. Overall there were no toxicologically meaningful drug-related animal findings associated with the long-term administration (6 months of ceftriaxone. These results support safety of long-term use of ceftriaxone in human clinical trials.

  15. Long-term outcome of craniopharyngioma in children. A review

    International Nuclear Information System (INIS)

    Tamiya, Takashi; Okada, Masaki; Miyake, Keisuke; Kawai, Nobuyuki

    2011-01-01

    The treatment for pediatric craniopharyngioma remains challenging and controversial. Although this tumor is histologically benign, the treatments include radical surgery, conservative surgery, radiotherapy, intracystic chemotherapy and multimodality approaches. In addition, the long-term functional outcomes including visual function, endocrine function, cognitive function, hypothalamic function, and quality of life are complex and major problems among survivors. In this paper, we reviewed the recent treatments for pediatric craniopharyngioma and the long-term outcomes after treatment in literatures. (author)

  16. Short- and Long-Term Quality of Life and Bowel Function in Patients With MRI-Defined, High-Risk, Locally Advanced Rectal Cancer Treated With an Intensified Neoadjuvant Strategy in the Randomized Phase 2 EXPERT-C Trial

    International Nuclear Information System (INIS)

    Sclafani, Francesco; Peckitt, Clare; Cunningham, David; Tait, Diana; Giralt, Jordi; Glimelius, Bengt; Keränen, Susana Roselló; Bateman, Andrew; Hickish, Tamas; Tabernero, Josep; Thomas, Janet; Brown, Gina; Oates, Jacqueline; Chau, Ian

    2015-01-01

    Objective: Intensified preoperative treatments have been increasingly investigated in locally advanced rectal cancer (LARC), but limited data are available for the impact of these regimens on quality of life (QoL) and bowel function (BF). We assessed these outcome measures in EXPERT-C, a randomized phase 2 trial of neoadjuvant capecitabine combined with oxaliplatin (CAPOX), followed by chemoradiation therapy (CRT), total mesorectal excision, and adjuvant CAPOX with or without cetuximab in magnetic resonance imaging-defined, high-risk LARC. Methods and Materials: QoL was assessed using the European Organization for Research and Treatment of Cancer QLQ-C30 and QLQ-CR29 questionnaires. Bowel incontinence was assessed using the modified Fecal Incontinence Severity Index questionnaire. Results: Compared to baseline, QoL scores during preoperative treatment were better for symptoms associated with the primary tumor in the rectum (blood and mucus in stool, constipation, diarrhea, stool frequency, buttock pain) but worse for global health status, role functioning, and symptoms related to the specific safety profile of each treatment modality. During follow-up, improved emotional functioning and lessened anxiety and insomnia were observed, but deterioration of body image, increased urinary incontinence, less sexual interest (men), and increased impotence and dyspareunia were observed. Cetuximab was associated with a deterioration of global health status during neoadjuvant chemotherapy but did not have any long-term detrimental effect. An improvement in bowel continence was observed after preoperative treatment and 3 years after sphincter-sparing surgery. Conclusions: Intensifying neoadjuvant treatment by administering induction systemic chemotherapy before chemoradiation therapy improves tumor-related symptoms and does not appear to have a significantly detrimental effect on QoL and BF, in both the short and the long term

  17. Short- and Long-Term Quality of Life and Bowel Function in Patients With MRI-Defined, High-Risk, Locally Advanced Rectal Cancer Treated With an Intensified Neoadjuvant Strategy in the Randomized Phase 2 EXPERT-C Trial

    Energy Technology Data Exchange (ETDEWEB)

    Sclafani, Francesco; Peckitt, Clare [The Royal Marsden NHS Foundation Trust, London (United Kingdom); Cunningham, David, E-mail: david.cunningham@rmh.nhs.uk [The Royal Marsden NHS Foundation Trust, London (United Kingdom); Tait, Diana [The Royal Marsden NHS Foundation Trust, London (United Kingdom); Giralt, Jordi [Vall d' Hebron University Hospital, Universitat Autònoma de Barcelona, Department of Medical Oncology, Barcelona (Spain); Glimelius, Bengt [University of Uppsala, Uppsala (Sweden); Keränen, Susana Roselló [Biomedical Research Institute INCLIVA, Department of Hematology and Medical Oncology, University of Valencia (Spain); Bateman, Andrew [Southampton General Hospital, Cancer Sciences Unit, University of Southampton (United Kingdom); Hickish, Tamas [Poole Hospital NHS Foundation Trust, Department of Medical Oncology, Bournemouth University (United Kingdom); Tabernero, Josep [Vall d' Hebron University Hospital, Universitat Autònoma de Barcelona, Department of Medical Oncology, Barcelona (Spain); Thomas, Janet; Brown, Gina; Oates, Jacqueline; Chau, Ian [The Royal Marsden NHS Foundation Trust, London (United Kingdom)

    2015-10-01

    Objective: Intensified preoperative treatments have been increasingly investigated in locally advanced rectal cancer (LARC), but limited data are available for the impact of these regimens on quality of life (QoL) and bowel function (BF). We assessed these outcome measures in EXPERT-C, a randomized phase 2 trial of neoadjuvant capecitabine combined with oxaliplatin (CAPOX), followed by chemoradiation therapy (CRT), total mesorectal excision, and adjuvant CAPOX with or without cetuximab in magnetic resonance imaging-defined, high-risk LARC. Methods and Materials: QoL was assessed using the European Organization for Research and Treatment of Cancer QLQ-C30 and QLQ-CR29 questionnaires. Bowel incontinence was assessed using the modified Fecal Incontinence Severity Index questionnaire. Results: Compared to baseline, QoL scores during preoperative treatment were better for symptoms associated with the primary tumor in the rectum (blood and mucus in stool, constipation, diarrhea, stool frequency, buttock pain) but worse for global health status, role functioning, and symptoms related to the specific safety profile of each treatment modality. During follow-up, improved emotional functioning and lessened anxiety and insomnia were observed, but deterioration of body image, increased urinary incontinence, less sexual interest (men), and increased impotence and dyspareunia were observed. Cetuximab was associated with a deterioration of global health status during neoadjuvant chemotherapy but did not have any long-term detrimental effect. An improvement in bowel continence was observed after preoperative treatment and 3 years after sphincter-sparing surgery. Conclusions: Intensifying neoadjuvant treatment by administering induction systemic chemotherapy before chemoradiation therapy improves tumor-related symptoms and does not appear to have a significantly detrimental effect on QoL and BF, in both the short and the long term.

  18. Long term study of mechanical

    Directory of Open Access Journals (Sweden)

    Ahmed M. Diab

    2016-06-01

    Full Text Available In this study, properties of limestone cement concrete containing different replacement levels of limestone powder were examined. It includes 0%, 5%, 10%, 15%, 20% and 25% of limestone powder as a partial replacement of cement. Silica fume was added incorporated with limestone powder in some mixes to enhance the concrete properties. Compressive strength, splitting tensile strength and modulus of elasticity were determined. Also, durability of limestone cement concrete with different C3A contents was examined. The weight loss, length change and cube compressive strength loss were measured for concrete attacked by 5% sodium sulfate using an accelerated test up to 525 days age. The corrosion resistance was measured through accelerated corrosion test using first crack time, cracking width and steel reinforcement weight loss. Consequently, for short and long term, the use of limestone up to 10% had not a significant reduction in concrete properties. It is not recommended to use blended limestone cement in case of sulfate attack. The use of limestone cement containing up to 25% limestone has insignificant effect on corrosion resistance before cracking.

  19. Long-term competence restoration.

    Science.gov (United States)

    Morris, Douglas R; DeYoung, Nathaniel J

    2014-01-01

    While the United States Supreme Court's Jackson v. Indiana decision and most state statutes mandate determinations of incompetent defendants' restoration probabilities, courts and forensic clinicians continue to lack empirical evidence to guide these determinations and do not yet have a consensus regarding whether and under what circumstances incompetent defendants are restorable. The evidence base concerning the restoration likelihood of those defendants who fail initial restoration efforts is even further diminished and has largely gone unstudied. In this study, we examined the disposition of a cohort of defendants who underwent long-term competence restoration efforts (greater than six months) and identified factors related to whether these defendants were able to attain restoration and adjudicative success. Approximately two-thirds (n = 52) of the 81 individuals undergoing extended restoration efforts were eventually deemed restored to competence. Lengths of hospitalization until successful restoration are presented with implications for the reasonable length of time that restoration efforts should persist. Older individuals were less likely to be restored and successfully adjudicated, and individuals with more severe charges and greater factual legal understanding were more likely to be restored and adjudicated. The significance of these findings for courts and forensic clinicians is discussed.

  20. Uranium ... long-term confidence

    International Nuclear Information System (INIS)

    Anon.

    1983-01-01

    Half way through 1983 the outlook for the world's uranium producers was far from bright if one takes a short term view. The readily accessible facts present a gloomy picture. The spot prices of uranium over the past few years decreased from a high of $42-$43/lb to a low of $17 in 1982. It now hovers between $23 and $24. the contract prices negotiated between producers and consumers are not so accessible but they do not reflect the spot price. The reasons why contractual uranium prices do not follow the usual dictates of supply and demand are related to the position in which uranium and associated power industries find themselves. There is public reaction with strong emotional overtones as well as much reduced expectations about the electric power needs of the world. Furthermore the supply of uranium is not guaranteed despite present over production. However the people in the industry, taking the medium- and long-term view, are not despondent

  1. Long-term corrosion studies

    International Nuclear Information System (INIS)

    Gdowski, G.

    1998-01-01

    The scope of this activity is to assess the long-term corrosion properties of metallic materials under consideration for fabricating waste package containers. Three classes of metals are to be assessed: corrosion resistant, intermediate corrosion resistant, and corrosion allowance. Corrosion properties to be evaluated are general, pitting and crevice corrosion, stress-corrosion cracking, and galvanic corrosion. The performance of these materials will be investigated under conditions that are considered relevant to the potential emplacement site. Testing in four aqueous solutions, and vapor phases above them, and at two temperatures are planned for this activity. (The environmental conditions, test metals, and matrix are described in detail in Section 3.0.) The purpose and objective of this activity is to obtain the kinetic and mechanistic information on degradation of metallic alloys currently being considered for waste package containers. This information will be used to provide assistance to (1) waste package design (metal barrier selection) (E-20-90 to E-20-92), (2) waste package performance assessment activities (SIP-PA-2), (3) model development (E-20-75 to E-20-89). and (4) repository license application

  2. Mild prenatal protein malnutrition increases alpha2C-adrenoceptor density in the cerebral cortex during postnatal life and impairs neocortical long-term potentiation and visuo-spatial performance in rats.

    Science.gov (United States)

    Soto-Moyano, Rubén; Valladares, Luis; Sierralta, Walter; Pérez, Hernán; Mondaca, Mauricio; Fernández, Victor; Burgos, Héctor; Hernández, Alejandro

    2005-06-01

    Mild reduction in the protein content of the mother's diet from 25 to 8% casein, calorically compensated by carbohydrates, does not alter body and brain weights of rat pups at birth, but leads to significant enhancements in the concentration and release of cortical noradrenaline during early postnatal life. Since central noradrenaline and some of its receptors are critically involved in long-term potentiation (LTP) and memory formation, this study evaluated the effect of mild prenatal protein malnutrition on the alpha2C-adrenoceptor density in the frontal and occipital cortices, induction of LTP in the same cortical regions and the visuo-spatial memory. Pups born from rats fed a 25% casein diet throughout pregnancy served as controls. At day 8 of postnatal age, prenatally malnourished rats showed a threefold increase in neocortical alpha2C-adrenoceptor density. At 60 days-of-age, alpha2C-adrenoceptor density was still elevated in the neocortex, and the animals were unable to maintain neocortical LTP and presented lower visuo-spatial memory performance. Results suggest that overexpression of neocortical alpha2C-adrenoceptors during postnatal life, subsequent to mild prenatal protein malnutrition, could functionally affect the synaptic networks subserving neocortical LTP and visuo-spatial memory formation.

  3. Semi-empirical long-term cycle life model coupled with an electrolyte depletion function for large-format graphite/LiFePO4 lithium-ion batteries

    Science.gov (United States)

    Park, Joonam; Appiah, Williams Agyei; Byun, Seoungwoo; Jin, Dahee; Ryou, Myung-Hyun; Lee, Yong Min

    2017-10-01

    To overcome the limitation of simple empirical cycle life models based on only equivalent circuits, we attempt to couple a conventional empirical capacity loss model with Newman's porous composite electrode model, which contains both electrochemical reaction kinetics and material/charge balances. In addition, an electrolyte depletion function is newly introduced to simulate a sudden capacity drop at the end of cycling, which is frequently observed in real lithium-ion batteries (LIBs). When simulated electrochemical properties are compared with experimental data obtained with 20 Ah-level graphite/LiFePO4 LIB cells, our semi-empirical model is sufficiently accurate to predict a voltage profile having a low standard deviation of 0.0035 V, even at 5C. Additionally, our model can provide broad cycle life color maps under different c-rate and depth-of-discharge operating conditions. Thus, this semi-empirical model with an electrolyte depletion function will be a promising platform to predict long-term cycle lives of large-format LIB cells under various operating conditions.

  4. Health-related quality of life and functional outcomes from a randomized-withdrawal study of long-term lisdexamfetamine dimesylate treatment in children and adolescents with attention-deficit/hyperactivity disorder.

    Science.gov (United States)

    Banaschewski, Tobias; Johnson, Mats; Lecendreux, Michel; Zuddas, Alessandro; Adeyi, Ben; Hodgkins, Paul; Squires, Liza A; Coghill, David R

    2014-12-01

    The stimulant prodrug lisdexamfetamine dimesylate (LDX) is an effective and generally well tolerated treatment for the symptoms of attention-deficit/hyperactivity disorder (ADHD). Positive impacts of LDX on health-related quality of life and functional impairment have previously been demonstrated in a 7-week, randomized, double-blind, placebo-controlled, phase III study in children and adolescents in Europe. Maintenance of these broad benefits, as well as symptomatic control, is a key goal of long-term management of ADHD. Secondary objectives of this multinational study in children and adolescents with ADHD were to assess the long-term maintenance of effectiveness of LDX in improving health-related quality of life and reducing functional impairment, as gauged using the Child Health and Illness Profile-Child Edition: Parent Report Form (CHIP-CE: PRF) and the Weiss Functional Impairment Rating Scale-Parent Report (WFIRS-P), respectively. Patients aged 6-17 years with diagnosed ADHD and a baseline ADHD Rating Scale IV total score of at least 28 were enrolled from the previous European study and from US sites. Patients who completed an open-label LDX treatment period of at least 26 weeks were randomized (1:1) to continue on their optimized dose of LDX or to switch to placebo for a 6-week, double-blind, withdrawal period. Parents completed CHIP-CE: PRF and WFIRS-P questionnaires at weeks 0, 8 and 26 of the open-label period and at weeks 0 and 6 of the randomized-withdrawal period, or at early termination. The endpoint of each period was defined as the last visit with valid data. Effect sizes were the difference (LDX minus placebo) in least-squares (LS)-mean change from baseline to endpoint divided by root-mean-square error. P values were nominal and not adjusted for multiple comparisons. The open-label and randomized full analysis sets comprised 262 and 153 (LDX n = 76; placebo n = 77) patients, respectively. Mean pretreatment CHIP-CE: PRF T-scores were more than one

  5. Strategies to meet the need for long-term data.

    Science.gov (United States)

    Chalmers, John; Woodward, Mark; Borghi, Claudio; Manolis, Athanasios; Mancia, Giuseppe

    2016-08-01

    Chronic diseases afflict patients for many years, often to the end of life, and there is increasing need for estimating lifelong risk and for evaluating the effects of treatment in the long term. Yet recommendations for lifelong treatment are most frequently based on findings from randomized clinical trials lasting only a few years. There is therefore a clear need for much longer term data, and here we present the advantages and disadvantages of many strategies, including the use of long-term posttrial follow-up, of long-term prospective cohort studies, registry databases, and of administrative databases. We also emphasize the need for long-term cost-effectiveness studies. One of the most promising strategies comes from linkage of data gathered through the ever-expanding pool of administrative databases worldwide with data from other sources, including randomized trials and the many forms of observational study.

  6. Long-term risks of kidney living donation

    DEFF Research Database (Denmark)

    Maggiore, Umberto; Budde, Klemens; Heemann, Uwe

    2017-01-01

    Two recent matched cohort studies from the USA and Norway published in 2014 have raised some concerns related to the long-term safety of kidney living donation. Further studies on the long-term risks of living donation have since been published. In this position paper, Developing Education Science...... and Care for Renal Transplantation in European States (DESCARTES) board members critically review the literature in an effort to summarize the current knowledge concerning long-term risks of kidney living donation to help physicians for decision-making purposes and for providing information...... to the prospective live donors. Long-term risk of end-stage renal disease (ESRD) can be partially foreseen by trying to identify donors at risk of developing ‘de novo’ kidney diseases during life post-donation and by predicting lifetime ESRD risk. However, lifetime risk may be difficult to assess in young donors...

  7. Long-term opioid therapy in Denmark

    DEFF Research Database (Denmark)

    Birke, H; Ekholm, Ola; Sjøgren, P

    2017-01-01

    significantly associated with initiation of L-TOT in individuals with CNCP at baseline. During follow-up, L-TOT in CNCP patients increased the likelihood of negative changes in pain interference with work (OR 9.2; 95% CI 1.9-43.6) and in moderate activities (OR 3.7; 95% CI 1.1-12.6). The analysis of all......,145). A nationally representative subsample of individuals (n = 2015) completed the self-administered questionnaire in both 2000 and 2013. Collected information included chronic pain (≥6 months), health behaviour, self-rated health, pain interference with work activities and physical activities. Long-term users were...... individuals indicated a dose-response relationship between longer treatment duration and the risk of experiencing negative changes. CONCLUSIONS: Individuals on L-TOT seemed not to achieve the key goals of opioid therapy: pain relief, improved quality of life and functional capacity. SIGNIFICANCE: Long...

  8. Long-term results of peripheral arterial disease rehabilitation

    NARCIS (Netherlands)

    Menard, J.R.; Smith, H.E.; Riebe, D.; Braun, C.M.; Blissmer, B.; Patterson, R.B.

    2004-01-01

    Purpose Although the Peripheral Arterial Disease Rehabilitation Program (PADRx) improves walking ability and quality of life over brief periods of follow-up, the long-term durability of results has not been established. This study examined functional status, walking ability, and quality of life in

  9. Safety objectives and basic design for surface centres for long-term storage of solid radioactive waste with short or medium half-life and low or medium specific activity

    International Nuclear Information System (INIS)

    1984-06-01

    RFS or Regles Fondamentales de Surete (Basic Safety Rules) applicable to certain types of nuclear facilities lay down requirements with which compliance, for the type of facilities and within the scope of application covered by the RFS, is considered to be equivalent to compliance with technical French regulatory practice. The object of the RFS is to take advantage of standardization in the field of safety, while allowing for technical progress in that field. They are designed to enable the operating utility and contractors to know the rules pertaining to various subjects which are considered to be acceptable by the Service Central de Surete des Installations Nucleaires, or the SCSIN (Central Department for the Safety of Nuclear Facilities). These RFS should make safety analysis easier and lead to better understanding between experts and individuals concerned with the problems of nuclear safety. The SCSIN reserves the right to modify, when considered necessary, any RFS and specify, if need be, the terms under which a modification is deemed retroactive. The role of this RFS is to define the safety objectives and the basic design philosophy for surface centres for long-term storage of packages of radioactive waste with short or medium half-life and with low or medium specific activity

  10. Numerical simulation of long-term radiation effects for MOSFETs

    International Nuclear Information System (INIS)

    Wei Yuan; Xie Honggang; Gong Ding; Zhu Jinhui; Niu Shengli; Huang Liuxing

    2013-01-01

    A coupled algorithm is introduced to simulate the long-term radiation effects of MOSFETs, which combines particle transport with semiconductor governing equations. The former is dealt with Monte-Carlo method, and the latter is solved by finite-volume method. The trapped charge in SiO 2 and the free charge in Si are both described by the drift-diffusion model, and the deposited energy by incident particles can be coupled with the continuous equations of charge, acting as a source item. The discrete form of governing equations is obtained using the finite-volume method, and the numerical solutions of these equations are the long-term radiation response result of MOSFETs. The threshold voltage shift and off-state leakage current of an irradiated MOSFET are simulated with the coupled algorithm respectively, showing a good accordance with results by other calculations. (authors)

  11. Compromised quality of life in adult patients who have received a radiation dose towards the basal part of the brain. A case-control study in long-term survivors from cancer in the head and neck region

    Directory of Open Access Journals (Sweden)

    Löfdahl Elisabet

    2012-10-01

    Full Text Available Abstract Background Adult patients with hypothalamic-pituitary disorders have compromised quality of life (QoL. Whether this is due to their endocrine consequences (hypopituitarism, their underlying hypothalamic-pituitary disorder or both is still under debate. The aim of this trial was to measure quality of life (QoL in long-term cancer survivors who have received a radiation dose to the basal part of the brain and the pituitary. Methods Consecutive patients (n=101 treated for oropharyngeal or epipharyngeal cancer with radiotherapy followed free of cancer for a period of 4 to10 years were identified. Fifteen patients (median age 56 years with no concomitant illness and no hypopituitarism after careful endocrine evaluation were included in a case-control study with matched healthy controls. Doses to the hypothalamic-pituitary region were calculated. QoL was assessed using the Symptom check list (SCL-90, Nottingham Health Profile (NHP, and Psychological Well Being (PGWB questionnaires. Level of physical activity was assessed using the Baecke questionnaire. Results The median accumulated dose was 1.9 Gy (1.5–2.2 Gy to the hypothalamus and 2.4 Gy (1.8–3.3 Gy to the pituitary gland in patients with oropharyngeal cancer and 6.0–9.3 Gy and 33.5–46.1 Gy, respectively in patients with epipharyngeal cancer (n=2. The patients showed significantly more anxiety and depressiveness, and lower vitality, than their matched controls. Conclusion In a group of long time survivors of head and neck cancer who hade received a low radiation dose to the hypothalamic-pituitary region and who had no endocrine consequences of disease or its treatment QoL was compromised as compared with well matched healthy controls.

  12. Compromised quality of life in adult patients who have received a radiation dose towards the basal part of the brain. A case-control study in long-term survivors from cancer in the head and neck region.

    Science.gov (United States)

    Löfdahl, Elisabet; Berg, Gertrud; Johansson, Karl-Axel; Zachrisson, Maria Leonsson; Malmgren, Helge; Mercke, Claes; Olsson, Erik; Wiren, Lena; Johannsson, Gudmundur

    2012-10-29

    Adult patients with hypothalamic-pituitary disorders have compromised quality of life (QoL). Whether this is due to their endocrine consequences (hypopituitarism), their underlying hypothalamic-pituitary disorder or both is still under debate. The aim of this trial was to measure quality of life (QoL) in long-term cancer survivors who have received a radiation dose to the basal part of the brain and the pituitary. Consecutive patients (n=101) treated for oropharyngeal or epipharyngeal cancer with radiotherapy followed free of cancer for a period of 4 to10 years were identified. Fifteen patients (median age 56 years) with no concomitant illness and no hypopituitarism after careful endocrine evaluation were included in a case-control study with matched healthy controls. Doses to the hypothalamic-pituitary region were calculated. QoL was assessed using the Symptom check list (SCL)-90, Nottingham Health Profile (NHP), and Psychological Well Being (PGWB) questionnaires. Level of physical activity was assessed using the Baecke questionnaire. The median accumulated dose was 1.9 Gy (1.5-2.2 Gy) to the hypothalamus and 2.4 Gy (1.8-3.3 Gy) to the pituitary gland in patients with oropharyngeal cancer and 6.0-9.3 Gy and 33.5-46.1 Gy, respectively in patients with epipharyngeal cancer (n=2). The patients showed significantly more anxiety and depressiveness, and lower vitality, than their matched controls. In a group of long time survivors of head and neck cancer who hade received a low radiation dose to the hypothalamic-pituitary region and who had no endocrine consequences of disease or its treatment QoL was compromised as compared with well matched healthy controls.

  13. Compromised quality of life in adult patients who have received a radiation dose towards the basal part of the brain. A case-control study in long-term survivors from cancer in the head and neck region

    International Nuclear Information System (INIS)

    Löfdahl, Elisabet; Berg, Gertrud; Johansson, Karl-Axel; Zachrisson, Maria Leonsson; Malmgren, Helge; Mercke, Claes; Olsson, Erik; Wiren, Lena; Johannsson, Gudmundur

    2012-01-01

    Adult patients with hypothalamic-pituitary disorders have compromised quality of life (QoL). Whether this is due to their endocrine consequences (hypopituitarism), their underlying hypothalamic-pituitary disorder or both is still under debate. The aim of this trial was to measure quality of life (QoL) in long-term cancer survivors who have received a radiation dose to the basal part of the brain and the pituitary. Consecutive patients (n=101) treated for oropharyngeal or epipharyngeal cancer with radiotherapy followed free of cancer for a period of 4 to10 years were identified. Fifteen patients (median age 56 years) with no concomitant illness and no hypopituitarism after careful endocrine evaluation were included in a case-control study with matched healthy controls. Doses to the hypothalamic-pituitary region were calculated. QoL was assessed using the Symptom check list (SCL)-90, Nottingham Health Profile (NHP), and Psychological Well Being (PGWB) questionnaires. Level of physical activity was assessed using the Baecke questionnaire. The median accumulated dose was 1.9 Gy (1.5–2.2 Gy) to the hypothalamus and 2.4 Gy (1.8–3.3 Gy) to the pituitary gland in patients with oropharyngeal cancer and 6.0–9.3 Gy and 33.5–46.1 Gy, respectively in patients with epipharyngeal cancer (n=2). The patients showed significantly more anxiety and depressiveness, and lower vitality, than their matched controls. In a group of long time survivors of head and neck cancer who hade received a low radiation dose to the hypothalamic-pituitary region and who had no endocrine consequences of disease or its treatment QoL was compromised as compared with well matched healthy controls

  14. NR2B subunit-dependent long-term potentiation enhancement in the rat cortical auditory system in vivo following masking of patterned auditory input by white noise exposure during early postnatal life.

    Science.gov (United States)

    Hogsden, Jennifer L; Dringenberg, Hans C

    2009-08-01

    The composition of N-methyl-D-aspartate (NMDA) receptor subunits influences the degree of synaptic plasticity expressed during development and into adulthood. Here, we show that theta-burst stimulation of the medial geniculate nucleus reliably induced NMDA receptor-dependent long-term potentiation (LTP) of field postsynaptic potentials recorded in the primary auditory cortex (A1) of urethane-anesthetized rats. Furthermore, substantially greater levels of LTP were elicited in juvenile animals (30-37 days old; approximately 55% maximal potentiation) than in adult animals (approximately 30% potentiation). Masking patterned sound via continuous white noise exposure during early postnatal life (from postnatal day 5 to postnatal day 50-60) resulted in enhanced, juvenile-like levels of LTP (approximately 70% maximal potentiation) relative to age-matched controls reared in unaltered acoustic environments (approximately 30%). Rats reared in white noise and then placed in unaltered acoustic environments for 40-50 days showed levels of LTP comparable to those of adult controls, indicating that white noise rearing results in a form of developmental arrest that can be overcome by subsequent patterned sound exposure. We explored the mechanisms mediating white noise-induced plasticity enhancements by local NR2B subunit antagonist application in A1. NR2B subunit antagonists (Ro 25-6981 or ifenprodil) completely reversed white noise-induced LTP enhancement at concentrations that did not affect LTP in adult or age-matched controls. We conclude that white noise exposure during early postnatal life results in the maintenance of juvenile-like, higher levels of plasticity in A1, an effect that appears to be critically dependent on NR2B subunit activation.

  15. Financing long term liabilities (Germany)

    International Nuclear Information System (INIS)

    2003-01-01

    charges and fees levied from the waste producers. Altogether, financial resources for decommissioning are needed for the following steps: the post-operational phase in which the facility is prepared for dismantling after its final shut-down, dismantling of the radioactive part of the facility, management, storage and disposal of the radioactive waste, restoration of the site, licensing and regulatory supervision of all these steps. Additional means are necessary for the management, storage and disposal of the spent fuel. The way in which the availability of financial resources is secured differs between public owned installations and installations of the private power utilities. In Germany, past practices has resulted in singular contaminated sites of limited extent, mainly during the first half of the 20. century. Those contaminated sites have been or are being cleaned up and redeveloped. In large areas of Saxony and Thuringia, the geological formations permitted the surface and underground mining of Uranium ore. Facilities of the former Soviet-German WISMUT Ltd. where ore was mined and processed from 1946 until the early 1990's can be found at numerous sites. In the course of the re-unification of Germany, the soviet shares of the WISMUT were taken over by the Federal Republic of Germany and the closure of the WISMUT facilities was initiated. In that phase the extent of the damages to the environment and of the necessary remediation work became clear. All mining and milling sites are now closed and are under decommissioning. A comprehensive remediation concept covers all WISMUT sites. Heaps and mill-tailing ponds are transferred into a long-term stable condition. The area of the facilities to be remediated amounts to more than 30 km 2 . Heaps cover a total area of ca. 15,5 km 2 , tailing ponds in which the tailings resulting from the Uranium production are stored as sludges cover 6,3 km 2 ). In total, the remediation issues are very complex and without precedent. The

  16. Efficacy of a long-term secondary prevention programme following inpatient cardiovascular rehabilitation on risk and health-related quality of life in a low-education cohort: a randomized controlled study.

    Science.gov (United States)

    Mayer-Berger, Wolfgang; Simic, Dusan; Mahmoodzad, Jawad; Burtscher, Ralph; Kohlmeyer, Martin; Schwitalla, Birgitta; Redaèlli, Marcus

    2014-02-01

    The aim of this study was to evaluate the efficacy of a long-term secondary prevention programme following inpatient cardiovascular rehabilitation on cardiovascular risk and health-related quality of life in a cohort of middle-aged (≤58 years) coronary artery disease (CAD) patients of low educational level compared to usual care. The study included 600 patients with CAD, with 271 in the intervention group (IG) and 329 in the control group (CG). The average age was nearly 50 years in both groups, nearly 90% were male, and 77% had less than 10 years of school education. No significant differences existed between the groups at baseline. Both groups had a 3-week comprehensive cardiovascular inpatient rehabilitation programme at the beginning, the intervention consisted of one further rehabilitation session in hospital after 6 months and regular telephone reminders over a period of 36 months. Analyses were conducted on an intention-to-treat basis. To evaluate the individual risk level, we used the PROCAM score and intima-media thickness (IMT) was measured at the common carotid artery on both sides following international standards. Health-related quality of life was assessed with the EUROQOL and HADS. Patients in the IG showed better 3-year risk profile outcomes. The PROCAM score increased by 3.0 (IG) and by 3.7 (CG) from the beginning to after 3 years (p > 0.05 intention-to-treat). The average IMT increased by 0.04 mm in the CG and was reduced by 0.03 mm in the IG (p = 0.014 for the difference). The IG had a significant improvement in health-related quality of life. Mortality, myocardial infarction, and stroke were not different although 'other cardiac events' (cardiac surgery or intervention) were significantly lower in the IG than the CG patients (p quality of life between the IG and CG, despite the relatively positive outcomes in the CG. In this low-education (predominantly male), middle-aged cohort, the positive impact on cardiovascular risk was

  17. Containment long-term operational integrity

    International Nuclear Information System (INIS)

    Sammataro, R.F.

    1990-01-01

    Periodic integrated leak rate tests are required to assure that containments continue to meet allowable leakage limits. Although overall performance has been quite good to date, several major containment aging and degradation mechanisms have been identified. Two pilot plant life extension (PLEX) studies serve as models for extending the operational integrity of present containments for light-water cooled nuclear power plants in the United States. One study is for a Boiling-Water Reactor (BWR) and the second is for a Pressurized-Water Reactor (PWR). Research and testing programs for determining the ultimate pressure capacity and failure mechanisms for containments under severe loading conditions and studies for extending the life of current plants beyond the present 40-year licensed lifetime are under way. This paper presents an overview of containment designs in the United States. Also presented are a discussion of the American Society of Mechanical Engineers Boiler and Pressure Vessel Code (ASME Code) and regulatory authority requirements for the design, construction, inservice inspection, leakage testing and repair of steel and concrete containments. Findings for containments from the pilot PLEX studies and continuing containment integrity research and testing programs are discussed. The ASME Code and regulatory requirements together with recommendations from the PLEX studies and containment integrity research and testing provide a basis for continued containment long-term operational integrity. (orig./GL)

  18. A Long-term Plan for Kalk

    DEFF Research Database (Denmark)

    2017-01-01

    In this case, the author demonstrates together with the owner-manager of KALK A/S, Mr Rasmus Jorgensen, how to use the Family Business Map to frame a constructive discussion about long-term planning. The Family Business Map is a tool for long-term planning in family firms developed by Professor...

  19. Virtual Models of Long-Term Care

    Science.gov (United States)

    Phenice, Lillian A.; Griffore, Robert J.

    2012-01-01

    Nursing homes, assisted living facilities and home-care organizations, use web sites to describe their services to potential consumers. This virtual ethnographic study developed models representing how potential consumers may understand this information using data from web sites of 69 long-term-care providers. The content of long-term-care web…

  20. Sexuality and Aging: Implications for Long Term Care.

    Science.gov (United States)

    Hinkley, Nancy E.

    With increasing emphasis on treating the whole person, on the maintenance of an individual's former life style, and on patients' rights, long-term care personnel need to become aware that many nursing home residents experience needs related to their sexuality. A model two-day workshop is presented wlth a focus on the following topics: (1) a broad…

  1. Long-term implant performance and patients' satisfaction in oligodontia

    NARCIS (Netherlands)

    Filius, Marieke A P; Vissink, Arjan; Cune, Marco S; Raghoebar, Gerry M; Visser, Anita

    Objectives: To assess long-term (>= 10 years) implant survival, peri-implant health, patients' satisfaction and oral health related quality of life (OHQoL) in oligodontia patients rehabilitated with implant-based fixed prosthodontics. Methods: All oligodontia patients treated >= 10 years previously

  2. Long-term Morbidity of Testicular Cancer Treatment.

    Science.gov (United States)

    Fung, Chunkit; Fossa, Sophie D; Williams, Annalynn; Travis, Lois B

    2015-08-01

    Second malignant neoplasms, cardiovascular disease, neurotoxicity and ototoxicity, pulmonary complications, hypogonadism, and nephrotoxicity are potentially life-threatening long-term complications of testicular cancer and its therapy. This article describes the pathogenesis, risks, and management of these late effects experienced by long-term testicular cancer survivors, who are defined as individuals who are disease free 5 years or more after primary treatment. Testicular cancer survivors should follow applicable national guidelines for cancer screening and management of cardiovascular disease risk factors. In addition, health care providers should capitalize on the time of cancer diagnosis as a teachable moment to introduce and promote lifestyle changes. Copyright © 2015 Elsevier Inc. All rights reserved.

  3. The developmental environment, epigenetic biomarkers and long-term health.

    Science.gov (United States)

    Godfrey, K M; Costello, P M; Lillycrop, K A

    2015-10-01

    Evidence from both human and animal studies has shown that the prenatal and early postnatal environments influence susceptibility to chronic disease in later life and suggests that epigenetic processes are an important mechanism by which the environment alters long-term disease risk. Epigenetic processes, including DNA methylation, histone modification and non-coding RNAs, play a central role in regulating gene expression. The epigenome is highly sensitive to environmental factors in early life, such as nutrition, stress, endocrine disruption and pollution, and changes in the epigenome can induce long-term changes in gene expression and phenotype. In this review we focus on how the early life nutritional environment can alter the epigenome leading to an altered susceptibility to disease in later life.

  4. The long-term lasting effectiveness on self-efficacy, attribution style, expression of emotions and quality of life of a body awareness program for chronic a-specific psychosomatic symptoms

    NARCIS (Netherlands)

    Landsman-Dijkstra, Jeanet J. A.; van Wijck, R; Groothoff, JW

    Objective: A 3-day residential body awareness program (BAP) was developed to teach people with chronic a-specific psychosomatic symptoms (CAPS) to react adequately to disturbances of the balance between a daily workload and the capacity to deal with it. The long-term effects of the program on body

  5. Long term wet spent nuclear fuel storage

    International Nuclear Information System (INIS)

    1987-04-01

    The meeting showed that there is continuing confidence in the use of wet storage for spent nuclear fuel and that long-term wet storage of fuel clad in zirconium alloys can be readily achieved. The importance of maintaining good water chemistry has been identified. The long-term wet storage behaviour of sensitized stainless steel clad fuel involves, as yet, some uncertainties. However, great reliance will be placed on long-term wet storage of spent fuel into the future. The following topics were treated to some extent: Oxidation of the external surface of fuel clad, rod consolidation, radiation protection, optimum methods of treating spent fuel storage water, physical radiation effects, and the behaviour of spent fuel assemblies of long-term wet storage conditions. A number of papers on national experience are included

  6. Industrial Foundations as Long-Term Owners

    DEFF Research Database (Denmark)

    Thomsen, Steen; Poulsen, Thomas; Børsting, Christa Winther

    Short-termism has become a serious concern for corporate governance, and this has inspired a search for institutional arrangements to promote long-term decision-making. In this paper, we call attention to long-term ownership by industrial foundations, which is common in Northern Europe but little...... known in the rest of the world. We use a unique Danish data set to document that industrial foundations are long-term owners that practice long-term governance. We show that foundation ownership is highly stable compared to other ownership structures. Foundation-owned companies replace managers less...... frequently. They have conservative capital structures with low financial leverage. They score higher on an index of long-termism in finance, investment, and employment. They survive longer. Overall, our paper supports the hypothesis that corporate time horizons are influenced by ownership structures...

  7. Coping with PH over the Long Term

    Science.gov (United States)

    ... a job, a volunteer commitment, or even a hobby can take a toll on long-term survivors ... people find solace in meditation, faith, humor, writing, hobbies and more. Find an outlet that you enjoy ...

  8. Long term effects of radiation in man

    International Nuclear Information System (INIS)

    Tso Chih Ping; Idris Besar

    1984-01-01

    An overview of the long term effects of radiation in man is presented, categorizing into somatic effects, genetic effects and teratogenic effects, and including an indication of the problems that arise in their determination. (author)

  9. Long term liquidity analysis of the firm

    Directory of Open Access Journals (Sweden)

    Jaroslav Gonos

    2009-09-01

    Full Text Available Liquidity control is a very difficult and important function. If the business is not liquid in the long term, it is under threatof bankruptcy, and on the other hand surplus of the cash in hand threaten its future efficiency, because the cash in hand is a sourceof only limited profitability. Long term liquidity is related to the ability of the short term and long term liabilities payment. Articleis trying to point out to the monitoring and analyzing of the long term liquidity in the concrete business, in this case the printing industrycompany. Hereby at the end of the article mentioned monitored and analyzed liquidity is evaluated in the five years time period.

  10. Long Term Care Minimum Data Set (MDS)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Long-Term Care Minimum Data Set (MDS) is a standardized, primary screening and assessment tool of health status that forms the foundation of the comprehensive...

  11. Long-term follow-up of mental health, health-related quality of life and associations with motor skills in young adults born preterm with very low birth weight.

    Science.gov (United States)

    Husby, Ingrid Marie; Stray, Kaia Mølbach-Thellefsen; Olsen, Alexander; Lydersen, Stian; Indredavik, Marit Sæbø; Brubakk, Ann-Mari; Skranes, Jon; Evensen, Kari Anne I

    2016-04-07

    Being born with very low birth weight (VLBW: ≤ 1,500 g) is related to long-term disability and neurodevelopmental problems, possibly affecting mental health and health-related quality of life (HRQoL). However, studies in young adulthood yield mixed findings. The aim of this study was to examine mental health and HRQoL at 23 years, including changes from 20 to 23 years and associations with motor skills in VLBW young adults compared with controls. In a geographically based follow-up study, 35 VLBW and 37 term-born young adults were assessed at 23 years by using Achenbach Adult Self-Report (ASR), Short Form 36 Health Survey (SF-36), Beck Depression Inventory (BDI) and various motor tests. The ASR and SF-36 were also used at 20 years. Longitudinal changes in ASR and SF-36 from 20 to 23 years were analysed by linear mixed models and associations with motor skills at 23 years by linear regression. At 23 years, total ASR score was 38.6 (SD: 21.7) in the VLBW group compared with 29.0 (SD: 18.6) in the control group (p = 0.048). VLBW participants had higher scores for attention problems, internalizing problems and critical items, and they reported to drink less alcohol than controls. BDI total score did not differ between groups. On SF-36, VLBW participants reported significantly poorer physical and social functioning, more role-limitations due to physical and emotional problems, more bodily pain and lower physical and mental component summaries than controls. In the VLBW group, total ASR score increased by 9.0 (95 % CI: 3.3 to 14.7) points from 20 to 23 years (p = 0.009 vs controls), physical and mental component summaries of SF-36 decreased by 2.9 (95 % CI: -4.8 to -1.1) and 4.4 (95 % CI: -7.1 to -1.7) points, respectively (p = 0.012 and p = 0.022 vs controls). Among VLBW participants, more mental health problems and lower physical and mental HRQoL were associated with poorer motor skills at 23 years. VLBW young adults reported poorer and declining

  12. Sleep facilitates long-term face adaptation

    OpenAIRE

    Ditye, Thomas; Javadi, Amir Homayoun; Carbon, Claus-Christian; Walsh, Vincent

    2013-01-01

    Adaptation is an automatic neural mechanism supporting the optimization of visual processing on the basis of previous experiences. While the short-term effects of adaptation on behaviour and physiology have been studied extensively, perceptual long-term changes associated with adaptation are still poorly understood. Here, we show that the integration of adaptation-dependent long-term shifts in neural function is facilitated by sleep. Perceptual shifts induced by adaptation to a distorted imag...

  13. [Psychosocial issues of long-term cancer survivors].

    Science.gov (United States)

    Weis, J; Faller, H

    2012-04-01

    Although cancer incidence rates are increasing, recent statistical studies suggest that cancer patients are showing higher cure rates as well as improved overall survival rates for most cancer locations. These advances are explained by improved strategies in early diagnoses as well as improved cancer therapies. Therefore, the number of long-term cancer survivors has also increased, but only few studies, especially within the last years, have focused on psychosocial issues of this subgroup. Some studies show that overall quality of life of long-term cancer survivors is quite high and comparable to that of the normal population. Nevertheless, a substantial percentage of former patients shows reduced quality of life and suffers from various sequelae of cancer and its treatment. This review focuses on the most common psychosocial issue of long-term survivors such as reduced psychological wellbeing, neuropsychological deficits and cancer-related fatigue syndrome. Finally, recommendations for problem-oriented interventions as well as improvement of psychosocial care of long-term survivors are given.

  14. [Effect of anemia on child development: long-term consequences].

    Science.gov (United States)

    Zavaleta, Nelly; Astete-Robilliard, Laura

    2017-01-01

    Anemia in children younger than 3 years is a public health problem in Peru and worldwide. It is believed that one of the primary causes of anemia is iron deficiency. Numerous studies and reviews have reported that iron deficiency limited psychomotor development in children and that, despite the correction of anemia, children with iron deficiency experienced poorer long-term performance in cognitive, social, and emotional functioning. These outcomes were reported in observational studies, follow-up studies, and experimental studies with a control group. Anemia can decrease school performance, productivity in adult life, quality of life, and the general income of affected individuals. Here we describe possible mechanisms underlying the effect of iron deficiency, with or without anemia, on childhood development. The high rate of anemia in this age group is a cause for concern. Moreover, anemia should be prevented in the first year of life to avoid long-term negative effects on individual development.

  15. Long term creep strength of silver alloyed copper

    International Nuclear Information System (INIS)

    Auerkari, P.; Sandlin, S.

    1988-12-01

    The long term creep strength of silver alloyed copper has been estimated using literature creep data for materials with less than 0.1% Ag. The available data was very limited, and it was necessary to test the differences between various data sets and extrapolation methods. Assuming constant stress level and constant or changing temperature, the creep behaviour has been assessed using mainly Larson-Miller and theta-projection approaches. The calculations indicate that the different extrapolation methods and data sources can yield strongly different life estimates. With the available incomplete data the theta projection method may give the conservative life predictions, whereas the Larson-Miller approach grossly overestimates creep life. It is recommended that supplementary data is acquired to better assess the long term creep properties of canisters in repository conditions

  16. Very long-term sequelae of craniopharyngioma.

    Science.gov (United States)

    Wijnen, Mark; van den Heuvel-Eibrink, Marry M; Janssen, Joseph A M J L; Catsman-Berrevoets, Coriene E; Michiels, Erna M C; van Veelen-Vincent, Marie-Lise C; Dallenga, Alof H G; van den Berge, J Herbert; van Rij, Carolien M; van der Lely, Aart-Jan; Neggers, Sebastian J C M M

    2017-06-01

    Studies investigating long-term health conditions in patients with craniopharyngioma are limited by short follow-up durations and generally do not compare long-term health effects according to initial craniopharyngioma treatment approach. In addition, studies comparing long-term health conditions between patients with childhood- and adult-onset craniopharyngioma report conflicting results. The objective of this study was to analyse a full spectrum of long-term health effects in patients with craniopharyngioma according to initial treatment approach and age group at craniopharyngioma presentation. Cross-sectional study based on retrospective data. We studied a single-centre cohort of 128 patients with craniopharyngioma treated from 1980 onwards (63 patients with childhood-onset disease). Median follow-up since craniopharyngioma presentation was 13 years (interquartile range: 5-23 years). Initial craniopharyngioma treatment approaches included gross total resection ( n  = 25), subtotal resection without radiotherapy ( n  = 44), subtotal resection with radiotherapy ( n  = 25), cyst aspiration without radiotherapy ( n  = 8), and 90 Yttrium brachytherapy ( n  = 21). Pituitary hormone deficiencies (98%), visual disturbances (75%) and obesity (56%) were the most common long-term health conditions observed. Different initial craniopharyngioma treatment approaches resulted in similar long-term health effects. Patients with childhood-onset craniopharyngioma experienced significantly more growth hormone deficiency, diabetes insipidus, panhypopituitarism, morbid obesity, epilepsy and psychiatric conditions compared with patients with adult-onset disease. Recurrence-/progression-free survival was significantly lower after initial craniopharyngioma treatment with cyst aspiration compared with other therapeutic approaches. Survival was similar between patients with childhood- and adult-onset craniopharyngioma. Long-term health conditions were comparable after

  17. Long-term quality of life in patients with rectal cancer treated with preoperative (chemo)-radiotherapy within a randomized trial; Evaluation a long terme de la qualite de vie de patients atteints de cancer rectal apras (chimio) radiotherapie dans un essai controle

    Energy Technology Data Exchange (ETDEWEB)

    Tiv, M.; Puyraveau, M.; Mercier, M.; Bosset, J.F. [EA3181, Besancon University Hospital, University of Franche-Comte, 25 - Besancon (France); Puyraveau, M. [Clinical Research Management Unit, Besancon University Hospital, 25 - Besancon (France); Mineur, L. [Department of Radiation Therapy, Clinic Sainte-Catherine, 84 - Avignon (France); Calais, G. [Department of Radiation Therapy, University Francois-Rabelais, 37 - Tours (France); Maingon, P. [Department of Radiation Therapy, Cancer Center Dijon, 21 - Dijon (France); Bardet, E. [Department of Radiation Therapy, centre Rene-Gauducheau, 44 - Nantes-Saint-Herblain (France); Mercier, M.; Bosset, J.F. [Department of Radiation Therapy, Besancon University Hospital, 25 - Besancon (France)

    2010-10-15

    Purpose: Few studies have evaluated the quality of life (QoL) of patients with rectal cancer. This report describes the quality of life of French patients who entered the 22921 EORTC trial that investigated the role and place of chemotherapy (CT) added to preoperative radiotherapy (preop-RT). Patients and Methods: Patients without recurrences were evaluated with EORTC QLQ-C30 and QLQ-CR38 questionnaires, after a median time of 4.6 years from randomization. Results: All the scores of QLQ-C30 functions were high, from 78 up to 88, with those of global health quality of life scale (GHQL) status being 73. The mean scores of symptoms were low except for diarrhea. For QLQ-CR38, the mean scores for 'body image' and 'future perspective' were high at 79.6 and 69.7 respectively. The scores for 'sexual functioning' and 'enjoyment' were low. Men had more sexual problems than females (62.5 vs 25 mean scores respectively). Chemotherapy was associated with more diarrhea complaints, lower 'role', lower 'social functioning' and lower global health quality of life scale. Conclusion: The overall quality of life of patients with rectal cancer is quite good 4.6 years after the beginning preoperative treatments. However, adding chemotherapy to preoperative radiotherapy has a negative effect on diarrhea complaints and some quality of life dimensions. (authors)

  18. Perinatal respiratory infections and long term consequences

    Directory of Open Access Journals (Sweden)

    Luciana Indinnimeo

    2015-10-01

    Full Text Available Respiratory syncytial virus (RSV is the most important pathogen in the etiology of respiratory infections in early life. 50% of children are affected by RSV within the first year of age, and almost all children become infected within two years. Numerous retrospective and prospective studies linking RSV and chronic respiratory morbidity show that RSV bronchiolitis in infancy is followed by recurrent wheezing after the acute episod. According to some authors a greater risk of wheezing in children with a history of RSV bronchiolitis would be limited to childhood, while according to others this risk would be extended into adolescence and adulthood. To explain the relationship between RSV infection and the development of bronchial asthma or the clinical pathogenetic patterns related to a state of bronchial hyperreactivity, it has been suggested that RSV may cause alterations in the response of the immune system (immunogenic hypothesis, activating directly mast cells and basophils and changing the pattern of differentiation of immune cells present in the bronchial tree as receptors and inflammatory cytokines. It was also suggested that RSV infection can cause bronchial hyperreactivity altering nervous airway modulation, acting on nerve fibers present in the airways (neurogenic hypothesis.The benefits of passive immunoprophylaxis with palivizumab, which seems to represent an effective approach in reducing the sequelae of RSV infection in the short- and long-term period, strengthen the implementation of prevention programs with this drug, as recommended by the national guidelines of the Italian Society of Neonatology. Proceedings of the 11th International Workshop on Neonatology and Satellite Meetings · Cagliari (Italy · October 26th-31st, 2015 · From the womb to the adultGuest Editors: Vassilios Fanos (Cagliari, Italy, Michele Mussap (Genoa, Italy, Antonio Del Vecchio (Bari, Italy, Bo Sun (Shanghai, China, Dorret I. Boomsma (Amsterdam, the

  19. Long-term strategies in world energy supply

    International Nuclear Information System (INIS)

    Haefele, W.

    1980-01-01

    The International Institute for Applied Systems Analysis of Laxenburg, Austria has carried out a comprehensive systems analysis in which the problems of the long-term world energy supply are treated first qualitatively and then quantiatively. The results of this five-year study have been published in a book entitled 'Energy in a Finite World: a Global Energy Systems Analysis.' This summary of the book indicates that the world's energy supply in the next fifty years will not be limited by resources, but the rates at which new technologies will be built up. (orig.) [de

  20. Long-term prisoner in prison isolation

    Directory of Open Access Journals (Sweden)

    Karolina Grudzińska

    2013-06-01

    Full Text Available Long-term prisoner belongs to a particular category of people who are imprisoned in prisons. On the one hand in this group are often heavily demoralized people who committed the most serious crimes, on the other hand it is a group of prisoners, who should be well thought out and programmed the impact of rehabilitation. The situation of man trapped for years poses in a complicated situation not only the prisoners, but also the entire prison staff. They have to take care of the fact that the prison isolation did not cause the state in which convicts form itself in learned helplessness and lack of skills for self-planning and decision-making. In addition, planning the rehabilitation impact of long-term prisoners should not be forgotten that these prisoners in the short or the long term will return to the libertarian environment therefore, should prevent any negative effects of long-term imprisonment. This article presents the main issues related to the execution of imprisonment against long-term prisoners. It is an attempt to systematize the knowledge of this category of people living in prison isolation.

  1. A new mathematical programming model for long-term production scheduling considering geological uncertainty

    OpenAIRE

    Gholamnejad, J.; Moosavi, E.

    2012-01-01

    Determination of the optimum production schedules over the life of a mine is a critical mechanism in open pit mine planning procedures. Long-term production scheduling is used to maximize the net present value of the project under technical, financial, and environmental constraints. Mathematical programming models are well suited for optimizing long-term production schedules of open pit mines. There are two approaches to solving long-term production problems: deterministic- and uncertainty- b...

  2. Long-Term Prognosis of Plantar Fasciitis

    DEFF Research Database (Denmark)

    Hansen, Liselotte; Krogh, Thøger Persson; Ellingsen, Torkell

    2018-01-01

    , exercise-induced symptoms, bilateral heel pain, fascia thickness, and presence of a heel spur) could predict long-term outcomes, (3) to assess the long-term ultrasound (US) development in the fascia, and (4) to assess whether US-guided corticosteroid injections induce atrophy of the heel fat pad. Study....... The risk was significantly greater for women (P heel...... regardless of symptoms and had no impact on prognosis, and neither did the presence of a heel spur. Only 24% of asymptomatic patients had a normal fascia on US at long-term follow-up. A US-guided corticosteroid injection did not cause atrophy of the heel fat pad. Our observational study did not allow us...

  3. Long-term dependence in exchange rates

    Directory of Open Access Journals (Sweden)

    A. Karytinos

    2000-01-01

    Full Text Available The extent to which exchange rates of four major currencies against the Greek Drachma exhibit long-term dependence is investigated using a R/S analysis testing framework. We show that both classic R/S analysis and the modified R/S statistic if enhanced by bootstrapping techniques can be proven very reliable tools to this end. Our findings support persistence and long-term dependence with non-periodic cycles for the Deutsche Mark and the French Franc series. In addition a noisy chaos explanation is favored over fractional Brownian motion. On the contrary, the US Dollar and British Pound were found to exhibit a much more random behavior and lack of any long-term structure.

  4. Adjuvant psychological therapy in long-term endocrine conditions.

    Science.gov (United States)

    Daniels, J; Turner-Cobb, J M

    2017-06-01

    Consideration of psychological distress in long-term endocrine conditions is of vital importance given the prevalence of anxiety and depression in such disorders. Poor mental health can lead to compromised self-care, higher utilization of health services, lower rates of adherence, reduced quality of life and ultimately poorer outcomes. Adjuvant psychological therapy offers an effective resource to reduce distress in endocrine conditions. While the vast majority of work in this area has focused on psychological screening and intervention in diabetes, identification and recognition of psychological distress are equally important in other endocrinological conditions, with supportive evidence in polycystic ovary syndrome and Addison's disease. Referral pathways and recommendations set out by UK guidelines and the Department of Health mandate requires greater attention across a wider range of long-term endocrine conditions to facilitate improved quality of life and health outcome. © 2017 John Wiley & Sons Ltd.

  5. Long-term high temperature strength of 316FR steel

    International Nuclear Information System (INIS)

    Takahashi, Yukio

    1995-01-01

    As low-carbon medium-nitrogen type 316 stainless steel (316FR) was selected as a primary candidate for main structural material of a next fast reactor plant in Japan, its long-term high-temperature strength gains much interest from many organizations involved in design activities of the plant. Central Research Institute of Electric Power Industry (CRIEPI), as a research organization for electric power industry in Japan, has been conducting a multi-year project under the sponsorship of Ministry of International Trade and Industry (MITI) for studying the long-term high temperature strength of this steel. Data obtained by various strength tests, including short-time tensile, fatigue, creep and creep-fatigue tests for this steel are given in this paper. The results of study on creep-fatigue life prediction methods are also presented. It was found that modified ductility exhaustion method previously proposed by the author has satisfactory accuracy in creep-fatigue life estimation

  6. Long term plan of atomic energy development and utilization

    International Nuclear Information System (INIS)

    1982-01-01

    The atomic energy utilization and development in Japan have progressed remarkably, and already nuclear power generation has borne an important part in electric power supply, while radiation has been utilized in the fields of industry, agriculture, medicine and so on. Now, atomic energy is indispensable for national life and industrial activity. The former long term plan was decided in September, 1978, and the new long term plan should be established since the situation has changed largely. The energy substituting for petroleum has been demanded, and the expectation to nuclear power generation has heightened because it enables stable and economical power supply. The independently developed technology related to atomic energy must be put in practical use. The peaceful utilization of atomic energy must be promoted, while contributing to the nuclear non-proliferation policy. The Atomic Energy Commission of Japan decided the new long term plan to clearly show the outline of the important measures related to atomic energy development and utilization in 10 years hereafter, and the method of its promotion. The basic concept of atomic energy development and utilization, the long term prospect and the concept on the promotion, the method of promoting the development and utilization, and the problems of funds, engineers and location are described. (kako, I.)

  7. Long term planning for wind energy development

    International Nuclear Information System (INIS)

    Trinick, M.

    1995-01-01

    In a planning system intended to be governed primarily by policies in statutory plans a reasonable horizon for long term planning is 10 years or longer. Because of statutory requirements, developers have no option but to pay due regard to, and take a full part in, long term planning. The paper examines the type of policies which have emerged in the last few years to cater for wind energy development. It canvasses the merits of different types of policies. Finally, it discusses the policy framework which may emerge to cater for development outside NFFO. (Author)

  8. Long-term characteristics of nuclear emulsion

    International Nuclear Information System (INIS)

    Naganawa, N; Kuwabara, K

    2010-01-01

    Long-term characteristics of the nuclear emulsion so called 'OPERA film' used in the neutrino oscillation experiment, OPERA, has been studied for 8 years since its production or refreshing after it. In the results, it turned out to be excellent in sensitivity, amount of random noise, and refreshing characteristics. The retention capacity of latent image of tracks was also studied. The result will open the way to the recycling of 7,000,000 emulsion films which will remain not developed after 5 years of OPERA's run, and other long-term experiments with emulsion.

  9. Long-term characteristics of nuclear emulsion

    Science.gov (United States)

    Naganawa, N.; Kuwabara, K.

    2010-02-01

    Long-term characteristics of the nuclear emulsion so called ``OPERA film'' used in the neutrino oscillation experiment, OPERA, has been studied for 8 years since its production or refreshing after it. In the results, it turned out to be excellent in sensitivity, amount of random noise, and refreshing characteristics. The retention capacity of latent image of tracks was also studied. The result will open the way to the recycling of 7,000,000 emulsion films which will remain not developed after 5 years of OPERA's run, and other long-term experiments with emulsion.

  10. Long-term home care scheduling

    DEFF Research Database (Denmark)

    Gamst, Mette; Jensen, Thomas Sejr

    In several countries, home care is provided for certain citizens living at home. The long-term home care scheduling problem is to generate work plans spanning several days such that a high quality of service is maintained and the overall cost is kept as low as possible. A solution to the problem...... provides detailed information on visits and visit times for each employee on each of the covered days. We propose a branch-and-price algorithm for the long-term home care scheduling problem. The pricing problem generates one-day plans for an employee, and the master problem merges the plans with respect...

  11. Long term storage techniques for 85Kr

    International Nuclear Information System (INIS)

    Foster, B.A.; Pence, D.T.; Staples, B.A.

    1975-01-01

    As new nuclear fuel reprocessing plants go on stream, the collection of fission product 85 Kr will be required to avoid potential local release problems and long-term atmospheric buildup. Storage of the collected 85 Kr for a period of at least 100 years will be necessary to allow approximately 99.9 percent decay before it is released. A program designed to develop and evaluate proposed methods for long-term storage of 85 Kr is discussed, and the results of a preliminary evaluation of three methods, high pressure steel cylinders, zeolite encapsulation, and clathrate inclusion are presented. (U.S.)

  12. Narrow Framing and Long-Term Care Insurance

    OpenAIRE

    Daniel Gottlieb; Olivia S. Mitchell

    2015-01-01

    We propose a model of narrow framing in insurance and test it using data from a new module we designed and fielded in the Health and Retirement Study. We show that respondents subject to narrow framing are substantially less likely to buy long-term care insurance than average. This effect is distinct from, and much larger than, the effects of risk aversion or adverse selection, and it offers a new explanation for why people underinsure their later-life care needs.

  13. Long-term monitoring as aging management component in the NPP Grohnde

    International Nuclear Information System (INIS)

    Reese, Sven H.; Seichter, Johannes

    2009-01-01

    In the frame of aging management of safety relevant mechanical systems, structures and components (SSC) a classification is performed with respect to the safety relevance. For SSC of group M1 integrity has to be assured, i.e. components must not fail. The other safety relevant components are classified as group M2, i.e. failure is admissible as isolated case. SSC of group M1 in the NPP Grohnde are included into the long-term monitoring system, the annual status report ''fatigue'' has to identify the actual usage value and predict the end-of-life usage. The authors describe the used methodology concerning loading evaluation based on temperature cycling data, the thermal hydraulic modeling using finite element methods for fatigue relevant components.

  14. Experiences of long-term tranquillizer use

    DEFF Research Database (Denmark)

    Skinhoj, K T; Larsson, S; Helweg-Joergensen, S

    2001-01-01

    , the psychodynamic perspective is integrated within a multi-dimensional model that considers biological, cognitive, identity, gender and social learning factors. The analysis reveals the possibility of achieving a detailed understanding of the dynamic processes involved in the development of long-term tranquillizer...

  15. Long-Term Orientation in Trade

    NARCIS (Netherlands)

    Hofstede, G.J.; Jonker, C.M.; Verwaart, D.

    2008-01-01

    Trust does not work in the same way across cultures. This paper presents an agent model of behavior in trade across Hofstedes cultural dimension of long-term vs. short-term orientation. The situation is based on a gaming simulation, the Trust and Tracing game. The paper investigates the

  16. Safety of long-term PPI therapy

    DEFF Research Database (Denmark)

    Reimer, Christina

    2013-01-01

    Proton pump inhibitors have become the mainstay of medical treatment of acid-related disorders. Long-term use is becoming increasingly common, in some cases without a proper indication. A large number of mainly observational studies on a very wide range of possible associations have been publishe...... to a careful evaluation of the indication for PPI treatment....

  17. Long term consequences of early childhood malnutrition

    NARCIS (Netherlands)

    Kinsey, B.H.; Hoddinott, J; Alderman, H.

    2006-01-01

    This paper examines the impact of pre-school malnutrition on subsequent human capital formation in rural Zimbabwe using a maternal fixed effects - instrumental variables (MFE-IV) estimator with a long term panel data set. Representations of civil war and drought shocks are used to identify

  18. Financial Incentives in Long-Term Care

    NARCIS (Netherlands)

    P.L.H. Bakx (Pieter)

    2015-01-01

    markdownabstract__Abstract__ Long-term care (ltc) aims to help individuals to cope with their impairments. In my thesis, I describe ltc financing alternatives and their consequences for the allocation of ltc. This thesis consists of two parts. In the first part, I investigate how alternative ways

  19. Long-term outcomes of patellofemoral arthroplasty.

    NARCIS (Netherlands)

    Jonbergen, J.P.W. van; Werkman, D.M.; Barnaart, L.F.; Kampen, A. van

    2010-01-01

    The purpose of this study was to correlate the long-term survival of patellofemoral arthroplasty with primary diagnosis, age, sex, and body mass index. One hundred eighty-five consecutive Richards type II patellofemoral arthroplasties were performed in 161 patients with isolated patellofemoral

  20. Long-Term Memory and Learning

    Science.gov (United States)

    Crossland, John

    2011-01-01

    The English National Curriculum Programmes of Study emphasise the importance of knowledge, understanding and skills, and teachers are well versed in structuring learning in those terms. Research outcomes into how long-term memory is stored and retrieved provide support for structuring learning in this way. Four further messages are added to the…

  1. The 2013 Long-Term Budget Outlook

    Science.gov (United States)

    2013-09-01

    number of years, leading to substantial additional federal spending. For example, the nation could experience a massive earthquake, a nuclear meltdown...budget surpluses remaining after paying down publicly held debt available for redemption . a. For comparison with the current long-term projections, CBO

  2. Long-term effects of ionizing radiation

    International Nuclear Information System (INIS)

    Kaul, Alexander; Burkart, Werner; Grosche, Bernd; Jung, Thomas; Martignoni, Klaus; Stephan, Guenther

    1997-01-01

    This paper approaches the long-term effects of ionizing radiation considering the common thought that killing of cells is the basis for deterministic effects and that the subtle changes in genetic information are important in the development of radiation-induced cancer, or genetic effects if these changes are induced in germ cells

  3. The long term stability of lidar calibrations

    DEFF Research Database (Denmark)

    Courtney, Michael; Gayle Nygaard, Nicolai

    Wind lidars are now used extensively for wind resource measurements. One of the requirements for the data to be accepted in support of project financing (so-called ‘banka-bility’) is to demonstrate the long-term stability of lidar cali-brations. Calibration results for six Leosphere WindCube li...

  4. Rebalancing for Long-Term Investors

    NARCIS (Netherlands)

    Driessen, Joost; Kuiper, Ivo

    2017-01-01

    In this study we show that the rebalance frequency of a multi-asset portfolio has only limited impact on the utility of a long-term passive investor. Although continuous rebalancing is optimal, the loss of a suboptimal strategy corresponds to up to only 30 basis points of the initial wealth of the

  5. Physiological, Molecular and Genetic Mechanisms of Long-Term Habituation

    Energy Technology Data Exchange (ETDEWEB)

    Calin-Jageman, Robert J

    2009-09-12

    Work funded on this grant has explored the mechanisms of long-term habituation, a ubiquitous form of learning that plays a key role in basic cognitive functioning. Specifically, behavioral, physiological, and molecular mechanisms of habituation have been explored using a simple model system, the tail-elicited siphon-withdrawal reflex (T-SWR) in the marine mollusk Aplysia californica. Substantial progress has been made on the first and third aims, providing some fundamental insights into the mechanisms by which memories are stored. We have characterized the physiological correlates of short- and long-term habituation. We found that short-term habituation is accompanied by a robust sensory adaptation, whereas long-term habituation is accompanied by alterations in sensory and interneuron synaptic efficacy. Thus, our data indicates memories can be shifted between different sites in a neural network as they are consolidated from short to long term. At the molecular level, we have accomplished microarray analysis comparing gene expression in both habituated and control ganglia. We have identified a network of putatively regulated transcripts that seems particularly targeted towards synaptic changes (e.g. SNAP25, calmodulin) . We are now beginning additional work to confirm regulation of these transcripts and build a more detailed understanding of the cascade of molecular events leading to the permanent storage of long-term memories. On the third aim, we have fostered a nascent neuroscience program via a variety of successful initiatives. We have funded over 11 undergraduate neuroscience scholars, several of whom have been recognized at national and regional levels for their research. We have also conducted a pioneering summer research program for community college students which is helping enhance access of underrepresented groups to life science careers. Despite minimal progress on the second aim, this project has provided a) novel insight into the network mechanisms by

  6. Teen motherhood and long-term health consequences.

    Science.gov (United States)

    Patel, Payal H; Sen, Bisakha

    2012-07-01

    The objective of this article is to examine the association of teen motherhood and long-term physical and mental health outcomes. The physical and mental health components (PCS and MCS) of the SF-12 Healthy Survey in the NLSY79 health module were used to assess long-term health outcomes of women who experienced teenage motherhood. Various familial, demographic, and environmental characteristics were indentified and controlled for that may have predicted teen motherhood and long-term health outcomes. The two comparison groups for teen mothers were women who experienced teen-pregnancy only and women who were engaged in unprotected sexual activity as a teenage but did not experience pregnancy. Multivariate ordinary least squares regression was used for analysis. The average PCS and MCS for teen mothers was 49.91 and 50.89, respectively. Teen mothers exhibited poorer physical health later in life compared to all women as well as the comparison groups. When controlling for age, teen mothers had significantly lower PCS and MCS scores compared to all other women. Furthermore, when controlling for familial, demographic, and environmental characteristics, teen mothers exhibited significantly lower PCS and MCS scores. When comparing teen mothers to the two comparison groups, PCS was not statistically different although MCS was significantly lower in the teen-pregnancy group. Teen motherhood does lead to poorer physical health outcomes later in life. On the other hand, poorer mental health outcomes in later life may be attributed to the unmeasured factors leading to a teen pregnancy and not teen motherhood itself. Additional research needs to be conducted on the long-term consequences of teen motherhood.

  7. Residual fatigue life evaluation of rail at squats seeds using 3D explicit finite element analysis

    NARCIS (Netherlands)

    Deng, X.; Naeimi, M.; Li, Z.; Qian, Z.

    2014-01-01

    A modeling procedure to predict the residual fatigue life of rail at squats seeds is developed in this article. Two models are involved: a 3D explicit Finite Element (FE) model to compute the stress and strain at squats in rail, and the J-S fatigue damage model to determine the residual fatigue life

  8. A Multi-Stage Maturity Model for Long-Term IT Outsourcing Relationship Success

    Science.gov (United States)

    Luong, Ming; Stevens, Jeff

    2015-01-01

    The Multi-Stage Maturity Model for Long-Term IT Outsourcing Relationship Success, a theoretical stages-of-growth model, explains long-term success in IT outsourcing relationships. Research showed the IT outsourcing relationship life cycle consists of four distinct, sequential stages: contract, transition, support, and partnership. The model was…

  9. Long-Term Cognitive Impairment After First-Ever Ischemic Stroke in Young Adults

    NARCIS (Netherlands)

    Schaapsmeerders, P.; Maaijwee, N.A.M.M.; Dijk, E.J. van; Rutten-Jacobs, L.C.A.; Arntz, R.M.; Schoonderwaldt, H.C.; Dorresteijn, L.D.A.; Kessels, R.P.C.; Leeuw, H.F. de

    2013-01-01

    Background and Purpose—Up to 14% of all ischemic strokes occur in young adults (<50 years). Poststroke cognitive performance is a decisive determinant of their quality of life. However, virtually no studies report on cognition after young stroke, especially not on the long term. This long-term

  10. Long-term cognitive impairment after first-ever ischemic stroke in young adults

    NARCIS (Netherlands)

    Schaapsmeerders, P.; Maaijwee, N.A.M.M.; Dijk, E.J. van; Rutten-Jacobs, L.C.A.; Arntz, R.M.; Schoonderwaldt, H.C.; Dorresteijn, L.D.A.; Kessels, R.P.C.; Leeuw, F.E. de

    2013-01-01

    BACKGROUND AND PURPOSE: Up to 14% of all ischemic strokes occur in young adults (<50 years). Poststroke cognitive performance is a decisive determinant of their quality of life. However, virtually no studies report on cognition after young stroke, especially not on the long term. This long-term

  11. Long-Term Care for People with Development Disabilities: A Critical Analysis.

    Science.gov (United States)

    Palley, Howard A.; Van Hollen, Valerie

    2000-01-01

    Explores how the trends toward long-term community care affecting people with developmental disabilities developed. Appropriateness of care and quality of life issues are discussed. Reviews the development of long-term care for frail and disabled elderly people and explores the arguments for a continuum of care that have developed in this area.…

  12. Elderly and long-term care trends and policy in Taiwan: Challenges and opportunities for health care professionals

    Directory of Open Access Journals (Sweden)

    Hsiu-Hung Wang

    2012-09-01

    Full Text Available The purpose of this article is to address the trends and policy of elderly and long-term care in Taiwan. In response to the increasing demand of an aging society, healthcare professionals play crucial roles in elderly and long-term care and quality assurance of services. This article focuses on the current situation of elderly health care, demands of long-term care, long-term care policy in Taiwan, draft of the Long-term Care Services Act, and draft of the Long-term Care Insurance Act. After the 10-year long-term care project was proposed by the Taiwan government, the supply of health care services and demand for long-term care have created many challenges and opportunities for innovative health professional development. Challenges consist of low old dependency ratio caused by low birth rate, lack of elderly and long-term care related manpower, services and education reform related to long-term care for the future society, and interprofessional collaboration and team work of long-term care. Opportunities include expanding the roles and the career pathways of healthcare professionals, promoting the concepts of active aging and good quality of life, and developing industrial cooperation related to long-term care services. Under these circumstances, healthcare professonals are actively involved in practice, education and research of long-term care services that ensure elderly and disabled people can live a healthier and better life.

  13. Long-Term Testosterone Therapy Improves Cardiometabolic Function and Reduces Risk of Cardiovascular Disease in Men with Hypogonadism: A Real-Life Observational Registry Study Setting Comparing Treated and Untreated (Control) Groups.

    Science.gov (United States)

    Traish, Abdulmaged M; Haider, Ahmad; Haider, Karim Sultan; Doros, Gheorghe; Saad, Farid

    2017-09-01

    In the absence of large, prospective, placebo-controlled studies of longer duration, substantial evidence regarding the safety and risk of testosterone (T) therapy (TTh) with regard to cardiovascular (CV) outcomes can only be gleaned from observational studies. To date, there are limited studies comparing the effects of long-term TTh in men with hypogonadism who were treated or remained untreated with T, for obvious reasons. We have established a registry to assess the long-term effectiveness and safety of T in men in a urological setting. Here, we sought to compare the effects of T on a host of parameters considered to contribute to CV risk in treated and untreated men with hypogonadism (control group). Observational, prospective, cumulative registry study in 656 men (age: 60.7 ± 7.2 years) with total T levels ≤12.1 nmol/L and symptoms of hypogonadism. In the treatment group, men (n = 360) received parenteral T undecanoate (TU) 1000 mg/12 weeks following an initial 6-week interval for up to 10 years. Men (n = 296) who had opted against TTh served as controls. Median follow-up in both groups was 7 years. Measurements were taken at least twice a year, and 8-year data were analyzed. Mean changes over time between the 2 groups were compared by means of a mixed-effects model for repeated measures, with a random effect for intercept and fixed effects for time, group, and their interaction. To account for baseline differences between the 2 groups, changes were adjusted for age, weight, waist circumference, fasting glucose, blood pressure, and lipids. There were 2 deaths in the T-treated group, none was related to CV events. There were 21 deaths in the untreated (control) group, 19 of which were related to CV events. The incidence of death in 10 patient-years was 0.1145 in the control group (95% confidence interval [CI]: 0.0746-0.1756; P control group and none in the T-treated group. Long-term TU was well tolerated with excellent adherence suggesting a high level of

  14. Long-term monitoring for closed special sites

    International Nuclear Information System (INIS)

    Golchert, N.W.; Sedlet, J.

    1987-01-01

    A methodology is presented for planning and implementing a long-term environmental monitoring program for closed special radioactive waste disposal sites. The steps in the method involve collection of the available background information on the site history, site and area characteristics, waste inventory, pathway analysis, prior monitoring programs, applicable standards, and the legal/regulatory requirements. This information is coupled with factors such as experience, half-life, radionuclide migration rates, and potential hazard to develop a monitoring program. As an example, a site-specific long-term monitoring program is described for the AMAX site using the available information. Sampling techniques and practices for the monitoring program are discussed and techniques and practices expected to be available in the future are considered. 7 references, 2 tables

  15. Samish Indian Nation Long-Term Strategic Energy Plan

    Energy Technology Data Exchange (ETDEWEB)

    Christine Woodward; B. Beckley; K. Hagen

    2005-06-30

    The Tribes strategic energy planning effort is divided into three phases: (1) Completing an Energy Resource Assessment; (2) Developing a Long-Term Strategic Energy Plan; and (3) Preparing a Strategic Energy Implementation Plan for the Samish Homelands. The Samish Indian Nation developed a comprehensive Strategic Energy plan to set policy for future development on tribal land that consists of a long-term, integrated, systems approach to providing a framework under which the Samish Community can use resources efficiently, create energy-efficient infrastructures, and protect and enhance quality of life. Development of the Strategic Energy plan will help the Samish Nation create a healthy community that will sustain current and future generations by addressing economic, environmental, and social issues while respecting the Samish Indian Nation culture and traditions.

  16. Long-term selenium status in humans

    International Nuclear Information System (INIS)

    Baskett, C.K.; Spate, V.L.; Mason, M.M.; Nichols, T.A.; Williams, A.; Dubman, I.M.; Gudino, A.; Denison, J.; Morris, J.S.

    2001-01-01

    The association of sub-optimal selenium status with increased risk factors for some cancers has been reported in two recent epidemiological studies. In both studies the same threshold in selenium status was observed, below which, cancer incidence increased. To assess the use of nails as a biologic monitor to measure the long-term selenium status, an eight-year longitudinal study was undertaken with a group of 11 adult subjects, 5 women and 6 men. Selenium has been measured by instrumental neutron activation analysis. Differences between fingernails and toenails with be discussed. In addition, the results will be discussed in the context of the long-term stability of the nail monitor to measure selenium status during those periods when selenium determinants are static; and the changes that occur as a result of selenium supplementation. (author)

  17. Influenza in long-term care facilities.

    Science.gov (United States)

    Lansbury, Louise E; Brown, Caroline S; Nguyen-Van-Tam, Jonathan S

    2017-09-01

    Long-term care facility environments and the vulnerability of their residents provide a setting conducive to the rapid spread of influenza virus and other respiratory pathogens. Infections may be introduced by staff, visitors or new or transferred residents, and outbreaks of influenza in such settings can have devastating consequences for individuals, as well as placing extra strain on health services. As the population ages over the coming decades, increased provision of such facilities seems likely. The need for robust infection prevention and control practices will therefore remain of paramount importance if the impact of outbreaks is to be minimised. In this review, we discuss the nature of the problem of influenza in long-term care facilities, and approaches to preventive and control measures, including vaccination of residents and staff, and the use of antiviral drugs for treatment and prophylaxis, based on currently available evidence. © 2017 The Authors. Influenza and Other Respiratory Viruses Published by John Wiley & Sons Ltd.

  18. Long-Term Ownership by Industrial Foundations

    DEFF Research Database (Denmark)

    Børsting, Christa Winther; Kuhn, Johan Moritz; Poulsen, Thomas

    2016-01-01

    in Denmark. Industrial foundations are independent legal entities without owners or members typically with the dual objective of preserving the company and using excess profits for charity. We use a unique Danish data set to examine the governance of foundation-owned companies. We show that they are long......-term in several respects. Foundations hold on to their shares for longer. Foundation-owned companies replace managers less frequently. They have more conservative capital structures with less leverage. Their companies survive longer. Their business decisions appear to be more long term. This paper supports...... the hypothesis that time horizons are influenced by ownership structures and particularly that industrial foundations promote longtermism. Policymakers which are interested in promoting longtermism should allow and perhaps even encourage the creation of industrial foundations. More generally they should consider...

  19. Analysis of long-term energy scenarios

    Energy Technology Data Exchange (ETDEWEB)

    Lemming, J.; Morthorst, P.E.

    1998-09-01

    When addressing the role of fusion energy in the 21. century, the evaluation of possible future structures in the electricity market and the energy sector as a whole, can be a useful tool. Because fusion energy still needs demonstration, commercialized fusion energy is not likely to be a reality within the next few decades. Therefore long-term scenarios are needed describing the energy markets, which fusion energy eventually will be part of. This report performs an analysis of two of the most detailed existing long-term scenarios describing possible futures of the energy system. The aim is to clarify the frames in which the future development of the global energy demand, as well as the structure of the energy system can be expected to develop towards the year 2100. (au) 19 refs.

  20. Long-term effects of radiation

    International Nuclear Information System (INIS)

    Smith, J.; Smith, T.

    1981-01-01

    It is pointed out that sources of long-term damage from radiation are two-fold. People who have been exposed to doses of radiation from initial early fallout but have recovered from the acute effects may still suffer long-term damage from their exposure. Those who have not been exposed to early fallout may be exposed to delayed fallout, the hazards from which are almost exclusively from ingesting strontium, caesium and carbon isotopes present in food; the damage caused is relatively unimportant compared with that caused by the brief doses from initial radiation and early fallout. A brief discussion is presented of the distribution of delayed long-lived isotope fallout, and an outline is sketched of late biological effects, such as malignant disease, cataracts, retarded development, infertility and genetic effects. (U.K.)

  1. Long term economic relationships from cointegration maps

    Science.gov (United States)

    Vicente, Renato; Pereira, Carlos de B.; Leite, Vitor B. P.; Caticha, Nestor

    2007-07-01

    We employ the Bayesian framework to define a cointegration measure aimed to represent long term relationships between time series. For visualization of these relationships we introduce a dissimilarity matrix and a map based on the sorting points into neighborhoods (SPIN) technique, which has been previously used to analyze large data sets from DNA arrays. We exemplify the technique in three data sets: US interest rates (USIR), monthly inflation rates and gross domestic product (GDP) growth rates.

  2. Murine model of long term obstructive jaundice

    Science.gov (United States)

    Aoki, Hiroaki; Aoki, Masayo; Yang, Jing; Katsuta, Eriko; Mukhopadhyay, Partha; Ramanathan, Rajesh; Woelfel, Ingrid A.; Wang, Xuan; Spiegel, Sarah; Zhou, Huiping; Takabe, Kazuaki

    2016-01-01

    Background With the recent emergence of conjugated bile acids as signaling molecules in cancer, a murine model of obstructive jaundice by cholestasis with long-term survival is in need. Here, we investigated the characteristics of 3 murine models of obstructive jaundice. Methods C57BL/6J mice were used for total ligation of the common bile duct (tCL), partial common bile duct ligation (pCL), and ligation of left and median hepatic bile duct with gallbladder removal (LMHL) models. Survival was assessed by Kaplan-Meier method. Fibrotic change was determined by Masson-Trichrome staining and Collagen expression. Results 70% (7/10) of tCL mice died by Day 7, whereas majority 67% (10/15) of pCL mice survived with loss of jaundice. 19% (3/16) of LMHL mice died; however, jaundice continued beyond Day 14, with survival of more than a month. Compensatory enlargement of the right lobe was observed in both pCL and LMHL models. The pCL model demonstrated acute inflammation due to obstructive jaundice 3 days after ligation but jaundice rapidly decreased by Day 7. The LHML group developed portal hypertension as well as severe fibrosis by Day 14 in addition to prolonged jaundice. Conclusion The standard tCL model is too unstable with high mortality for long-term studies. pCL may be an appropriate model for acute inflammation with obstructive jaundice but long term survivors are no longer jaundiced. The LHML model was identified to be the most feasible model to study the effect of long-term obstructive jaundice. PMID:27916350

  3. Long-term economic outlook. Annual review

    Energy Technology Data Exchange (ETDEWEB)

    1988-01-01

    This review provides economic growth forecast tables for Ontario, Canada, the US, Western Europe, and Japan. Economic growth, government policy, the long-term prospects for inflation, interest rates and foreign exchange rates, trends in the Canadian dollar, and energy markets and prices are also reviewed. Data generally cover 1965-2025. Appendices give a summary of historical and forecast data. 18 figs., 16 tabs.

  4. Long-term data storage in diamond

    OpenAIRE

    Dhomkar, Siddharth; Henshaw, Jacob; Jayakumar, Harishankar; Meriles, Carlos A.

    2016-01-01

    The negatively charged nitrogen vacancy (NV?) center in diamond is the focus of widespread attention for applications ranging from quantum information processing to nanoscale metrology. Although most work so far has focused on the NV? optical and spin properties, control of the charge state promises complementary opportunities. One intriguing possibility is the long-term storage of information, a notion we hereby introduce using NV-rich, type 1b diamond. As a proof of principle, we use multic...

  5. French Approach for Long Term Storage Safety

    International Nuclear Information System (INIS)

    Marciano, Jacob; Carreton, Jean-Pierre; Lizot, Marie Therese; Lhomme, Veronique

    2014-01-01

    IRSN presents its statement regarding long-term storage facilities; in France, the regulatory documents do not define the long term duration. The storage facility lifetime can only be appreciated according to the needs and materials stored therein. However, the magnitude of the long-term can be estimated at a few hundred years compared to a few decades for current storage. Usually, in France, construction of storage facilities is driven from the necessity various necessities, linked to the management of radioactive material (eg spent fuel) and to the management of radioactive waste. Because of the variety of 'stored materials and objects' (fission product solutions, plutonium oxide powders, activated solids, drums containing technological waste, spent fuel...), a great number of storage facility design solutions have been developed (surface, subsurface areas, dry or wet conditions...) in the World. After describing the main functions of a storage facility, IRSN displays the safety principles and the associated design principles. The specific design principles applied to particular storage (dry or wet spent fuel storage, depleted uranium or reprocessed uranium storage, plutonium storage, waste containing tritium storage, HLW and ILLW storage...) are also presented. Finally, the concerns due to the long-term duration storage and related safety assessment are developed. After discussing these issues, IRSN displays its statement. The authorization procedures governing the facility lifetime are similar to those of any basic nuclear installation, the continuation of the facility operation remaining subject to periodic safety reviews (in France, every 10 years). The applicant safety cases have to show, that the safety requirements are always met; this requires, at minimum, to take into account at the design stage, comfortable design margins. (author)

  6. Accounting of Long-Term Biological Assets

    OpenAIRE

    Valeriy Mossakovskyy; Vasyl Korytnyy

    2015-01-01

    The article is devoted to generalization of experience in valuation of long-term biological assets of plant-growing and animal-breeding, and preparation of suggestions concerning improvement of accounting in this field. Recommendations concerning accounting of such assets are given based on the study of accounting practice at specific agricultural company during long period of time. Authors believe that fair value is applicable only if price level for agricultural products is fixed by the gov...

  7. Optimal long-term contracting with learning

    OpenAIRE

    He, Zhiguo; Wei, Bin; Yu, Jianfeng; Gao, Feng

    2016-01-01

    We introduce uncertainty into Holmstrom and Milgrom (1987) to study optimal long-term contracting with learning. In a dynamic relationship, the agent's shirking not only reduces current performance but also increases the agent's information rent due to the persistent belief manipulation effect. We characterize the optimal contract using the dynamic programming technique in which information rent is the unique state variable. In the optimal contract, the optimal effort is front-loaded and decr...

  8. Timber joints under long-term loading

    DEFF Research Database (Denmark)

    Feldborg, T.; Johansen, M.

    This report describes tests and results from stiffness and strength testing of splice joints under long-term loading. During two years of loading the spicimens were exposed to cyclically changing relative humidity. After the loading period the specimens were short-term tested. The connectors were...... integral nail-plates and nailed steel and plywood gussets. The report is intended for designers and researchers in timber engineering....

  9. Inflation Hedging for Long-Term Investors

    OpenAIRE

    Shaun K. Roache; Alexander P. Attie

    2009-01-01

    Long-term investors face a common problem-how to maintain the purchasing power of their assets over time and achieve a level of real returns consistent with their investment objectives. While inflation-linked bonds and derivatives have been developed to hedge the effects of inflation, their limited supply and liquidity lead many investors to continue to rely on the indirect hedging properties of traditional asset classes. In this paper, we assess these properties over different time horizons,...

  10. Long term evolution 4G and beyond

    CERN Document Server

    Yacoub, Michel; Figueiredo, Fabrício; Tronco, Tania

    2016-01-01

    This book focus on Long Term Evolution (LTE) and beyond. The chapters describe different aspects of research and development in LTE, LTE-Advanced (4G systems) and LTE-450 MHz such as telecommunications regulatory framework, voice over LTE, link adaptation, power control, interference mitigation mechanisms, performance evaluation for different types of antennas, cognitive mesh network, integration of LTE network and satellite, test environment, power amplifiers and so on. It is useful for researchers in the field of mobile communications.

  11. Long-Term Care Services for Veterans

    Science.gov (United States)

    2017-02-14

    includes but is not limited to home physical , occupational, or speech therapy ; wound care; and intravenous (IV) care. A VA physician determines that a...restoring/rehabilitating the veteran’s health, such as skilled nursing care, physical therapy , occupational therapy , and IV therapy Same as HBPC... geriatric evaluation,  palliative care,  adult day health care,  homemaker/home health aide care,  respite care, Long-Term Care Services for

  12. Long term adequacy of uranium resources

    International Nuclear Information System (INIS)

    Steyn, J.

    1990-01-01

    This paper examines the adequacy of world economic uranium resources to meet requirements in the very long term, that is until at least 2025 and beyond. It does so by analysing current requirements forecasts, existing and potential production centre supply capability schedules and national resource estimates. It takes into account lead times from resource discovery to production and production rate limitations. The institutional and political issues surrounding the question of adequacy are reviewed. (author)

  13. [Participation as Target of Social Medicine and Nursing Care: - Legal Definition of Long-Term Care Dependency - Strategies to Prevent Long-Term Care Dependency].

    Science.gov (United States)

    Nüchtern, Elisabeth; Gansweid, Barbara; Gerber, Hans; von Mittelstaedt, Gert

    2017-01-01

    Objective: By the "Second Bill to Strengthen Long-Term Care", a new concept of long-term care dependency will be introduced, valid from 2017. Long-term care dependency according to Social Code XI will be defined covering more aspects than today. Therefore, the working group "Nursing Care" of the division "Social Medicine in Practice and Rehabilitation" in the German Society for Social Medicine and Prevention presents their results after working on the social medicine perspective of the definition and prevention of long-term care dependency. Methods: Both the definition and strategies to prevent long-term care dependency are systematically taken into consideration from the point of view of social medicine on the basis of the International Classification of Functioning, Disability and Health (ICF), as long-term care dependency means a defined condition of disability. Results: Both the current and the new concept of long-term care dependency focus activity limitations. The perspective of social medicine considers the interactions of health condition, its effects on daily activities and personal as well as environmental factors. From this point of view approaches for social benefits concerning prevention and rehabilitation can be identified systematically so as to work against the development and progression of long-term care dependency. The reference to the ICF can facilitate the communication between different professions. The new "graduation" of long-term care dependency would allow an international "translation" referring to the ICF. Conclusion: Experts from the field of social medicine as well as those of nursing care, care-givers and nursing researchers have in common the objective that persons in need of nursing care can participate in as many aspects of life of importance to them in an autonomous and self-determined way. The point of view of social medicine on long-term care dependency is fundamental for all occupational groups that are involved and for their

  14. Finite

    Directory of Open Access Journals (Sweden)

    W.R. Azzam

    2015-08-01

    Full Text Available This paper reports the application of using a skirted foundation system to study the behavior of foundations with structural skirts adjacent to a sand slope and subjected to earthquake loading. The effect of the adopted skirts to safeguard foundation and slope from collapse is studied. The skirts effect on controlling horizontal soil movement and decreasing pore water pressure beneath foundations and beside the slopes during earthquake is investigated. This technique is investigated numerically using finite element analysis. A four story reinforced concrete building that rests on a raft foundation is idealized as a two-dimensional model with and without skirts. A two dimensional plain strain program PLAXIS, (dynamic version is adopted. A series of models for the problem under investigation were run under different skirt depths and lactation from the slope crest. The effect of subgrade relative density and skirts thickness is also discussed. Nodal displacement and element strains were analyzed for the foundation with and without skirts and at different studied parameters. The research results showed a great effectiveness in increasing the overall stability of the slope and foundation. The confined soil footing system by such skirts reduced the foundation acceleration therefore it can be tended to damping element and relieved the transmitted disturbance to the adjacent slope. This technique can be considered as a good method to control the slope deformation and decrease the slope acceleration during earthquakes.

  15. Sexuality and Physical Intimacy in Long Term Care: Sexuality, long term care, capacity assessment

    OpenAIRE

    Lichtenberg, Peter A.

    2014-01-01

    Sexuality and sexual needs in older adults remains a neglected area of clinical intervention, particularly so in long term care settings. Because older adults in medical rehabilitation and long term care beds present with significant frailties, and often significant neurocognitive disorders it makes it difficult for occupational therapists and other staff to evaluate the capacity of an older adult resident to participate in sexual relationships. The current paper reviews the current literatur...

  16. Dienogest in long-term treatment of endometriosis

    Directory of Open Access Journals (Sweden)

    Schindler AE

    2011-07-01

    Full Text Available Adolf E SchindlerInstitute for Medical Research and Education, Essen, GermanyAbstract: Endometriosis is a chronic disease primarily affecting women of childbearing age, in which endometriotic lesions form outside the uterus, typically leading to painful symptoms, fatigue, and infertility. The symptoms of endometriosis may cause significant impairment in quality of life and represent a substantial economic burden to patients, families, and society. There is no cure for endometriosis; management consists of alleviating pain and other symptoms, reducing endometriotic lesions, and improving quality of life. Recurrence after surgical intervention is common, while the clinical evidence to support the efficacy and safety of many medications currently used in endometriosis is limited. Dienogest is an oral progestin that has been investigated extensively in the treatment of endometriosis in two clinical programs performed in Europe and Japan, including dose-ranging, placebo-controlled, active comparator-controlled, and long-term (up to 65 weeks studies. These studies demonstrated that dienogest 2 mg daily effectively alleviates the painful symptoms of endometriosis, reduces endometriotic lesions, and improves indices of quality of life. Dienogest showed a favorable safety and tolerability profile in these studies, with predictable adverse effects, high rates of patient compliance, and low withdrawal rates. This review article describes the clinical trial evidence that characterizes the efficacy and safety of dienogest in endometriosis, including two studies characterizing dienogest in long-term use. The relevance of these findings to the management of endometriosis in clinical practice is discussed.Keywords: dienogest, endometriosis, progestins, long-term treatment, quality of life, symptoms, pain

  17. On the very long term delayed behavior of concrete

    International Nuclear Information System (INIS)

    Torrenti, J.M.; Benboudjema, F.; Barre, F.; Gallitre, E.

    2015-01-01

    The prediction of very long-term deformation of prestressed concrete structures is a major challenge considering the service life of these structures. It is therefore necessary to correctly model the delayed behavior of these structures. Using a review of laboratory tests and observations of the delayed behavior of structures (bridges and nuclear power plants), the main conclusions of this work are the following ones. First, very long term creep in laboratory or of real structures seems to be non asymptotic. In the actual Eurocode-2, creep is calculated by means of an asymptotic hyperbolic function while in the recent Model Code 2010 creep is expressed as a combination of an asymptotic and a logarithmic functions. In the latter case the logarithmic function corresponds to basic creep while drying creep is asymptotic. Secondly, using a long test (3 years) in a laboratory is not enough to assess the long term behaviour of a massive structure. We need physical relations for creep in codes in order to predict the delayed behavior of massive structures. Thirdly, the biaxial creep of nuclear power plant could be modelled but using data of the structure itself. This would allow to predict the delayed behavior of these structures. Further work is needed to improve the prediction in the design phase

  18. Birds choose long-term partners years before breeding

    Science.gov (United States)

    Teitelbaum, Claire S.; Converse, Sarah J.; Mueller, Thomas

    2017-01-01

    Pair bonds can provide social benefits to long-term monogamous species alongside their benefits for reproduction. However, little is known about when these bonds form, in particular how long they are present before breeding. Previous studies of pair formation in long-term monogamous birds have been rather data-limited, but for many migratory birds they report pair formation on the wintering grounds. We provide the first systematic investigation of prebreeding association patterns of long-term monogamous pairs by examining entire life histories based on tracking data of migratory whooping cranes, Grus americana. We found that a substantial portion (62%) of breeding pairs started associating at least 12 months before first breeding, with 16 of 58 breeding pairs beginning to associate over 2 years before first breeding. For most pairs, these associations with future breeding partners also became unique and distinguishable from association patterns with nonpartner individuals 12 months before first breeding. In addition, 60% of pair associations began before at least one partner had reached nominal sexual maturity. Most pairs began associating in the late spring upon arrival at the summer grounds, while associations beginning at other times of the year were rare. Patterns in the associations of pairs prior to breeding can point to the potential benefits of prebreeding relationships, for instance providing support in competitive interactions or increasing partner familiarity.

  19. Advancing nursing leadership in long-term care.

    Science.gov (United States)

    O'Brien, Jennifer; Ringland, Margaret; Wilson, Susan

    2010-05-01

    Nurses working in the long-term care (LTC) sector face unique workplace stresses, demands and circumstances. Designing approaches to leadership training and other supportive human-resource strategies that reflect the demands of the LTC setting fosters a positive work life for nurses by providing them with the skills and knowledge necessary to lead the care team and to address resident and family issues. Through the St. Joseph's Health Centre Guelph demonstration site project, funded by the Nursing Secretariat of Ontario's Ministry of Health and Long-Term Care, the Excelling as a Nurse Leader in Long Term Care training program and the Mentor Team program were developed to address these needs. Evaluation results show that not only have individual nurses benefitted from taking part in these programs, but also that the positive effects were felt in other parts of the LTC home (as reported by Directors of Care). By creating a generally healthier work environment, it is anticipated that these programs will also have a positive effect on recruitment and retention.

  20. Esophageal replacement in children: Challenges and long-term outcomes

    Directory of Open Access Journals (Sweden)

    Giampiero Soccorso

    2016-01-01

    Full Text Available Replacement of a nonexistent or damaged esophagus continues to pose a significant challenge to pediatric surgeons. Various esophageal replacement grafts and techniques have not produced consistently good outcomes to emulate normal esophagus. Therefore, many techniques are still being practiced and recommended with no clear consensus. We present a concise literature review of the currently used techniques and with discussions on the advantages and anticipated morbidity. There are no randomized controlled pediatric studies to compare different types of esophageal replacements. Management and graft choice are based on geographical and personal predilections rather than on any discernible objective data. The biggest series with long-term outcome are reported for gastric transposition and colonic replacement. Comparison of different studies shows no significant difference in early (graft necrosis and anastomotic leaks or late complications (strictures, poor feeding, gastro-esophageal reflux, tortuosity of the graft, and Barrett′s esophagus. The biggest series seem to have lower complications than small series reflecting the decennials experience in their respective centers. Long-term follow-up is recommended following esophageal replacement for the development of late strictures, excessive tortuosity, and Barrett′s changes within the graft. Once child overcomes initial morbidity and establishes oral feeding, long-term consequences and complications of pediatric esophageal replacement should be monitored and managed in adult life.

  1. LONG-TERM OUTCOME IN PEDIATRIC TRICHOTILLOMANIA.

    Science.gov (United States)

    Schumer, Maya C; Panza, Kaitlyn E; Mulqueen, Jilian M; Jakubovski, Ewgeni; Bloch, Michael H

    2015-10-01

    To examine long-term outcome in children with trichotillomania. We conducted follow-up clinical assessments an average of 2.8 ± 0.8 years after baseline evaluation in 30 of 39 children who previously participated in a randomized, double-blind, placebo-controlled trial of N-acetylcysteine (NAC) for pediatric trichotillomania. Our primary outcome was change in hairpulling severity on the Massachusetts General Hospital Hairpulling Hospital Hairpulling Scale (MGH-HPS) between the end of the acute phase and follow-up evaluation. We also obtained secondary measures examining styles of hairpulling, comorbid anxiety and depressive symptoms, as well as continued treatment utilization. We examined both correlates and predictors of outcome (change in MGH-HPS score) using linear regression. None of the participants continued to take NAC at the time of follow-up assessment. No significant changes in hairpulling severity were reported over the follow-up period. Subjects reported significantly increased anxiety and depressive symptoms but improvement in automatic pulling symptoms. Increased hairpulling symptoms during the follow-up period were associated with increased depression and anxiety symptoms and increased focused pulling. Older age and greater focused pulling at baseline assessment were associated with poor long-term prognosis. Our findings suggest that few children with trichotillomania experience a significant improvement in trichotillomania symptoms if behavioral treatments are inaccessible or have failed to produce adequate symptom relief. Our findings also confirm results of previous cross-sectional studies that suggest an increased risk of depression and anxiety symptoms with age in pediatric trichotillomania. Increased focused pulling and older age among children with trichotillomania symptoms may be associated with poorer long-term prognosis. © 2015 Wiley Periodicals, Inc.

  2. Long-term EEG in children.

    Science.gov (United States)

    Montavont, A; Kaminska, A; Soufflet, C; Taussig, D

    2015-03-01

    Long-term video-EEG corresponds to a recording ranging from 1 to 24 h or even longer. It is indicated in the following situations: diagnosis of epileptic syndromes or unclassified epilepsy, pre-surgical evaluation for drug-resistant epilepsy, follow-up of epilepsy or in cases of paroxysmal symptoms whose etiology remains uncertain. There are some specificities related to paediatric care: a dedicated pediatric unit; continuous monitoring covering at least a full 24-hour period, especially in the context of pre-surgical evaluation; the requirement of presence by the parents, technician or nurse; and stronger attachment of electrodes (cup electrodes), the number of which is adapted to the age of the child. The chosen duration of the monitoring also depends on the frequency of seizures or paroxysmal events. The polygraphy must be adapted to the type and topography of movements. It is essential to have at least an electrocardiography (ECG) channel, respiratory sensor and electromyography (EMG) on both deltoids. There is no age limit for performing long-term video-EEG even in newborns and infants; nevertheless because of scalp fragility, strict surveillance of the baby's skin condition is required. In the specific context of pre-surgical evaluation, long-term video-EEG must record all types of seizures observed in the child. This monitoring is essential in order to develop hypotheses regarding the seizure onset zone, based on electroclinical correlations, which should be adapted to the child's age and the psychomotor development. Copyright © 2015. Published by Elsevier SAS.

  3. Long-term governance for sustainability

    International Nuclear Information System (INIS)

    Martell, M.

    2007-01-01

    Meritxell Martell spoke of the long-term aspects of radioactive waste management. She pointed out that decision-making processes need to be framed within the context of sustainability, which means that a balance should be sought between scientific considerations, economic aspects and structural conditions. Focusing on structural aspects, Working Group 3 of COWAM-Spain came to the conclusion that the activity of the regulator is a key factor of long-term management. Another finding is that from a sustainability perspective multi-level governance is more effective for coping with the challenges of radioactive waste management than one tier of government-making decisions. The working group also felt that the current Local Information Committees need to evolve towards more institutionalized and legitimized mechanisms for long-term involvement. Ms. Martell introduced a study comparing the efficiency of economic instruments to advance sustainable development in nuclear communities vs. municipalities in mining areas. The study found that funds transferred to nuclear zones had become a means to facilitate local acceptance of nuclear facilities rather than a means to promote socio-economic development. Another finding is that economic instruments are not sufficient guarantees of sustainable development by themselves; additional preconditions include leadership, vision and entrepreneur-ship on the part of community leaders, private or public investments, among others. Finally, Ms. Martell summarised the challenges faced by the Spanish radioactive waste management programme, which include the need for strategic thinking, designing the future in a participatory fashion, and working with local and regional governments and citizens to devise mechanisms for social learning, economic development and environmental protection. (author)

  4. Long term aspects of uranium tailings management

    International Nuclear Information System (INIS)

    Bragg, K.

    1980-05-01

    This paper sets out the background issues which lead to the development of interim close-out criteria for uranium mill tailings. It places the current state-of-the-art for tailings management into both a national and international perspective and shows why such interim criteria are needed now. There are seven specific criteria proposed dealing with the need to have: passive barriers, limits on surface water recharge, durable systems, long term performance guarantees, limits to access, controls on water and airborne releases and finally to have a knowledge of exposure pathways. This paper is intended to serve as a focus for subsequent discussions with all concerned parties. (auth)

  5. Human Behaviour in Long-Term Missions

    Science.gov (United States)

    1997-01-01

    In this session, Session WP1, the discussion focuses on the foll