Is it possible to improve the quality of life of patients who have undergone pelvic evisceration?

Locally spread cancer makes up considerable percent (20-30%) in statistical structure of rectal tumors. In cases of cancer spread into the area of urine bladder triangle the operation of choice is pelvic evisceration. From 1977 to 1997 in the State research Centre of the Ministry of Health for Coloproctology pelvic evisceration in cancer spread to back wall of urine bladder in the area of triangle was carried out in 22 patients (20 male and 2 female). Mean age was 43.4 (29-56) years, 16 patients have undergone typical infralevator pelvic evisceration. There were no intraoperative lethality. Postoperative lethality made up 6.3%, complications--68.8%, 5-years survival rate--25%. Presence of two fecal fistulas on the anterior abdominal wall has decreased considerably the quality of life of the patients. Since 1993 the conception of preservation and restoration of natural passage of urine and bowel contents was adopted. In 4 cases infralevator pelvic evisceration with various types of ileocystoplasty and pull-through of colon into small pelvis with creation of smooth muscle cuff in perineal colostomy was carried out. In 2 patients evisceration was of supralevator-character cystoplasty of local tissues and performance of coloanal anastomosis were carried out. The application of reconstructive-restorative ways in coloproctology and urology considerably contributed to the improvement of the quality of life of the patients after pelvic evisceration.     

Sexuality and quality of life among young people

Associations between quality of life and attitudes toward, and experience of, sexual activities during adolescence were investigated in a sample of 240 Australian university students. Sexuality was explored using the Sexual Knowledge, Experience and Needs Scale (SexKen). Both objective and subjective quality of life were evaluated in seven domains using the Comprehensive Quality of Life Scale (ComQol). The findings demonstrated the importance of relationships and sexual experience to satisfaction with life. The results are discussed in terms of the significance of sexuality for general well-being during adolescence.     

科学管理优化配置是提高生产运行质量的有效途径

通过安钢降低锭坯库存的探索与尝试,阐述了管理在企业生产经营活动中的重要性。     

Teaching writing to children who are underserved.

Writing instruction for children from low-income families has been dominated by 2 antithetical views, one emphasizing component skills and drill-and-practice instruction, the other emphasizing natural processes of learning language. A 3rd approach, one that reflects pedagogical principles that are based on a sociocognitive model of writing was investigated. Writing instruction that featured these principles in varying degrees was examined in 26 4th-grade and 16 6th-grade classrooms. Regression analysis indicated that more than 40% of the variance in children's posttest writing-quality scores was accounted for by degree of adherence to the model, and scores in writing mechanics did not suffer from application of the model. The results suggest that sociocognitive approaches to writing instruction have much to offer this population of children. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

护理干预对提高癫痫患儿生活质量的效果研究

目的 探讨护理干预对癫痫患儿生活质量的影响.方法 采用癫痫儿童生活质量量表(QOLCE)对在本院确诊的80例癫痫儿童及40例同龄健康儿童生活质量进行比较;按患儿家属自愿原则将患儿分成对照组与干预组各40例,对照组在门诊采用常规的抗癫痫治疗,发放健康教育处方;干预组在常规抗癫痫治疗的基础上进行护理干预.在治疗后3月、6月分别再次对2组患儿生活质量进行比较.结果 癫痫儿童与健康儿童生活质量得分分别为(56.4±7.5)分,(78.8±7.2)分,差异有统计学意义(P＜0.001);患儿治疗3个月后,对照组与干预组得分分别为(61.5±7.0)分,(64.4±6.8)分,2者比较差异无统计学意义(P＞0.05);6月后,对照组与干预组得分分别为(65.6±5.9)分,(73.8±6.3)分,干预组生活质量显著高于对照组,差异有统计学意义(P＜0.05).结论 癫痫儿童生活质量明显低于正常儿童;通过长期的护理干预可以显著改善癫痫患儿的生活质量,提高治疗依从性和治疗效果.     

The development of an instrument for assessing the quality of life of people with diabetes. Diabetes-39

OBJECTIVES: The aim of this 2-year research project was to develop an instrument specifically designed to assess the quality of life of people with diabetes. METHODS: The project was divided into two phases. In the first phase, information from a detailed literature review, from existing quality-of-life instruments, and from interviews with health professionals and people with diabetes was used to develop an initial instrument of 92 items considered to address important aspects of patients' lives. This questionnaire was mailed to 1,000 people with diabetes, and data from the 516 respondents were used to select the most important and useful items. Fifty items were excluded, leaving 42 items that constituted the pilot instrument. During phase 2, the pilot instrument was used to assess the quality of life of 427 diabetic patients who completed the revised questionnaire. After analyzing this data, three additional items were dropped. The final instrument consists of 39 items and covers five dimensions of patients' lives: Energy and Mobility, Diabetes Control, Anxiety and Worry, Social Burden, and Sexual Functioning. RESULTS: The results of validity and reliability tests conducted to date testify to the relevance of the 39-item questionnaire (Diabetes-39) as a valid discriminative instrument, one which shows significant correlations with an overall quality-of-life assessment, the pattern of diabetes severity, and comorbidity. Further, the results from Diabetes-39 correlate well with the results from the established generic quality-of-life instrument, the Medical Outcomes Study 36-Item Short-Form Health Survey. CONCLUSIONS: Validation of a quality-of-life instrument, however, is an ongoing process. Further research is required to corroborate these early findings and to ensure that this is an instrument that can capture data of greatest relevance to the diabetic patient and that is responsive to change in quality of life.     

Dancing in the sky: Enhancing quality of life for people with AIDS-related dementia and their caregivers.

Among the many feared consequences of contracting AIDS is the possibility of HIV or AIDS dementia complex (ADC). As the individual with dementia becomes progressively unable to communicate with his or her caregivers (therapists, loved ones, and medical professionals), the quality of life for both the individual and the caregiver can deteriorate. The person with ADC, faced with a foreshortened future as well as confronted with impending death, must suddenly attend to developmental tasks of dying when he or she may have been in the prime of life. As dementia takes hold, caregivers may disengage because communication becomes disjointed and nonsensical. One of the authors found that, by entering the metaphorical world of the person with ADC, communication could be not only prolonged but deepened, enhancing the relationship between the caregiver and the individual with dementia. Using case examples, this article describes the process of communicating in metaphor with people with ADC. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Why people are reluctant to tempt fate.

The present research explored the belief that it is bad luck to tempt fate. Studies 1 and 2 demonstrated that people do indeed have the intuition that actions that tempt fate increase the likelihood of negative outcomes. Studies 3-6 examined our claim that the intuition is due, in large part, to the combination of the automatic tendencies to attend to negative prospects and to use accessibility as a cue when judging likelihood. Study 3 demonstrated that negative outcomes are more accessible following actions that tempt fate than following actions that do not tempt fate. Studies 4 and 5 demonstrated that the heightened accessibility of negative outcomes mediates the elevated perceptions of likelihood. Finally, Study 6 examined the automatic nature of the underlying processes. The types of actions that are thought to tempt fate as well as the role of society and culture in shaping this magical belief are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Use of spa therapy to improve the quality of life of chronic low back pain patients

OBJECTIVES: This study assessed the effectiveness of adding spa therapy to usual drug treatment in chronic low back pain patients. METHODS: A total of 224 patients were assigned randomly to either a treatment (n=128) or a control (n=96) group. Subjects in both groups received usual drug therapy. Those in the treatment group also underwent spa therapy in Vittel, France, for 6 days a week for 3 consecutive weeks. Effectiveness was assessed using a quality-of-life scale (the Duke Health Profile), clinical measures, and the Roland and Morris disability questionnaire. Groups were compared using an analysis of variance with repeated measures. RESULTS: At both 3 weeks and 3 months, patients in the treatment group exhibited significant improvement in measures of: physical and mental dimensions of quality of life, anxiety, depression, pain duration, pain intensity, and functional disability. CONCLUSION: This study suggests that spa therapy is an effective treatment for chronic low back pain patients.     

Psychological interventions for cancer patients to enhance the quality of life.

Although the thrust of the nation's cancer objectives for the year 2000 is prevention and screening, each year approximately 1 million Americans are diagnosed and must cope with the disease and treatments. They do so with the aid of family, friends, and the health care system, but accumulating data suggest that psychological interventions may be important for reducing emotional distress, enhancing coping, and improving "adjustment." Experimental and quasi-experimental studies of psychological interventions are reviewed, and a discussion of treatment components and mechanism is offered. A final section discusses future research directions and challenges to scientific advance. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Illness and demographic correlates of quality of life among people with multiple sclerosis.

Objective: To evaluate the strength of illness-related, employment-related, and familial support variables as predictors of quality of life (QOL) among people with multiple sclerosis (MS). Design/Participants: An ex post facto, multiple correlational study of 227 people with MS. Measure: A questionnaire that included (a) demographic and illness-related items with fixed and open response sets and (b) a QOL scale that asked respondents to rate on a scale of 1 (totally unsatisfying) to 7 (completely satisfying) their levels of satisfaction in major life areas. Results: A regression analysis resulted in a simplified model in which QOL was positively related to educational level and employment status and negatively related to number of symptoms. Conclusions: These findings provide support for 2 of 3 factors (illness-related, employment-related) proposed in a model of adjustment to MS. The value of employment as an intervention to enhance QOL is also supported. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Strategies for improving the quality of work life.

Presents a number of legislative and public policy approaches to improving the quality of work life (QOWL). Voluntary dissemination of new practices is limited in effectiveness by a lack of knowledge and incentive for adopting practices directed toward improving the QOWL. Significant work life improvement can best be achieved by a combination of more evaluation research and new legislation designed to encourage experimentation with new approaches to designing work organizations. (34 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Development of the multidimensional index of life quality. A quality of life measure for cardiovascular disease

OBJECTIVES: The purpose of this study was to design a multidimensional measure of health-related quality of life appropriate for patients with cardiovascular disease that was psychometrically sound, brief, and easy to administer. METHODS: Qualitative interviews conducted with healthy subjects and patients with cardiovascular diseases identified nine major quality of life domains. Based on the responses of 129 cardiovascular disease patients recruited from hospitals and clinics, a criterion-based approach was used to select 35 questionnaire items that best tapped these domains. Psychometric properties of the Multidimensional Index of Life Quality (MILQ) were tested with a sample of 348 patients with various cardiovascular diseases. RESULTS: Cronbach's alpha was 0.76 or higher for eight of the nine MILQ domains. Test-retest reliability coefficients were 0.73 or greater in all but two domains. Individual domain scores as well as a weighted overall quality of life index were correlated highly with self-assessed health and the number of heart-related symptoms. CONCLUSIONS: The Multidimensional Index of Life Quality is a psychometrically reliable and valid instrument for measuring quality of life in patients with cardiovascular diseases. The MILQ also may be a suitable measure for other types of chronic diseases.     

Spiritual pain in dying people: the nurse's role

Spirituality is a vital aspect of health care, as it affects physical, psychological and social needs. In a dying person spiritual pain may preclude a peaceful death. Nurses are in an ideal position to assess, plan and provide care for those in spiritual pain. 'Being with' a person in spiritual pain is often more important than any intervention. Evaluation of relief from spiritual pain is often difficult but should be attempted.     

提高重轨质量的途径

本文从国内重轨钢的冶炼(包括：铁水预处理、转炉的终点控制、炉外精炼、连铸)、重轨的轧制、热处理工艺技术和设备所存在的质量问题和条件,提出了改善包钢重轨质量的措施,同时研究了高速(200km／h)轨的技术条件以及包钢开发生产高速轨的建议。     

浅谈如何提高安全评价工作的质量

安全生产是企业持续稳定发展的基本保证．安全评价是企业实现安全生产的重要手段。本文结合安全评价的工作实践,分析了安全评价中存在的主要问题,提出了进一步提高安全评价质量的建议,努力寻求一条使安全评价质量持续改进、不断提高的有效途径。