The World Health Organization WHOQOL-100: Tests of the universality of quality of life in 15 different cultural groups worldwide.

The World Health Organization Quality of Life assessment (WHOQOL-100) was developed simultaneously across 15 international field centers and includes 24 facets relating to quality of life, which are grouped into 4 larger domains: physical, psychological, social relationships, and environment. It also includes 1 facet examining overall quality of life and general health perceptions. This article examines the extent to which the WHOQOL-100 assesses quality of life perceptions in different cultures and whether it is structurally comparable in these cultures. Regression analysis showed all 4 domains to be important in assessing quality of life in each of the 15 centers. Structural equation modeling suggested further support for the proposal that there are universal facets and domains that are cross-culturally important in determining quality of life and suggested that the ordering of facets within domains is comparable across cultures. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Pain and quality of life following radical retropubic prostatectomy

PURPOSE: We assess pain and quality of life following radical retropubic prostatectomy and determine whether intraoperative anesthetic management has any long-term effects on outcomes. MATERIALS AND METHODS: A total of 110 patients undergoing radical retropubic prostatectomy were randomly assigned to receive epidural and/or general anesthesia. Patients responded to a questionnaire mailed 3 and 6 months following surgery that assessed prostate symptoms, pain related to surgery, quality of life and mood. RESULTS: No long-term effects of anesthesia were observed. Of the 103 respondents (94%) at 3 months 49% had some pain related to surgery. Although pain was not related to anesthesic technique, patients who had it at 3 months used significantly more pain medication on postoperative day 3. Pain at 3 months was mild, averaging 1.5 on a scale of 0 to 10, and associated with poor perceptions of overall health (p <0.02), and reduced physical (p <0.01) and social (p <0.01) functioning. Pain at 3 months was associated with higher levels of preoperative anxiety (p <0.05). At 6 months 36 of 90 patients (35%) had some pain related to surgery and the impact was similar. CONCLUSIONS: Long-term effects of intraoperative anesthesic technique were not apparent. Mild pain following radical retropubic prostatectomy was common and associated with reduced quality of life, particularly social functioning. Affective distress, particularly anxiety, before surgery and use of pain medications following surgery may be predictors of chronic pain following radical retropubic prostatectomy.     

The relationship of community quality to the health of women and men

Using a 1996 community survey of behavioral risk factors, this cross-sectional study of 804 residents in a rural community examines the relationship of community quality to the health status of women and men. We use two categories of community factors to assess community quality: measures of the social quality of community life, and measures of community quality that focus on the physical environment. Health status is assessed by four measures that examine perceived health status and functioning. Regression results indicate that there is a significant relationship between the quality of the community and health status for both women and men. Specifically, women's perceptions about the social quality of their community are positively associated with their perceived health status and functioning; furthermore, these relationships are significantly different from those of men. Men's perceptions of their physical environment are significantly related to their reported functioning and health, to a limited extent these relationships are different from women. These relationships support our hypothesis that gender differentially affects the relationship between community quality and health.     

Health status and health care costs for publicly funded patients with schizophrenia started on clozapine

OBJECTIVE: The study examined the effect of clozapine treatment on the health care costs and health status of people with schizophrenia who are supported by public funds. METHODS: Thirty-three patients with schizophrenia hospitalized in a state facility were interviewed within one week of starting clozapine and six months later. Health status was assessed with four clinical rating scales measuring severity of psychopathology, negative symptoms, depression, and quality of life. Cost and health care utilization data were collected for the six months before and after initiation of clozapine. RESULTS: Only 52 percent of the subjects stayed on clozapine for six months. Subjects who continued on clozapine were more likely to be discharged within six months than those who did not continue. Six months after clozapine was started, health care costs showed a sayings of $11,464 per person, even after adjustment for pretreatment costs, and health status was improved. CONCLUSIONS: For subjects who continued on clozapine for six months, clozapine treatment was associated with reduced days of psychiatric hospital care, reduced overall costs despite increased outpatient treatment and residential costs, and improved health status.     

The social environment and health in rheumatoid arthritis: marital quality predicts individual variability in pain severity

OBJECTIVE: To examine prospective relations between a wide array of measures of social functioning and pain, while controlling for disease duration and activity and functional grade. METHODS: As part of a larger study on health care utilization, longitudinal data were collected from 136 Dutch and 98 German outpatients on clinical status and pain. Social data included information on sexual handicap, spouse behavior, loneliness, daily emotional support, and the maintenance of pleasurable life domains. Pain severity was assessed at baseline and 12 months later with standard measures of pain and analyzed with hierarchical regressions. RESULTS: Social measures obtained at baseline were consistently associated with pain at followup. Depression was a moderate correlate of pain in the Dutch and German samples. The regressions revealed that patient reports of negative spouse behavior (such as avoidance and critical remarks) and baseline depression predicted worse pain outcome, and this association remained significant in analyses controlling for baseline pain. The level of formal education was a weak correlate of disability, emotional support, and pain. Daily emotional support and social life domains associated with positive affect had an indirect influence on outcome. The absence of strong rather than weak social ties was the component of the loneliness construct linked to pain. These associations between social prognostic factors and pain severity, however, were mediated by psychological functioning at baseline. CONCLUSION: The social environment was found to operate on the core health outcome, pain severity, via several pathways. Social functioning may be affected by rheumatoid arthritis (RA) progression, but it also appears to form a determinant of future health outcome. Not only the status of being married but also the quality of the relationship in terms of long-term stress and emotional support may be useful prognostic factors in RA.     

Outcomes of acute exacerbation of severe congestive heart failure: quality of life, resource use, and survival. SUPPORT Investigators. The Study to Understand Prognosis and Preferences for Outcomes and Risks of Treatments

BACKGROUND: Congestive heart failure (CHF) is a common disease with high health care costs and high mortality rates. Knowledge of the health-related quality of life outcomes of CHF may guide decision making and be useful in assessing new therapies for this population. METHODS: A prospective cohort study was conducted involving 1390 adult patients hospitalized with an acute exacerbation of severe CHF (New York Heart Association class III-IV). Demographic data and health-related quality of life were determined by interview; physiologic status and cost and intensity of care were determined from hospital charts. RESULTS: The median (25th, 75th percentiles) age of patients was 68.0 (58.2, 76.9) years; 61.7% were male. Survival was 93.4% at discharge from the index hospitalization, 72.9% at 180 days, and 61.5% at 1 year. Of patients interviewed at 180 days, the median health rating on a scale of 0 to 100 (0 indicates death; 100, excellent health) was 60 (interquartile range, 50-80), and 59.7% were independent in their activities of daily living. Overall quality of life was reported to be good, very good, or excellent in 58.2% at 180 days. Patients with worse functional capacity were more likely to die. Health perceptions among the patients with available interview data improved at 60 and 180 days after acute exacerbation of severe CHF. CONCLUSIONS: Patients hospitalized for acute exacerbation of severe CHF have a generally poor 6-month survival, but survivors retain relatively good functional status and have good health perceptions. Furthermore, health perceptions improve after the acute exacerbation.     

The short tandem repeat loci hTPO, THO1 and FGA

PURPOSE: The purpose of this study was to describe perceptions of quality of life (QOL) of Hispanic patients with cancer pain. DESCRIPTION OF STUDY: This qualitative pilot study is guided by the conceptual framework of pain and QOL. From interviews with 17 Hispanic patients with cancer pain, data on perceptions of QOL were analyzed and are reported here. RESULTS: The study demonstrated the influence of culture on perceptions of QOL and the impact of pain on QOL. Several themes were identified for each domain of QOL, including physical, psychological, social, and spiritual well-being. The role of the family and faith in God were important components of QOL for all patients. CLINICAL IMPLICATIONS: It is important for clinicians to devote greater attention to cultural assessment and to include cultural beliefs in cancer care to improve QOL for Hispanic patients. The role of the family and religious beliefs should be included in the planning and evaluation of each patient's care.     

Discriminability in length of lines in the Müller-Lyer figure

OBJECTIVE: To compare patients' health-related quality of life after systemic methotrexate therapy versus laparoscopic salpingostomy for tubal pregnancy. DESIGN: Multicenter randomized clinical trial. SETTING: Departments of obstetrics and gynecology of six Dutch hospitals. PATIENT(S): Hemodynamically stable patients with a laparoscopically confirmed unruptured tubal pregnancy without signs of active bleeding, who were randomly assigned to undergo either systemic methotrexate therapy or laparoscopic salpingostomy. INTERVENTION(S): Standard health-related quality of life questionnaires administered before and 2 days, 2 weeks, 4 weeks. and 16 weeks after confirmative laparoscopy. MAIN OUTCOME MEASURE(S): Health-related quality of life. RESULT(S): Health-related quality of life was impaired most severely 2 days after confirmative laparoscopy in both treatment groups and improved during follow-up. Health-related quality of life was impaired more severely after systemic methotrexate therapy than after laparoscopic salpingostomy. Medically treated patients had more limitations in physical functioning, role functioning, and social functioning; had worse health perceptions, less energy, more pain, more physical symptoms, and a worse overall quality of life; and were more depressed than surgically treated patients. CONCLUSION(S): Systemic methotrexate therapy had a more negative impact on patients' health-related quality of life than did laparoscopic salpingostomy. This negative impact on patients' health-related quality of life of systemic methotrexate therapy should be taken into account when deciding on the appropriate therapy for tubal pregnancy.     

Influence of mood on health-relevant cognitions.

Three experiments assessed the effects of mood on symptom appraisal, health behavior self-efficacy, outcome expectations, and perceptions of vulnerability. Ss in Experiments 1 and 2 were acutely ill, whereas Ss in Experiment 3 were healthy. In each experiment, happy, sad, and neutral moods were induced. In Experiment 1, Ss who experienced sadness reported more aches and pains and greater discomfort than happy Ss. Sad Ss were less confident that they could carry out illness-alleviating behaviors. Experiments 2 and 3 demonstrated that mood's influence of vulnerability perceptions is moderated by health status. Although mood had little impact on perceptions of vulnerability among ill Ss, probability estimates of future negative health-relevant events among healthy Ss were mood sensitive. Seeing oneself as invulnerable to future negative events was accentuated among happy Ss and attenuated among sad Ss. Mood may be an important determinant of care seeking, adherence, and recovery from illness. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of concerns about child care among single, employed black mothers with preschool children

This study investigated whether differences in child care arrangements and mothers' attitudes about leaving their child in nonmaternal care were associated with maternal psychological well-being and perceptions of children in a sample of single, employed, low-income, Black mothers who were former welfare recipients. Feelings of discomfort with regard to nonmaternal care were associated with higher levels of maternal depressive symptomatology, which, in turn, predicted more negative perceptions of children. Preference for employment and increased working hours were associated with greater life satisfaction. Maternal education and the gender of the child were important moderating variables. Type of child care arrangement was nonsignificant. Policy implications are discussed.     

Quality of life following spinal cord injury: knowledge and attitudes of emergency care providers

STUDY OBJECTIVES: To measure emergency care providers' attitudes toward quality of life after spinal cord injury (SCI) and to determine if their perceptions influence the care they provide. DESIGN: A closed-ended questionnaire. SETTING AND PARTICIPANTS: Two hundred thirty-three emergency nurses, emergency medicine technicians, emergency medicine residents, and attending physicians at three level I trauma centers were surveyed. Their responses were compared with previously reported quality-of-life ratings of a group of 128 high-level SCI survivors. MEASUREMENTS AND RESULTS: One hundred fifty-three emergency care providers completed the survey (response rate, 63%). Forty-one percent believed that resuscitation efforts after severe SCI are too aggressive, and 28% believed that future quality of life should be a factor in determining the interventions that should be provided. If they sustained severe SCIs themselves, 22% of providers would want nothing done to ensure their survival, and 23% would want pain relief only. Only 18% imagined they would be glad to be alive with a severe SCI, compared with 92% of a true SCI comparison group. Seventeen percent of providers anticipated an average or better quality of life compared with 86% of the actual SCI comparison group. CONCLUSION: The quality of life, self-esteem, and outcomes that emergency health care providers imaging after SCI are considerably more negative than those reported by SCI survivors. Because providers' knowledge and attitudes may affect the care they provide and may influence patients and families struggling with critical treatment decisions, emergency care providers must be aware of outcomes, well-being, and life satisfaction following severe SCI.     

Enlisted men's perceptions of leader attributes and satisfaction with military life.

Assessed the relative degree of association between 130 US Army lower-ranking enlisted men's perceptions of the quality of army life and their perceptions of attributes of different types of leaders. Interviews with the Ss provided information regarding their satisfaction with various facets of military experience and their perceptions of the behavior of superiors who they viewed as either formulating daily orders (originators) or merely relaying them (givers). Results of regression analyses indicated that satisfaction with both the quality of army life in general and leadership in particular were more closely related to perceived attributes of the originator rather than to those of the giver. It is suggested that the finding is attributed to the originator's greater hierarchical influence within the army structure. Implications of the result for policy makers who seek to improve the attractiveness of army life for enlisted personnel are considered. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The impact of dependent-care responsibility and gender on work attitudes.

On the basis of a survey of 18,120 federal employees in dual-income households, six 5-stage hierarchical multiple regression analyses, controlling for 10 demographic variables, assessed the impact of child care, elder care, and gender on work–family balance and various facets of job satisfaction. Elder-care responsibility was associated with lower levels of satisfaction with perceived organizational support, pay, leave benefits, and work–family balance, whereas the negative main effects of child care were limited to leave benefits and work–family balance. However, child-care responsibility also interacted with gender: Its negative influence was greater on women's work–family balance and leave satisfaction. Decrements in satisfaction associated with dependent care on the "sandwich generation" were additive, not interactive. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Taste and smell complaints in HIV-infected patients

OBJECTIVES: To define the scope of taste and smell (chemosensory) complaints amongst HIV-infected persons in the study population; to evaluate the clinical factors associated with chemosensory complaints; and to determine the impact of chemosensory complaints on quality of life. DESIGN: Cross-sectional survey. SETTING: Tertiary care university medical center clinic. PARTICIPANTS: A total of 207 HIV-infected patients. MAIN OUTCOME MEASURES: Chemosensory complaint score from taste and smell questionnaire and quality of life scores from the Medical Outcomes Study HIV Health Survey (MOS-HIV). RESULTS: A total of 144 patients (70%) reported chemosensory complaints, 91 (44%) reported both taste and smell complaints, 47 (23%) reported only taste complaints, and six (3%) reported only smell complaints. Many patients complained that drugs interfered with their sense of taste, or that medications tasted bad. Higher chemosensory complaint scores were associated with a greater number of medications taken, tobacco use, and hay fever. Patients with chemosensory complaints had significantly lower scores in all domains of the MOS-HIV than those without complaints. Quality of life as measured by the MOS-HIV was lower in patients with chemosensory complaints even after controlling for number of AIDS diagnoses, number of medications, CD4 cell count, and HIV-1 viral load. CONCLUSIONS: Chemosensory complaints were common in the patient population and were associated with a poor quality of life. Medications played an important role in chemosensory complaints. Measures to optimize taste and smell function may improve quality of life and medication adherence, and prevent complications such as inadequate oral intake, malnutrition, weight loss, and ultimately wasting.     

Autoimmune hyperthyroidism in prepubertal children and adolescents: comparison of clinical and biochemical features at diagnosis and responses to medical therapy

The purpose of this study was: (i) to examine the impact of the clinical severity, anatomical location and treatment of psoriasis on patients' quality of life, and (ii) to investigate the effects of perceptions of psoriasis-related stress on patients' physical and mental health and on areas of disability in everyday life. All patients (n = 204) attending a psoriasis specialty clinic were invited to complete a multidimensional quality of life assessment comprising the Psoriasis Disability Index (PDI), the SF-36 Health Survey and the Psoriasis Life Stress Inventory (PLSI). Results (n = 150) indicated that overall clinical severity of psoriasis as assessed by the Psoriasis Area and Severity Index, and duration of psoriasis, were unrelated to impairment in any areas of quality of life. Anatomical location (social visibility) of psoriasis was associated with self-report of poor physical health (P = 0.01), and there was a modest association with patients' mental health (P = 0.04); however, anatomical location of psoriasis was not significantly associated with self-reported disability in everyday life, or stress scores. Patients who were classified as more reactive to the stress associated with psoriasis (78% of the sample) were functioning less well in terms of their mental health (P = 0.001) and also experienced significantly more disability in all areas of everyday life (P = 0.001). Differences in method of treatment for psoriasis did not significantly affect scores on the psoriasis-specific (PDI; PLSI) or generic (SF-36) quality of life measures. A multiple regression analysis demonstrated that stress resulting from anticipating other people's reactions to their psoriasis contributed more to the variance in patients' disability in everyday life than any other medical or health status variable. The results support the importance of assessing the effects of stress in patients' adjustment to their condition and may indicate a role for adjunctive psychological stress management training for a significant number of patients with psoriasis.     

Parallel syndromes: Two dimensions of narcissism and the facets of psychopathic personality in criminally involved individuals.

Little research has examined different dimensions of narcissism that may parallel psychopathy facets in criminally involved individuals. In this study, we examined the pattern of relationships between grandiose and vulnerable narcissism, assessed using the Narcissistic Personality Inventory–16 and the Hypersensitive Narcissism Scale, respectively, and the four facets of psychopathy (interpersonal, affective, lifestyle, and antisocial) assessed via the Psychopathy Checklist: Screening Version. As predicted, grandiose and vulnerable narcissism showed differential relationships to psychopathy facets, with grandiose narcissism relating positively to the interpersonal facet of psychopathy and vulnerable narcissism relating positively to the lifestyle facet of psychopathy. Paralleling existing psychopathy research, vulnerable narcissism showed stronger associations than grandiose narcissism to (a) other forms of psychopathology, including internalizing and substance use disorders, and (b) self- and other-directed aggression, measured with the Life History of Aggression and the Forms of Aggression Questionnaire. Grandiose narcissism was nonetheless associated with social dysfunction marked by a manipulative and deceitful interpersonal style and unprovoked aggression. Potentially important implications for uncovering etiological pathways and developing treatment interventions for these disorders in externalizing adults are discussed. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Fracture Surface Facets and Fatigue Life Potential of Castings

Fatigue potential has been studied in cast aluminum alloys with regard to the fatigue crack initiation mechanism at the casting defects, particularly surface and subsurface defects. The significance of facets is interpreted as the presence of defects in the interior of castings. Furthermore, two varieties of facets have been identified, one originating as a dendrite-straightened bifilm (type I facet) and the other originating from a slip plane mechanism around casting defects (type II facet). The fatigue life potential of castings is reexamined based on the involvement of defects during the formation of both types of facets. It is proposed that the true fatigue life potential of defect free castings has yet to be observed, i.e., if castings can be produced without defects, then their fatigue performance will be significantly higher than even the best performances observed so far.     

Crystal Growth and Characterization of Ca3NbGa3Si2O14 Single Crystal

Single crystals of Ca3NbGa3Si2O14 (CNGS) with ordered Ca3Ga2Ge4O14 (CGG) structure were successfully grown from stoichiometric melts by conventional Czochralski technique along the a-axis and two large (001) facets and two small (100) facets appear in every crystal. An arrangement of parallel steps and a clear height change were observed in (001) facet by atomic force microscopy (AFM). High-resolution X-ray diffraction (HRXRD) results indicate that CNGS crystals have good quality and free low-angle boundaries. The crystals also exhibit good optical quality and high optical transmittance in c-direction.     

Undifferentiated cells in the developing Drosophila eye influence facet assembly and require the Fat facets ubiquitin-specific protease

The Drosophila compound eye develops by a complex series of cell interactions where multiple positive and inhibitory cues guide cells in each facet into their positions and fates. The results of many genetic and molecular experiments have led to the view that facet assembly is directed by cells within developing ommatidial preclusters. Here fat facets mutants and the cloned fat facets gene were used to show that, in order to limit the number of photoreceptors in a facet to eight, undifferentiated cells surrounding assembling facets send an inhibitory signal to extraneous cells within the facet preclusters. Generation of the inhibitory signal requires the ubiquitin-specific protease encoded by the fat facets gene and is thus regulated by ubiquitin-dependent proteolysis.