Venous disease: from pathophysiology to quality of life

Venous insufficiency is a multifactorial pathology that has an important impact on the quality of life of the patients. The primary factor of venous disease is an abnormal wall distensibility, which seems to be correlated with genetic factors. Facilitating factors include hormonal impregnation and prolonged hydrostatic load, particularly under conditions where the control of the sympathetic nervous system is reduced by an increase in local temperature. The resulting valvular incompetence, combined with the augmented hydrostatic load, leads to varicosis and venous stasis. The ensuing tissue hypoxia and local edema favor inflammation and infection, which ultimately favor the occurrence of ulcers. The available data on the impact of the disease suggest a relation between the physiopathological phenomena and some parameters of health-related quality of life.     

Psychopathy and recidivism from mid-adolescence to young adulthood: Cumulating legal problems and limiting life opportunities.

This study examined the ability of psychopathy as indexed by the following 4 scales: Psychopathy Checklist: Youth Version (A. E. Forth, D. S. Kosson, & R. D. Hare, 1996/2003), Antisocial Process Screening Device (P. J. Frick & R. D. Hare, 2001), Hare Self-Report Psychopathy Scale-II (R. D. Hare, 1991), and Personality Assessment Inventory-Antisocial Scale (L. C. Morey, 1991, 2007) to prospectively predict antisocial outcomes including general and violent recidivism across a 3- to 4-year time span. Results indicated that psychopathy was predictive of both general and violent recidivism from mid-adolescence to young adulthood even after accounting for 14 variables theoretically linked to offending. These findings add to the recent research showing stability in the psychopathy traits across time by also demonstrating that psychopathy in adolescents also has a real-world effect, including a cost to society with higher rates of offending in the community and a cost to youth with cumulating legal records that are likely to narrow their potential for prosocial growth in the community. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Medicaid's not-so-"quiet revolution": A call to action for psychologists.

Psychologists are research-based health care providers with much to offer to the development of programs for people with disabilities and chronic illnesses. An exemplar for psychologists' involvement in health care planning is Health Care Options Plus (HCO+), a prevention-oriented, Medicaid-funded program for people with disabilities. Contributions such as HCO+ will make a positive impact on the future of professional psychology and health care delivery models for people with disabilities. Psychologists must recognize the importance of Medicaid as well as their own potential for influencing public and private health care sectors in order to thrive in the current health care climate. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The contribution of job and leisure satisfaction to quality of life.

Examined the relationships between job and leisure satisfaction and their contributions to the perception of quality of life. Data were collected from a national probability sample of 1,297 adult Americans interviewed in May 1972. The magnitude of the correlations between job and leisure satisfaction measures was low; however, both accounted for meaningful variation in perceived quality of life for the total sample. Separate analyses for demographic subgroups were also performed. They indicated that job satisfaction and leisure satisfaction contributed relatively little to the life quality of minorities and other often "disadvantaged" subgroups compared to "advantaged" workers. Implications of the results for the application of motivational stategies in the work setting are discussed. (28 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The quality of life of diabetics

The purposes of this study were to identify the meaning of the quality of life for the people who suffer from Diabetes Mellitus, to recognize the aspects which affect most their lives due to this disease and the degree of the satisfaction in their lives as well. Participated in this research forty-six (46) diabetic patients, adults of both sexes, who were in a polyclinic for treatment. The results showed that the meaning of the quality of life had priority related to the physical well-being (54.5%), to the social and economical stability (26.0%), and to the spiritual and emotional well-being (16.9%). The most affected aspects due to this disease were: studying and home activities (38.5%) physical ability (25.6%) and family relationship (10.3%). Concerning about the degree of satisfaction with their lives, the majority of them (66.6%) considered themselves satisfied or very satisfied. It is worth while to point out the importance of considering the multimensionality of the concept of quality of life while attending the diabetic person.     

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

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

The interpretation of scores from the EORTC quality of life questionnaire QLQ-C30

While quality of life (QOL) assessment is becoming more common, interpreting the results remains problematic. This paper demonstrates an approach to developing clinically-based interpretations for QOL outcomes, using the QLQ-C30 as an example. The results from 14 published QLQ-C30 studies which group patients by performance status, weight loss, toxicity, extent or severity of disease are collated. Groups with lower clinical status generally have worse QOL. The largest differences are between performance status groups, and the smallest differences are between groups of patients with local disease and those with metastases. The physical and role scores have the largest ranges of means across patient groups, and show the largest differences between clinical groups, while the cognitive and emotional scores have the smallest ranges of means and differences. Sicker groups have larger score standard deviations than healthier groups. Relatively large and small means and differences, and corresponding effect sizes, are presented. Collectively, the results provide a sense of the relative sizes of means and of differences, and of the types of clinical groups which give rise to them, thereby providing clinically-based benchmarks by which to interpret QLQ-C30 results.     

Measuring quality of life for patients with terminal illness: the Missoula-VITAS quality of life index

OBJECTIVE: To investigate whether fibronectin fragments (Fn-fs), shown to damage cultured cartilage, can be found in cartilage from patients with osteoarthritis (OA) or rheumatoid arthritis, or can be generated from fibronectin (Fn) within synovial fluids or from Fn in the matrix of cultured cartilage. To also determine whether cartilage or synovial fluid Fn-fs are active and, thus, could contribute to cartilage damage in vivo. METHODS: Fn-fs were immunochemically identified in cartilage extracts from patients with OA or rheumatoid arthritis or in bovine cartilage cultured with IL-1 alpha or in bovine synovial fluids treated with stromelysin-1 (MMP-3). The effect of removal of Fn-fs from OA synovial fluids was tested by passing fluids over an anti-Fn column and adding the resultant fluids to bovine cartilage cultures to measure proteoglycan (PG) degradation. Gelatin-Sepharose purified Fns from bovine plasma, synovial fluid or cartilage were digested with MMP-3 and the Fn-fs tested for degradation of PG in cultured cartilage. RESULTS: Extracts of cartilage from patients with rheumatoid arthritis or with OA contained a range of Fn-fs. Removal of Fn-fs from OA synovial fluids significantly reduced the resultant damage when the fluids were added to cultured cartilage. Addition of IL-1 alpha to cultured cartilage or of MMP-3 to synovial fluids enhanced generation of Fn-fs. Fn-fs, whether derived from bovine plasma or synovial fluid or cartilage Fns, damaged cartilage. CONCLUSIONS: These data demonstrate that although Fn-fs could be generated in vivo within synovial fluids and Fn-fs found in OA synovial fluid may contribute to cartilage damage in vivo, Fn-fs could also be generated within cartilage and amplify cartilage damage. Thus, Fn-fs may be both autocrine and paracrine regulators of cartilage metabolism.     

HIV and quality of life: a rehabilitation perspective

Access to families affected by HIV in their own home puts health visitors in a prime position to encourage health promotion strategies for people with HIV infection, and to recognise and make early referral for rehabilitation needs, writes Cherry Lang. Here she describes how physiotherapy and stress management techniques can help tackle symptoms of HIV infection.     

The quality of life of prostatic cancer patients

A questionnaire was used to assess the quality of life (QOL) of forty-two outpatients with prostate cancer. Most of the patients were old, so reduced physical comfort was correlated with bodily factors other than those caused by prostate cancer. Many patients with progressive disease reported disease--and treatment--related physical problems that tended to be correlated to the extent of the disease. Many patients treated with female hormones complained of breast induration or discomfort. Patient's sexual life was impaired remarkably. Our treatment for cancer pain would be especially inadequate to cancer pain relief. We must give positive aid to cancer pain relief from now on. Most patients lost sexual interest after developing prostate cancer. Only three of the patients were able to have sexual intercourse. Some of the patients who underwent radical prostatectomy suffered from urinary incontinence after the operation. Thus, the patients' social life was remarkably affected for relative good performance status. Many patients lived only with other elderly individuals. Therefore, it is also important to manage patients in the light of their living environment.     

Childhood epilepsy and asthma: comparison of quality of life

We report results from the first data collection on an ongoing longitudinal study aimed at describing the natural history of adaptation to childhood epilepsy and asthma in children and their families. We studied 136 children with epilepsy and 134 children with asthma aged 8-12 years. Data were collected from the children, their mothers, and their school teachers through interviews, school records, and questionnaires. The two samples were compared on four domains of quality of life: physical, psychological, social, and school. Data were analyzed by a 2 x 2 between-subjects multivariate analysis of covariance with type of illness (epilepsy or asthma) as the independent variable and length of time since onset of illness as a covariate. A significant main effect was noted for illness [multivariate F (15, 236) = 11.36, p < 0.001]. Our major finding was that children with epilepsy had a relatively more compromised quality of life in the psychological, social, and school domains. In contrast, children with asthma had a more compromised quality of life in the physical domain. Our findings suggest that attention simply to seizure control in the clinical setting will not address the full range of quality-of-life problems of children with epilepsy.     

Dimensions of coaching related to productivity and quality of life.

This article examines the impact of coaching 19 recruiting first sergeants (district managers) over six months. The relationships between coaching dimensions (intensity of coaching and involvement in coaching) and measures of goal attainment, stress, life satisfaction, quality of life, and work productivity were examined. A self-reported negative relationship between goal achievement and the quality of recruitment productivity among personnel was found. Additionally, managers who more frequently applied coaching advice reported more work satisfaction and a tendency toward more life satisfaction. These findings provide some direction in exploring goal achievement and adherence in coaching. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Lung cancer and quality of life

Quality of life (QOL) is frequently used as an endpoint of measurement in cancer treatment. Compared to other cancers, there are only a few reports of QOL in the treatment of lung cancer. Several QOL instruments have been developed and this paper reports experience with the functional Living-Index-Cancer and Quality of Life Index tools in Lung Cancer treatment, in a randomised controlled trial of chemotherapy.     

A new instrument to assess the long-term quality of life effects from migraine: development and psychometric testing of the MSQOL

Quality of life is important to persons experiencing migraine. This study discusses the development of a migraine-specific quality-of-life measure (MSQOL). Participants, who included migraineurs from both tertiary care centers and the community, were screened using the International Headache Society migraine criteria prior to enrollment. Internal consistency of the MSQOL was high (alpha 0.92). Reproducibility over an average of 24 days was high (intraclass correlation 0.90). Construct validity was determined by convergent validity and known groups validity. The MSQOL was compared to two other frequently used health status questionnaires; results indicate that the MSQOL more closely resembles well-being than functional status. Results also indicate that migraineurs with more symptoms, medical appointments per year to treat migraines, and migraine episodes per year have a significantly worse quality of life. The MSQOL proved valid and reliable as a self-administered measure and will be a useful tool in clinical migraine research. The information gained from its use in the clinical environment should provide important additional information about the impact of migraine on quality of life and the potential benefits of therapeutic interventions.