35 resultados para LIFE-SPAN
Resumo:
Over the last seven decades, Papua New Guinea (PNG) has grown from a disparate collection of traditional societies loosely governed by its neighbour, Australia, to a thriving, developing state. The story of how PNG came to lose its colonial shackles and gain independence is one of collective endeavour, as the tiny group of Papua New Guineans who gathered in the dusty streets of Port Moresby transformed into the leaders of the new nation. One of them was the young teacher, Ebia Olewale, who in his own journey from the village to the nation experienced many triumphs and tragedies. PNG’s story – from the village to the world – is retold in this book, through the experiences of Ebia Olewale.
Resumo:
Purpose:
To identify the demographic factors, impairments and activity limitations that contribute to health-related quality of life (HRQOL) in people with idiopathic Parkinson’s disease (PD).
Method:
Two hundred and ten individuals with idiopathic PD who participated in the baseline assessment of a randomized clinical trial were included. The Parkinson’s Disease Questionnaire-39 summary index was used to quantify HRQOL. In order to provide greater clarity regarding the determinants of HRQOL, path analysis was used to explore the relationships between the various predictors in relation to the functioning and disability framework of the International Classification of Functioning model.
Results:
The two models of HRQOL that were examined in this study had a reasonable fit with the data. Activity limitations were found to be the strongest predictor of HRQOL. Limitations in performing self-care activities contributed the most to HRQOL in Model 1 (β = 0.38; p < 0.05), while limitations in functional mobility had the largest contribution in Model 2 (β = −0.31; p < 0.0005). Self-reported history of falls was also found to have a significant and direct relationship with HRQOL in both models (Model 1 β = −0.11; p < 0.05; Model 2 β = −0.21; p < 0.05).
Conclusions:
Health-related quality of life in PD is associated with self-care limitations, mobility limitations, self-reported history of falls and disease duration. Understanding how these factors are inter-related may assist clinicians focus their assessments and develop strategies that aim to minimize the negative functional and social sequelae of this debilitating disease.
Resumo:
OBJECTIVE:
To determine whether improvements in glycemic control and diabetes-specific quality of life (QoL) scores reported in research studies for the type 1 diabetes structured education program Dose Adjustment For Normal Eating (DAFNE) are also found when the intervention is delivered within routine U.K. health care.
RESEARCH DESIGN AND METHODS:
Before and after evaluation of DAFNE to assess impact on glycemic control and QoL among 262 adults with type 1 diabetes.
RESULTS:
There were significant improvements in HbA1c from baseline to 6 and 12 months (from 9.1 to 8.6 and 8.8%, respectively) in a subgroup with suboptimal control. QoL was significantly improved by 3 months and maintained at both follow-up points.
CONCLUSIONS:
Longer-term improved glycemic control and QoL is achievable among adults with type 1 diabetes through delivery of structured education in routine care, albeit with smaller effect sizes than reported in trials.
Resumo:
Background
Many inpatients receive little or no rehabilitation on weekends. Our aim was to determine what effect providing additional Saturday rehabilitation during inpatient rehabilitation had on functional independence, quality of life and length of stay compared to 5 days per week of rehabilitation.
Methods
This was a multicenter, single-blind (assessors) randomized controlled trial with concealed allocation and 12-month follow-up conducted in two publically funded metropolitan inpatient rehabilitation facilities in Melbourne, Australia. Patients were eligible if they were adults (aged ≥18 years) admitted for rehabilitation for any orthopedic, neurological or other disabling conditions excluding those admitted for slow stream rehabilitation/geriatric evaluation and management. Participants were randomly allocated to usual care Monday to Friday rehabilitation (control) or to Monday to Saturday rehabilitation (intervention). The additional Saturday rehabilitation comprised physiotherapy and occupational therapy. The primary outcomes were functional independence (functional independence measure (FIM); measured on an 18 to 126 point scale), health-related quality of life (EQ-5D utility index; measured on a 0 to 1 scale, and EQ-5D visual analog scale; measured on a 0 to 100 scale), and patient length of stay. Outcome measures were assessed on admission, discharge (primary endpoint), and at 6 and 12 months post discharge.
Results
We randomly assigned 996 adults (mean (SD) age 74 (13) years) to Monday to Saturday rehabilitation (n = 496) or usual care Monday to Friday rehabilitation (n = 500). Relative to admission scores, intervention group participants had higher functional independence (mean difference (MD) 2.3, 95% confidence interval (CI) 0.5 to 4.1, P = 0.01) and health-related quality of life (MD 0.04, 95% CI 0.01 to 0.07, P = 0.009) on discharge and may have had a shorter length of stay by 2 days (95% CI 0 to 4, P = 0.1) when compared to control group participants. Intervention group participants were 17% more likely to have achieved a clinically significant change in functional independence of 22 FIM points or more (risk ratio (RR) 1.17, 95% CI 1.03 to 1.34) and 18% more likely to have achieved a clinically significant change in health-related quality of life (RR 1.18, 95% CI 1.04 to 1.34) on discharge compared to the control group. There was some maintenance of effect for functional independence and health-related quality of life at 6-month follow-up but not at 12-month follow-up. There was no difference in the number of adverse events between the groups (incidence rate ratio = 0.81, 95% CI 0.61 to 1.08).
Conclusions
Providing an additional day of rehabilitation improved functional independence and health-related quality of life at discharge and may have reduced length of stay for patients receiving inpatient rehabilitation.
Resumo:
A longstanding, successful and frequently controversial career spanning more than four decades establishes David Bowie as charged with individual agency. The notion of ‘agency’ here refers particularly to the ‘ability of people, individually and collectively to influence their own lives and the society in which they live’ (Germov and Poole, 2007: 7). That Bowie has influenced many lives is undeniable to his fans. He has long demonstrated an avid curiosity for the enduring patterns of social life which is reflected in his art. Bowie’s opus contains the elements of ideological narratives around sexual (mis)adventure, expressivity, and; resistance to ‘normative’ behaviour. He requisitions his audiences, through frequently indirect lyrics and images, to critically question sanity, identity and essentially what it means to be ‘us’ and why we are here. Here, in this context, ‘dancing with madness’ assumes an intimate relationship, even if brief, where ideas and emotions come passionately together for the purpose of creative expression much like the intertwining and energetic performance of the partner dance Tango. As such, ‘dancing’ is argued here to be an appropriate descriptor for how Bowie has engaged with creative cultural forms but not meant to be self-conscious nor indicate superficiality or ignorance. The idea of madness for its part is a theme in many of his compositions, for example the original album cover for The Man Who Sold the World (1971) depicts an asylum and includes the song ‘All The Madmen’ and Aladdin Sane (1973)—a lad insane--are but two examples. This paper argues that Bowie’s frequently astute contemplations, manifest through his art over a period now spanning more than forty years, continues to draw fans of like mind to his work with the result that he has a legitimate claim to influence and affect.
