Quality of life, symptom experience, and use of complementary and alternative medicine among women with ovarian cancer

The objectives of this dissertation were to determine the quality of life in women with ovarian cancer and the association of their physical and emotional well-being with the number of symptoms, duration of symptoms, and the scores of common symptoms of ovarian cancer; to study the prevalence of complementary and alternative medicine techniques for symptom relief and its association with the number of symptoms, age, education, insurance, comorbidity, and satisfaction with medical care they received, and their pre-diagnostic experience of symptoms.^ This study was based on a secondary data analysis of a study of early detection of ovarian cancer. A sample of 139 women with ovarian cancer was recruited and was administered a questionnaire comprised of questions on their quality of life, their symptoms and what they did about the symptoms, whether they used any complementary and alternative medicine techniques, and other medical conditions they had. Out of this sample, 53 patients underwent in-depth interviews relating to their symptoms before the diagnosis and their experiences with the health care system leading to the ovarian cancer diagnosis. ^ In article #1, ovarian cancer patients were observed to have significantly poorer quality of life on all subscales and summary scores except pain, compared to that of the general population of US women. Physical well-being scores were negatively associated with the number of symptoms before diagnosis and a significant negative association of comorbidity index was observed with physical well-being. Higher education and increase in time since diagnosis was found to have better physical scores. Emotional well-being scores showed marginally significant associations with number of symptoms and bloating. ^ In article #2, a thematic content analysis of the ovarian cancer patients’ interviews revealed that on recognition of their symptoms women first assumed their symptoms to be a normal transient occurrence due to a pre-existing disease condition, or due to some other disease. A series of misattributions of their symptoms on their and their doctors’ part impacted their health care seeking.In article #3, a significantly greater likelihood of CAM use with an increase in the number of symptoms was observed.^ Based on the foregoing results, it is important to educate women on possible signs of ovarian cancer and also to educate doctors about the results of current research regarding ovarian cancer diagnosis. This will help to avoid a delay in getting a diagnosis and improve women’s quality of life. It emphasizes the diagnosis of ovarian cancer in earlier stages by more sensitive screening techniques. This study emphasizes the importance of consideration of comorbidity in any quality of life research. Additionally, educating women in the safe use of CAM techniques carries immense significance because the efficacy and safety of many of the currently advertized CAM products has not been scientifically validated. Further research is needed to confirm the findings of this study. ^

The steam engine indicator and its appliances. Being a comprehensive treatise for the use of constructing, erecting and operating engineers, superintendents, master mechanics, and students ... with many illustrations, rules, tables, and examples for obtaining the best results in the economical operation of all classes of steam, gas and ammonia engines ... Its correct use, management and care, derived from the author's practical and professional experience ...

Mode of access: Internet.

The field book of manures; or The American muck book; treating of the nature, properties, sources, history, and operations of all the principal fertilizers and manures in common use, with specific directions for their preparation, preservation, and application to the soil and to crops; as combined with the leading principles of practical and scientific agriculture; drawn from authentic sources, actual experience, and personal observation ...

Mode of access: Internet.

The angler's guide, abridged for the use of young anglers; being a complete practical treatise on angling. Containing the art of trolling, fly-fishing & making, etc. Founded on 40 years experience.

Mode of access: Internet.

Model parking code provisions to encourage ridesharing and transit use (including a review of experience) /

"HHP-25/11-83(2M)E"--P. [4] of cover.

Land use impacts of rapid transit : implications of recent experience : executive summary /

Issued Dec. 1977.

Land use impacts of rapid transit : implications of recent experience : final report /

Report no. DOT-TPI-10-77-29.

The use of state and local labor market data from the Current population survey : the New York experience /

Presented at 14th annual meeting of the Association of Public Data Users, Washington, D.C., Oct. 24, 1989.

Seclusion use with children and adolescents: an Australian experience

Objective: To summarize the current state of knowledge on the use of seclusion and restraint with children and adolescents and to report the findings of an exploratory study to identify factors that place a child or adolescent at increased risk of seclusion during their admission. Method: Literature searches were undertaken on MEDLINE, CINAHL and PsycINFO databases. Articles were identified that focused specifically on seclusion and restraint use with children and adolescents or contained material significant to this population. The study reports findings from a retrospective review of patient charts, seclusion registers and staffing from an Australian acute inpatient facility. Results: The data available in regard to seclusion use in this population is limited and flawed. Further research is needed on the use and outcomes of seclusion and restraint and on alternative measures in the containment of dangerousness. Both the literature and this study find that patients with certain factors are at increased risk of being secluded during an inpatient stay. These factors include being male, diagnoses of disruptive behaviour disorder and a previous history of physical abuse. Staffing factors did not show a relationship to the use of seclusion. Conclusions: There are patient factors that predict increased risk of seclusion; these factors and their interrelationships require further elucidation. Further research is also needed on the outcomes, both positive and negative, of seclusion use and of alternatives to seclusion.