Validation of an instrument to evaluate quality of life in the aging population: WHOQOL-AGE.

BACKGROUND: There is a need for short, specific instruments that assess quality of life (QOL) adequately in the older adult population. The aims of the present study were to obtain evidence on the validity of the inferences that could be drawn from an instrument to measure QOL in the aging population (people 50+ years old), and to test its psychometric properties. METHODS: The instrument, WHOQOL-AGE, comprised 13 positive items, assessed on a five-point rating scale, and was administered to nationally representative samples (n = 9987) from Finland, Poland, and Spain. Cronbach's alpha was employed to assess internal consistency reliability, whereas the validity of the questionnaire was assessed by means of factor analysis, graded response model, Pearson's correlation coefficient and unpaired t-test. Normative values were calculated across countries and for different age groups. RESULTS: The satisfactory goodness-of-fit indices confirmed that the factorial structure of WHOQOL-AGE comprises two first-order factors. Cronbach's alpha was 0.88 for factor 1, and 0.84 for factor 2. Evidence supporting a global score was found with a second-order factor model, according to the goodness-of-fit indices: CFI = 0.93, TLI = 0.91, RMSEA = 0.073. Convergent validity was estimated at r = 0.75 and adequate discriminant validity was also found. Significant differences were found between healthy individuals (74.19 ± 13.21) and individuals with at least one chronic condition (64.29 ± 16.29), supporting adequate known-groups validity. CONCLUSIONS: WHOQOL-AGE has shown good psychometric properties in Finland, Poland, and Spain. Therefore, considerable support is provided to using the WHOQOL-AGE to measure QOL in older adults in these countries, and to compare the QOL of older and younger adults.

The Impact of Aspen and Alder on the Quality of NHBK

The purpose of this work was to study the effect of aspen and alder on birch cooking and the quality of the pulp produced. Three different birch kraft pulps were studied. As a reference, pure aspen and alder were included. The laboratory trials were done at the UPM Research Centre in Lappeenranta, Finland. The materials used were birch, aspen and alder mill chips that were collected around the area of South-Carelia in Finland. The chips used in the study were pulped using a standard kraft process. The pulps including birch fibres were ECF-bleached at laboratory scale to a target brightness of 85 %. The bleached pulps were beaten at low consistency by a laboratory Voith Sulzer refiner and tested for optical and physical properties. The theoretical part is a study of hardwoods that takes into accounts the differences between birch, aspen and alder. Major sub-areas were fibre and paper-technical properties as well as chemical composition and their influence on the different properties. The pulp properties of birch, aspen and alder found in previous studies were reported. Russian hardwood forest resources were also investigated. The fundamentals of kraft pulping and bleaching were studied at the end of theoretical part. The major effect of replacing birch with aspen and alder was the deterioration (lowering) of tensile and tear strengths. In other words, addition of aspen and alder to a birch furnish reduced strength properties. The reinforcement ability of the tested pulps was the following: 100 % birch > 80 % birch, 20 % aspen > 70 % birch, 20 % aspen, 10 % alder. The second thing noted was that blending of birch together with aspen and alder give better smoothness, optical properties and also formation. It can be concluded, that replacement of birch with alder during cooking by more than 10 % can negatively affect on the paper-technical properties of birch pulp. Mixing pure birch and aspen pulps would be more beneficial when producing printing paper made from chemical pulp.

Indicadores sociales y psicosociales de calidad de vida de las personas mayores en un municipio = Social and psychosocial quality of life indicators of older persons in a municipality

A research about the quality of life of the older persons of a municipality starting from the analysis of the perceptions, evaluations and expectations related to concrete spheres of their lives (familiar characteristics, housing, health, nearby environment, activities, needs and dependencies and persons helping them to satisfy needs) is presented. Answers to 1988 questionnaires obtained from two representative samples of older per - sons living in private homes in the city have been analysed: persons over 65 years old and a specific one composed by a sub-sample of the general one, with persons over 75 years living alone. Data shaping contextual indicators related to housing have been analysed. The auto - nomy to drive and the evaluation of on’s health seem to be positive indicators to take in account while sutying quality of life at these ages. Sentinel indicators of the physical and relational conditions in the family and indicators of dependency are analysed as well. The evaluations of the older persons about their own life conditions are also analysed through psychosocial indicators connected to housing, nearby environmenent, their activities andincomes. The results obtained are applicable in order to improve the decision making process in social intervention programmes developed in the field of ageing aiming to take into account their perspectives

Survival and Quality of Life among Patients with Severe Lower Extremity Peripheral Arterial Disease

Lower extremity peripheral arterial disease (PAD) is associated with decreased functional status, diminished quality of life (QoL), amputation, myocardial infarction, stroke, and death. Nevertheless, public awareness of PAD as a morbid and mortal disease is low. The aim of this study was to assess the incidence of major lower extremity amputation due to PAD, the extent of reamputations, and survival after major lower extremity amputation (LEA) in a population based PAD patient cohort. Furthermore, the aim was to assess the functional capacity in patients with LEA, and the QoL after lower extremity revascularization and major amputation. All 210 amputees due to PAD in 1998–2002 and all 519 revascularized patients in 1998–2003 were explored. 59 amputees alive in 2004 were interviewed using a structured questionnaire of QoL. Two of each amputee age-, gender- and domicile-matched controls filled in and returned postal self-administered QoL questionnaire as well as 231 revascularized PAD patients (the amount of these patients who engaged themselves to the study), and one control person for each patient completed postal self-administered QoL questionnaire. The incidence rate of major LEA was 24.1/100 000 person-years and it was considerably high during the years studied. The one-month mortality rate was 21%, 52% at one-year, and the overall mortality rate was 80%. When comparing the one-year mortality risk of amputees, LEAs were associated with a 7.4-fold annual mortality risk compared with the reference population in Turku. Twenty-two patients (10%) had ipsilateral transversions from BK to AK amputation. Fifty patients (24%) ended up with a contralateral major LEA within two to four amputation operations. Three bilateral amputations were performed at the first major LEA operation. Of the 51 survivors returning home after their first major LEA, 36 (71%) received a prosthesis; (16/36, 44%) and were able to walk both in- and outdoors. Of the 68 patients who were discharged to institutional care, three (4%) had a prosthesis one year after LEA. Both amputees and revascularized patients had poor physical functioning and significantly more depressive symptoms than their controls. Depressive symptoms were more common in the institutionalized amputees than the home-dwelling amputees. The surviving amputees and their controls had similar life satisfaction. The amputees felt themselves satisfied and contented, whether or not they lived in long-term care or at home. PAD patients who had undergone revascularizations had poorer QoL than their controls. The revascularized patients’ responses on their perceived physical functioning gave an impression that these patients are in a declining life cycle and that revascularizations, even when successful, may not be sufficient to improve the overall function. It is possible that addressing rehabilitation issues earlier in the care may produce a more positive functional outcome. Depressive symptoms should be recognized and thoroughly considered at the same time the patients are recovering from their revascularization operation. Also primary care should develop proper follow-up, and community organizations should have exercise groups for those who are able to return home, since they very often live alone. In rehabilitation programs we should consider not only physical disability assessment but also QoL.

Computational visual quality of digitally printed images

The problem of understanding how humans perceive the quality of a reproduced image is of interest to researchers of many fields related to vision science and engineering: optics and material physics, image processing (compression and transfer), printing and media technology, and psychology. A measure for visual quality cannot be defined without ambiguity because it is ultimately the subjective opinion of an “end-user” observing the product. The purpose of this thesis is to devise computational methods to estimate the overall visual quality of prints, i.e. a numerical value that combines all the relevant attributes of the perceived image quality. The problem is limited to consider the perceived quality of printed photographs from the viewpoint of a consumer, and moreover, the study focuses only on digital printing methods, such as inkjet and electrophotography. The main contributions of this thesis are two novel methods to estimate the overall visual quality of prints. In the first method, the quality is computed as a visible difference between the reproduced image and the original digital (reference) image, which is assumed to have an ideal quality. The second method utilises instrumental print quality measures, such as colour densities, measured from printed technical test fields, and connects the instrumental measures to the overall quality via subjective attributes, i.e. attributes that directly contribute to the perceived quality, using a Bayesian network. Both approaches were evaluated and verified with real data, and shown to predict well the subjective evaluation results.

Assessment of hydrochemical quality of ground water under some urban areas within sana'a secreteriat

Groundwater from nine wells of three different districts, located at Sana'a secretariat was analyzed for hydrochemical quality assessment. Measurements of water quality parameters including pH, EC, CO3(2-), HCO3-, Cl-, NO3-, SO4(2-), Ca2+, Mg2+, Fe3+, K+, and Na+ were carried out . Classification of the groundwater samples according to Cl, SO4(2-), CO3(2-) and HCO3-, hardness (H), total dissolved solids (TDS), base-exchange, and meteoric genesis was demonstrated. Suitability of ground water samples for irrigation and industrial uses according to sodium adsorption ration (SAR), ratio of dissolved sodium (RDS), residual sodium carbonate (RSC) and saturation index (SI) was also investigated. The results of this study showed that almost all ground water samples were of good quality that makes them suitable for drinking and domestic uses. Results also indicated that even though some of the ground water samples were suitable for irrigation purposes, almost all of them were found not be good for industrial uses. Despite all drawbacks of the sewerage system built around Sana'a secretariat at the beginning of the first decade of the third millennium, the results of this study indicate that there is scope of significant improvement in Sana'a secretariat ground water quality.

Success of service-intensive manufacturing firms - resource-based view

The main objective of this study is to examine the relationships between resources, competitive advantage and firm success. The study focuses, on one hand, on the financial performance of service-intensive manufac-turing firms against competitors with a lower service intensity and, on the other hand, on the resources as drivers for competitive advantage and success. The purpose of the theoretical part is to link the study in the field of the strategy research. The empirical part of the study is based on the quantitative analyses of the survey data collected from 50 major suppliers of industrial machinery and transportation equipment in Europe and North America. Results indicate that service-intensive manufacturing firms have performed better and their performance has been more stable vis-à-vis their peers. The main resources that differentiate service-intensive manufacturing firms from their non-service intensive competitors are service strategy and service-oriented top management. The analyses on the VRIO resources produced only a limited amount of information and solely service-centred culture appeared to be a rent generating resource.

Improving Quality of Life of Patients With Schizophrenia In Acute Psychiatric Wards

The overall goal of this study was to identify means by which the quality of life (QoL) of patients with schizophrenia could be improved in acute psychiatric wards. First, subjective QoL of patients (n=35) was explored. Second, two different QoL instruments (EuroQoL-5D, EQ-5D; Quality of Life Enjoyment and Satisfaction Questionnaire Short Form, Q-LES-Q SF) were examined. Third, patients’ (n=35) and nurses’ (n=29) perceptions of nursing interventions to support patients’ QoL were examined. Fourth, the effect of three different patient education methods on patients’ QoL (n=311) was compared. The data were collected during the period 2005-2007. Patients named health, family, leisure activities, work or study, and social relationships most frequently as their important QoL areas. It emerged that patients’ QoL was impaired. Examination of two QoL instruments showed that the EQ-5D has moderate and the Q-LES-Q SF good internal consistency. Moreover, both instruments proved to be reasonably valid and feasible for use with patients with schizophrenia. Altogether six nursing interventions which nurses use to support patients’ QoL, and which should be further developed were identified from nurses’ descriptions: interventions related to care planning, empowering interventions, social interventions, activating interventions, security interventions, and interventions to support physical health. Evaluation of different patient education methods showed that patients’ QoL improved significantly during follow-up. No significant differences between groups were found. In light of the findings it is recommended to assess QoL of patients with schizophrenia as a basis for care planning and care evaluation in clinical settings. Valid and feasible instruments should be used in this assessment. Moreover, it is recommend that nursing interventions should be further developed to better improve patients’ QoL.

Chitosan and fungicides on postharvest control of Guignardia citricarpa and on quality of 'Pêra Rio' oranges

Citrus fruits are affected by the black spot disease caused by the fungus Guignardia citricarpa. Chitosan can be used as covering for fruits and may delay the ripening process and inhibit the growth of some fungi. Thus, the control of citrus black spot using chitosan and the fungicides thiabendazole and imazalil was assessed in addition to the physicochemical quality of 'Pêra Rio' oranges. The oranges were immersed into chitosan, thiabendazole or imazalil, and in chitosan mixed with both fungicides. The fruits were then stored at 25 °C, 80% RH, for 7 days and, after this storage period, subjected to physicochemical analyses. Chitosan in association with the fungicides reduced black spot in 'Pêra Rio' oranges and delayed the change in the orange skin colour from green to yellow during the postharvest storage. Total soluble solids, titratable acidity, pH, ascorbic acid content and ratio were not influenced by the treatments. Thus, chitosan applied with the fungicides thiabendazole and imazalil showed potential to control the development of black spot lesions on 'Pêra Rio' oranges during the postharvest period.

The Productivity, Economy and Quality of Welding in the Different Geographical Areas of China - Today and in the Future

This master’s thesis gives out the real situation of the China welding industry and factories nowadays in different geographical areas, in order to inform the Finnish companies who have the willing to find a Chinese welding subcontractor a proper and correct selection concept by analyzing and supplying the information of different scale and form welding factories in different Chinese areas. The first section of this thesis gives out the general situation about the co-operation between China and Finland in the welding industry, also includes the general introduction of the Chinese welding industry. The second section gives out the geographical compartmentalization result of Chinese welding industry, which is where and how many areas will be studied in this thesis. The main body of this thesis is the real information of welding productivity, welding cost, and welding quality in China. All the information was collected from real factories in China by the author. The last section of this thesis is the improvements to the Chinese welding factories that have the willing to become a subcontractor, and the suggestions to the Finnish companies who may find a Chinese welding factory as their subcontractor in future.

Evaluation of the physiological quality of anadenenthera peregrina (L.) Speg. seeds during storage

The aim of this experiment was to evaluate the effect of storage temperature on the viability and vigour of A. peregrina seeds. Seeds of A. peregrina harvested in Viçosa-MG, in September 2005 were used. The seeds were stored in the Laboratory of Forest Seeds Analysis (LASF) of the Universidade Federal de Viçosa (UFV), in a cold chamber, under approximately 5ºC over150 days. The seeds were stored under 20ºC for 150 days more. Seed moisture was determined after oven-drying at 105 ± 3ºC for 24 hours. The seeds were analyzed monthly using germination, tetrazolium and electrical conductivity tests and Osmopriming during 300 days, with four repetitions of 25 seeds. A. peregrina seeds kept a constant percentage of germination and viable seeds under the tetrazolium test for five months of storage, under either 5ºC and 20ºC. The electrical conductivity test showed significant differences in relation to the storage period, proving to be more sensitive than the standard germination test. Seed priming in PEG -0,4 MPa solution was not efficient in recovering the viability and vigor of the stored seeds at 5ºC and 20ºC.

Quality of Abdominal Surgical Nursing Care

The study evaluates the quality of abdominal surgical nursing care. The data were collected from patients (n=1208) having undergone abdominal surgical operations on their last day of hospitalization and nurses (n=218) working in the same wards. Three instruments originally created in Finland and adapted to the Lithuanian context were used: (1) Good Nursing Care Scale for patients and nurses (GNCS-P, GNCS-N), (2) Nurse Competence Scale (NCS), and (3) Nurse Empowerment Scale (NES). Patient and nurses’ perceptions of the quality of nursing care were evaluated. In addition, nurses’ perceptions of their competence and empowerment were evaluated. The patient and nurses' perceptions of the quality of abdominal surgical nursing care were positive, with more criticism in the nurses’ perceptions. Both patients and nurses gave the lowest evaluation to the quality in the progress of nursing care and the co-operation with significant others. The nurses gave the highest evaluation to the self-assessed level of their competence and the frequency of using competences in practice, with the highest assessment given to situation management and their role at work and the lowest to teaching-coaching and ensuring quality. The nurse perceptions of their empowerment were positive in the qualities and performance of an empowered nurse and empowerment promoting factors, with the highest evaluation in moral principles and sociability and the lowest evaluation in the future-orientedness and expertise. The empowerment-impeding factors were evaluated as negative. The perceptions of the quality of nursing care of both patients and nurses had significant correlations with patient and nurse satisfaction and nurse job independence. The nurse perceptions of their competence and empowerment correlated with their education, the type of the nurse license, completed courses of development of their knowledge and skills, nurse job independence, and nurse satisfaction. The nurse perceptions of the quality of nursing care had a positive correlation with their perceptions of competence and empowerment. Generally, the quality of nursing care was evaluated as high and had correlations with the patients' demographic and satisfaction factors and with the nurse demographic, work-related, and satisfaction factors. The study produced the knowledge that the quality in co-operation with significant others and the progress of nursing process, surgical nurse competence in teaching-coaching, and future-orientedness of surgical nurse empowerment need to be improved in order to develop the quality of abdominal surgical nursing care. The knowledge may be used to offer better services for abdominal surgical patients and increase their satisfaction with nursing care, as well as to increase nurses' satisfaction with work and independence at work. The study suggests implications for clinical practice and management, nursing education, and nursing research.