1000 resultados para Conduct of life.
Resumo:
Objective : To examine prospective associations of television viewing time with quality of life, following a colorectal cancer diagnosis.
Methods : One thousand, nine hundred and sixty-six colorectal cancer survivors were recruited through the Queensland Cancer Registry. Interviews were conducted at 5, 12, 24, and 36 months post-diagnosis. Generalized linear mixed models estimated the effects of television viewing time on quality of life.
Results : Participants who watched ≥5 h of television per day had a 16% lower total quality of life score than did participants reporting ≤2 h per day. Deleterious associations of television viewing time were found with all quality of life subscales: functional well-being showed the strongest association (23% difference in quality of life scores between highest and lowest television viewing categories), and social well-being the weakest association (6% difference). Participants who increased their television viewing by one category (e.g., ≤2 h, increasing to 3–4 h per day) had a proportional decrease of some 6% in their quality of life score (intra-individual effect).
Conclusions : The deleterious associations of television viewing time with quality of life were clinically significant and consistent over time. Decreasing sedentary behavior may be an important behavioral strategy to enhance the quality of life of cancer survivors.
Prospective relationships of physical activity and quality of life among colorectal cancer survivors
Resumo:
Objective : To examine the associations between physical activity and quality of life for colorectal cancer survivors; and to describe the associations of medical and sociodemographic attributes with overall quality of life, and their moderating effects on the relationships between physical activity and quality of life.
Methods : Telephone interviews were conducted with 1,996 colorectal cancer survivors recruited through the Queensland Cancer Registry. Data were collected on current quality of life; leisure-time physical activity pre- and post-diagnosis; cancer treatment and side-effects; and general sociodemographic attributes. Hierarchical generalized linear models identified variables significantly associated with quality of life.
Results : After controlling for sociodemographic variables, disease-specific variables, treatment side-effects, and pre-diagnosis leisure-time physical activity, there were significant differences in quality of life scores by post-diagnosis physical activity category. Compared to participants who were inactive after their diagnosis, those who were sufficiently active had a 17.0% higher total quality of life score. Physical activity also had a significant independent positive association with the physical well-being, functional well-being, and additional concerns subscales of the FACT-C.
Conclusions : Our findings demonstrate that quite modest changes in leisure-time physical activity are associated with quality of life. Colorectal cancer survivors may benefit from a more active lifestyle.
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:
The pace-of-life syndrome (POLS) hypothesis specifies that closely related species or populations experiencing different ecological conditions should differ in a suite of metabolic, hormonal and immunity traits that have coevolved with the life-history particularities related to these conditions. Surprisingly, two important dimensions of the POLS concept have been neglected: (i) despite increasing evidence for numerous connections between behavioural, physiological and life-history traits, behaviours have rarely been considered in the POLS yet; (ii) the POLS could easily be applied to the study of covariation among traits between individuals within a population. In this paper, we propose that consistent behavioural differences among individuals, or personality, covary with life history and physiological differences at the within-population, interpopulation and interspecific levels. We discuss how the POLS provides a heuristic framework in which personality studies can be integrated to address how variation in personality traits is maintained within populations.
Resumo:
The domestic dog has undergone extensive artificial selection resulting in an extreme diversity in body size, personality, lifehistory, and metabolic traits among breeds. Here we tested whether proactive personalities (high levels of activity, boldness, and aggression) are related to a fast “pace of life” (high rates of growth, mortality, and energy expenditure). Data from the literature provide preliminary evidence that artificial selection on dogs (through domestication) generated variations in personality traits that are correlated with life histories and metabolism. We found that obedient (or docile, shy) breeds live longer than disobedient (or bold) ones and that aggressive breeds have higher energy needs than unaggressive ones. These correlations could result from either human preference for particular trait combinations or, more likely, correlated responses to artificial selection on personality. Our results suggest the existence of a general pace‐of‐life syndrome arising from the coevolution of personality, metabolic, and lifehistory traits.
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:
Abstract:
Diabetes is the most significant chronic disease and the global prevalence is increasing. Diabetes is associated with debilitating long term complications and other comorbidities that cause high rates of morbidity and mortality. Keeping blood glucose and other metabolic parameters within an acceptable, personalised range is important to comfort and quality of life but can be challenging, especially during end-of-life care. Guidelines can help clinicians make appropriate care decisions; however, there is little research about what constitutes best practice diabetes care at the end-of-life: existing recommendations and guidelines blend the best available evidence with consensus opinion. In addition, there are important ethical and methodological considerations concerning research involving vulnerable people at the end-of-life. Chapter 3 describes the ethical and methodological issues that needed to be considered when developing guidelines for managing diabetes at the end-of-life and the contribution interviews with dying people and their family carers made to developing a guiding philosophy and to person-centred guidelines.
Resumo:
This article describes the pastoral movements and material culture of a community of nomads in Eastern Tibet and how they negotiate changes brought about not only by national government policies and international development plans, but also by a local lama.
Security in uncertain times: policies for increasing the popularity of life annuities among retirees
Resumo:
Life annuities offer retirees an assured income stream for as long as they live. This makes it surprising that they are unpopular in most markets where their purchase is not compelled by government policy. With the numbers of retirees in the population set to increase dramatically, this low take-up rate of life annuities could exacerbate financial insecurity. Consequently, it is in society’s interest to implement non-coercive policies that increase annuitization levels. Although there is research that has focused on the possible causes of low annuitization rates, much of this research falls short of suggesting comprehensive strategies for persuading retirees to annuitize their savings.
This article discusses what mix of policies would increase the attractiveness of life annuities. It does this by determining the salient characteristics of the few markets where life annuities are popular. It then suggests how the correct policy settings could make such characteristics a feature of the mainstream annuity market. It also discusses other policies, including limited tax incentives or subsidies on annuities that might play an important role. It is argued that policy innovations such as these are preferable to making the purchase of annuities compulsory. This is because the one-size-fits-all approach will not be ideal for everyone, and it interferes with freedom of choice, an important right in a capitalist society. An alternative is to make annuity purchases a default choice. But this is effectively compulsion by stealth as it relies on inertia and, therefore, carries some of the disadvantages of mandatory annuitization. The article concludes with a discussion of how the appropriate marketing and innovation of different life annuity products could supplement annuity-maximizing policies and further improve annuitization rates.
Resumo:
Objective
To investigate the relationship between excess weight (overweight and obesity) and health-related quality of life (HRQoL) in a sample of secondary school children in Fiji, by gender, age and ethnicity.
Methods
The study comprised 8947 children from forms 3–6 (age 12–18 years) in 18 secondary schools on Viti Levu, the main island of Fiji. Body mass index (BMI) was calculated from measured height and weight, and weight status was classified according to the International Obesity Task Force recommendations. HRQoL was measured by the self-report version of the Pediatric Quality of Life Inventory 4.0.
Results
HRQoL was similar in children with obesity and normal weight. Generally, this was replicated when analyzed separately by gender and ethnicity, but age stratification revealed disparities. In 12–14-year-old children, obesity was associated with better HRQoL, owing to better social and school functioning and well-being, and in 15–18-year olds with poorer HRQoL, owing to worse physical, emotional and social functioning and well-being (Cohen’s d 0.2–0.3). Children with a BMI in the overweight range also reported a slightly lower HRQoL than children with a BMI in the normal weight range, but although statistically significant, the size of this difference was trivial (Cohen’s d <0.2).
Discussion
The results suggest that, overall there is no meaningful negative association between excess weight and HRQoL in secondary school children in Fiji. This is in contradiction to the negative relationship between excess weight and HRQoL shown in studies from other countries and cultures. The assumption that a large body size is associated with a lower quality of life cannot be held universally. Although a generally low HRQoL among children in Fiji may be masking or overriding the potential effect of excess weight on HRQoL, socio-economic and/or socio-cultural factors, may help to explain these relationships.
Resumo:
Background:
Recent research identified the issue that family carers of people with diabetes at the end of life (EOL) did not receive sufficient information to enable them to help their relative manage their diabetes at the EOL.
Aim:
The aim of the current study was to undertake a literature review to identify the information needs of family carers of people with diabetes at the EOL.
Method:
A comprehensive review of the literature was conducted by searching the following databases: CINAHL, PubMed, PsychInfo, Scopus, and SocINDEX. The grey literature was also searched for papers relevant to the aim. All study designs were included. A content analysis of relevant papers was undertaken to identify themes.
Results:
Sixteen of the more than 300 papers identified addressed the information needs of family carers of people with diabetes at the EOL and were included in the review. Five key themes were identified from the papers reviewed: (1) performing diabetes care tasks, (2) focus of care, (3) blood glucose management, (4) EOL stages, and (5) involving patients and family carers in decisions about diabetes care. Most of the 16 papers represented the views of health professionals and focused on the need to provide information about the medical aspects of diabetes management.
Conclusions:The review suggests further research is needed to identify the information needs of family carers of people with diabetes at the EOL to enable interventions to be developed to support the family carers and meet their unique information needs.
Resumo:
Background
Cost-effectiveness analyses of interventions for older adults have traditionally focused on health status. There is increasing recognition of the need to develop new instruments to capture quality of life in a broader sense in the face of age-associated increasing frailty and declining health status, particularly in the economic evaluation of aged and social care interventions which may have positive benefits beyond health.
Objective
To explore the relative importance of health and broader quality of life domains for defining quality of life from the perspective of older South Australians.
Methods
Older adults (n=21) from a day rehabilitation facility in Southern Adelaide, South Australia attended one of two audiorecorded focus groups. A mixed methods (qualitative and quantitative) approach was adopted. The study included three main components. Firstly, a general group discussion on quality of life and the factors of importance in defining quality of life. Secondly, a structured ranking exercise in which individuals were asked to rank domains from the brief Older People’s Quality of Life questionnaire (OPQOL-brief) and Adult Social Care Outcomes Toolkit (ASCOT) in order of importance. Thirdly, participants were asked to self-complete the Euroqol (EQ-5D) a measure of health status, and two broader quality of life measures: the OPQOL-brief and ASCOT.
Results
Mean scores on the EQ-5D, OPQOL-brief and ASCOT were 0.71 (SD 0.20, range 0.06-1.00), 54.6 (SD 5.5, range 38-61) and 0.87 (SD 0.13, range 0.59-1.00) respectively, with higher scores reflecting better ratings of QOL. EQ-5D scores were positively associated with OPQOL-brief (rho: .730, p<.01), but not ASCOT. Approximately half (52.4%) of the respondents ranked either “health” or “psychological and emotional well- being” as the domain most important to their quality of life. However, one-third (33.3%) of the total sample ranked a non-health domain from the ASCOT or OPQOL-brief (safety, dignity, independence) as the most important contributing factor to their overall quality of life. Qualitative analysis of focus group transcripts supported the high value of both health-related (health, psychological well-being) and social (independence, safety) domains to quality of life.
Conclusions
Older adults value both health and social domains as important to their overall quality of life. Future economic evaluations of health, community and aged-care services for older adults should include assessment of both healthrelated and broader aspects quality of life.
