The Scored Patient-Generated Subjective Global Assessment (PG-SGA) and its Association with Quality of Life in Ambulatory Patients Receiving Radiotherapy

OBJECTIVE: To evaluate the scored Patient-generated Subjective Global Assessment (PG-SGA) tool as an outcome measure in clinical nutrition practice and determine its association with quality of life (QoL). DESIGN: A prospective 4 week study assessing the nutritional status and QoL of ambulatory patients receiving radiation therapy to the head, neck, rectal or abdominal area. SETTING: Australian radiation oncology facilities. SUBJECTS: Sixty cancer patients aged 24-85 y. INTERVENTION: Scored PG-SGA questionnaire, subjective global assessment (SGA), QoL (EORTC QLQ-C30 version 3). RESULTS: According to SGA, 65.0% (39) of subjects were well-nourished, 28.3% (17) moderately or suspected of being malnourished and 6.7% (4) severely malnourished. PG-SGA score and global QoL were correlated (r=-0.66, P<0.001) at baseline. There was a decrease in nutritional status according to PG-SGA score (P<0.001) and SGA (P<0.001); and a decrease in global QoL (P<0.001) after 4 weeks of radiotherapy. There was a linear trend for change in PG-SGA score (P<0.001) and change in global QoL (P=0.003) between those patients who improved (5%) maintained (56.7%) or deteriorated (33.3%) in nutritional status according to SGA. There was a correlation between change in PG-SGA score and change in QoL after 4 weeks of radiotherapy (r=-0.55, P<0.001). Regression analysis determined that 26% of the variation of change in QoL was explained by change in PG-SGA (P=0.001). CONCLUSION: The scored PG-SGA is a nutrition assessment tool that identifies malnutrition in ambulatory oncology patients receiving radiotherapy and can be used to predict the magnitude of change in QoL.

Willingness to trial functional foods and vitamin supplements: the role of attitudes, subjective norms, and dread of risks

Australian non-users of vitamin supplements (N = 162) and functional foods (N = 226) responded to a questionnaire examining their attitudes, subjective norms, and perceived behavioural control from the Theory of Planned Behaviour (TPB), risk dread and risk familiarity, and willingness to engage in free product trials. The impact of participants’ gender and age was also examined. Attitude and subjective norms were significant determinants of non-users willingness to trial each of the health products. Participants’ dread of the risk associated with the product was also a determinant of willingness to use functional foods. The overall models predicted between 25% and 30% of the variance in people’s willingness to trial the products. The findings provided some support for the TPB in predicting people’s willingness to trial functional foods and vitamin supplements and suggested, for willingness to trial functional foods, that non-users are also influenced by their dread of the risk associated with product use.

Comparing subjective and objective measures of health : Evidence from hypertension for the income/health gradient

Economists rely heavily on self-reported measures to examine the relationship between income and health. We directly compare survey responses of a self-reported measure of health that is commonly used in nationally representative surveys with objective measures of the same health condition. We focus on hypertension. We find no evidence of an income/health greadient using self-reported hypertension but a sizeable gradient when using objectively measured hypertension. We also find that the probability of a false negative reporting is significantly income graded. Our results suggest that using commonly available self-reported chronic health measures might underestimate true income-related inequalities in health.

The relationship between subjective appetite sensations, markers of inflammation and appetite in dialysis patients

Background: Poor appetite is a marker of morbidity and mortality in hemodialysis patients, making it an important area for research. Visual analog scales (VAS) can capture a range of subjective sensations related to appetite (such as hunger, desire to eat or fullness), but have not been commonly used to measure appetite in dialysis patients. The aim of this study was to explore the association between retrospective ratings of appetite using VAS and a range of clinical variables as well as biomarkers of appetite in hemodialysis patients.----- Methods: 28 hemodialysis patients (mean age 61±17y, 50% male, median dialysis vintage 19.5(4-101) months) rated their appetite using VAS for hunger, fullness and desire to eat and a 5-point categorical scale measuring general appetite. Blood levels of the appetite peptides leptin, ghrelin and peptide YY were also measured.----- Results: Hunger ratings measured by VAS were significantly (p<0.05) correlated with a range of clinical, nutritional and inflammatory markers: age (r=-0.376), co-morbidities, (r=-0.380) PG-SGA score (r=-0.451), weight (r=-0.375), fat-free mass (r=-0.435), C-Reactive Protein (CRP) (r=-0.383) and Intercellular adhesion molecule (sICAM-1) (r=-0.387). There was a consistent relationship between VAS and appetite on a 5-point categorical scale for questions of hunger, and a similar trend for desire to eat, but not for fullness. Neither method of measuring subjective appetite correlated with appetite peptides.----- Conclusions: Retrospective ratings of hunger on a VAS are associated with a range of clinical variables and further studies are warranted to support their use as a method of measuring appetite in dialysis patients.

Subjective fit with organizational culture : an investigation of moderating effects in the work stressor-employee adjustment relationship

Occupational stress has been a concern for human resource managers in light of research investigating the work stressor-employee adjustment relationship. This research has consistently demonstrated many negative effects between stressors in the workplace and employee adjustment. A considerable amount of literature also describes potential moderators of this relationship. Subjective fit with organizational culture has been established as a significant predictor of employee job-related attitudes; however, research has neglected investigation of the potential moderating effect of subjective fit in the work stressor-employee adjustment process. It was predicted that perceptions of subjective fit with the organization’s values and goals would mitigate the negative effect of work stressors on employee adjustment in an employee sample from three organizations (N ¼ 256). Hierarchical multiple regression analyses revealed support for the stress-buffering effects of high subjective fit in the prediction of physical symptoms, job satisfaction, and intentions to leave. The theoretical and practical implications of the results are discussed.

The anatomy of subjective well-being

This paper contributes to the literature on subjective well-being (SWB) by taking into account different aspects of life, called domains, such as health, financial situation, job, leisure, housing, and environment. We postulate a two-layer model where individual total SWB depends on the different subjective domain satisfactions. A distinction is made between long-term and short-term effects. The individual domain satisfactions depend on objectively measurable variables, such as income. The model is estimated using a large German panel data set.

Feasibility of "subjective" engineering assessments of road safety improvements : Bayesian analysis development

Regional safety program managers face a daunting challenge in the attempt to reduce deaths, injuries, and economic losses that result from motor vehicle crashes. This difficult mission is complicated by the combination of a large perceived need, small budget, and uncertainty about how effective each proposed countermeasure would be if implemented. A manager can turn to the research record for insight, but the measured effect of a single countermeasure often varies widely from study to study and across jurisdictions. The challenge of converting widespread and conflicting research results into a regionally meaningful conclusion can be addressed by incorporating "subjective" information into a Bayesian analysis framework. Engineering evaluations of crashes provide the subjective input on countermeasure effectiveness in the proposed Bayesian analysis framework. Empirical Bayes approaches are widely used in before-and-after studies and "hot-spot" identification; however, in these cases, the prior information was typically obtained from the data (empirically), not subjective sources. The power and advantages of Bayesian methods for assessing countermeasure effectiveness are presented. Also, an engineering evaluation approach developed at the Georgia Institute of Technology is described. Results are presented from an experiment conducted to assess the repeatability and objectivity of subjective engineering evaluations. In particular, the focus is on the importance, methodology, and feasibility of the subjective engineering evaluation for assessing countermeasures.

Subjective blur limits for cylinder

Purpose: To compare subjective blur limits for cylinder and defocus. ---------- Method: Blur was induced with a deformable, adaptive-optics mirror when either the subjects’ own astigmatisms were corrected or when both astigmatisms and higher-order aberrations were corrected. Subjects were cyclopleged and had 5 mm artificial pupils. Black letter targets (0.1, 0.35 and 0.6 logMAR) were presented on white backgrounds. Results: For ten subjects, blur limits were approximately 50% greater for cylinder than for defocus (in diopters). While there were considerable effects of axis for individuals, overall this was not strong, with the 0° (or 180°) axis having about 20% greater limits than oblique axes. In a second experiment with text (equivalent in angle to N10 print at 40 cm distance), cylinder blur limits for 6 subjects were approximately 30% greater than those for defocus; this percentage was slightly smaller than for the three letters. Blur limits of the text were intermediate between those of 0.35 logMAR and 0.6 logMAR letters. Extensive blur limit measurements for one subject with single letters did not show expected interactions between target detail orientation and cylinder axis. ---------- Conclusion: Subjective blur limits for cylinder are 30%-50% greater than those for defocus, with the overall influence of cylinder axis being 20%.

Subjective blur limits for higher order aberrations

Purpose: We compared subjective blur limits for defocus and the higher-order aberrations of coma, trefoil, and spherical aberration. ---------- Methods: Spherical aberration was presented in both Zernike and Seidel forms. Black letter targets (0.1, 0.35, and 0.6 logMAR) on white backgrounds were blurred using an adaptive optics system for six subjects under cycloplegia with 5 mm artificial pupils. Three blur criteria of just noticeable, just troublesome, and just objectionable were used.---------- Results: When expressed as wave aberration coefficients, the just noticeable blur limits for coma and trefoil were similar to those for defocus, whereas the just noticeable limits for Zernike spherical aberration and Seidel spherical aberration (the latter given as an “rms equivalent”) were considerably smaller and larger, respectively, than defocus limits.---------- Conclusions: Blur limits increased more quickly for the higher order aberrations than for defocus as the criterion changed from just noticeable to just troublesome and then to just objectionable.

An investigation of the relationship between subjective sleep quality, loneliness and mood in an Australian sample: Can daily routine explain the links?

Background: Loneliness and low mood are associated with significant negative health outcomes including poor sleep, but the strength of the evidence underlying these associations varies. There is strong evidence that poor sleep quality and low mood are linked, but only emerging evidence that loneliness and poor sleep are associated. Aims: To independently replicate the finding that loneliness and poor subjective sleep quality are associated and to extend past research by investigating lifestyle regularity as a possible mediator of relationships, since lifestyle regularity has been linked to loneliness and poor sleep. Methods: Using a cross-sectional design, 97 adults completed standardized measures of loneliness, lifestyle regularity, subjective sleep quality and mood. Results: Loneliness was a significant predictor of sleep quality. Lifestyle regularity was not a predictor of, nor associated with, mood, sleep quality or loneliness. Conclusions: This study provides an important independent replication of the association between poor sleep and loneliness. However, the mechanism underlying this link remains unclear. A theoretically plausible mechanism for this link, lifestyle regularity, does not explain the relationship between loneliness and poor sleep. The nexus between loneliness and poor sleep is unlikely to be broken by altering the social rhythm of patients who present with poor sleep and loneliness.

Subjective and Objective Indicators of Recovery in Severe Mental Illness: a Cross-Sectional Study

Background: This study aimed to determine whether subjective dimensions of recovery such as empowerment are associated with self-report of more objective indicators such as level of participation in the community and income from employment. A secondary aim was to investigate the extent to which diagnosis or other consumer characteristics mediated any relationship between these variables. Methods: The Community Integration Measure, the Empowerment Scale, the Recovery Assessment Scale, and the Camberwell Assessment of Needs Short Appraisal Schedule were administered to a convenience sample of 161 consumers with severe mental illness. Results: The majority of participants had a primary diagnosis of schizophreniform, anxiety/depression or bipolar affective disorder. The Empowerment Scale was quite strongly correlated with the Recovery Assessment Scale and the Community Integration Measure. Participants with a diagnosis of bipolar affective disorder had signifi cantly higher recovery and empowerment scores than participants with schizophrenia or depression. Both empowerment and recovery scores were significantly higher for people engaged in paid employment than for those receiving social security benefits. Conclusions: The measurement of subjective dimensions of recovery such as empowerment has validity in evaluation of global recovery for people with severe mental illness. A diagnosis of bipolar disorder is associated with higher scores on subjective and objective indicators of recovery.