Magister Artium - MA / In this thesis I present – from the perspective of the capability approach and within the context of South Africa – a conceptual analysis of the relationship between quality of life, education, poverty and inequality. The role of education within the South African context is of particular importance. The capability approach, which was pioneered by economist-philosopher Amartya Sen and significantly further developed by philosopher Martha Nussbaum and a growing number of other scholars across the humanities and social sciences, is a theoretical framework for the assessment and comparison of quality of life and social justice. The argument is made that when inquiring about the prosperity of a nation or region in the world, traditional economic approaches – such as gross domestic product (GDP), which is the most commonly used indicator of economic activity – are not, by themselves, accurate or adequate. When assessing individuals and societies‟ quality of life and sense of well-being, we need to know not only about their levels of income, wealth, or consumption; but also about the opportunities they have, or do not have, to choose and to act. The capability approach provides a more comprehensive conceptualisation of quality of life, because it takes into account broader and more encompassing measures of well-being. Conceptualising quality of life from the perspective of the capability approach, makes it clear that large numbers, if not the vast majority, of people experience many forms of unfreedom that impedes their development (i.e. their freedom to choose), and prevents them from leading lives they consider valuable and worthwhile. Many people lack capabilities. The capability approach asserts that the expansion of the real freedoms that people enjoy (i.e. what people are effectively able to be and to do) is both the primary end and the principle means of development. Expansion of freedom equates to enhanced individual agency as a result of an increase in capabilities. Furthermore, individual agency is central to addressing various deprivations (both individual and societal).

Magister Scientiae (Physiotherapy) - MSc(Physio) / Introduction: Osteoarthritis (OA) is one of the prevalent debilitating diseases in South Africa, often leading to activity limitations, participation restrictions and a poor quality of life. Older people often lead more sedentary lifestyles, which may further aggravate their symptoms. Exercise therapy has demonstrated good outcomes in the OA population. Many dance interventions have become popular in OA treatment and results suggest their effects to be more successful than traditional physiotherapy exercises regimes. Ballet dance exercises have not yet been explored in the treatment of OA, even though it has been proposed to have positive effects on the body. Purpose: to determine the effect of a program of ballet dance exercise classes on BMI, perceived pain, physical function and quality of life in patients with osteoarthritis (OA) of the hip and knee, compared to the existing Midros Clinic program of exercise classes. Methods: The study used a randomized, cross-sectional, quantitative, experimental study using pre- and post-intervention as well as multiple time-point testing. A sample of 52 males and females were recruited in Midros, Middelburg Cape. The inclusion criteria of the study were persons aged 65 years and older, with OA of the hip and/or knee, clinically diagnosed according to the criteria of the American College of Rheumatology. The VAS, Timed Up and Go Test (TUGT), WOMAC and the SF-8 Index, respectively measured reported perceived pain, physical function, quality of life and health status in the study groups. BMI, pulse and blood pressure were also recorded to further monitor the effects of the interventions. A comparable number of scores were obtained over six weeks of bi-weekly ballet exercise classes (intervention group = IG), and nine weeks of two-weekly exercise classes at the Midros Clinic (comparison group = CG). Descriptive statistics were used to analyse the demographic information and inferential statistics were used to determine the associations for parametric data; a two tailed p-value was calculated; the 95% CI was calculated using the approximation of Katz. The p-value was classified as significant if p<0.05. Results: The demographics and baseline measurements of the IG and CG were comparable. A series of five exercise classes (over nine weeks) had a significantly beneficial effect on BMI and systolic BP, perceived and actual physical function, and QOL, whereas a series of 12 ballet exercise classes ( over six weeks) had a significant positive effect on BMI and diastolic BP, perceived pain, perceived physical function, and QOL. The comparison of responses to the outcome measures by male and female participants demonstrated that, contrary to findings in the reviewed literature, females held more positive perceptions than males on their perceived severity of joint pain and function, physical and mental health, and well being. A series of the existing exercise classes of Midros Clinic brought about more significant changes than a program of ballet exercise classes in the research parameters measured, despite exercise classes taking place much less frequently than the ballet classes. Conclusion: Although both interventions were found to both bring about positive changes in older persons with OA, a series of ballet exercises classes did not result in better outcomes than the currently existing Midros Clinic group exercise classes. The results of the current study demonstrate that exercise interventions are found to be the most beneficial in improving the quality of life of OA sufferers.

Magister Chirurgiae Dentium - MChD / Aim: To assess the change in the quality of life of patients while on the third molar surgery waiting list. Introduction: A large number of patients routinely present at the Tygerberg Oral Health Centre for removal of symptomatic impacted third molars. This results in many patients being placed on a surgical waiting list. In addition, many patients who have been placed on this waiting list return for adjunctive interventions, indicating a possible decrease in Quality of Life (QoL) over the waiting period. Numerous studies document post-surgery changes in QoL in patients that have had third molars removed. Many other studies detail QoL changes in patients awaiting orthopaedic and general surgery procedures. However, no study could be found that dealt with changes in QoL while awaiting third molar surgery. Materials and Methods: This is a prospective questionnaire-based study. It compares QoL at the beginning and the end of the waiting period for the removal of impacted third molars in order to determine whether a change in QoL occurs during the waiting period. The study sample was made up of 48 patients who met the inclusion criteria. Results: The present study shows that patients presenting with symptomatic impacted third molars have a decreased QoL at baseline, which further deteriorates over the waiting period. Although the overall change is negative, it is not statistically significant. This suggests that the null hypothesis cannot be excluded, and that it is therefore acceptable for patients to be managed on a waiting list. Conclusion: Third molar surgery results in a greater decrease in mental than physical wellbeing. The results in this study regarding a negative change in QoL was found not to be statistically significant. Only three out of 48 patients required emergency intervention. It can thus be concluded that placing patients on a waiting list for third molar surgery is acceptable.

Please read the abstract in the section 00front of this document / Thesis (DPhil)--University of Pretoria, 2010. / Medical Oncology / unrestricted

Background: Stroke is the disease that leads to most days of care in hospitals and which leads to the most disabilities in adults. With these disabilities, the patient often end up in a dependence to both relatives and healthcare professionals to cope with their daily lives. Previous research on family experience shows that they feel regret, stress and do not find time for relaxation. Describing how people experience their quality of life and their everyday life after stroke is important in order to give the nurse a better insight and understanding of the care of these patients.   Aim: To describe how people perceive their quality of life and their daily lives after a stroke and describe the study groups in the selected articles.   Method: A descriptive literature study. 13 scientific articles were used, with both quantitative and qualitative approaches.   Results: When the authors compiled the thirteen articles of this literature study, a continuous theme was seen on how stroke affected the quality of life of the participants and their everyday life. Stroke led to a changed life, both physically and mentally. Many suffered from speech disorders and disabilities, which meant isolating themselves from society. Quality of life was considered to be done by itself, having goals in life and having good social relations. To not have to rely on others and to be independent was a goal that the stroke sufferers constantly sought after.   Conclusion: Both physical and psychological problems arise that affected everyday life after a stroke. Finding new meaningful activities, establish goals, managing oneself and having good social relationships were important for a good quality of life after a stroke.

Due to the increasing healthcare costs and reduced length of hospital stay it is becoming increasingly important to identify individuals who are ‘at risk’ of experiencing long-term health issues. The purpose of the study was to: (1) determine if resilience, self efficacy and depression changed from inpatient to 3-month follow up; (2) examine the relationship between resilience, self efficacy, depression, and quality of life (social roles/activity limitations) at inpatient and 3-month follow up; and (3) identify if resilience at inpatient is related to change scores in selfefficacy and depression at 3-month follow up. Results from the paired sample t-test indicated that participants did not experience a significant change from inpatient to 3-month follow up in resilience or self-efficacy, but a significant decrease in depression was observed. Findings also indicated significant correlations between resilience, self-efficacy, and depression during inpatient stay and resilience, self-efficacy, depression, and quality of life at 3-month follow up. However, there was no relationship found between resilience and change scores in self-efficacy and depression. Future resilience research should continue to identify the variables that are most strongly related to resilience so effective interventions can be developed that improve rehabilitation outcomes, decrease secondary and chronic conditions as well as aid in the successful reintegration of individuals into their lives after a traumatic injury.

Abstract: En av de vanligaste folksjukdomarna i Sverige är demenssjukdomar. Personer med demenssjukdomar är i behov av vård och omsorg och ett hälsosamt liv med meningsfulla sysselsättningar. Syftet med denna litteraturstudie är att kartlägga vad aktuell forskning säger om aktiviteter för personer med demenssjukdomar och dess koppling till individens livskvalitet. Metoden som användes var en litteraturstudie med hjälp av scoping metoden som följer en sexstegsmodell som är framtagen av Arksey & O´Malley, (2005). Efter sökningen i databaserna Pubmed, Cinhal och Psykmed framkom det åtta artiklar som granskades. Resultaten visar att Gemenskaper, kunskaper om individens tidigare liv, individen i fokus och meningsfulla metoder har stor påverkan på personens livskvalitet. Det är genom personalens omvårdnad, respekt och professionellt bemötande den enskilde får uppleva trygghet och livskvalité. Individanpassade aktiviteter minskar ensamhet och isolering / Abstract: One of the most common public diseases in Sweden is dementia. People with dementia diseases need care and a healthy life with meaningful daily activity. The purpose of this literature review is to compile what current research says about activities for people with dementia diseases. Metod: A literature review was conducted using the scoping method following a six-step model developed by Arksey & O´Malley, (2005). Following the search in the databases Pubmed, Cinhal and Psykmed, the eight articles were examined. Results: shows that communities, knowledge of the past life of the individual, the individual in focus and meaningful methods greatly affect the person's quality of life. It is through the staff's nursing, respect and professional response, the individual's experience of safety and quality of life. Individual activities reduce loneliness and isolation.

OBJECTIVE: To examine Teen Oral Health-related Quality of Life (TOQL) for use in adults receiving orthodontic treatment and assess validity and reliability by age-group. METHODS: Teenagers ages 10-18 years and adults 18 years and over completed surveys at the Orthodontic Clinic at Boston University. The survey consisted of sociodemographic information, dental behavior questions, and the TOQL instrument. (Wright, Spiro, Jones, & Rich, n.d.) Malocclusion severity was assessed using the Index of Orthodontic Treatment Need (IOTN). RESULTS: 161 teens and 146 adults participated; teens had a mean age of 13 years and adults 32 years. Subjects represented both genders and diverse racial and ethnic backgrounds. In general, scores overall and by domains were higher for adults than for teens, signifying a greater effect on the quality of life. Mean TOQL scores were worse (17.55) in adults than in teens (11.92, p<0.01); emotional and social domains scores were higher for adults (p<0.001).Construct validity was supported by strong association of TOQL scores with self-reported oral health (p<0.0001). Cronbach’s alpha was higher in adults (0.75 in adults compared to 0.68 in teens) and for all the domains. CONCLUSION: Adults who come for orthodontic treatment report that they are more affected by their malocclusion as compared to teens. Total TOQL score and the emotional and social domains are significantly higher for adults than teens. The project suggests that TOQL is a valid and reliable way to measure impact of malocclusion in quality of life in both adults and teens.

Research has investigated testosterone and its role in biological and psychological functioning. Testosterone levels decrease as men age, and aging has been associated with declines in muscle mass and strength. Decreased functional mobility can impact quality of life. Aging has also been associated with increased vulnerability to depressive symptomatology. The purpose of this study was to investigate interrelationships among testosterone, physical functioning, quality of life, and depression in the Vietnam Era Twin Study of Aging (VETSA). The mean age of the 1,237 men in VETSA was 55.4 (+2.5). Testosterone data collection began in the third year of VETSA, yielding an available sample of 778. It was hypothesized that there would be significant associations between testosterone and physical functioning, depression, and quality of life as well as between physical functioning and depression and quality of life. Contrary to expectations, when mixed models for linear regression were used, testosterone was shown to be related only to physical functioning. As predicted, however, physical functioning was significantly related to depression and quality of life. Cholesky decompositions were conducted to address the hypothesis that there were shared genetic determinants of each phenotype. Best fitting bivariate models included additive genetic and unique environmental but not common environmental influences. Significant genetic correlations were found between physical functioning and depression, and physical functioning and the mental health component score of the Short Form Health Survey (SF-36). Contrary to expectations, while testosterone and physical functioning were significantly correlated with each other phenotypically, there was no genetic correlation between the two. Trivariate models revealed genetic influences specific to depression as well as genetic influences shared with quality of life and depression. Finally, path analysis demonstrated that testosterone had a direct impact on physical functioning. Physical functioning, but not testosterone, directly impacted depression and quality of life. As there was no genetic correlation between testosterone and physical functioning, but there was a phenotypic correlation, it may be that other factors, such as cortisol, influenced the association. In sum, in this sample, physical functioning seemed to be more important than testosterone to both depressive symptomatology and quality of life.

The purpose of the current study is to evaluate the relationship between discounting immediate and former life statuses prior to death related to quality of life across the lifespan. A discounting survey was completed by 83 participants in which they were asked to make hypothetical choices regarding returning back to an age they preferred or remaining at their current age prior to dying. In addition, participants completed surveys measuring quality of life, death depression, and death anxiety. Results indicated that participants who reported low quality of life and experienced high depression and anxiety towards death responded more impulsively to the discounting survey, engaging in steeper discounting. Additionally, results indicated that a positive correlation between participants aged 30 to 50 years old and AUC exists, indicating that as age increases, impulsivity decreases. However, this same trend was not evident in participants over the age of 65, yielding no correlation. Strengths and limitations, implications of the current study’s findings, and opportunities for future research are discussed.