Objectives: This thesis aims to further our understanding in relation to childhood obesity and associated psychological difficulties. Design: The systematic review aimed to investigate the relationship between childhood psychological functioning in overweight and obese children and parental mental health difficulties. The empirical study aimed to examine possible relationships between Body Mass Index (BMI), self-esteem, quality of life and resilience, in order to determine any factors which may protect against the negative psychological consequences of obesity. Methods: A systematic review was completed using a comprehensive literature search of relevant databases to identify studies examining the relationship between childhood psychological functioning in children who were deemed overweight or obese and parental mental health difficulties. In the empirical study children of a variety of differing Body Mass Indexes (BMI) were asked to complete measures of quality of life, resilience and self-esteem. Correlation analyses were carried out to determine any relationships between BMI, quality of life, resilience and self-esteem. Moderation analyses were then completed to examine whether resilience moderates the relationship between BMI and quality of life or between BMI and self-esteem. Results: Ten studies met inclusion criteria for the systematic review. Although the reviews appeared to indicate a significant relationship between parental mental health and childhood psychological functioning, the studies were predominantly of average or low methodological quality, weakening any conclusions drawn. Results of the empirical study indicated significant correlations between resilience and quality of life and resilience and self-esteem. BMI was not found to significantly correlate with any other factors. Further moderation analyses indicated no moderating effect for resilience. The lack of association between BMI and either quality of life or self-esteem may in part be because most children who took part were of normal weight. Conclusions: Interventions targeting childhood overweight/obesity and their psychological effects may need to take into account wider psychosocial factors including parenting and positive factors which may protect against the negative psychological effects of obesity. However, further research is needed, particularly in relation to resilience.

Background: In an ever-changing society with inadequate resources, the elderly are easily forgotten. Despite the risk of side-effect, pharmaceutical drugs are added to promote their quality of life. Instead of drugs as a first step, perhaps one can give man's best friend a chance. Aim: The aim of this study was to illuminate the therapy dog’s impact on the quality of life of the elderly person. Method: This study was a qualitative literature-based study with an inductive approach, using a qualitative content analysis of the results from eight qualitative scientific articles. Result: The study resulted in three themes and eight sub-themes. The therapy-dog had a positive impact on the quality of life of the elderly person, both subjective and objective. The experience of well-being was created by the therapy-dog's influence to develop old memories, the feeling of harmony, and a break from everyday life. New opportunities were created when the care dog motivated the elderly to dare to open up, activate, and seek new relationships. Conclusion: The result shows that the meetings with the therapy-dog had positive impacts on several fronts of the elderly. What counts as beneficial impacts is subjective as well as relative. Contrary to everything positive, negative impacts may also occur. Conclusions that can be deduced from this study’s result are that the therapy-dog as an implementation contributes positively to the elderly's quality of life. It should be noted, however, that this intervention is not for everyone as there are allergies, fears, negative impacts and general dislike towards dogs and that this has to be respected. Keywords: Elderly, animal assisted therapy, health, quality of life.

Patient reported outcomes (PROs) are becoming increasingly important in cancer studies, particularly with the emphasis on patient centered outcome research. However, multiple PROs, using different scales, with different directions of favorability are often used within a trial, making interpretation difficult. To enhance interpretability, we propose the use of a standardized effect size graph, which shows all PROs from a study on the same figure, on the same scale. Plotting standardized effects with their 95% confidence intervals (CIs) on a single graph clearly showing the null value conveys a comprehensive picture of trial results. We demonstrate how to create such a graph using data from a randomized controlled trial that measured 12 PROs at two time points. The 24 effect sizes and CIs are shown on one graph and clearly indicate that the intervention is effective and sustained.

Abstract Dental diseases such as dental caries and periodontal disease could well be seen as being behaviour-related. The high prevalence of periodontal disease in the Finnish adult population mirrors the need for improving oral health behaviours in a comprehensive manner. Thus far, scant attention has been drawn to the underlying psycho-social factors that could, in part, explain oral health and oral health behaviours. Deficiencies in oral health behaviour may also be indicative of an individual's poor health behaviour in general. The aim of this study was to introduce the salutogenic approach, called sense of coherence, into the domain of oral health and health behaviour. The present study uses data from the nationally representative Health 2000 survey carried out in 2000–2001 by the National Public Health Institute of Finland. The subjects of this study numbered 4175 in article I, 4131 in article II, 4039 in article III, and 4096 in article IV, and were 30- to 64-year-old dentate men and women. The cross-sectional data was collected via home interviews, self-administered questionnaires, or clinical examinations. Sense of coherence was positively associated with oral health behaviours, such as dental attendance and tooth-brushing frequency. In addition to tooth-brushing frequency, sense of coherence was also positively associated with the level of oral hygiene. The association between sense of coherence and level of oral hygiene weakened only marginally after controlling for tooth-brushing frequency. A strong sense of coherence was strongly associated with a positive oral health-related quality of life (OHIP). Sense of coherence was also associated with all of the OHIP sub-scales, and the association was most evident in the psychological discomfort, psychological disability and handicap sub-scales. Among males, health behaviours seemed multidimensional, whereas they tended to be unidimensional among females. A strong sense of coherence was a common determinant of healthy behaviours in general, as well as of a good subjective health status. The present study recognizes the sense of coherence as a common health-promoting determinant of oral and general health behaviours, good oral health, and a good oral health-related quality of life. The results thus suggest that the role of psycho-social factors should not be underestimated in health promotion.

Abstract Hearing aid (HA) rehabilitation was studied in northern Finland. The costs of HA fitting were examined at two hospitals, Kainuu Central Hospital and Oulu University Hospital. The patients were visited and interviewed at their home and use of HAs was charted. The benefit of HAs was evaluated using generic and disease-specific questionnaires. The effect of follow-up counselling of HA users on HA use and on the benefit of HAs was studied. The proportion of all HA possessors that are regular users has clearly increased during the past twenty years, and the number of non-users, in particular, has decreased significantly. Only 5.3% of first fitted HAs were not in use in 2001. The costs of HA fitting in 2000 were approximately € 900. There was not much difference in the costs between Kainuu Central Hospital and Oulu University Hospital. The price of a HA accounted for somewhat less than half of the total hospital costs, and the costs of the audiology personnel made up roughly a third of the overall costs. Emotional problems of HA users were significant before HA fitting, but six months after HA fitting the number of patients who felt handicapped by their hearing problems had decreased significantly. This could be seen in the results of both the social and the emotional items of the disease-specific health-related quality-of-life (HRQOL) measure, the short version of the Hearing Handicap Inventory for the Elderly (HHIE-S). The benefit could not, however, be shown with the generic HRQOL instrument, the EuroQol questionnaire (EQ-5D), which apparently lacks sensitivity for measuring changes brought about by audiological intervention. Follow-up counselling of HA users can significantly increase HA use and decrease the number of non-users. It can also significantly increase the users' handling skills. The cost of follow-up counselling is approximately € 83 per fitted HA, which is an 8.7% increment to the calculated cost of fitting a HA.

Abstract Systematic analyses of infections in critical illness are sparse and mostly restricted to specific infection categories. Thus, a prospective study was carried out in a medical-surgical ICU during 14 months on patients whose ICU stay was longer than 48 h. The prospectively gathered data included detailed patient history, infection survey, severity of illness scores (APACHE II, SOFA), resource use, short-term and long-term outcome and quality of life following hospital discharge. Altogether 335 patients were included, of whom 251 (74.9%) had an infection on admission; 59.3% had a community-acquired infection (CAI) and 40.7% a hospital-acquired infection (HAI), while 84 (25.1%) did not have any infection (NI). APACHE II scores and ICU or hospital mortality rates did not differ between the groups. The median hospital stay was longer in the HAI than in the CAI or NI groups. Eighty (23.9%) of the 335 patients developed an ICU-acquired infection (48 per 1000 patient days): ventilator-associated pneumonia (VAP) in 33.8% of the cases, central catheter-related (CRI) or primary bloodstream infections in 6.3% and urinary tract infections in 1.3%, while the corresponding device-related incidences per 1000 days were 18.8, 2.2 and 0.5, respectively. ICU-acquired infection was an independent risk factor for hospital mortality. It doubled the risk for hospital mortality in patients with an infection on admission and caused a threefold the risk in patients without an infection on admission and an almost fourfold increase in the use of nursing resources. Of the 272 hospital survivors, 83 (30.5%) died after discharge during the median follow-up of 17 weeks. Infection status on admission or during the ICU stay did not affect long-term mortality. ICU-acquired infection did not have an impact on patients' quality of life. The current general level of health compared to the status before ICU admission did not differ between the groups, either. Only 36% of those employed resumed their previous jobs. Three-fourths of patients had an infection on admission, while nearly one fourth acquired an ICU infection. The high VAP rate suggests a need for re-evaluation of preventive measures, whereas the low CRI indicates more successful prevention. ICU-acquired infection was a significant risk factor for hospital mortality, but did not affect patients' long-term survival or quality of life.

The theoretical part of the thesis is divided into four chapters dealing with the problems of radon and its influence on the human organism. The first chapter summarizes the basic issues of human environment, interaction and division of the environment based on its function (use for life). The second chapter focuses on the radioactivity of environment, specifically on ionizing radiation, its formation and division, as well as its effect on human health. The next chapter is about radon, its formation, sources of radon, its distribution in the environment, measurements, protection against radon, the history of problems with radon and the Radon Programme of the Czech Republic. The last chapter of the theoretical part is dedicated to lung carcinoma, its origin, distribution, diagnosis, treatment and relationship with the incidence of radon based on surveys of selected epidemiological studies. The practical part of the thesis includes description of source data and methodology of processing data sets of radon equilibrium equivalent concentration (EEC), number of deaths by causes and population status. Chapter of results includes map outputs of radon EEC, mortality rates of carcinoma lung for men, women, and both sexes. Other parts of the outputs are the results of the correlation analysis of the...

Objective: To evaluate associations between anxiety and severe impairment of quality of life (QoL) in Latin American postmenopausal women. Methods: This was a secondary analysis of a multicenter cross-sectional study among postmenopausal women aged 40 to 59 from 11 Latin American countries. We evaluated anxiety (The Goldberg Depression and Anxiety Scale), and QoL (Menopause Rating Scale [MRS]), and included sociodemographic, clinical, lifestyle, and anthropometric variables in the analysis. Poisson family generalized linear models with robust standard errors were used to estimate prevalence ratios (PRs) and 95% CIs. There were two adjusted models: a statistical model that included variables associated with the outcomes in bivariate analyses, and an epidemiologic model that included potentially confounding variables from literature review. Results: Data from 3,503 women were included; 61.9% had anxiety (Goldberg). Severe QoL impairment (total MRS score >=17) was present in 13.7% of women, as well as severe symptoms (MRS subscales): urogenital (25.5%), psychological (18.5%), and somatic (4.5%). Anxiety was independently associated with severe QoL impairment and severe symptoms in the epidemiological (MRS total score: PR 3.6, 95% CI, 2.6-5.0; somatic: 5.1, 95% CI, 2.6-10.1; psychological: 2.8, 95% CI, 2.2-3.6; and urogenital: 1.4, 95% CI, 1.2-1.6) and the statistical model (MRS total score: PR 3.5, 95% CI, 2.6-4.9; somatic: 5.0, 95% CI, 2.5-9.9; psychological: 2.9, 95% CI, 2.2-3.7; and urogenital: 1.4; 95% CI, 1.2-1.6). Conclusions: In this postmenopausal Latin American sample, anxiety was independently associated with severe QoL impairment. Hence, screening for anxiety in this population is important.

Background: A critical component of sexual health is healthy sexual functioning; being able to experience sexual enjoyment and satisfaction when desired. Sexual difficulties are not unusual and can have either physical or psychological causes. An estimated 100 million males worldwide suffer from erectile dysfunction (ED), with the expectation that this sexual problem will increase to 322 million cases by the year 2025 (Bacon, Mittleman, Kawachi, Giovannicci, Glasser, & Rimm, 2003). The prevalence of ED greatly escalates in older males and those with Cardiovascular Disease, Hyperlipidemia, and Diabetes due to related endothelial dysfunction (Bivalacqua, Usta, Champion, Kadowitz, & Hellstrom, 2003). Sexual dysfunction is a concern for all males, including those over the age of 65. Because sexual function or sexuality is a critical factor contributing to the quality of life among older adults (Gelfand, 2000; Robinson & Molzahn, 2007), attention to sexual dysfunction is needed to ensure a high quality of life among older adult males (Vincent & Velkoff, 2010). Furthermore, psychological and emotional stress have been associated with sexual dysfunction among males; both as a cause and a result of this condition. Purpose: The purpose of this study was to determine the level of distress associated with perceived stress and sexual function among community-dwelling older adult males in stable relationships. Study Aims: The study aims are to 1) describe perceived stress and sexual function in a community-dwelling older adult male population, 2) describe the relationship between perceived stress and sexual function, and 3) describe the relationship between perceived stress and sexual function while controlling for individual characteristics of the sample. Methods: A descriptive, cross-sectional research design was used. The sampling technique was a convenience sample of males aged 65 and older enrolled in a university affiliated lifelong learning institute in the southwestern United States. Inclusion criterion consisted of independent, active males aged 65 and older, in addition to being able to speak and read English. Exclusionary criterion comprised of those who have cognitive impairment determined by an Abbreviated Mental Test Score (AMTS) of six or less. Results: The majority of the 92 participants were between the ages of 65-70 and Caucasian. Overall, the sample was highly educated with most holding an Associate college degree or more advanced degree, was married, in age-related retirement, currently not working, and considered them self financially within the middle to higher middle-income level. Over half declared they have had sexual activity in the last month with an average level of sexual functioning and above average level of sexual satisfaction. In general, the participants indicated they are not stressed. There is a significant and negative correlation between perceived stress and sexual function (satisfaction). There is a significant relationship between perceived stress and Obesity with sexual function (erection, ejaculation, and satisfaction). Significant univariate effects were found on age with sexual function (erection, ejaculation, and satisfaction). Furthermore, significant univariate effects were found on Obesity with sexual function (ejaculation and satisfaction). Subsequently, a significant univariate effect was found on Cancer with sexual function (satisfaction). Significance: These study findings may serve as a foundation for enhancing sexual function; thus, establishing improved sexual health and quality of life among older adult males.

This thesis is an update of the bachelor work entitled "The application of physiotherapeutic tools for some tinnitus types". The original work was complemented with the latest findings in pathogenesis field and in therapy by physiotherapeutic tool. The fundamental of this diploma thesis is a study examining the quality of patients' lives with tinnitus. The study was based upon a research using a modified questionnaire Tinnitus Handicap Inventory by Newman's et. al. (1999). Powered by TCPDF (www.tcpdf.org)