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Jag är så trött : En litteraturstudie om hur det är att leva med fatigue vid cancer och cancerbehandling / I´m so tired : An literature review about how it is to live with fatigue in cancer and cancer treatmentPeyron Khedri, Malin, Leites, Maria January 2013 (has links)
Bakgrund: Varje år drabbas 55 000 personer i Sverige av cancer och behandlas oftast med kombinerade behandlingar. Den vanligaste biverkningen och det mest påfrestande symtomet vid cancer är fatigue. Fatigue betyder extrem trötthet/utmattninig och är en subjektiv upplevelse. Fatigue är inte en trötthet som går över efter sömn och vila. Syfte: Syftet med denna litteraturstudie är att beskriva hur det är att leva med fatigue vid cancer och cancerbehandling. Metod: En systematisk litteraturstudie som bygger på 15 vetenskapliga artiklar. Artiklarna är både kvalitativa och kvantitativa och har kvalitetsgranskats utifrån Fribergs kriterier för analys av vetenskapliga studier. Litteraturstudien utgår från det teoretiska begreppet livskvalitet. Resultat: Resultatet utmynnade i tre teman; Aspekter som påverkar graden av fatigue, Fatigues negativa påverkan på livskvalitet samt Sätt att hantera fatigue. I det första temat framkom det att fatigue är föränderligt beroende på vilken cancerdiagnos samt cancerbehandling personer genomgår. Det framkom hur fatigue är ett multidimensionellt begrepp där flera andra symtom är relaterade till fatigue. Andra temat innefattar hur avsaknad av energi och social isolation påverkar personers livskvalitet negativt. Det tredje temat innefattar hur personer hittar individuella strategier för att hantera sin fatigue och att fysisk aktivitet är den strategi som visats sig ha mest positiv inverkan på att minska graden av fatigue. Diskussion: I resultatdiskussionen diskuteras begreppet livskvalitet som är den teoretiska utgångspunkten i examensarbetet. Livskvalitet berör både sjukdomsspecifika aspekter samt biverkningar av behandlingen som bidrar till ohälsa. Detta är tillämpbart eftersom fatigue upplevs som psykiskt, fysisk och socialt påfrestande. Livskvalitet är något föränderligt och förändras då personer får en svår sjukdomsdiagnos. Även sjuksköterskans arbete är viktigt i mötet med personer med fatigue då sjuksköterkan kan komma med förslag på strategier som kan göra fatigue mindre påfrestande. / Background: Each year, 55 000people in Sweden affected by cancer and is usually treated with combined treatments. The most common side effect and the most distressing symptom of cancer is fatigue. Fatigue means extreme tiredness/exhaustion and it’s a subjective experience. Fatigue is not tiredness that goes over after sleep or rest. Aim: The aim of this study is to describe what it's like to live with fatigue in cancer and cancer treatment. Methods: A systematic literature review based on 15 scientific articles. The articles are both qualitative and quantitative and quality reviewed for Friberg's criteria for analyzing scientific studies. The literature review is based on the theoretical concept of quality of life. Results: The analysis resulted in three themes: Aspects that affect the level of fatigue, Fatigues negative impact on quality of life and method for managing fatigue. In the first place it was found that fatigue is constantly changing depending on the diagnosis of cancer and cancer treatment that people receiving. It also reached the conclusion how fatigue is a multidimensional concept where several other symptoms are related to fatigue. The Second theme includes the lack of energy and social isolation affects people's quality of life negatively. The third theme involves how people find individual strategies to deal with their fatigue and physical activity is the strategy that proved to have the most positive impact on reducing the severity of fatigue. Discussions: The results discussed the concept of quality of life, the theoretical concept in the literature review. Quality of life concerns both disease-specific aspects and treatment side effects that contribute to ill health. This is applicable because fatigue is experienced as mental, physical and social discomfort. Quality of life is something changing and change as people get a severe disease diagnosis. Even the nurse's work is important when meeting people with fatigue when nurses can make suggestions on strategies that can make fatigue less strenuous.
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Vuxna patienters livskvalité efter svår brännskada : En litteraturstudieMohammed Ali, Shokhan, Calisir, Nursel January 2015 (has links)
Bakgrund: I världen dör cirka 265,000 personer på grund av brännskador och för de som överlever är det en förödande och traumatisk livsförändring både för de själva och de anhöriga. Enbart i Sverige behandlas 1,500 personer för sina brännskador i sluten vård. Brännskador ger upphov till olika komplikationer som kräver intensiv vård och rätt kompetens inom vården. Syfte: Studiens syfte är att beskriva hur vuxna patienters upplever sin livskvalité efter svår brännskada samt beskriva de inkluderade artiklarnas urvalsmetod. Metod: En beskrivande litteraturstudie. Studien baseras på tio artiklar sökta i databaserna Cinahl, PubMed och PsycINFO och publicerade under åren 2004-2014. Huvudresultat: Livskvalitén var kopplat till huruvida man kunde återgå till sitt gamla liv efter skadan till exempel jobb, relationer, kroppsuppfattning samt aktivitet. Majoriteten av artiklarna använde sig av ändamåls urval. Tre av artiklarna angav inte urvalsmetod utan författarna till föreliggande studie tolkade dessa urvalsmetoder som är beskriven enligt Polit och Beck. Slutsats: En brännskada är en traumatisk upplevelse där patientens livskvalité kan förändras. Med ett socialt nätverk, familj och vänners stöd samt en god professionell vård kan patientens livskvalité förbättras och denne återfå meningsfullhet i livet. / Background: About 265,000 people dies in the world because of burns, and for those who survive it´s a devastating and traumatic life change event, both for themselves and for their relatives. In Sweden alone 1,500 people are treated for their burns in hospital every year. Burns gives rise to various complications that requires intensive care and the right healthcare skills. Aim: The aim of this study was to describe how the adult patient’s experience quality of life after severe burn and to describe the included articles sample method. Method: Descriptive literature review. The study is based on ten articles that were searched on the databases Cinahl, PubMed and PsycINFO and were published between the years of 2004-2014. Main result: Quality of life was linked to whether you could return to your old life after the injury for example job, relations, body image and activity. The majority of the articles used purposive sample. Three of the articles did not indicate any sample instead the authors of this study interpreted this samples from the description giving by Polit and Beck. Conclusion: A burn can be a traumatic experience which the patient's quality of life can changes. With a social network, family and friends support and a good professional care, the patient´s quality of life improves and regain meaning in life.
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A influência da prática de atividade física regular na qualidade de vida e na composição corporal de portadores de osteoartriteOscko, Gustavo Naxara [UNESP] 05 October 2007 (has links) (PDF)
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oscko_gn_me_arafcf.pdf: 337038 bytes, checksum: 57cda83ef3e7bfe646cca8879d4e0d6f (MD5) / Universidade Estadual Paulista (UNESP) / O exercício físico tem sido recomendado como forma de intervenção efetiva em aspectos da qualidade de vida relacionados à saúde de indivíduos portadores de inúmeras doenças crônicas. No quadro clínico da osteoartrite a limitação funcional é uma característica importante. Esta condição, frequentemente interfere de forma negativa no desempenho normal das atividades de vida diária e, consequentemente, na qualidade de vida dos portadores dessa doença. Dessa maneira os objetivos do trabalho foram comparar os indivíduos portadores de osteoartrite que praticam atividade física regular, com pacientes submetidos a tratamento fisioterápico de manutenção, traçar o perfil sócio-demográfico, antropométrico e a composição corporal, bem como avaliar a qualidade de vida relacionada à saúde e o nível de atividade física da população estudada. Foram estudados dois grupos de portadores de osteoartrite: o grupo controle (n=20) foi composto de pacientes que realizavam tratamento fisioterápico de analgesia em Unidade Básica de Saúde, três vezes por semana em dias alternados. Foram utilizadas a neuroestimulação elétrica transcutânea (TENS) e a diatermia por ondas curtas como técnicas analgésicas; compunham o grupo experimental (n=19) indivíduos portadores de osteoatrite participantes de aulas de hidroginástica em academia, três vezes por semana durante uma hora e por pelo menos seis meses. Foram relacionados o nível de atividade física basal (AFB – Baecke) e medidas de composição corporal (peso, dobra cutânea triciptal, relação cintura-quadril, circunferências musculares, IMC, percentual de massa gorda, peso corporal magro e peso da gordura) com os aspectos relacionados à qualidade de vida obtidos através do Medical Outcomes Short-form Health Survey (SF-36). Os resultados evidenciaram diferenças significativas entre... / The physical exercise has been recommended as an effective intervention form in aspects of the quality of life, in carrying patients of some chronic diseases. Into the clinics of osteoarthtritis the functional limitation is an important characteristic. This condition frequently interferes negatively on the normal performance of the daily activities, and consequently on the quality of life of the osteoarthritic patients. In this way, the aim of this study was the compare the patients carrying osteoarthritis which use regular physical activity with patients submitted to the physiotherapic treatment, to draw the social, demographic and anthropometric profile, as well to evaluate the quality of life related to the health and the level of physical activity of the studied population. For this, two groups had been studied; the control group (n=20) was compose by osteoarthritis patients underwent to the ambulatorial rehabilitation in Public Basic Unit of Health, three times at week in alternated days. Have been used the transcutaneous electric neurostimulation (TENS) and the short wave diathermy as analgesic techniques. The experimental group (n=19) was composed by osteoarthritis patients, participants of hydrogymnastic classes in academy three times a week during one hour and for at least six months. Have been related the level of basal physical activity (AFB – BAECKE) and anthropometric variables (weight, triciptal skinfold, waist-to-hip ratio, muscle circumferences, body mass index, %fat, free fat mass and fat mass) with the aspects related to the quality of life obtained by the Medical Outcomes Short-form Healthy Survey (SF-36). The results showed significant differences among the groups about the domains role physical (p=0,0376), vitality (p=0,0053) and general healthy (p<0,0001); about to the anthropometric variables... (Complete abstract click electronic access below)
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Construção de uma biblioteca digital especializada voltada para a disseminação de informações do tema qualidade de vida nos cursos de engenharia da UTFPR.Mendes, Ronaldo Stocco 27 February 2012 (has links)
Acompanha: Biblioteca Digital de Qualidade de Vida / Este trabalho teve por objetivo construir uma biblioteca digital especializada voltada para a disseminação de informações e conhecimentos sobre o tema Qualidade de Vida. Para que este fosse alcançado, estruturou-se um referencial teórico embasado nas temáticas: informação, biblioteca digital, internet e a Lei de Direitos Autorais. Em termos estruturais, a Biblioteca Digital de Qualidade de Vida (BDQV) foi construída com base no banco de dados do indexador de periódicos GeoDados, do qual utiliza um sistema em linguagem MySQL para o gerenciamento de seu banco de informações, apoiado pela ferramenta phpMyAdmin. Ainda, a criação da interface de trabalho, como também dos sistemas de busca e recuperação de material da BDQV, foram construídos com o auxílio de ferramentas como o phpEditor, em linguagens PHP, HTML e CSS, tornando possível a consulta online dos materiais anexados de maneira fácil e ágil. A biblioteca foi testada em duas etapas, sendo que a primeira tratou da realização de um pré-teste, com o objetivo da detecção de possíveis problemas e a coleta de sugestões de melhoria. A segunda etapa tratou do teste final de usabilidade da BDQV, que teve por objetivo a validação desta como ferramenta de apoio ao ensino da temática qualidade de vida. Com a BDQV construída e testada, foi possível então perceber sua considerável aplicabilidade no apoio ao ensino-aprendizagem da temática Qualidade de Vida, nesta disciplina. / This study aimed to build a digital library specialist dedicated to the dissemination of information and knowledge of the theme of Quality of Life. For this to be achieved, if a structured theoretical framework was based on the themes addressed: information, digital library, and Internet Copyright Act. In structural terms, the Digital Library Quality of Life (DLQL) was built on the index database of journals Geodis, which uses a MySQL language system for managing your database information, supported by the tool phpMyAdmin. Still, the creation of the working interface, as well as systems for search and retrieval of material from DLQL were built with the help of tools like phpEditor in languages PHP, HTML and CSS, making it possible to search online for materials attached easily and quickly. The library was tested in two stages, where the first dealt with the completion of a pre-test, with the aim of detecting possible problems and collect suggestions for improvement. The second step this was the ultimate test of usability DLQL, which aimed at the validation of the library as a tool to support teaching of thematic quality of life. With DLQL built and tested, it was possible then realize its considerable applicability in supporting teaching and learning of thematic quality of life, the discipline of the same name. The methodology used to evaluate the product was qualitative, descriptive and field.
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Validação de uma metodologia para avaliação de problemas locomotores em aves de corteRefatti, Rosana 10 October 2013 (has links)
O Brasil é o maior exportador e o terceiro maior produtor mundial de carne de aves, com
11,42 milhões de toneladas em 2010 e 12,86 milhões de toneladas em 2011. Com relação à
produção e exportação de carne de peru em 2011, as exportações totalizaram 141,2 mil
toneladas. , com uma redução de 10,5%, quando comparada com o ano anterior. O mercado de
produtos à base de carne de peru tem se mostrado bastante promissor não só no Brasil como em vários outros países, representando 6,9% da produção mundial. Aliado ao
desenvolvimento da produção animal, principalmente nos últimos anos, o bem-estar animal tem constituído tema de discussão e pesquisa, estando entre os assuntos mais discutidos atualmente na produção animal. É crescente a convicção dos consumidores de que os animais utilizados para produção de alimentos devem ser bem tratados. Problemas locomotores impedem que a ave se movimente livremente e, com isso, acessem os equipamentos necessários para sua sobrevivência: comedouros e bebedouros. Cerca de 10 a 40% do lucro bruto por lote é perdido devido a problemas locomotores nas aves, as quais podem ter a carcaça condenada completa ou parcialmente no abatedouro. Existem diversas formas de avaliar os problemas locomotores em aves de corte. No campo, as metodologias mais empregadas para avaliar problemas locomotores são exames visuais da capacidade de locomoção das aves, denominados de Gait Score (avaliação do caminhar). Entretanto essas metodologias são consideradas subjetivas, pois não utilizam nenhum equipamento e, sim,planilhas que orientam o usuário a observar o comportamento das aves ou medir com régua o tamanho das lesões. Isto quer dizer, que dependendo do avaliador e de sua interpretação um
escore de injúrias será concluído. Desta forma, o objetivo deste trabalho é validar uma nova tecnologia para mensuração de problemas locomotores em aves de corte (frangos e perus), que seja objetiva, de fácil manuseio, confiável (independente do avaliador) e de uso universal.Para tal, essa nova tecnologia foi desenvolvida e avaliada comparativamente com seis metodologias de mensuração de problemas locomotores, previamente estabelecidas pelas amplas citações na literatura, buscando ajustá-la e validá-la. / Brazil is the largest exporter and third largest producer of poultry meat, with 11.42 million tons in 2010 and 12.86 million tons in 2011. With this relation to the production and export of turkey meat in 2011, exports totaling 141,200 tons, with reduction of 10.5% when compared with the previous year. The market for products made from turkey meat has been shown very promising not only in Brazil and in several other countries, accounting 6.9% of global production. Allied with development of animal production, especially in recent years, animal welfare has been a subject of discussion and research, being among the most discussed
subjects currently in production animal. There is growing certainty of consumers that animals used for food production should to be treated well. The locomotor problems hinder the fowl from moving freely and with it accessing the equipment necessary for their survival: feeders and drinkers. About 10-40% of gross profit per lot is lost due to locomotor problems in birds, of which can be completely or partly condemned carcass the slaughterhouse. There are different ways of evaluating the locomotor problems in broiler chickens. In the field, the methodologies used to evaluate locomotor problems are visual examinations of walking ability of the birds, called Gait Score (evaluation of walking). Meanwhile these methods are
considered subjective because does not use any equipment and, yeah, worksheets that guide the user to observe the bird behavior with a ruler or measuring the size of the lesions. This means that depending the evaluator and their interpretation a score of injuries will be concluded. In this way, the purpose of this work is to validate a new technology for measurement of locomotors problems in broiler chickens (chickens and turkeys) that be objective, with easily managed and confidante, independent the evaluator and with universal use. To this the new technology was developed and evaluated in comparison with six methodologies to measure locomotors problems, previously established by extensive citations in the literature, look for adjust it and validate it.
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Qualidade ambiental e de vida na cidade de Várzea Paulista-SP : estudo de caso /Verona, Juliana Augusta. January 2003 (has links)
Orientador: Helmut Troppmair / Banca: Lucy Marion Calderini Philadelpho Machado / Banca: Marta Felicia Marujo Ferreira / Resumo: Entendendo-se que a sociedade humana depende, para o seu bem estar, da consideração não só dos fatores ambientais (físicos, químicos e biológicos), mas também dos parâmetros éticos e sociais, este trabalho procura analisar o significado da qualidade ambiental e da qualidade de vida sob o ponto de vista geográfico; para isso, realiza uma discussão acerca de todo o movimento que se iniciou desde a década de setenta a fim de discutir os problemas ambientais até a definição de "qualidade ambiental e de vida urbana", destaca os principais indicadores urbanos que contribuem para nos fornecer resultados referentes à boa ou má qualidade ambiental e evidencia a cidade de Várzea Paulista-SP, como estudo de caso, no que se refere a sua caracterização ambiental-social, como também o levantamento de alguns indicadores para avaliar sua qualidade de vida, destacando: a qualidade das águas da região que abrange o Município de Várzea Paulista-SP; distribuição de água encanada por bairros; situação do esgoto na cidade; relação do número de estabelecimentos comerciais e industriais e o desemprego; dados sobre saúde, educação e criminalidade. Coloca-se como um dos focos principais deste estudo à questão do adensamento do espaço urbanizado influenciando na queda da qualidade ambiental e de vida na cidade de Várzea Paulista-SP. / Abstract: Understanding that human society depends, for its well-being, of a consideration not only of environmental factors (physical, chemical and biological), but also of ethical and social parameters, this work looks for an analysis of the meaning of environmental quality and quality of life under the geographical point of view and of other sciences; for this, makes a discussion of the whole movement that started since the seventies in order to discuss the environmental problems unto the definition of "environmental and urban life qualities", foregrounds the main urban indicators that contribute to provide us with results referring to the good or bad environmental quality and makes evident the city of Várzea Paulista-SP, as a case study, in what refers to its social-environmental characterization, as well as the raising of some indicators to evaluate its quality of life, foregrounding: the quality of waters of the region that comprises the county of Várzea Paulista-SP; distribution of running water by districts; situation of sewage in the city; relation of the number of commercial and industrial establishments to unemployment; data on health, education, and criminality. It is made one of the main focal points of this study the question of the increasing density of the urbanized space influencing on the fall of environmental quality and quality of life in the city of Várzea Paulista-SP. / Mestre
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Chronic hepatitis C and health-related quality of life in patients with cognitive impairmentAlvarez, Italo, Urbina, Juan C., Tejada, Romina A. 05 1900 (has links)
Revisión por pares
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Patientens upplevelser och erfarenheter efter att ha drabbats av hjärtinfarkt : En litteraturöversikt / The Patient’s experiences after suffering from a Myocardial infarction : Literature reviewButrus, Neveen, Inza Correa, Melissa January 2018 (has links)
Bakgrund: I Sverige är hjärt- kärl sjukdomar den vanligaste dödsorsaken, år 2016 drabbades 25 700 individer av en akut hjärtinfarkt. Efter att ha drabbats av en hjärtinfarkt medför detta förändringar i kroppen och återhämtningsprocessen kan ta tid. För att bemöta dessa patienter med en individanpassad vård behöver sjuksköterskan ha kunskap om vad som påverkar dessa patienter under återhämtningsprocessen och på så sätt hjälpa patienten i deras behov. Syfte: Syftet var att belysa patientens upplevelser och erfarenheter av att ha drabbats av hjärtinfarkt upp till ett år efter insjuknandet. Metod: En litteraturöversikt där tio kvalitativa artiklar från PsychINFO, PubMed och Cinahl complete har granskats och analyserats. Resultat: I denna litteraturöversikt framkommer tre teman: patientens upplevelser som helhet, behovet av stöd samt ett förändrad syn på livet. I dessa teman beskrivs patienternas upplevelser och erfarenheter av att ha drabbats av hjärtinfarkt samt vilka utmaningar de möter i vardagliga livet. Diskussion: Patienterna möter olika utmaningar i det vardagliga livet efter att ha drabbats av hjärtinfarkt. Dessa förändringar kan upplevas som utmaningar och medförde frånvaro av välbefinnande och hälsa. Det är inte bara kroppen som påverkas och behöver behandling, patienter som drabbas av hjärtinfarkt påverkas psykiskt och fysiskt. Teoretikern Katie Eriksson menar att människan består av kropp, själ och ande vilket utgör kärnan för hälsoprocessen. Många patienter upplever oro och rädsla av att återigen drabbas av ny hjärtinfarkt. Resultatet visade på betydelsen av att bli informera av sjuksköterskan om vilka utmaningar som patienten möjligen kan möta, rehabiliteringens betydelse, symtom, samt vilka livsstilsförändringar som kan ha positiv påverkan på hälsan och välbefinnandet.
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Estimativas de expectativa de vida livre de e com incapacidade funcional: uma aplica????o de m??todo de Sullivan para idosos paulistanosCamargos, Mirela Castro Santos January 2004 (has links)
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Previous issue date: 2004 / Funda????o Jo??o Pinheiro / A popula????o idosa tende a apresentar, proporcionalmente, um maior n??mero de doen??as
cr??nicas que, conseq??entemente, levam a maior preval??ncia de incapacidade funcional e
depend??ncia. Considerando esta realidade, o objetivo do presente estudo foi medir, para os idosos da cidade de S??o Paulo, em 2000, por sexo e idade, a expectativa de vida livre de e com incapacidade funcional. No ??ltimo caso, foram mensurados os anos a serem vividos com e sem depend??ncia.
Para estimar a expectativa de vida em cada condi????o de sa??de, foi utilizado o m??todo de
Sullivan, combinando a t??bua de vida, com experi??ncia de mortalidade corrente na popula????o em 2000, e a preval??ncia de incapacidade funcional e de depend??ncia. As informa????es empregadas foram obtidas a partir de tr??s fontes de dados: Projeto SABE, Funda????o SEADE e Censo Demogr??fico.
Os resultados indicaram que, em 2000, ao atingir os 60 anos, os homens paulistanos podiam esperar viver, em m??dia, 17,6 anos, dos quais 14,6 (83%) seriam vividos livres de
incapacidade funcional. J?? entre as mulheres, apenas 16,4 anos (73,7%), dos 22,2 anos remanescentes, seriam vividos livres de incapacidade funcional. Nesse mesmo contexto, entre os homens, 1,55 ano (8,8%) seria vivido com incapacidade funcional e depend??ncia contra 2,5 anos (11,1%) das mulheres. Adicionalmente, pode-se observar que, apesar de em termos absolutos a diferen??as entre os sexos diminu??rem com o avan??ar da idade, em termos relativos
as diferen??as se ampliam, com maior desvantagem feminina. Concluiu-se este trabalho ressaltando que, apesar das mulheres idosas paulistanas apresentarem maior expectativa de vida, em rela????o aos homens, a propor????o de anos vividos livre de incapacidade funcional ?? menor. Al??m disso, nas idades mais avan??adas, essas passar??o um n??mero maior de anos com incapacidade funcional e depend??ncia. / The elderly population shows a higher number of chronic illnesses compared to any other age group and, therefore, a higher prevalence of functional disabilities and dependence. Given that, the aim of this study was to estimate, for the elderly of the Municipality of S??o Paulo in the year 2000, for each sex and age, the life expectancy free of functional disability and with functional disability, using the Sullivan???s Method. In this latter case, the remaining years to be lived with and without dependence were also estimated. Data came from three sources: the SABE database, Population Censuses, and mortality statistics (from SEADE Foundation).
The main results are as follows: at age 60, men could expect to live an additional 17.6 years. Out of these, 14.6 were expected to be free of functional disabilities. For women, these figures were 22.2 and 16.4, respectively. For men, 1.55 year could be expected to be lived with functional disability and dependence, and for women this figure was higher, 2.5 years.
Another finding was that in absolute numbers the sex-difference is shortened with age, but in relative terms this trend is reversed, and there is a female-disadvantage.
In conclusion, even though women show a higher life expectancy, the percentage of years free of functional disability, compared to men, is smaller. Also women will live a higher number of years with functional disability and dependence. / Sa??de
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Antioxidants and chronic pancreatitisShah, Nehal January 2017 (has links)
Chronic pancreatitis (CP) is characterised by chronic, frequent, disabling abdominal pain. It often leads to exocrine and endocrine insufficiency resulting in malabsorption and diabetes mellitus respectively. The incidence of CP is 5-10 per 100,000 population worldwide and is on the rise in UK. Alcohol (70%) is the commonest aetiologic cause, idiopathic (20%) and others (10%) being second and third respectively. There are various medical and surgical treatment options available depending on clinical characteristics and the stage of disease. In spite of wide spectrum of therapeutic options, pain control still remains a challenging problem to the clinicians. Surgical treatments for chronic pancreatitis, broadly classified into resectional and drainage procedures, may offer relief of symptoms. These surgeries are associated with severe morbidity and high mortality. In addition, our comprehensive review of surgery in chronic pancreatitis demonstrated lack of criteria for baseline assessment of patients with CP; resulting in lack of standardization, variation in indication and comparability in published literature on surgical treatment of chronic pancreatitis. These factors have collectively forced the medical fraternity to look for other non or minimally invasive options. Oxidative stress and deficiency of anti-oxidants have long been implicated in pathogenesis of CP. Our review of literature on oxidative stress and antioxidants has highlighted the shortcomings and inadequacies from the previously published reports. These reports were underpowered and not all included patients had chronic pancreatitis. This in turn led us to propose a well designed randomised, double blind, placebo controlled trial of antioxidant therapy in CP. Considering the loss of time and productivity, it is necessary to undertake Qol as an outcome measure in any intervention related to CP. Our study assessed the suitability and feasibility of validated quality of life indices in patients with painful chronic pancreatitis. After correction for disease duration, the outcome of contemporary quality of life assessments showed that patients with CP taking Antox had better scores than controls. Cytokines, a group of proteins and glycoproteins that act in regulation of immunity, inflammation and haematopoiesis are implicated in oxidative stress related pathogenesis of chronic pancreatitis. They are broadly classed as pro-inflammatory and anti-inflammatory. There have been few experimental studies suggesting that antioxidants ameliorate cytokine response in chronic pancreatitis. However our study has failed to demonstrate a significant effect on cytokine levels after six months of antioxidant therapy. Similarly, on the clinical front, a randomised, double blind placebo controlled study (referred to as ANTICIPATE TRIAL) has shown no benefit of antioxidant therapy in painful chronic pancreatitis, irrespective of age, gender, aetiology or operative intervention. So we are afraid to say that until we discover any novel treatment in management of intractable painful chronic pancreatitis, surgery and interventional endoscopy might be the only viable options.
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