Thesis (Ph. D.)--Virginia Commonwealth University, 2006. / Prepared for: School of Nursing. Bibliography: leaves 165-183. Also available online via the Internet.

BACKGROUND: Studies in various chronic diseases have correlated health-related quality of life (HRQOL) with disease state and treatment outcomes. Limited data exists on the association between HRQOL, survival, and clinical biomarkers of disease in wild-type and familial TTR amyloidosis (ATTRwt & ATTRm) patient populations. OBJECTIVES: To assess the association between HRQOL and survival, as well as HRQOL and clinical biomarkers of disease in transthyretin-mediated amyloidosis (ATTR) patient populations. METHODS: Using a retrospective cohort study design, HRQOL was assessed via SF-36 health surveys collected from patients with ATTRwt and ATTRm presenting for their initial evaluation at the BU Amyloidosis Center between 1985 and 2015. Kaplan-Meier curves and hazard ratios (HRs) calculated using Cox proportional hazards regression analysis were used to examine the association between physical (PCS) and mental (MCS) component scores derived from the SF-36 health surveys and survival follow-up. All analyses were adjusted for potential confounders such as age at presentation, gender, and co-morbidities including diabetes mellitus, hypertension and hyperlipidemia. Spearman’s rank correlations were calculated to assess the association between PCS, MCS and clinical biomarkers of disease (mBMI, troponin I and BNP) also collected at time of initial evaluation visit. Statistical significance was set at a two-sided alpha=0.05. RESULTS: In the ATTRwt cohort, 133 white males, aged 74.6 +/- 6.0 years (mean + SD) presented with mean MCS (45.7 +/- 12.3) and PCS (36.7 +/- 10.8) that were respectively, 0.5 and 1.5 SD below 50. Patients with PCS or MCS scores < 35 had a significantly higher risk of death during follow-up than those with scores >= 35 for PCS (HR=2.45; p=0.002) and for MCS (HR=3.38, p<0.0001). BNP and troponin I associated with MCS (r= - 0.24; p=0.01 and p=0.02, respectively) and PCS (r= - 0.29; p=0.002 and r= - 0.25; p=0.012, respectively). In the ATTRm cohort, 331 white (82%) males (67%), aged 57.5 +/- 13.9 years presented with mean MCS (45.2 +/- 11.7) and PCS (37.2 +/- 13.3). Patients with PCS scores < 35 had a significantly higher risk of death during follow-up than those with scores >= 35 (HR=2.76; p= <0.0001). In contrast, MCS scores < 35 did not correlate with increased risk of death during follow-up (HR=1.38, p=0.13). BNP and troponin I most strongly associated with PCS (r= - 0.50; p<0.0001 and r= - 0.41; p<0.0001, respectively) and less with MCS (r= - 0.16; p=0.03 and r= - 0.24; p=0.007, respectively). mBMI did not associate with MCS or PCS in the ATTRwt and ATTRm cohorts. CONCLUSIONS: ATTR disease significantly decreased an individual’s physical and mental HRQOL. PCS and MCS were shown to be independent predictors of mortality but their ability to predict survival varied by cohort. Assessment of HRQOL may provide valuable prognostic information that could be of use in the management of ATTR disease.

Made available in DSpace on 2014-06-11T19:29:35Z (GMT). No. of bitstreams: 0 Previous issue date: 2008-01-15Bitstream added on 2014-06-13T19:38:48Z : No. of bitstreams: 1 cassettari_mr_me_botfm.pdf: 966375 bytes, checksum: 01c8bc47fa4cbaaeadbacf93938286c5 (MD5) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / O envelhecimento tem sido motivo de preocupação e questionamentos constantes dentro de um contexto sócio-econômico e cultural mundial. No Brasil, devido o achatamento da pirâmide demográfica conseqüente ao declive na taxa de mortalidade e também à diminuição na taxa de natalidade, a política de saúde tem sido levada a enfocar atenção integral à saúde do idoso dentro do sistema de saúde brasileiro, mesmo considerando suas limitações. Além disso, há um constante progresso em relação à busca de alternativas para que se melhorem as condições de vida ou de sobrevivência dos idosos. A osteoartrose (OA) em joelhos em indivíduos acima de 60 anos é fator limitante na qualidade de vida dos mesmos, impossibilitando-os de realizar suas atividades de vida diária de forma qualitativa e quantitativa. Sendo assim, nesta pesquisa foi estudada a prevalência de OA de joelho em uma amostra populacional de idosos residentes em Botucatu, São Paulo, com o intuito de possibilitar uma avaliação da sua autonomia em relação a esse aspecto. Para tanto, utilizou-se instrumento validado na literatura e adaptado para a nossa realidade. Foram entrevistados 355 idosos. O processo amostral foi o de sorteio dos idosos para prevalência desconhecida a partir de famílias previamente selecionadas na amostragem sistemática, após atualização do censo do ano de 2002, com a localização das famílias (uma a cada quatro) através do mapa residencial da cidade. Essa população de idosos foi entrevistada três anos após o sorteio e, por este motivo, foi feita a reposição de perdas e óbitos de 80 idosos, estratificados por idade e sexo. Os idosos que na entrevista domiciliar referiram “dor em joelhos” foram encaminhados para exame clínico. Foi encontrado que 64% dos idosos referiram “dor em joelhos” e, destes, 98,6% apresentaram dor ou rigidez... / Aging process has been the cause of world socio-economic and cultural worry and questioning. In Brazil, due to the flattening of the demographic pyramid and the reduction of both mortality and birth rates, the health policy has focused total attention to the elderly health in the Brazilian health system, even considering its limitations. Besides, the search for alternatives to improve the life conditions or survival of the elderly is in constant progress. Knee osteoarthrosis (OA) in people at over 60 years old limits their quality of life, preventing them from doing their daily activities regarding quantity and quality. This work studied the prevalence of knee OA in an elderly population sample of Botucatu, São Paulo, to provide an evaluation of their autonomy considering this aspect. An instrument validated by the literature and adapted to our context was used in this study. Three hundred fifty-five elderly were interviewed. They were raffled for unknown prevalence among previously selected families in the systematic sample, after updated census of 2002; families (one out of four) were located through the residential map of the city. Three years after the raffle the elderly were interviewed, and stratified by sex and age. Eighty patients had to be replaced due to death. Patients who referred to “painful knee” during the home interview were sent to clinical examination. It was found out that 64% of elderly referred to “painful knee”, and, among these, 98.6% had morning pain or rigidity and protokinetic, with much difficulty to do their daily activities. This is an important finding especially concerning the elderly patient who lives alone and needs medical and physiotherapeutic follow-up to improve their quality of life. This result is similar to literature. This situation suggests that the National Health System (SUS) considerers, regarding the risky... (Complete abstract click electronic access below)

Class of 2012 Abstract / Specific Aims: To review overall quality of life (QOL) in active geriatric patients and to observe different attitudes toward aging in the student comparison groups. Subjects: Current students, regardless of academic year, attending the University of Arizona College of Pharmacy with a university email account. Methods: Data was collected using an electronic questionnaire. A link to the questionnaire was sent out via email to all University of Arizona, College of Pharmacy students. Another email containing the link to the questionnaire was sent two weeks after the initial notification. The questionnaire consisted of 36 questions requesting students to express their perspective on the health status, mental status and physical abilities of the elderly. Main Results: Geriatric patients tended to have a more positive view on their overall health when compared to students' perceptions of geriatric QOL (86.7% versus 35.7%, P <0.05). Students were also more likely to have the perception that geriatric patients had limitations in regular activities due to physical health and emotional problems when compared to the actual responses of older adults (72.6% versus 40.0%, P <0.05; and 60.0% versus 16.7%, P <0.05; respectively). There was a significant difference (P<0.05) between responses from students and geriatric patients to every question. Conclusions: There appears to be a noteworthy difference between pharmacy student perceptions of geriatric QOL and actual older adult QOL responses that may warrant an educational intervention.

M.Phil. / The central research problem of this study asks whether principle-based time management can increase quality of life? The second question, which arises, is what the underlying principles of quality of life creating time management would be? These principles were identified by looking at some of the most common time management problems. The principles are being proactive, living according to values, setting goals, acquiring self-knowledge and being motivated by importance rather than urgency. Quality of life can be defined as living, loving, learning and leaving a legacy. Principles are objective, universal, fundamental, primary truths that cannot be reduced to something more basic. Time management can be characterised as the process by which time is applied effectively to gain a return on the investment thereof in the form enhanced quality of life. Eight approaches to time management found in literature were fathomed to discover what their contribution to time management, strengths and weaknesses were. It could clearly be seen that utilising any of these methods in isolation would certainly lead to an ultimate decline in quality of life. Thus, a higher level approach to time management had to be found. Two higher level approaches to time management are found in the literature. A new approach to principle-based time management called the Journey approach was synthesised by interweaving current approaches to time management, with quality of life producing principles from a Personal and Professional Leadership perspective. The Journey metaphor was used to arrive at the following steps for a principle-based approach to time management: 1) Set life goals. 2) Gain self-knowledge. 3) Align your perception of reality with universal principles. 4) Set medium term gaols. 5) Make action plans. 6) Act according to the plan. Finally some guidelines for a course on principle-based time management are given.

Recent progress in science and medicine is that regions such as the United States, Canada, Australia, and Western Europe have witnessed dramatic declines in infant morbidity and mortality. The most significant of these declines has occurred among infants born prematurely and low birth weight (LBW)--the cohort that represents the highest proportion of illness and death among infants Despite these medical advances, recent longitudinal studies have provided clear evidence of physical health problems; cognitive and neuropsychological dysfunction; and other social, emotional, and behavioral problems among children born prematurely. A number of studies have indicated that premature and LBW infants are still at risk for psychosocial, physical, and mental problems despite the immediate contributions of post-natal interventions to their increased chance for survival The extant research has demonstrated that children born prematurely and LBW are at risk for problems in health, neuropsychological functioning, learning, academic achievement, behavior, and psychosocial adjustment. Research has further demonstrated that a variety of physical and psychological conditions are associated with poorer QOL among children. However, few studies have examined pediatric QOL among preterm school-aged children. Moreover, existing studies have not explored the relationship between cognitive, academic, and social/emotional functioning and QOL. The current study compared child and parent ratings of health-related quality of life among school-aged children born preterm (n = 26) and full-term (n = 28). Given the increased rates of physical, psychological, and cognitive problems among the preterm population, it was hypothesized that children born prematurely would have significantly poorer proxy-reported and self-reported QOL than children born preterm.

One modality to improve quality of life, in Breast Cancer Survivors (BCS), is physical activity (PA). Less than 30% of BCS participate in PA. The purpose of this study is to explore BCS’s intention to exercise. Seventy-five BCS patients, undergoing treatment, completed a survey. The survey assessed the following: Health care practitioner influence, Demographics, Stages of Change (SOC), anxiety and depression, perceived barriers to exercise, past and current exercise, and the constructs of the Theory of Planned Behavior (TPB). BCS who were older, had less education, did not exercise before diagnosis, were in the pre-contemplation and contemplation stages, and/or exhibited a low Perceived Behavioral Control had a lower intention to exercise. Incorporating the findings from this research into an intervention may assist with increasing intention to exercise among BCS. / Includes bibliography. / Thesis (MS)--Florida Atlantic University, 2021. / FAU Electronic Theses and Dissertations Collection

Preliminary normative data for the Brief Multidimensional Students' Life Satisfaction Scale (BMSLSS) total score were collected from 2,987 South Carolina middle school students in Grades 6 though 8. Tests for gender and ethnicity (African-American vs. Caucasian) effects were non-significant. Statistically significant differences between grade levels were discovered, but the magnitude of these differences was quite small. Thus, a single set of norms is appropriate for use when interpreting middle school students' responses to the BMSLSS.

No description available.

Neurofibromatosis Type 1 (NF1, von Recklinghausen’s disease) is among the more common autosomal dominant genetic disorders, with a worldwide incidence of approximately 1 in 3000 live births. NF1 can occur as either an inherited defect or as a spontaneous “de novo” mutation. NFI is caused by mutation of the neurofibromin gene that leads to a lack of neurofibromin in the cytoplasm of the cell. Neurofibromin, among other cytoplasmic roles, is a key regulator of certain cellular growth pathways. There is currently no cure for NF1. The disorder has an almost 100% penetrance, but is widely variable in its manifestation. NF1 is a progressive multisystem disorder, and the clinical manifestations tend to worsen with advancing age. NF1 typically manifests as multiple benign skin tumors (neurofibromas), café-au-lait spots, axillary freckles, optical nerve gliomas, iris hamartomas (Lisch nodules), learning disabilities, speech impairment, and orthopedic and cardiovascular problems. More severe manifestations can cause vision loss, headaches, seizures, chronic pain, and orthopedic problems limiting physical activity. Patients with NF1 are four times more likely to develop malignancies than the general population. Several studies have shown that NF1 impairs the patient’s quality of life through association with more severe complications, impacts on the patient’s appearance, and through learning disabilities and depression. In both mild and severe cases, there seemed to be an equal emotional impact on the patient. The psychosocial impact manifests in various ways, including loss of confidence and self-esteem. This can stem from insecurity due to an underlying learning disability or insecurity due to NF1-related cosmetic damage. The academic and emotional damage that follow the learning disability or the lack of confidence, if not treated with appropriate therapy, can go on to impact the patient’s relationships and career. The patient may suffer from social exclusion, financial hardship and inability to obtain health insurance. Patients may be unwilling to have children out of fear of passing on the mutation. This thesis seeks to present in detail the impacts on quality of life that neurofibromatosis causes, and discuss current management and treatment strategies that exist and what can be done further to improve these people’s lives. Early individualized treatment is necessary to achieve better outcomes. Support groups can help educate NF1 patients and their family members and may help alleviate stress. Widespread public education about the condition would help remove the public stigma of Nf1, and allow for patients to feel normal and valued in society. Early individualized treatment is necessary to achieve better outcomes.