Title: Quality of life of women with urinary stress incontinence Objectives: The aim of this thesis was to assess quality of life of women after conservative therapy and chirurgic therapy of urinary stress incontinence in Brno-město and Brno- venkov district. Methods: We did a questionnaire survey on quality of life by using a standardized questionnaire I-QoL (Urinary Incontinence Quality-of-life questionnaire). The questionnaire survey was conducted in patients after conservative or surgical therapy by TVT or TOT tape. Subjectively perceived quality of life of these patients after completion of the therapy was observed. The results were compared between the groups undergoing conservative and surgical therapy by TVT or TOT tape. Results: After the output assessment of quality of life of patients after the treatment, we found that there is a difference in the quality of life of patients treated conservatively and surgically by TVT or TOT tape. Patients treated surgically had higher quality of life than patients treated conservatively by 9%. We also found that there is a difference in the physical, mental and social scores of the groups. The respondents who were treated conservatively had lower score in all evaluated areas with the greatest difference in the physical area and the smallest difference...

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Submitted in fulfillment of the requirements for the Doctoral Degree in Nursing, Durban University of Technology, Durban, South Africa, 2016. / Background An increase in the world's population of ageing people is occurring not only in developed countries but also in developing countries. In South Africa, the proportion of the population aged 50 and over increased from 14.8% in 2006 to 15% in 2009 and is predicted to be 19% by 2030. This means that the supply of services for the elderly people should match the demand at all times, otherwise the quality of life of these senior citizens will be compromised. This study aimed at developing a model that would improve the quality of life for elderly people living in the uMhlathuze and uMlalazi sub-districts of the uThungulu district, KwaZulu-Natal. Methodology A qualitative, exploratory, descriptive design was applied for this study. A semi-structured interview guide based on the Health Related Quality of Life Theory and Maslow’s hierarchy of needs was used. Random sampling was used to select the elderly participants. Purposive sampling was used for the selection of the chairpersons of non-governmental organisations, and the District Programme Manager. Audits were conducted in the clubs that elderly people with chronic disease participate in. Data analysis followed Tesch’s steps after which themes and categories were formulated. Results Three major themes that emerged from the data analysis were social well-being of elderly people, physiological factors and psychological factors. The results revealed that elderly people experience poor living conditions and suffer poverty due to a number of factors which including the high unemployment rate of their children. Often the children are involved in substance abuse using the elderly person’s money pension money, which leaves them without any food items in the household. According to the District Programme Manager, there was a project on integrated chronic disease management that was conducted at uThungulu district by the Department of Health. The integrated chronic disease management focused on the population in general of all ages, yet in this study the focus has been on elderly people, which is why the researcher developed a model to improve the QoL of elderly people, due to their unique needs. Conclusion This research study gathered information regarding social, economic, health and environmental factors in rural areas which will help in bringing issues of elderly people’s quality of life to awareness. This research will deepen the knowledge and skills of professionals on ageing issues, especially in rural areas/communities. / D

Approved for public release, distribution is unlimited / The purpose of this thesis is to firstly analyze the determinants on the survival of United States Marine Corps Officers, and secondly, to develop the methodology to optimize the accessions of prior and non-prior enlisted officers. Using data from the Marine Corps Officer Accession Career file (MCCOAC), the Cox Proportional Hazards Model is used to estimate the effects of officer characteristics on their survival as a commissioned officer in the USMC. A Markov model for career transition is combined with fiscal data to determine the optimum number of prior and non-prior enlisted officers under the constraints of force structure and budget. The findings indicate that prior enlisted officers have a better survival rate than their non-prior enlisted counterparts. Additionally, officers who are married, commissioned through MECEP, graduate in the top third of their TBS class, and are assigned to a combat support MOS have a better survival rate than officers who are unmarried, commissioned through USNA, graduate in the middle third of their TBS class, and are assigned to either combat or combat service support MOS. The findings also indicate that the optimum number of prior enlisted officer accessions may be considerably lower than recent trends and may differ across MOS. Based on the findings; it is recommended that prior enlisted officer accession figures be reviewed. / Major, Australian Army

Introduction: Stress urinary incontinence is a common problem which affects a high percentage of women. Anti-incontinent surgery has played an important role in the treatment of stress urinary incontinence. Burch colposuspension was considered a gold standard in anti-incontinence surgery, with good long-term results. However, over the past decade this procedure has been largely replaced by the application of various types of TVTs (tensionfree vaginal tapes). In our study we have focused on comparing developments in the quality of life and the occurrence of complications in a long-term follow-up after TVT, TVT O and colposuspension. For subjective assessment of urinary incontinence we have chosen a validated specialized Incontinence Quality of Life questionnaire (I-QoL). The aim of our study was to monitor the trends with quality of life after TVT, TVT O and colposuspension procedures and to establish whether the occurrence of complications affects the quality of life (QoL) and compare of the quality of life among anti-incontinence procedures and longterm subjective and objective outcome. Methods: The study included 215 women who underwent a TVT, TVT O or Burch procedure between 1.6.2002 - 31.5.2005. Women were completely urogynecologic examined and urodynamic stress incontinence was documented....

Magister Artium (Social Work) - MA(SW) / The burden of HIV disease is concentrated in sub-Saharan Africa and South Africa (SA) is particularly affected. Whilst there have been many studies conducted on the biomedical and socio-psychological aspects of HIV and AIDS, insufficient attention has been paid to the quality of life of those infected with the virus. The primary purpose of this study was to determine the predictors of quality of life enjoyment and satisfaction (Q-LES) of individuals living with HIV and or AIDS and those on anti-retroviral treatment or being prepared for it. Further, the study determined the relationship between psychological distress and Q-LES of HIV positive individuals because psychological distress is reported to contribute substantially to the burden of the disease in sub-Saharan Africa, including SA. This quantitative study used a battery of questionnaires administered to 121 participants in an out-patient clinic setting. The main hypothesis tested in this study is: psychological distress is a strong predictor of Q-LES. The Hospital Anxiety and Depression Scale (HADS) was used to screen for psychological distress and the Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q) to assess the various components of QoL. A purposive sampling strategy was used to recruit participants into the study. Data analysis included descriptive and inferential statistics using SPSS to test the hypothesis. Of the total sample (N=121), 74% were females. The study found that a large proportion (49.5%) of the sample within the age group 25-49 years old had significant presence of psychological distress. Those not on ART yet were significantly affected (66%). The relationship between Q-LES subscales and psychological distress was significant (p< 0.01). The results show that psychological distress was significantly prevalent among HIV positive individuals and it was the strongest predictor of Q-LES among the study participants. Modifying the current psychological intervention programmes, in the public health clinics, for individuals vi infected with the HI virus will assist in improving the current health outcomes and also help to achieve better Quality of Life outcomes.

Brain tumors are the second leading cause of cancer deaths in young adults ages 20- 39. (Armstrong et al., 2004) According to the South African Medical Research Council, there was an estimate 801 deaths because of brain cancer in South Africa in 2000. If these statistics are compared to other types of cancers like breast-, lung- and prostate cancers, is the prevalence of the diagnoses of brain tumors, a very small percentage. According to the Mayo clinic in South Africa, the estimate number of brain tumor incidences was 3% in 2007. Despite of these statistics with regards Brain tumors, one in six South African men and one in seven South African women will be diagnosed with cancer during their life times. Despite this small percentage, the diagnoses of brain tumors have escalated the last few years. The reason for these new statistics is still unknown. With exercise that is becoming one of the most important adjuvant therapies for most diseases or illnesses, we may sustain this idea of using exercise intervention as an adjuvant therapy for brain tumor cancers we can prove this through many researches that has been done in the last few years. (Schwartz, 2003) Studies done by different researchers they found that exercise intervention is becoming increasingly recognized as a safe, feasible and beneficial supportive therapy for cancer patients both during and after the cessation of adjuvant therapy. (Jones et al., 2006) Exercise influences a lot of different systems in the body, to the advantage of the cancer patient (Schwartz, 2003) and emerging new research shows that physical exercise may boost brain function, which include improve mood. (Kong, 1999) Exercise, according to Cotman and Berchtold (2002) is commonly believed to be a behavioral strategy to relieve stress, and reduce depression and anxiety in humans. Exercise intervention further influence following aspects of the human body, namely brain deprived neurotrophic factor (BDNF) and 5-HT (Serotonin). Improvement of these could, in fact, lead to a better quality of life (QoL) of a brain tumor patient (Cotman&Berchtold, 2002). Fatigue that sets in, due to the different cancer therapies, is also a factor that has an affect on depression and anxiety of the patient. Keeping still and rest to prevent fatigue were followed in previous regiment when working with cancer patients was followed. This approach, in fact, has a very negative effect on the patient. Being diagnosed with a brain tumor the patient will never be emotionally prepared for this type of information and it usually shatters their sense of well being and their personal security. All of these factors, especially depression, affect the patient’s QoL. (Vaynman et al., 2004) An exercise regiment for brain tumor patients has not yet been developed properly, because exercise intervention for familiar cancers could be problematic and not suitable for brain tumor patients. (Schwartz, 2003) Therefore, the purpose of this study is to further the knowledge and the field of expertise of exercise as an adjuvant therapy in brain tumor patients to better QoL over a larger period of time. AFRIKAANS : Die tweede grootste leier in siektes tussen die ouderdomme van 20-39 jaar wat lewens eis is Brein gewasse (brein kanker). (Armstrong et al., 2004) Volgens die Suid- Afrikaanse Mediese Navorsingraad, is daar tot 801 gevalle van breingewas sterftes in die jaar 2000 aangemeld. As hierdie statistieke vergelyk word met statistieke van kanker wat meer prominent voorkom soos byvoorbeeld bors-, long-, en protaatkanker, lyk die voorkoms van breinkanker diagnosis maar na ‘n baie klein persentasie. Die Mayo Kliniek in Suid-Afrika het in 2007 bevind dat die voorkoms van breinkanker in Suid-Afrika ‘n persentasie van 3% uitgemaak het. Ten spyte van hierdie statistieke betreffende breingewasse, sal een uit elke ses mans en een uit elke sewe vroue, gediagnoseer word met een of ander kanker gedurende hulle leeftyd. Alhoewel die persentasie wat reeds genoem is maar na ‘n klein hoeveelheid lyk, het die voorkoms van breingewasse baie toegeneem in die laaste paar jaar en selfs maande. Die rede vir hierdie aansienlike toename is steeds onbekend. Oefening word al hoe belangriker en word al hoe meer deur verskeie dokters voorgeskryf om te dien as ‘n bykomende behandeling vir verskeie siekte toestande. Dit word veral ook vir kanker pasiënte voorgeskryf. Oefen intervensie kan dus gebruik word vir breinkanker pasiënte, hierdie stelling gestaaf kan word, aangesien daar verskeie navorsings reeds bewys het dat oefening as bykomende terapie gebruik is vir kanker pasiënte. (Schwartz, 2003) Hierdie studies het bevind dat oefening as ‘n veilige, uitvoerbare en voordelige bykomende intervensie vir kanker pasiënte erken word. Hierdie intervensie kan tydens en na hoof kanker behandeling gebruik word (Jones et al., 2006). Oefening beinvloed verskeie sisteme in die liggaam, tot voordeel van die kanker pasiënt. (Schwartz, 2003) Nuwe navorsing het ook aan die lig laat kom dat fisieke aktiwiteit ‘n persoon se breinfunksie bevorder, wat onder andere ‘n baie groot invloed het om die pasiënt se gemoedstoestand. (Kong, 1999) Volgens, Cotman and Berchtold (2002), is daarvolgens studies bewys dat oefenterapie ‘n manier is om stres te verlig, sowel as depressie en angstigheid in meeste mense. Oefenterapie beinvloed ook die volgende aspekte positief in die menslike liggaam naamlik, Brein ontnemende neurtrofiese-faktor (BDNF) en 5-HT (Serotonien). Verbetering van hierdie faktore, kan ly tot ‘n beter kwaliteit van lewe van ‘n pasiënt wat met ‘n breingewas gediagnoseer is (Cotman&Berchtold, 2002). Uitputting (moegheid) wat gewoonlik intree as gevolg van kanker terapie, is ook ‘n faktor wat ‘n effek het op die depressie- en angsvlakke van ‘n pasiënt. In vroeë behandelingsprotokol van kankerpasiënte, moes die pasiënt so stil as moontlik verkeer om sodoende uitputting of moegheid te voorkom. Hierdie benadering het in die uiteinde ‘n baie negatiewe effek op die pasiënte tot gevolg gehad. ‘n Persoon wat met ‘n breingewas gediagnoseer word sal nooit emosioneel voorbereid wees op hierdie diagnose nie en sodoende kan dit lei tot ‘n ineenstorting van die persoon se geestestoestand en persoonlike sekuriteit. Hierdie “ineenstorting” kan ‘n groot invloed hê op die kwaliteit van lewe van hierdie pasiënt (Vaynman et al., 2004). ‘n Oefenintervensie protokol vir breinkanker pasiënte is nog nie voldoende vasgestel nie, aangesien oefenterapie intervensies wat vir bekende kankers problematies en selfs gevaarlik kan wees vir breingewas pasiënte nie. (Schwartz, 2003) Daarom is die doel van die studie, om inligting te verkry en kennis in te samel om die veld van deskundiges uit te brei om sodoende ‘n oefenterapie protokol neer te lê vir breinkanker pasiënte. Hierdie protokol sal dus dien as ‘n bevordering van kwaliteit van lewe van hierdie pasiente deur middel van oefen intervensie as bykomende behandeling. Copyright / Dissertation (MA)--University of Pretoria, 2012. / Biokinetics, Sport and Leisure Sciences / unrestricted

Introduction: Stress urinary incontinence is a common problem which affects a high percentage of women. Anti-incontinent surgery has played an important role in the treatment of stress urinary incontinence. Burch colposuspension was considered a gold standard in anti-incontinence surgery, with good long-term results. However, over the past decade this procedure has been largely replaced by the application of various types of TVTs (tensionfree vaginal tapes). In our study we have focused on comparing developments in the quality of life and the occurrence of complications in a long-term follow-up after TVT, TVT O and colposuspension. For subjective assessment of urinary incontinence we have chosen a validated specialized Incontinence Quality of Life questionnaire (I-QoL). The aim of our study was to monitor the trends with quality of life after TVT, TVT O and colposuspension procedures and to establish whether the occurrence of complications affects the quality of life (QoL) and compare of the quality of life among anti-incontinence procedures and longterm subjective and objective outcome. Methods: The study included 215 women who underwent a TVT, TVT O or Burch procedure between 1.6.2002 - 31.5.2005. Women were completely urogynecologic examined and urodynamic stress incontinence was documented....

Hintergrund Ziel der vorliegenden Untersuchung war die Erfassung der Lebensqualität von älteren Menschen mit leichten kognitiven Störungen im Vergleich zu kognitiv gesunden älteren Menschen. Die Prävalenz von leichten kognitiven Störungen in der Bevölkerung wird in epidemiologischen Studien mit 3 bis 19 % der über 65-Jährigen angegeben (Ritchie, 2004). Methode Es handelt sich um eine 2012 bundesweit durchgeführte bevölkerungsrepräsentative Befragung zur subjektiven Lebensqualität von 997 Probanden (60 Jahre und älter). Die Erfassung erfolgte mittels der Messinstrumente WHOQOL-BREF und dem speziell für ältere Menschen entwickelten WHOQOL-OLD. Zudem wurden die ermittelten Werte für die Lebensqualität in den soziodemografischen Kontext gesetzt, um eventuelle Faktoren zu ermitteln, die die unterschiedlichen Bereiche der Lebensqualität beeinflussen. Zur Identifikation kognitiver Störungen wurde der DemTect eingesetzt. Bei Verdacht auf Demenz fand das Interview nicht statt. Probanden mit leichten kognitiven Beeinträchtigungen wurden interviewt. Das Ergebnis des DemTects bestimmte die Zuteilung der Probanden in die jeweilige Gruppe (leichte kognitive Störungen vs. kognitiv gesund). Die Kriterien für die Gruppe der Probanden mit leichten kognitiven Störungen erfüllten 267 Probanden, für 730 Teilnehmer fanden sich keine Anzeichen einer kognitiven Beeinträchtigung. Ergebnis Die befragten Probanden im Alter ab 60 Jahre mit leichten kognitiven Störungen schätzten ihre Lebensqualität in allen Bereichen des WHOQOL-BREF und WHOQOL-OLD (außer im Bereich Ängste und Befürchtungen hinsichtlich Tod und Sterben) geringer ein als kognitiv gesunde Probanden. Schlussfolgerung Es konnte gezeigt werden, dass bereits leichte kognitive Störungen mit einer erheblichen Reduktion der subjektiven Lebensqualität einhergehen.:Bibliografische Zusammenfassung 3 Abkürzungsverzeichnis 4 Abbildungs- und Tabellenverzeichnis 6 1 Einleitung 7 1.1 Lebensqualität und ihre Erfassungsinstrumente 8 1.2 Leichte kognitive Störungen und ihre Diagnostik 13 2 Theorie und Stand der Forschung 17 2.1 Theoretischer Ansatz 17 2.2 Stand der Forschung 18 3 Fragestellungen und Ziele der Studie 39 4 Methodisches Vorgehen 41 4.1 Auswahl der Probanden 41 4.2 Datenerhebung 41 4.3 Beschreibung der Erhebungsinstrumente 42 4.4 Statistische Auswertung 44 5 Ergebnisse 45 5.1 Soziodemografische Merkmale der Studienteilnehmer 45 5.2 Mittelwerte WHOQOL-BREF 48 5.3 Mittelwerte WHOQOL-OLD 49 5.4 Einfluss von soziodemografischen und gesundheitsbezogenen Determinanten auf die Lebensqualität 50 5.4.1 Lebensqualitätsbereiche des WHOQOL-BREF 51 5.4.2 Lebensqualitätsbereiche des WHOQOL-OLD 54 6 Diskussion 57 7 Schlussfolgerungen und Ausblick 69 8 Zusammenfassung der Arbeit 70 9 Literaturverzeichnis 72 Erklärung über die eigenständige Abfassung der Arbeit 89 Lebenslauf 90 Publikationen 91 Danksagung 92

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