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General Well-being (general + well-being)
Selected AbstractsInternational validation of ReQuest in patients with endoscopy-negative gastro-oesophageal reflux diseaseALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 8 2004K. D. Bardhan Summary Background :,Reflux Questionnaire (ReQuest), a newly developed gastro-oesophageal reflux disease-sensitive scale, can be used to reliably evaluate the effect of treatment on gastro-oesophageal reflux disease symptoms. Aim :,International validation of this scale, in patients suffering from endoscopy-negative gastro-oesophageal reflux disease. Methods :,In this open, multicentre and multinational clinical trial 840 endoscopy-negative gastro-oesophageal reflux disease patients received pantoprazole 20 mg daily for 28 days. The long and short versions of ReQuest were completed both in the pre-treatment and treatment phases. For scale development an item reduction analysis was performed. Internal consistency, test,retest reliability and responsiveness were calculated for psychometric analysis. Construct validity was evaluated by comparison with the Gastrointestinal Symptom Rating Scale and the Psychological General Well-being questionnaire by means of correlation coefficients. Results :,Factor analyses confirmed the content validity of both long and short version of ReQuest. Psychometric calculations proved high internal consistency (Cronbach's alpha: 0.9), test,retest reliability [Intraclass Correlation Coefficient: 0.9 (long vs. long) and 0.8 (short vs. short)], and responsiveness (Responsiveness Index 320.3) of the scale, for which also good construct validity was achieved (correlation coefficient: Gastrointestinal Symptom Rating Scale ,0.6; Psychological General Well-being ,0.4). Conclusion :,ReQuest proved valid, reliable, and responsive in this multinational clinical trial to evaluate treatment response in endoscopy-negative gastro-oesophageal reflux disease patients. [source] Improvement of Reflux Symptoms 3 Years After Cure of Helicobacter pylori Infection: A Case-Controlled Study in the Japanese PopulationHELICOBACTER, Issue 4 2002Hiroto Miwa Abstract Background. Development of reflux esophagitis is one of the adverse effects that cause concern in relation to curative treatment of Helicobacter pylori infection. However, recent studies present a rather negative association between curative treatment and development of reflux esophagitis or reflux symptoms. Therefore, this issue has remained controversial. Accordingly, we investigated the long-term adverse effects of H. pylori eradication treatment in special reference to development of reflux symptoms. Patients and Methods. We conducted a case controlled study by mailing structured questionnaires on past (before curative treatment or 3 years previously) and current status. A case was an endoscopically confirmed peptic ulcer patient with confirmed cure of the infection after eradication treatment 3 years previously and a control was one who had not undergone the eradication treatment during the same period. We studied 241 pairs who matched for age, gender, and type of ulcer disease (GU, DU or GDU). Of these pairs, 81.3% were male and the mean age was 52.6 ± 9.6 year (range 23,76). Results. The rates of patients with improved reflux symptoms in the case and control groups were 65.4% and 30.4%, respectively, with the rate being significantly greater in the case group. On the contrary, the rates of those with worsened reflux symptoms were similar (5.1% and 7.6%). Regarding general events, the rate of patients with decreased frequency of hospital visits and of those who regularly used antiacid medications were significantly decreased in the case group. Furthermore, the case group experienced significantly fewer hospital admissions for various diseases in this 3-year period. However, a significantly greater number of case group patients than control subjects gained weight. Conclusion. Reflux symptoms as well as general well-being were significantly improved after cure of H. pylori infection. [source] Infliximab improves quality of life in patients with Crohn's diseaseINFLAMMATORY BOWEL DISEASES, Issue 4 2002Dr. Gary R. Lichtenstein Abstract Objective The aim of this study was to assess the effect of infliximab on quality of life in patients with active Crohn's disease (CD) inadequately responsive to concomitant therapies. Methods We examined responses to the Inflammatory Bowel Disease Questionnaire (IBDQ) from patients enrolled in a previously reported, randomized, placebo-controlled study. Patients with active CD received a single intravenous infusion of either placebo or infliximab 5, 10, or 20 mg/kg. Most patients received stable doses of mesalamine, corticosteroids, azathioprine, or 6-mercaptopurine throughout the study. Changes from baseline in overall IBDQ score and individual dimensions at 4 weeks postinfusion were compared. Results Patients treated with infliximab had a significantly larger improvement in overall IBDQ score than those treated with placebo at 4 weeks (p < 0.001). Infliximab-treated patients also had larger improvements in all IBDQ dimensions: bowel (p = 0.007), social (p = 0.002), emotional (p < 0.001), and systemic (p < 0.001). A significantly larger proportion of infliximab-treated patients reported having normal or near-normal frequency of bowel movements in the past week (p < 0.001), full or a lot of energy (p = 0.019), and no or hardly any difficulty doing leisure or sports activities (p = 0.011), and being extremely or very satisfied with their personal life (p = 0.046). They also significantly differed in responses regarding fatigue, frustration, ability to work, general well-being, depression, anxiety, and anger resulting from bowel problems. Conclusions These results indicate that infliximab significantly improved quality of life in patients with active CD, increasing their ability to work and participate in leisure activities, and decreasing feelings of fatigue, depression, and anger. [source] Quality of life in partners of people with congestive heart failure: gender and involvement in careJOURNAL OF ADVANCED NURSING, Issue 7 2009Marie Louise Luttik Abstract Title.,Quality of life in partners of people with congestive heart failure: gender and involvement in care. Aim., This paper is a report of a study conducted to investigate quality of life in partners of people with congestive heart failure in comparison to individuals living with a healthy partner. Background., Congestive heart failure is a chronic debilitating disease with severe symptoms and complex treatment. The support of partners is essential in the management of congestive heart failure. Living with a chronic illness generally affects the quality of life of patients and their partners. Method., Data were collected using a cross-sectional, comparative design between October 2002 and February 2005 with 303 partners of people with congestive heart failure. Reference data were collected in 304 age- and gender-matched individuals living with a healthy partner, drawn from the general population. All respondents completed questionnaires at home on quality of life and general well-being. Analysis of variance was used to analyse the data. Findings., Overall, differences in quality of life between partners of people with heart failure and matched controls were small. However, substantial variation in the quality of life of partners was found by exploring the role of gender and involvement in care. Quality of life scores varied strongly for male and female partners who had to perform caregiving tasks. The performance of these caregiving tasks was negatively associated with the quality of life of female partners but not with that of male partners. Conclusion., Female partners especially should not be overlooked when they become involved in personal care tasks. Nurses should not be reluctant to involve male partners in caring for women with heart failure. [source] The well-being of gays, lesbians and bisexuals in BotswanaJOURNAL OF ADVANCED NURSING, Issue 6 2001V.J. Ehlers BA BSSc MA DLitt RGN RM The well-being of gays, lesbians and bisexuals in Botswana Aims.,To investigate the level of well-being of gays, lesbians and bisexuals (GLBs) in Botswana, how this level of well-being could be promoted and whether their health care needs were met by health care professionals. Rationale.,It is illegal to engage in same-sex activities in Botswana, punishable by imprisonment. Although Botswana's citizens have one of Africa's best health care systems, little is known about the health status, health care needs and general well-being of Botswana's GLBs. This survey attempted to uncover some of these potential health care needs, impacting on the GLBs' well-being. Design/methods.,The research framework adopted was the health and human rights approach, placing dignity before rights. A survey design, with structured questionnaires, was used. Snow-ball sampling techniques were used. Results.,Results indicated that varying degrees of distress were experienced by 64% of the GLBs in this study. The GLBs identified a need for human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) education and had concerns about their general health, discrimination against them and vulnerability to violence including sexual assaults. Conclusions.,The well-being of the GLBs in Botswana was influenced by both positive internal acceptance of their sexual orientation and negative external acceptance by society. Health care professionals played insignificant roles in the promotion of GLBs' well-being, and could make greater inputs into health education efforts, and more significant contributions towards enhancing the GLBs' levels of well-being. Enhanced collaboration between health professionals and human rights activists are recommended to reduce violations of Botswana's GLBs' dignity and to improve their quality of life, including enhanced access to and utilization of health care services. [source] Predicting General Well-Being From Emotional Intelligence and Three Broad Personality TraitsJOURNAL OF APPLIED SOCIAL PSYCHOLOGY, Issue 3 2008Malika Singh This paper examined the joint predictive effects of trait emotional intelligence (trait-EI), Extraversion, Conscientiousness, and Neuroticism on 2 facets of general well-being and job satisfaction. An employed community sample of 123 individuals from the Indian subcontinent participated in the study, and completed measures of the five-factor model of personality, trait-EI, job satisfaction, and general well-being facets worn-out and up-tight. Trait-EI was related but distinct from the 3 personality variables. Trait-EI demonstrated the strongest correlation with job satisfaction, but predicted general well-being no better than Neuroticism. In regression analyses, trait-EI predicted between 6% and 9% additional variance in the well-being criteria, beyond the 3 personality traits. It was concluded that trait-EI may be useful in examining dispositional influences on psychological well-being. [source] Views of xerostomia among health care professionals: a qualitative studyJOURNAL OF CLINICAL NURSING, Issue 6 2009Solgun Folke Aim., To explore and describe views of xerostomia among health care professionals. Background., Xerostomia (dry mouth) is caused by changes in quality and quantity of saliva due to poor health, certain drugs and radiation therapy. It is a common symptom, particularly among older people and has devastating consequences with regard to oral health and general well-being. Methods., Data were obtained and categorised by interviewing 16 health care professionals. Qualitative content analysis was chosen as the method of analysis. Design., Qualitative. Results., The latent content was formulated into a theme: xerostomia is a well-known problem, yet there is inadequate management of patients with xerostomia. The findings identified three categories expressing the manifest content: awareness of xerostomia, indifferent attitude and insufficient support. Conclusions., Although xerostomia was recognised as commonly occurring, it was considered to be an underestimated and an ignored problem. Proper attention to conditions of xerostomia and subsequent patient management were viewed as fragmentary and inadequate. Additional qualitative studies among patients with xerostomia would be desirable to gain further understanding of the problems with xerostomia, its professional recognition and management. Relevance to clinical practice., A holistic view, positive professional attitudes and enhanced knowledge of xerostomia seem essential to augment collaboration among health care professionals and to improve compassion for and support of patients with xerostomia. [source] The impact of a nurse-led support and education programme for spouses of stroke patients: a randomized controlled trialJOURNAL OF CLINICAL NURSING, Issue 8 2005Jenny Larson RN, PhD student Aims and objectives., The aim of the present study was to determine the impact of a nurse-led support and education programme for improving the spouses' perceived general quality of life, life situation, general well-being and health state. Background., Stroke is a disease with great consequences for the patients and their families. The spouses often feel obligated to care for the patient, providing psychological and physical support and having to cope with the patient's physical and cognitive impairments. This might lead to increased problems, as family members struggle to adapt to their new roles and responsibilities. Design and methods., Longitudinal, randomized controlled trial. One hundred spouses were randomly assigned to intervention or control groups, 50 in each group. The intervention group participated in a support and education programme, six times during six months, led by stroke specialist nurses. Both groups were followed for 12 months. Results., No significant differences were found, between intervention and control groups, over time. In the sub analyses, we found that the group attending 5,6 times had a significant decrease in negative well-being and increased quality of life over time, while the group attending fewer times had a significant decrease in positive well-being and health state, similar to the control group, which also had a significant decrease in negative and general well-being. Conclusions., A support and education programme might have a positive effect on spouses' well-being, on condition that they attend at least five times. Relevance to clinical practice., To facilitate the spouses' role as informal caregivers to the stroke patients, further development of the support and education programme used in the present study is needed, including empowerment approach and implementation of coping strategies. [source] Rapid response of severe refractory metastatic Crohn's disease to infliximabJOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 8 2001Ashley M Miller Abstract A case is described of a middle-aged female who developed an aggressive form of biopsy-proven metastatic Crohn's disease involving the inguinal, perineal and submammary areas. Her condition had been unresponsive to topical and systemic corticosteroids, antibiotics, immunosuppressives, and repeated surgical debridement. Administration of infliximab resulted in a rapid clinical response with subjective improvements in pain and general well-being, and an objective decline in exudate, erythema and size of the lesions. Infliximab may be a suitable therapeutic option in patients with metastatic Crohn's disease. [source] Use of topical misoprostol to reduce radiation-induced mucositis: Results of a randomized, double-blind, placebo-controlled trialJOURNAL OF MEDICAL IMAGING AND RADIATION ONCOLOGY, Issue 5 2006MJ Veness Summary Radiation-induced mucositis is an acute reaction of the mucosa of patients undergoing head and neck radiotherapy. It can have debilitating and dose-limiting consequences. There is no consensus on an accepted intervention that significantly reduces its severity. Misoprostol is a synthetic prostaglandin E1 analogue, with properties of a mucosal cytoprotectant. We designed a randomized, double-blind, placebo-controlled trial of misoprostol in patients with head and neck cancer. The aim of this study was to determine if topical misoprostol was effective in reducing the severity of radiation-induced mucositis in patients receiving radical dose radiotherapy. The effect of this intervention on a patient's general well-being was also investigated. The primary end-point of the study was the incidence of Radiation Therapy Oncology Group grade 3 mucositis. Between 1999 and 2002, 83 patients were recruited into the study at Westmead and Nepean Hospitals, Sydney. Forty-two patients were randomized to receive misoprostol and 41 to receive a placebo. Most patients received radiotherapy in the adjuvant setting (52 of the 83) and had either an oral cavity (42 of the 83) or an oropharyngeal (16 of the 83) cancer. We could not identify any significant difference in the incidence of severe mucositis based on whether patients were allocated to receive misoprostol or placebo. There was no significant difference in the mean area under the mucositis curve (13.2 vs 16.6; P = 0.1). Patients allocated to misoprostol did report slightly increased soreness (7.6 vs 6.9; P = 0.04) and a greater use of analgesics. However, this difference did not translate into a worse feeling of general well-being as measured by a simple visual analogue scale (5.8 vs 5.2; P = 0.3). In conclusion, we were unable to identify a reduction in radiation-induced mucositis in patients receiving misoprostol. There is a paucity of high-level evidence on potentially useful interventions and a continued need for new and innovative research, incorporating quality-of-life measurements, in patients experiencing radiation-induced mucositis. [source] Disturbances in melatonin and core body temperature circadian rhythms after minimal invasive surgeryACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 8 2007I. Gögenur Background:, Sleep disturbances, fatigue and reduced general well-being frequently occur after minimal invasive surgery. The circadian rhythms of melatonin and core body temperature are central to the regulation of normal sleep. The aim of this study was to assess changes in these circadian rhythms after laparoscopic cholecystectomy. Methods:, Twelve women were studied before and after laparoscopic cholecystectomy. The major urinary melatonin metabolite, 6-sulphatoxymelatonin (aMT6s), and the core body temperature were measured for 1 day before and 1 day after surgery. The basal and maximum secretion of aMT6s were determined, as well as the timing and amplitude of aMT6s and the temperature rhythm. The patients' rest,activity and calculated sleep parameters were assessed by actigraphy. Results:, A significant delay in the timing of aMT6s rhythm was observed after surgery [median (range) peak time of aMT6s: after surgery, 05:49 h (02:57,08:23 h); before surgery, 04:32 h (02:18,06:49 h); P, 0.05]. The amplitude of the aMT6s rhythm was also significantly decreased after surgery [after surgery, 7.1 ng aMT6s/mg creatinine (1,15.9 ng); before surgery, 13.2 ng aMT6s/mg creatinine (2.9,22.7 ng); P, 0.005]. There was almost a12-h phase delay of the core body temperature rhythm after surgery [peak time: before surgery, 17:39 h (15:17,22:06 h); after surgery, 05:14 h (03:24,21:43 h); P, 0.01]. Conclusions:, Following laparoscopic cholecystectomy, there was a delay in the timing of the aMT6s rhythm and a decreased evening decline in the temperature rhythm. [source] Changes in quality of life and sexual health are associated with low-dose peginterferon therapy and disease progression in patients with chronic hepatitis CALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 7 2010K. K. SNOW Aliment Pharmacol Ther,31, 719,734 Summary Background, Primary analysis of the Hepatitis C Antiviral Long-Term Treatment against Cirrhosis (HALT-C) Trial showed long-term peginterferon therapy did not reduce complications in patients with chronic hepatitis C and advanced fibrosis or cirrhosis. Aim, To assess the effects of long-term peginterferon therapy and disease progression on health-related quality of life (HRQOL), symptoms and sexual health in HALT-C patients. Methods, A total of 517 HALT-C patients received peginterferon alfa-2a (90 ,g/week); 532 received no additional treatment for 3.5 years. Patients were followed up for outcomes of death, hepatocellular carcinoma and hepatic decompensation. Sexual health, SF-36 scores and symptoms were serially assessed by repeated-measures analyses of covariance. Results, Patients with cirrhosis (n = 427) reported lower general well-being and more fatigue (P < 0.001) than patients with fibrosis (n = 622). Physical scores declined significantly over time, independent of treatment, and patients with cirrhosis reported lower scores. Vitality scores were lower in those with cirrhosis, and treated patients experienced a greater decline over time than untreated patients; HRQOL rebounded after treatment ended. Patients with a clinical outcome had significantly greater declines in all SF-36 and symptom scores. Among men, Sexual Health scores were significantly worse in treated patients and in those with a clinical outcome. Conclusion, Clinical progression of chronic hepatitis C and maintenance peginterferon therapy led to worsening of symptoms, HRQOL and, in men, sexual health in a large patient cohort followed up over 4 years (NCT00006164). [source] Effect of mesalazine on mucosal immune biomarkers in irritable bowel syndrome: a randomized controlled proof-of-concept studyALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 3 2009R. CORINALDESI Summary Background, Intestinal immune infiltration contributes to symptoms in patients with irritable bowel syndrome (IBS). Aim, To assesses the effect of mesalazine (mesalamine) on mucosal immune cells in patients with IBS, through a pilot study. Methods, A randomized, double-blind, placebo-controlled trial in 20 patients with IBS in tertiary care setting. Patients were randomized to receive placebo or 800 mg mesalazine three times daily for 8 weeks. The primary endpoint was a significant reduction in total colonic immune cells on biopsies obtained at the end of treatment compared to baseline. Secondary endpoints included effects on subsets of immune cells, inflammatory mediators and symptom severity. Intention-to-treat analysis was performed. Results, Mesalazine markedly reduced immune cells as compared with placebo (P = 0.0082); this effect was ascribed to a marked inhibition of mast cells (P = 0.0014). Mesalazine significantly increased general well-being (P = 0.038), but had no significant effects on abdominal pain (P = 0.084), bloating (P = 0.177) or bowel habits. No serious drug-related adverse events were reported during the study. Conclusions, Mesalazine is an effective and safe approach to reduce mast cell infiltration and may improve general well-being in patients with IBS. These results support the hypothesis that immune mechanisms represent potential therapeutic targets in IBS. [source] Clinical trial: B vitamins improve health in patients with coeliac disease living on a gluten-free dietALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 8 2009C. HALLERT Summary Background, Patients with coeliac disease living on a gluten-free diet show vitamin deficiency and reduced subjective health status. Aim, To study the biochemical and clinical effects of B vitamin supplementation in adults with longstanding coeliac disease. Methods, In a double blind placebo controlled multicentre trial, 65 coeliac patients (61% women) aged 45,64 years on a strict gluten-free diet for several years were randomized to a daily dose of 0.8 mg folic acid,0.5 mg cyanocobalamin and 3 mg pyridoxine or placebo for 6 months. The outcome measures were psychological general well-being (PGWB) and the plasma total homocysteine (tHcy) level, marker of B vitamin status. Results, Fifty-seven patients (88%) completed the trial. The tHcy level was baseline median 11.7 ,mol/L (7.4,23.0), significantly higher than in matched population controls [10.2 ,mol/L (6.7,22.6) (P < 0.01)]. Following vitamin supplementation, tHcy dropped a median of 34% (P < 0.001), accompanied by significant improvement in well-being (P < 0.01), notably Anxiety (P < 0.05) and Depressed Mood (P < 0.05) for patients with poor well-being. Conclusions, Adults with longstanding coeliac disease taking extra B vitamins for 6 months showed normalized tHcy and significant improvement in general well-being, suggesting that B vitamins should be considered in people advised to follow a gluten-free diet. [source] Conservation of the Eurasian beaver Castor fiber: an olfactory perspectiveMAMMAL REVIEW, Issue 4 2010Róisín CAMPBELL-PALMER ABSTRACT 1Chemical communication in mammals includes an array of specific behaviours that are often ignored in terms of their potential relevance to conservation. Often used during territorial or social interactions between animals, chemical communication can also be used as a tool in reintroduction programmes. Reintroductions still exhibit high failure rates and methods to improve success should be investigated. The Eurasian beaver Castor fiber has been widely reintroduced across Europe after its near extinction in the 19th century. 2Using olfactory studies in the beaver, we aim to demonstrate how scent transfers a range of information about the sender which can be used to monitor social and territorial behaviour along with general well-being. Scent manipulation can be used to reduce human,beaver conflicts, and aid reintroduction success through reducing stress and territorial conflicts, and by influencing dispersal and settlement. 3Two species of beavers, the Eurasian beaver and the North American beaver Castor canadensis, occupy freshwater habitats throughout North America and in parts of South America, most of Europe and parts of Asia. Most of the reviewed literature concerns the wild Eurasian beaver, its chemical communication and conservation; however, captive studies and those addressing North American beavers are also included. 4Chemical communication is advanced and has been well documented in this highly territorial species. However, few studies directly link olfaction with conservation practices. 5Olfactory studies in beavers can provide non-invasive methods to monitor translocated animals and indicators of health. We conclude that chemical analysis, olfactory studies and behavioural manipulations involving semiochemicals have important impacts on conservation and can generate practical solutions to conservation problems including aiding animal capture, captive stress reduction, breeding pair formation and release site fidelity. [source] Outcomes generated by patients with rheumatoid arthritis: how important are they?MUSCULOSKELETAL CARE, Issue 3 2005Sarah Hewlett PhD MA RGN Arc Senior Lecturer Abstract Background: It has been shown previously that patients with rheumatoid arthritis (RA) can generate a wide range of outcomes that they consider important in treatment. It is not known if these outcomes are generally important in the wider RA patient community. Objectives: (1) To examine whether recent patient-generated outcomes are generalizable within a wider RA population; (2) to assess the relative importance of each outcome; and(3) to explore whether any important outcomes have been omitted. Methods: A questionnaire, listing 23 outcomes previously generated by RA patients, was distributed through three rheumatology centres in the UK. Patients gave an importance score to each outcome (0,3), selected their top three most important outcomes, and then listed any outcomes of personal importance that were missing. Results: 323 questionnaires were returned (65%). All outcomes were deemed important. Independence, pain, and mobility were most frequently selected by patients in their top three outcomes but were not chosen by 61,66% of patients. The next most commonly chosen outcomes related to feeling well and fatigue. Factor analysis revealed six reasonably distinct groupings: general well-being (11.9% explained variance), day-to-day functioning(10.6%), emotional and psychological well-being (10.6%), social role and confidence (10%), physical symptoms (9.5%) and medication issues (7.9%). Conclusion: Outcomes generated by patients as important in RA, are generalizable and inclusive. The most important (independence, pain and mobility) are routinely treated and measured. The next most important (feeling well, fatigue) are infrequently addressed and deserve urgent consideration for measurement, treatment and research. Copyright © 2005 John Wiley & Sons, Ltd. [source] Diabetes and complementary therapies: mapping the evidencePRACTICAL DIABETES INTERNATIONAL (INCORPORATING CARDIABETES), Issue 7 2007K Pilkington MSc, MRPharmS Senior Research Fellow Abstract Complementary therapies are widely used by people with diabetes for the condition itself, for diabetes-related complications or for non-diabetes related problems. The aim of this review is to summarise the current research evidence on complementary therapies in the management of diabetes and resulting complications. The review draws primarily on systematic reviews conducted as part of the CAMEOL project (www.rccm.org.uk/cameol), included in the Cochrane Library or on the National Library for Health Complementary and Alternative Medicine Specialist Library (www.library.nhs.uk/cam). Searches were also carried out for studies published subsequently or on other therapies to provide an indication of overall research activity. Systematic reviews were found or conducted on a range of herbs, dietary supplements, massage, acupuncture, homoeopathy, hypnotherapy, meditation, reflexology and yoga. Individual studies were located on several other therapies. Studies addressed metabolic control, general well-being and complications. Herbs and dietary supplements continue to be the main focus of research activity. Acupuncture trials are also numerous but almost exclusively conducted in China using traditional approaches. For most other therapies, research evidence is limited by extent or quality. Overall, limited data from well-designed randomised controlled trials are available and results are difficult to translate into clinical practice. Based on promising findings, several herbs, dietary supplements, exercise or body-based therapies and acupuncture require further investigation. For most therapies, well-designed robust studies replicating small preliminary studies are required to support those involved in diabetes care in providing evidence-based advice on the safe and effective use of complementary therapies. Copyright © 2007 John Wiley & Sons. [source] QUALITY-OF-LIFE EFFECT OF TONSILLECTOMY IN A YOUNG ADULT GROUPANZ JOURNAL OF SURGERY, Issue 11 2007Amanda L. Richards Background: To examine the quality of life after tonsillectomy in a young adult group with chronic or recurrent tonsillitis. Methods: Retrospective survey of patients aged 15,25 years who underwent tonsillectomy for chronic or recurrent tonsillitis in 2002 or 2003. The Glasgow Benefit Inventory was mailed to patients who were selected from two private general otolaryngology practices. Results: Participants had an overall benefit from the procedure as well as improvement in their general well-being and physical health. A benefit in social function was not imparted. Conclusion: Tonsillectomy in a young adult group results in significant improvement in overall quality of life, physical health and general well-being. [source] Influence of local geomagnetic storms on arterial blood pressureBIOELECTROMAGNETICS, Issue 6 2004S. Dimitrova Abstract This study attempts to assess the influence of local geomagnetic storms at middle latitudes on some human physiological parameters. The blood pressure (bp), heart rate and general well-being of 86 volunteers were measured, the latter by means of a standardised questionnaire, on work days in autumn, 2001 (1 Oct to 9 Nov), and in spring, 2002 (8 April to 28 May). These timespans were chosen as periods of maximal expected geomagnetic activity (GMA). Altogether, 2799 recordings were obtained and analysed. A four factor analysis of variance (MANOVA) was employed to check the significance of the influence of four factors (local GMA level; sequence of the days of measurements covering up to 3 days before and after geomagnetic storms; sex and the presence of medication) on the physiological parameters under consideration. Post hoc analysis was performed to elicit the significance of differences in the factors' levels. Arterial bp was found to increase with the increase of the GMA level, and systolic and diastolic bp were found to increase significantly from the day before till the second day after the geomagnetic storm. These effects were present irrespective of sex and medication. Bioelectromagnetics 25:408,414, 2004. © 2004 Wiley-Liss, Inc. [source] High suicidal ideation in persons testing for Huntington's diseaseACTA NEUROLOGICA SCANDINAVICA, Issue 3 2000T-B. Robins Wahlin This study examined the first participants who registered for the Huntington's disease predictive testing program 1990,1995 in Stockholm, Sweden. A psychosocial investigation was performed to evaluate potential effects of the presymptomatic testing. The results showed no significant differences between 13 genecarriers and 21 noncarriers in pretest attitudes, expectations, general well-being, life satisfaction and lifestyle, the need for support, estimated sense of well-being or degree of health. However, both groups showed high suicidal ideation and self-injurious behavior. Noncarriers had a very high frequency of attempted suicide, and both groups had similarly pronounced psychiatric dysfunction. Their relatives also had high frequencies of psychiatric diseases, suicide or suicidal attempts. Most of the participants had a desire to meet a psychologist or a social worker. The need for counseling, using a well designed protocol, and the importance of focusing on suicide risk of participants in predictive testing programs is emphasized. [source] Quality of life in allergic rhinitisCLINICAL & EXPERIMENTAL ALLERGY REVIEWS, Issue 3 2006G. Passalacqua Summary Quality of life (QoL)or, better, health-related quality of life, is now recognized as a crucial aspect in assessing the impact of a given disease on the general well-being of patients. This fact was ascertained in the last 10 years also for respiratory allergy (asthma and rhinitis). In particular, it was shown that allergic rhinitis (AR), although not life threatening, profoundly affects many aspects of everyday life. In this regard, a number of specific questionnaires (instruments) have been developed and validated to assess the quality of life in adults, adolescents and children. Although the concept of QoL is easy to understand, the development and validation process of questionnaires is quite complex and time consuming. The literature provided strong evidence of the effects of AR and its treatments on QoL, but also evidenced some controversial points, including the weak correlation of QoL with objective parameters. It has therefore become clear that QoL questionnaires measure aspects of the disease that partially differ from the routinely evaluated parameters and that quality of life should integrate, not replace, the objective measurements. In the near future, ,sharper' instruments are expected to be developed for the evaluation of quality of life and of the effects of treatments in AR. [source] | |||||||||||||||||||||||||||||||