12 research outputs found

    Predictors of increasing disability in activities of daily living among people with advanced respiratory disease: a multi-site prospective cohort study, England UK

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    Disability in activities of daily living (ADL) is a common unmet need among people with advanced respiratory disease. Rehabilitation could help prolong independence, but indicators for timely intervention in this population are lacking. This study aimed to identify trajectories of disability in ADLs over time, and predicting factors, in advanced respiratory disease. Multi-site prospective cohort study in people with advanced non-small cell lung cancer (NSCLC), chronic obstructive pulmonary disease (COPD) or interstitial lung disease (ILD), recruited from hospital or community services, throughout England. Disability in basic (Barthel Index) and instrumental (Lawton–Brody IADL Scale) ADLs were assessed monthly over six months. Visual graphical analysis determined individual trajectories. Multivariate logistic regression examined predictors of increasing disability in basic and instrumental ADLs. Between March 2020 and January 2021, we recruited participants with a diagnosis of NSCLC (n = 110), COPD (n = 72), and ILD (n = 19). 151 participants completed ≥3 timepoints and were included in the longitudinal analysis. Mobility limitation was an independent predictor of increasing disability in instrumental ADLs (odds ratio, 1⋅41 [CI: 1⋅14–1⋅74], p = 0⋅002). Mobility limitation could be used as a simple referral criterion across people with advanced respiratory disease to ensure timely rehabilitation that targets independence in ADLs. To our knowledge this is the first prospective cohort study of trajectories of disability in activities of daily living (ADL) in advanced respiratory disease, including recruitment during the Covid-19 pandemic.It adds to existing evidence by identifying individual variability in trajectories of ADL disability which are undetected at group level.The identification of mobility limitation as a predictor of increasing ADL disability, while controlling for malignant or non-malignant respiratory disease, is novel and has practical utility.Our findings have implications for clinical care, as early identification of functional decline through use of mobility limitation tools could flag early referral to rehabilitation services, potentially preventing or delaying forthcoming functional decline and avoiding reactive crisis management.Mobility limitation is a predictor of increasing disability in activities of daily living in advanced disease, which could be used to flag early referral to rehabilitation services, to help prevent or delay forthcoming functional decline and avoid reactive crisis management To our knowledge this is the first prospective cohort study of trajectories of disability in activities of daily living (ADL) in advanced respiratory disease, including recruitment during the Covid-19 pandemic. It adds to existing evidence by identifying individual variability in trajectories of ADL disability which are undetected at group level. The identification of mobility limitation as a predictor of increasing ADL disability, while controlling for malignant or non-malignant respiratory disease, is novel and has practical utility. Our findings have implications for clinical care, as early identification of functional decline through use of mobility limitation tools could flag early referral to rehabilitation services, potentially preventing or delaying forthcoming functional decline and avoiding reactive crisis management. Mobility limitation is a predictor of increasing disability in activities of daily living in advanced disease, which could be used to flag early referral to rehabilitation services, to help prevent or delay forthcoming functional decline and avoid reactive crisis management</p

    Additional file 1: of Social and clinical determinants of preferences and their achievement at the end of life: prospective cohort study of older adults receiving palliative care in three countries

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    Copy of the questionnaire. Questionnaire used in the study for IARE project. Note this is British version of the questionnaire. There were minor amendments to some introductory text in USA and Dublin (e.g. opening explanation), to comply with local requirements, but the questions remained the same. (PDF 477 kb

    Endometriosis and its influence on woman's life

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    This work is about gynecological disease, whose incidence is evergrowing, end metriosis. Endometriosis is in itself a very controversial disease, which is sign ificant intervening into life of a woman. Endometriosis is a common gynecological di sorder affecting fertile female population. It is the disease, that is presented by functional endometrial glandules and stroma outside their usuallocality within uterus (womb). General symptoms are pain and infertility. The diagnostic key is the cyclic character of symptom s and laparoscopy - histology testification presence of lesions. Tbe surgical treatment of endometriosis is considered as a golden standard of the therapy. My aim of this work is to have look up to aH sections of the disease. At the same time my work covers survey. I detected prospective abnormalities with theoretic knowledges via fonns distributed to patients with endometriosis. The fonn appraised frequen y oĹĄ symptoms in patiens. It presents the most frequent age group of disabled women as well. Fonns a1so outline dilernma of arguments about character of creation and it observes problems of indisposed women and possibility oftheir naturally gravidity. It also deals of possibilities of available therapy and its use in patients. ln no little importance my work adverts to next facts des rving next..
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