Health-related quality of life in patients with prostate cancer and their spouses : Results from a longitudinal study

Purpose: The purpose of this study was to explore changes in HRQoL (health-related quality of life) and identify the associated factors in patients with prostate cancer and their spouses during the year following their diagnosis of prostate cancer. Methods: The longitudinal study design consisted of 179 patients and 166 spouses, using discretionary sampling, at five Finnish central hospitals. Participants completed a self-reported RAND-36-Item Health Survey at three time-points: time of diagnosis and 6 and 12 months later. Changes in HRQoL were analysed using descriptive statistics and non-parametric tests. Linear mixed-effects models were used to identify the factors associated with the changes in HRQoL in the patients and their spouses. Results: On average, the HRQoL of patients with prostate cancer changed in physical functioning (p = 0.015), emotional well-being (p = 0.029) and general health (p = 0.038) were statistically significant over the 12 month study period. In spouses, statistically significant changes in HRQoL were not observed. Interaction between the age of participants and changes in HRQoL were statistically significant. Conclusions: Findings in this study suggest that interventions aimed at improving the HRQoL of patients should support a few different dimensions of HRQoL for the patients themselves than for their spouses. Nurses should pay more attention to elderly couples.Peer reviewe

The marital relationship and health-related quality of life of prostate cancer patients and their spouses : A prospective, longitudinal study

Aims This study aims to measure any changes in the marital relationship during the first year after a diagnosis of prostate cancer, identify the demographic characteristics that influenced such changes, and measure changes related to health-related quality of life (HRQoL). Background Knowledge is limited on the impact of a diagnosis of prostate cancer on the marital relationship and HRQoL of patients and their spouses. Design A 1-year longitudinal study. Methods Data were collected from five Finnish hospitals between October 2013 and January 2017. Of the 350 recruited couples (N = 700), 179 patients and 166 spouses completed the Marital Questionnaire and the RAND 36-Item Health Survey 1 year after diagnosis. Results No major changes were found in the marital relationship during the follow-up period. The spouses reported statistically significant changes in their marital relationships, but the patients did not. Furthermore, changes in the marital relationship were not associated with the patients' HRQoL. Among spouses, emotional well-being was associated with changes in the marital relationship. Conclusion The marital relationship was relevant in terms of the spouses' HRQoL during the first year after a diagnosis of prostate cancer. Nurses and other healthcare providers should assess counselling and support provided to spouses individually.Peer reviewe

Women’s Perceptions of Caesarean Birth: A Roy International Study

The purpose of this Roy adaptation model-based multi-site international mixed method study was to examine the relations of type of caesarean birth (unplanned/planned), number of caesarean births (primary/repeat), and preparation for caesarean birth to women’s perceptions of and responses to caesarean birth. The sample included 488 women from the United States (n = 253), Finland (n = 213), and Australia (n = 22). Path analysis revealed direct effects for type of and preparation for caesarean birth on responses to caesarean birth, and an indirect effect for preparation on responses to caesarean birth through perception of birth the experience

米国における気候変動政策 : 米国および日韓の地球環境政策ネットワーク調査からの考察 (特集 地球環境政治と市民社会)

近年政治学では政策決定過程に及ぼすネットワークの役割に関心が集っている。本稿は米国環境政策ネットワーク調査を日韓の同調査と比較し、米国の特性を浮き彫りにする。これは広範な政策ネットワークの構造と機能を国際比較する白米独韓調査計画の中間報告である

Periodontal disease and bacterial vaginosis increase the risk for adverse pregnancy outcome.

OBJECTIVES: To determine whether periodontal disease or bacterial vaginosis (BV) diagnosed before pregnancy increase the risk for adverse pregnancy outcome. METHODS: We enrolled a total of 252 women who had discontinued contraception in order to become pregnant. The first 130 pregnant women were included in the analyses. RESULTS: Multivariate analysis showed a strong association between periodontal disease and adverse pregnancy outcome (OR 5.5, 95% confidence interval 1.4-21.2; p = 0.014), and a borderline association between BV and adverse pregnancy outcome (OR 3.2, 95% confidence interval 0.9-10.7; p = 0.061). CONCLUSION: Our study suggests that pre-pregnancy counseling should include both oral and vaginal examinations to rule out periodontal disease and BV. This may ultimately have an impact on antenatal healthcare, and decrease the risk for adverse pregnancy outcome

Draama-intervention vaikutus 4.- ja 5.-luokkalaisten oppilaiden sosiaaliseen kompetenssiin

Tutkimushankkeen tarkoituksena oli kehittää ja toteuttaa draamamenetelmiin pohjautuva ohjelma, joka tukee lasten sosio-emotionaalista hyvinvointia. Tässä artikkelissa kuvataan opettajien arvioita 4. ja 5. luokan oppilaiden sosiaalisesta kompetenssista ennen draamaohjelmaa ja sen jälkeen lukuvuonna 2007 – 2008. Tutkimus toteutettiin kontrolloituna pitkittäistutkimuksena, jonka aineisto kerättiin kyselylomakkeella. Vastausprosentti oli 71. Tyttöjen ja poikien sosiaaliset taidot olivat samansuuntaisia, mutta pojilla esiintyi antisosiaalista käyttäytymistä merkittävästi enemmän kuin tytöillä (p < 0.01). Draamaohjelmaan osallistuneiden oppilaiden (n = 78) sosiaaliset taidot paranivat, kun ne verrokeilla (n = 56) puolestaan heikkenivät (MANOVA, p = 0.04). Oppilaiden antisosiaalinen käyttäytyminen pysyi harvinaisena ohjelmaan osallistuneiden kohdalla lukuvuoden aikana, mutta verrokkiryhmässä antisosiaalinen käyttäytyminen lisääntyi (MANOVA, p < 0.001). Tulokset antavat viitteitä siitä, että draaman avulla on mahdollista vahvistaa oppilaiden sosiaalista kompetenssia, erityisesti empatiakykyä

Neurological symptoms and natural course of xeroderma pigmentosum

We have prospectively followed 16 Finnish xeroderma pigmentosum (XP) patients for up to 23 years. Seven patients were assigned by complementation analysis to the group XP-A, two patients to the XP-C group and one patient to the XP-G group. Six of the seven XP-A patients had the identical mutation (Arg228Ter) and the seventh patient had a different mutation (G283A). Further patients were assigned to complementation groups on the basis of their consanguinity to an XP patient with a known complementation group. The first sign of the disease in all the cases was severe sunburn with minimal sun exposure in early infancy. However, at the time the diagnosis was made in only two cases. The XP-A patients developed neurological and cognitive dysfunction in childhood. The neurological disease advanced in an orderly fashion through its successive stages, finally affecting the whole nervous system and leading to death before the age of 40 years. Dermatological and ocular damage of the XP-A patients tended to be limited. The two XP-C patients were neurologically and cognitively intact despite mild brain atrophy as seen by neuroimaging. The XP-G patients had sensorineural hearing loss, laryngeal dystonia and peripheral neuropathy. The XP-C patients had severe skin and ocular malignancies that first presented at pre-school age. They also showed immunosuppression in cell-mediated immunity. Neurological disease appears to be associated with the complementation group and the failure of fibroblasts to recover RNA synthesis following UV irradiation, but not necessarily to the severity of the dermatological symptoms, the hypersensitivity of fibroblasts to UVB killing or the susceptibility of keratinocytes to UVB-induced apoptosis

GWAS meta-analysis of over 29,000 people with epilepsy identifies 26 risk loci and subtype-specific genetic architecture

Epilepsy is a highly heritable disorder affecting over 50 million people worldwide, of which about one-third are resistant to current treatments. Here we report a multi-ancestry genome-wide association study including 29,944 cases, stratified into three broad categories and seven subtypes of epilepsy, and 52,538 controls. We identify 26 genome-wide significant loci, 19 of which are specific to genetic generalized epilepsy (GGE). We implicate 29 likely causal genes underlying these 26 loci. SNP-based heritability analyses show that common variants explain between 39.6% and 90% of genetic risk for GGE and its subtypes. Subtype analysis revealed markedly different genetic architectures between focal and generalized epilepsies. Gene-set analyses of GGE signals implicate synaptic processes in both excitatory and inhibitory neurons in the brain. Prioritized candidate genes overlap with monogenic epilepsy genes and with targets of current antiseizure medications. Finally, we leverage our results to identify alternate drugs with predicted efficacy if repurposed for epilepsy treatment

Asiakkaiden ja heidän läheistensä kokemukset kotihoidosta

Tutkimuksen tarkoituksena on kuvata kotihoidon asiakkaiden ja heidän läheistensä kokemuksia kotihoidosta. Iäkäs, säännöllisen kotihoidon asiakas vastasi yhdessä läheisensä kanssa lomakekyselyyn, joka sisälsi perhehoitotyö -mittarin sekä avoimen kysymyksen, jossa pyydettiin kuvaamaan kokemuksia kotihoidosta. Tässä artikkelissa kuvataan avoimen kysymyksen aineisto, joka koostuu 50 vastauksesta.Aineisto analysointiin induktiivisella sisällönanalyysillä. Kokemukset kotihoidon palveluista muodostuivat palveluiden organisoinnista, kotikäyntien ajoittamisesta sekä kokemuksista palvelujärjestelmään liittyen. Asiakkaiden ja läheisten kokemus hoitajan toiminnasta muodostui vuorovaikutuksesta, hoitajien ammatillisuudesta, omahoitajan merkityksestä, asiakkaan avuntarpeisiin vastaavan tuen saamisesta sekä läheisten ja kotihoidon yhteistyöstä. Kotihoidossa tulee edelleen kehittää asiakkaan kohtaamista, yhteistyötä, asiakkaan yksilöllistä ja avun tarpeisiin vastaavaa hoitoa sekä omahoitajuutta