Impact of age and comorbidities on health-related quality of life for patients with prostate cancer: evaluation before a curative treatment

<p>Abstract</p> <p>Background</p> <p>Interpretation of comparative health-related quality of life (HRQOL) studies following different prostate cancer treatments is often difficult due to differing patient ages. Furthermore, age-related changes can hardly be discriminated from therapy-related changes. The evaluation of age-and comorbidity-related changes was in focus of this study.</p> <p>Methods</p> <p>HRQOL of 528 prostate cancer patients was analysed using a validated questionnaire (Expanded Prostate Cancer Index Composite) before a curative treatment. Patients were divided into age groups ≤65, 6670, 7175 and >75 years. The impact of specific comorbidities and the Charlson Comorbidity Index (CCI) were evaluated. The questionnaire comprises 50 items concerning the urinary, bowel, sexual and hormonal domains for function and bother. For assessment of sexual and hormonal domains, only patients without prior hormonal treatment were included (n = 336).</p> <p>Results</p> <p>Urinary incontinence was observed increasingly with higher age (mean function scores of 92/88/85/87 for patients ≤65, 6670, 7175 and >75 years) complete urinary control in 78%/72%/64%/58% (p < 0.01). Sexual function scores decreased particularly (48/43/35/30), with erections sufficient for intercourse in 68%/50%/36%/32% (p < 0.01) a decrease of more than a third comparing patients ≤65 vs. 6670 (36%) and 6670 vs. 7175 years (39%). The percentage of patients with comorbidities was lowest in the youngest group (48% vs. 66%/68%/63% for ages 6670/7175/>75 years; p < 0.05). A multivariate analysis revealed an independent influence of both age and comorbidities on urinary incontinence, specifically diabetes on urinary bother, and both age and diabetes on sexual function/bother. Rectal domain scores were not significantly influenced by age or comorbidities. A CCI>5 particularly predisposed for lower urinary and sexual HRQOL scores.</p> <p>Conclusion</p> <p>Urinary continence and sexual function are the crucial HRQOL domains with age-related and independently comorbidity-related decreasing scores. The results need to be considered for the interpretation of comparative studies or longitudinal changes after a curative treatment.</p

Personality psychology: Lexical approaches, assessment methods, and trait concepts reveal only half of the story—Why it is time for a paradigm shift

This article develops a comprehensive philosophy-of-science for personality psychology that goes far beyond the scope of the lexical approaches, assessment methods, and trait concepts that currently prevail. One of the field’s most important guiding scientific assumptions, the lexical hypothesis, is analysed from meta-theoretical viewpoints to reveal that it explicitly describes two sets of phenomena that must be clearly differentiated: 1) lexical repertoires and the representations that they encode and 2) the kinds of phenomena that are represented. Thus far, personality psychologists largely explored only the former, but have seriously neglected studying the latter. Meta-theoretical analyses of these different kinds of phenomena and their distinct natures, commonalities, differences, and interrelations reveal that personality psychology’s focus on lexical approaches, assessment methods, and trait concepts entails a) erroneous meta-theoretical assumptions about what the phenomena being studied actually are, and thus how they can be analysed and interpreted, b) that contemporary personality psychology is largely based on everyday psychological knowledge, and c) a fundamental circularity in the scientific explanations used in trait psychology. These findings seriously challenge the widespread assumptions about the causal and universal status of the phenomena described by prominent personality models. The current state of knowledge about the lexical hypothesis is reviewed, and implications for personality psychology are discussed. Ten desiderata for future research are outlined to overcome the current paradigmatic fixations that are substantially hampering intellectual innovation and progress in the field

Long-term yield trend and sustainability of rainfed soybean–wheatsystem through farmyard manure application in a sandy loam soil of the Indian Himalayas

A long-term (30 years) soybean–wheat experiment was conducted at Hawalbagh, Almora, India to study the effects of organic and inorganic sources of nutrients on grain yield trends of rainfed soybean (Glycine max)–wheat (Triticum aestivum) system and nutrient status (soil C, N, P and K) in a sandy loam soil (Typic Haplaquept). The unfertilized plot supported 0.56 Mg ha−1 of soybean yield and 0.71 Mg ha−1 of wheat yield (average yield of 30 years). Soybean responded to inorganic NPK application and the yield increased significantly to 0.87 Mg ha−1 with NPK. Maximum yields of soybean (2.84 Mg ha−1) and residual wheat (1.88 Mg ha−1) were obtained in the plots under NPK + farmyard manure (FYM) treatment, which were significantly higher than yields observed under other treatments. Soybean yields in the plots under the unfertilized and the inorganic fertilizer treatments decreased with time, whereas yields increased significantly in the plots under N + FYM and NPK + FYM treatments. At the end of 30 years, total soil organic C (SOC) and total N concentrations increased in all the treatments. Soils under NPK + FYM-treated plots contained higher SOC and total N by 89 and 58% in the 0–45 cm soil layer, respectively, over that of the initial status. Hence, the decline in yields might be due to decline in available P and K status of soil. Combined use of NPK and FYM increased SOC, oxidizable SOC, total N, total P, Olsen P, and ammonium acetate exchangeable K by 37.8, 42.0, 20.8, 30.2, 25.0, and 52.7%, respectively, at 0–45 cm soil layer compared to application of NPK through inorganic fertilizers. However,the soil profiles under all the treatments had a net loss of nonexchangeable K, ranging from 172 kg ha−1 under treatment NK to a maximum of 960 kg ha−1 under NPK + FYM after 30 years of cropping. Depletion of available P and K might have contributed to the soybean yield decline in treatments where manure was not applied. The study also showed that although the combined NPK and FYM application sustained long-term productivity of the soybean– wheat system, increased K input is required to maintain soil nonexchangeable K level