scholarly journals Setting priorities fairly in response to Covid-19: identifying overlapping consensus and reasonable disagreement

2020 ◽  
Vol 7 (1) ◽  
Author(s):  
David Wasserman ◽  
Govind Persad ◽  
Joseph Millum
Keyword(s):  
Quality Of Life ◽  
Life Expectancy ◽  
Priority Setting ◽  
Clinical Ethics ◽  
Overlapping Consensus ◽  
Reasonable Disagreement ◽  
The Face ◽  
The Difference ◽  
Role Based

Abstract Proposals for allocating scarce lifesaving resources in the face of the Covid-19 pandemic have aligned in some ways and conflicted in others. This paper attempts a kind of priority setting in addressing these conflicts. In the first part, we identify points on which we do not believe that reasonable people should differ—even if they do. These are (i) the inadequacy of traditional clinical ethics to address priority-setting in a pandemic; (ii) the relevance of saving lives; (iii) the flaws of first-come, first-served allocation; (iv) the relevance of post-episode survival; (v) the difference between age and other factors that affect life-expectancy; and (vi) the need to avoid quality-of-life judgments. In the second part, we lay out some positions on which reasonable people can and do differ. These include (i) conflicts between maximizing benefits and priority to the worst off; (ii) role-based priority; and (iii) whether patients’ existing lifesaving resources should be subject to redistribution.

scholarly journals The Changing Face of Cystic Fibrosis and Its Implications for Screening

2020 ◽  
Vol 6 (3) ◽  
pp. 54 ◽  
Author(s):  
Lutz Naehrlich
Keyword(s):  
Quality Of Life ◽  
Cystic Fibrosis ◽  
Life Expectancy ◽  
Early Diagnosis ◽  
Newborn Screening ◽  
Treatment Options ◽  
Preventive Treatment ◽  
Multidisciplinary Care ◽  
The Face

Early diagnosis, multidisciplinary care, and optimized and preventive treatments have changed the face of cystic fibrosis. Life expectancy has been expanded in the last decades. Formerly a pediatric disease, cystic fibrosis has reached adulthood. Mutation-specific treatments will expand treatment options and give hope for further improvement of quality of life and life expectancy. Newborn screening for CF fits perfectly into these care structures and offers the possibility of preventive treatment even before symptoms occur. Especially in countries without screening, newborn screening will fulfill that promise only with increased awareness and new care structures.

scholarly journals Evaluation of platelet-rich plasma on infraorbital dark circles by using the FACE-Q scales

2019 ◽  
Vol 5 (2) ◽  
pp. 224
Author(s):  
Kadri Ozer ◽  
Ozlem Colak
Keyword(s):  
Quality Of Life ◽  
Platelet Rich Plasma ◽  
Patient Reported Outcome ◽  
Psychological Function ◽  
Outcome Instrument ◽  
Post Procedure ◽  
Patient Reported ◽  
The Face ◽  
The Difference

<p class="abstract"><strong>Background:</strong> Infraorbital dark circles, also referred to as idiopathic cutaneous hyperchromia of the orbital region, periorbital melanosis, periorbital hyperpigmentation or infraorbital pigmentation, is a common condition frequently observed in dark-skinned patients, but has little data in scientific literature. We aimed to discuss our results of PRP procedure in the treatment of infraorbital dark circles using objective scales based on patient satisfaction and the quality of life.</p><p class="abstract"><strong>Methods:</strong> Between 2016 and 2017, 9 patients complaining of infraorbital darkness were included who underwent 3 sessions of platelet-rich plasma injection. The outcome was determined by the difference in pre- and post- procedure FACE-Q modules which were designed as patient-reported outcome instrument to evaluate the unique outcomes of patients undergoing facial cosmetic procedures. Surveys conducted were modules of satisfaction with facial appearance, satisfaction with skin, psychological function, social function, aging appearance appraisal and satisfaction with outcome.<strong></strong></p><p class="abstract"><strong>Results:</strong> All patients were followed up a minimum of 9 months. No major complications were recorded. Only transient ecchymosis and edema were seen in all patients who were improved during follow-up. The patient-reported FACE-Q satisfaction and FACE-Q quality of life pre- and post- procedure results showed statistically significant improvement (&lt;0.05). Overall satisfaction with outcome was 83.33±16.25 (range 63–100).</p><p class="abstract"><strong>Conclusions:</strong> PRP as a potent source of growth factors, can be seen as a safe, biocompatible, autologous and appropriate treatment modality for the dark eye circles formed in lower eye regions which can increase the quality of patients’ lives in terms of social and psychological function.</p>

Cancer pain management

2014 ◽  
Vol 155 (3) ◽  
pp. 93-99
Author(s):  
Péter Heigl
Keyword(s):  
Quality Of Life ◽  
Pain Management ◽  
Pain Relief ◽  
Life Expectancy ◽  
Cancer Pain ◽  
Cancer Pain Management ◽  
Medical Activity ◽  
Short Summary ◽  
Adequate Quality

Pain is a significant and alarming symptom of cancer seriously affecting the activity and quality of life of patients. Recent research proved that inadequate analgesia shortens life expectancy. Therefore, pain relief is not only a possibility but a professional, ethical and moral commitment to relieve patients from suffering, as well as ensure their adequate quality of life and human dignity. Proper pain relief can be achieved with medical therapy in most of the cases and the pharmacological alternatives are available in Hungary. Yet medical activity regarding pain relief is far from the desired. This paper gives a short summary of the guidelines on medical pain management focusing particularly on the use of opioids. Orv. Hetil., 2014, 155(3), 93–99.

“Position Paper” Timely Insulinisation in Type 2 Diabetes Patients

2012 ◽  
Vol 19 (4) ◽  
pp. 441-444
Author(s):  
László Barkai ◽  
Nicolae Hâncu ◽  
György Jermendy ◽  
Maya Konstantinova ◽  
Radu Lichiardopol ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Type 2 Diabetes ◽  
Life Expectancy ◽  
Insulin Therapy ◽  
Metabolic Control ◽  
Current Medical ◽  
Position Paper ◽  
Medical Evidence

AbstractThe objective of this position paper is to review the current medical evidence andguidelines regarding the treatment of type 2 diabetes (T2DM) and to issue medicalrecommendations strengthening the timely use of insulin in patients with T2DMuncontrolled on noninsulin therapy. When noninsulin therapy fails to achieve or tomaintain HbA1c targets, insulin therapy is required. Timely insulin therapy couldprovide proper metabolic control that might prevent complications, lead toimprovement of life expectancy and quality of life.

Quality-of-Life Measurement in Advanced Cancer: Assessing the Individual

1999 ◽  
Vol 17 (11) ◽  
pp. 3603-3611 ◽  
Author(s):  
Dympna Waldron ◽  
Ciaran A. O'Boyle ◽  
Michael Kearney ◽  
Michael Moriarty ◽  
Desmond Carney
Keyword(s):  
Quality Of Life ◽  
Advanced Cancer ◽  
Internal Validity ◽  
Semistructured Interview ◽  
Incurable Cancer ◽  
Life Measurement ◽  
The Difference ◽  
The Individual ◽  
Very High

PURPOSE: Despite the increasing importance of assessing quality of life (QoL) in patients with advanced cancer, relatively little is known about individual patient's perceptions of the issues contributing to their QoL. The Schedule for the Evaluation of Individual Quality of Life (SEIQoL) and the shorter SEIQoL–Direct Weighting (SEIQoL-DW) assess individualized QoL using a semistructured interview technique. Here we report findings from the first administration of the SEIQoL and SEIQoL-DW to patients with advanced incurable cancer. PATIENTS AND METHODS: QoL was assessed on a single occasion using the SEIQoL and SEIQoL-DW in 80 patients with advanced incurable cancer. RESULTS: All patients were able to complete the SEIQoL-DW, and 78% completed the SEIQoL. Of a possible score of 100, the median QoL global score was as follows: SEIQoL, 61 (range, 24 to 94); SEIQoL-DW, 60.5 (range, 6 to 95). Psychometric data for SEIQoL indicated very high levels of internal consistency (median r = .90) and internal validity (median R2 = 0.88). Patients' judgments of their QoL were unique to the individual. Family concerns were almost universally rated as more important than health, the difference being significant when measured using the SEIQoL-DW (P = .002). CONCLUSION: Patients with advanced incurable cancer were very good judges of their QoL, and many patients rated their QoL as good. Judgments were highly individual, with very high levels of consistency and validity. The primacy given to health in many QoL questionnaires may be questioned in this population. The implications of these findings are discussed with regard to clinical assessment and advance directives.

Quality of life in Hungarian polio survivors

2021 ◽  
Author(s):  
Erika Viktória Miszory ◽  
Melinda Járomi ◽  
Annamária Pakai
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Sample Selection ◽  
Cross Sectional Study ◽  
Two Dimensions ◽  
Cross Sectional ◽  
Emotional Role ◽  
The Difference ◽  
Polio Survivors

Abstract Aim The number of Hungarian polio patients can be estimated at approximately 3000. Polio infection is currently affecting people 56–65 years of age. The aim of the study was to reveal the quality of life of patients living with polio virus in Hungary. Subject and methods The quantitative cross-sectional study was conducted in January–April 2017 among polyomyelitis patients living in Hungary. In the non-random, targeted, expert sample selection, the target group was composed of patients infected with poliovirus (N = 268). We have excluded those who refused to sign the consent statement. Our data collection method was an SF-36 questionnaire. Using the IBM SPSS Statistics Version 22 program, descriptive and mathematical statistics (χ2-test) were calculated (p < 0.05). Results The mean age of the members of the examined population is 63.5 years; 68.1% were women and 31.90% were men. The majority of the respondents were infected by the polyovirus in 1956 (11.9%), 1957 (24.3%), and 1959 (19.5%). Polio patients, with the exception of two dimensions (mental health, social operation), on the scale of 100 do not reach the “average” quality of life (physical functioning 23 points, functional role 36 points, emotional role 47 points, body pain 48 points, general health 42 points, vitality 50 points, health change 31 points). Conclusion The quality of life of polio patients is far below the dimensions of physical function, while the difference in mental health compared to healthy people is minimal. It would be important to educate health professionals about the existing disease, to develop an effective rehabilitation method.

scholarly journals AB0468 QUALITY OF LIFE IN SYSTEMIC LUPUS WOMEN WITH CUTANEOUS DAMAGE ON THE FACE: COSMETIC CAMOUFLAGE IMPACT

2019 ◽  
Author(s):  
Cristina Costa Lanna ◽  
Fernando Afranio Palmeira Oliveira ◽  
Fabiana Miranda Moura Dos Santos ◽  
Maria Veloso Rocha Mameluque ◽  
Thiago Loredo e Silva ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Systemic Lupus ◽  
The Face ◽  
Cutaneous Damage

scholarly journals Prediction of all-cause mortality from 24 month trajectories in patient-reported psychological, clinical and quality of life outcomes in uveal melanoma patients

2021 ◽  
Author(s):  
Stephen L. Brown ◽  
Peter L. Fisher ◽  
Laura Hope-Stone ◽  
Heinrich Heimann ◽  
Rumana Hussain ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Life Expectancy ◽  
Uveal Melanoma ◽  
Cox Regression ◽  
Multivariate Analyses ◽  
Tumor Diameter ◽  
Control Variables ◽  
Patient Reported ◽  
All Cause Mortality

AbstractA number of patient-reported outcomes (PROs) predict increased mortality after primary cancer treatment. Studies, though, are sometimes affected by methodological limitations. They often use control variables that poorly predict life expectancy, examine only one or two PROs thus not controlling potential confounding by unmeasured PROs, and observe PROs at only a single point in time. To predict all-cause mortality, this study used control variables affording good estimates of life expectancy, conducted multivariate analyses of multiple PROs to identify independent predictors, and monitored PROs two years after diagnosis. We recruited a consecutive sample of 824 patients with uveal melanoma between April 2008 and December 2014. PROs were variables shown to predict mortality in previous studies; anxiety, depression, visual and ocular symptoms, visual function impairment, worry about cancer recurrence, and physical, emotional, social and functional quality of life (QoL), measured 6, 12 and 24 months after diagnosis. We conducted Cox regression analyses with a census date of December 2018. Covariates were age, gender, marital and employment status, self-reported co-morbidities, tumor diameter and thickness, treatment modality and chromosome 3 mutation status, the latter a genetic mutation strongly associated with mortality. Single predictor analyses (with covariates), showed 6-month depression and poorer functional QoL predicting mortality, as did 6–12 month increases in anxiety and 6–12 month decreases in physical and functional QoL. Multivariate analyses using all PROs showed independent prediction by 6-month depression and decreasing QoL over 6–12 months and 12–24 months. Elevated depression scores six months post-diagnosis constituted an increased mortality risk. Early intervention for depressive symptoms may reduce mortality.

Analysis of the Impact of Personalized Nursing Service and Hospice Care on the Quality of Life of Elderly Cancer Patients

2021 ◽  
Vol 7 (4) ◽  
pp. 469-473
Author(s):  
Ting Fang ◽  
Nian Wang ◽  
Meng Chen ◽  
Hongmei Ma
Keyword(s):  
Quality Of Life ◽  
Cancer Patients ◽  
Advanced Cancer ◽  
Hospice Care ◽  
Pain Treatment ◽  
Control Group ◽  
Study Group ◽  
The Difference ◽  
The Impact

Objective Explore the impact of personalized nursing services and hospice care on the quality of life of elderly patients with advanced cancer. Method We selected 80 elderly cancer patients admitted to our hospital from September 2020 to May 2021, and divided these patients into a study group and a control group using a random number table method. The patients in the control group used conventional nursing methods to treat and care for the patients, and the patients in the study group used hospice care measures and combined personalized nursing measures. The quality of life and pain treatment effects of the two groups of patients before and after treatment were compared. Result Before treatment, the quality-of-life scores of the two groups of patients were low, and there was no statistical difference (P>0.05); After treatment, the quality of life of the two groups of patients improved, but compared with the control group, the improvement was more obvious in the study group, and the difference was statistically significant (P<0.05). In terms of pain treatment effect, the total effective rate of pain treatment in the study group was 87.5%, which was significantly better than the 62.5% in the control group. The difference was statistically significant (P<0.05). Conclusion Personalized nursing services and hospice care are conducive to improving the survival and treatment of elderly patients with advanced cancer, and can be used as a clinical application program for the care of advanced cancer patients.

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