| 1. |
- Luoma, M. L., et al.
(författare)
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Physical performance, toxicity, and quality of life as assessed by the physician and the patient
- 2002
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Ingår i: Acta Oncol. - 0284-186X .- 1651-226X. ; 41:1, s. 44-9
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to study the relationship between physician-assessed quality of life parameters, i.e., toxicity and physical performance, and patients' self-reports of their quality of life (QoL). QoL was assessed at baseline and before each treatment, using the EORTC QLQ-C30. The WHO performance score (PS) and toxicity were assessed in physician interviews. The correlations between the WHO PS and the QLQ-C30 functioning scale scores varied from weak to moderate, depending on the scale. Strongest associations were found in physical-, social-, and role functioning, and in the global QoL. The QLQ-C30 nausea/vomiting and diarrhea scales correlated moderately to corresponding WHO scores. A multiple linear regression analysis was used to analyze the contribution of WHO PS and toxicity variables to the global QoL. The best model explained only 16% of the variance of the global QoL score. The present findings highlight the importance of independent QoL assessments focused on those aspects of QoL not captured in clinical interviews with the physician.
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| 2. |
- Luoma, ML, et al.
(författare)
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Prognostic value of quality of life scores for time to progression (TTP) and overall survival time (OS) in advanced breast cancer
- 2003
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Ingår i: European Journal of Cancer. - 1879-0852 .- 0959-8049. ; 39:10, s. 1370-1376
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of the study was to investigate whether baseline quality of life (QoL) and changes in QoL scores from baseline are prognostic for time to progression (TTP) and/or overall survival (OS) in patients with advanced breast cancer receiving docetaxel (T) or sequential methotrexate and 5-fluorouracil (MF). QoL was assessed at baseline and before each treatment using the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ-C30). Survival curves and probabilities were estimated using the Kaplan-Meier technique. The Cox proportional hazards regression model was used for both the univariate and multivariate analyses to explore relationships between baseline QoL variables and TTP, as well as OS. In the univariate analysis, more severe pain and fatigue at baseline were predictive for a shorter OS; global QoL, physical functioning and appetite loss had a borderline significance (P=0.0130 for global QoL; P=0.0256 for physical functioning: P=0.0149 for appetite loss). World Health Organization (WHO) performance status was significantly predictive for OS. In the multivariate analysis, more severe pain at baseline was predictive for a shorter OS. In contrast, baseline QoL had no prognostic value for the duration of TTP. QoL change scores from baseline QoL predicted neither OS nor TTP. Our findings suggest that while QoL measurements are important in evaluating patients' QoL, they have no great importance in predicting primary clinical endpoints such as TTP or OS in advanced breast cancer patients. (C) 2002 Elsevier Science Ltd. All rights reserved.
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| 3. |
- Hakamies-Blomqvist, Liisa, et al.
(författare)
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Quality of life in patients with metastatic breast cancer receiving either docetaxel or sequential methotrexate and 5-fluorouracil : A multicentre randomised phase III trial by the Scandinavian breast group
- 2000
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Ingår i: European Journal of Cancer. - 0959-8049 .- 1879-0852. ; 36:11, s. 1411-7
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of this study was to evaluate the effects of two alternative chemotherapy regimes on the quality of life (QoL) of patients with advanced breast cancer. In a multicentre trial, 283 patients were randomised to receive either docetaxel (T) or sequential methotrexate and 5-fluorouracil (MF). QoL was assessed at baseline and before each treatment using the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ-C30). Initial compliance in the QoL study was 96% and the overall compliance 82%. QoL data were available for 245 patients (T 130 and 115 MF). Both treatment groups showed some improvement in emotional functioning during treatment, with a significant difference favouring the MF group at treatment cycles 5 and 6. In the T group, the scores on the other functional scales remained stable throughout the first six cycles. There were significant differences favouring the MF group on the social functioning scale at treatment cycle 6 and on the Global QoL scale at treatment cycles 5 and 6. On most symptom and single-item scales there were no statistically significant differences between the groups. However, at baseline, the T patients reported more appetite loss, at treatment cycles 2-4, the MF patients reported more nausea/vomiting, and at treatment cycle 6, the T patients reported more symptoms of fatigue, dyspnoea and insomnia. There were no statistically significant differences between the groups in the mean change scores of the functional and symptom scales. Interindividual variance was, however, larger in the T group. Differences in QoL between the two treatment groups were minor. Hence, given the expectancy of comparable QoL outcomes, the choice of treatment should be made on the basis of the expected clinical effect.
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| 4. |
- Sajaniemi, N., et al.
(författare)
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Early cognitive and behavioral predictors of later performance : A follow-up study of ELBW children from ages 2 to 4
- 2001
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Ingår i: Early Childhood Research Quarterly. - 0885-2006 .- 1873-7706. ; 16:3, s. 343-361
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to examine whether behavioral style and cognitive performance predict cognitive development in ELBW children. The children were assessed at age 2 (40 girls, 41 boys) with the Bayley Scales of Infant Development. At age 4 they were assessed with the WPPSI-R, and with the word fluency, visual attention and recognition of incomplete figures subsets of the Finnish Neuropsychological Investigation for Children (NEPSY-R, Korkman et al. 1997). The results indicated that there was stability in cognitive performance from 2 to 4 years of age. Along with cognitive performance, behavioral style, especially orientation-engagement at age 2, was an important predictor of subsequent cognitive performance (WPPSI-R). Significant gender differences were also found. For boys, orientation-engagement factor at time one was the best predictor of subsequent nonverbal cognitive performance, arithmetical abilities and word fluency at time two. In contrast, girls' cognitive performance measured at the 2-year assessment was the most powerful predictor of nonverbal performance and word fluency at 4 years. As a whole, it seems that behavioral factors merit more consideration in understanding cognitive development than has been thought before. © 2001 Elsevier Science Inc.
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| 5. |
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| 6. |
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| 7. |
- Hakamies-Blomqvist, L., et al.
(författare)
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Driver ageing does not cause higher accident rates per km
- 2002
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Ingår i: Transportation Research Part F. - 1369-8478 .- 1873-5517. ; 5:4, s. 271-274
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Tidskriftsartikel (refereegranskat)abstract
- Based on Finnish survey data, older (65+, n=1559) and younger (26-40, n=310) drivers' accident rates were compared. In accordance with earlier studies, the rates were similar per driver (0.1) but there was a non-significant trend towards older drivers having more accidents per distance driven (10.8 vs. 8.3 per 1 million km). However, when the accidents-per-km comparison was made in groups matched for yearly exposure, there is no evidence for higher risk with increasing age. In both age groups, risk per km decreased with increasing yearly driving distance. We suggest that the previous perception of an age-related risk increase of accidents per distance driven arises from a failure to control for low mileage bias at all ages. © 2003 Elsevier Science Ltd. All rights reserved.
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| 8. |
- Lundberg, C., et al.
(författare)
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Driving tests with older patients : Effect of unfamiliar versus familiar vehicle
- 2003
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Ingår i: Transportation Research Part F. - 1369-8478 .- 1873-5517. ; 6:3, s. 163-173
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the study was to study the effect, for older license holders, of taking a driving test with an unfamiliar vehicle, as compared to their own cars. The study population consisted of licensed patients 65-85 years referred to the Traffic Medicine Centre (TrMC), Huddinge University Hospital, for an evaluation of their medical and cognitive fitness to drive. In the clinical practice of TrMC, driving tests have been used since 1997, with inspectors from the Swedish National Road Administration (SNRA) acting as evaluators. Initially, patients were allowed to use their own cars. From the beginning of the year 2000, however, dual brakes were made mandatory and most evaluations were then made with SNRA cars. When comparing the outcomes of driving tests from the period prior to 2000 (n=96) and after 2000 (n=69), it was found that the number of drivers who failed the test increased by 16%. Also, those who passed the test after more than one trial decreased by 20%. The potential of the neuropsychological assessment to correctly classify drivers in outcome groups was considerably reduced in the period after 2000. These results support the view that, for older drivers with cognitive deterioration, the need to adapt to an unfamiliar vehicle represents a supplementary cognitive load that may compromise their driving ability and the validity of the assessment. A measure aimed only at increasing the safety of examiners and examinees thus had an unintended side-effect that is detrimental to older clinical populations. © 2003 Elsevier Ltd. All rights reserved.
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| 9. |
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| 10. |
- Lundberg, C, et al.
(författare)
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License suspension revisited: A 3-year follow-up study of older drivers
- 2003
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Ingår i: JOURNAL OF APPLIED GERONTOLOGY. - : SAGE Publications. - 0733-4648 .- 1552-4523. ; 22:4, s. 427-444
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- This 3-year follow-up study addressed changes in health, cognitive functioning, and driving status among 37 older drivers and 37 individually matched controls. Initially, the study group had suspended driver’s licenses due to traffic violations. The in-person follow-up medical and neuropsychological examinations concerned 20 case participants and 22 controls. Mortality tended to be higher with case participants than with controls (p = .085), and there was more dementia or cognitive impairment with case participants (5/37) than with controls (0/37,p = .027). Initially, crash-involved case participants performed consistently worse on measures of cognitive functioning than did controls and noncrashed case participants and showed greater deterioration over time. Compared to controls, more crash-involved drivers had died (p = .019) or had stopped driving (p = .040). Because some older drivers with unsafe driving behavior may be in early phases of dementing processes or serious medical conditions, they should be medically and cognitively assessed.
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