Linda V. Nyquist

Comprehensive Comparison of Health-Related Quality of Life After Contemporary Therapies for Localized Prostate Cancer

PURPOSE Health-related quality-of-life (HRQOL) concerns are pivotal in choosing prostate cancer therapy. However, concurrent HRQOL comparison between brachytherapy, external radiation, radical prostatectomy, and controls is hitherto lacking. HRQOL effects of hormonal adjuvants and of cancer control after therapy also lack prior characterization. PATIENTS AND METHODS A cross-sectional survey was administered to patients who underwent brachytherapy, external-beam radiation, or radical prostatectomy during 4 years at an academic medical center and to age-matched controls. HRQOL among controls was compared with therapy groups. Comparison between therapy groups was performed using regression models to control covariates. HRQOL effects of cancer progression were evaluated. RESULTS One thousand fourteen subjects participated. Compared with controls, each therapy group reported bothersome sexual dysfunction; radical prostatectomy was associated with adverse urinary HRQOL; external-beam radiation was associated with adverse bowel HRQOL; and brachytherapy was associated with adverse urinary, bowel, and sexual HRQOL (P < or =.0002 for each). Hormonal adjuvant symptoms were associated with significant impairment (P <.002). More than 1 year after therapy, several HRQOL outcomes were less favorable among subjects after brachytherapy than after external radiation or radical prostatectomy. Progression-free subjects reported better sexual and hormonal HRQOL than subjects with increasing prostate-specific antigen (P <.0001). CONCLUSION Long-term HRQOL after prostate brachytherapy showed no benefit relative to radical prostatectomy or external-beam radiation and may be less favorable in some domains. Hormonal adjuvants can be associated with significant impairment. Progression-free survival is associated with HRQOL benefits. These findings facilitate patient counseling regarding HRQOL expectations and highlight the need for prospective studies sensitive to urinary irritative and hormonal concerns in addition to incontinence, sexual, and bowel HRQOL domains.

Specificity of the American Urological Association Voiding Symptom Index: Comparison of Unselected and Selected Samples of Both Sexes

The American Urological Association voiding symptom index questionnaire for benign prostatic hypertrophy was administered to an elderly unselected sample and a selected urology clinic sample of both sexes to investigate the ability of this instrument to identify prostatic pathological conditions. The female subjects in these cohorts provided a control. In the large unselected sample the male subjects scored statistically higher in only 2 categories, weak stream (487 subjects) and strain (507) (p < 0.05 for both categories). The clinical significance of these scores is questionable, however, since they were low (less than 2 of 5). In the selected group (145 subjects) the female subjects showed a higher total mean score due to the contribution of statistically higher irritative scores (p < 0.05). We conclude that the American Urological Association voiding symptom index does not specifically identify prostatic pathological conditions, and that elderly men and women have similar voiding symptom scores. Therefore, treatment that results in improvement in symptom scores may not specifically affect the prostate. Other factors, such as an aging detrusor, changes in physiological production of urine or other unknown factors, may contribute to the symptoms.

Task-specific resistance training to improve the ability of activities of daily living-impaired older adults to rise from a bed and from a chair.

OBJECTIVES: To determine the effect of a 12‐week intervention to improve the ability of disabled older adults to rise from a bed and from a chair.

Effects of high- and low-velocity resistance training on the contractile properties of skeletal muscle fibers from young and older humans

A two-arm, prospective, randomized, controlled trial study was conducted to investigate the effects of movement velocity during progressive resistance training (PRT) on the size and contractile properties of individual fibers from human vastus lateralis muscles. The effects of age and sex were examined by a design that included 63 subjects organized into four groups: young (20-30 yr) men and women, and older (65-80 yr) men and women. In each group, one-half of the subjects underwent a traditional PRT protocol that involved shortening contractions at low velocities against high loads, while the other half performed a modified PRT protocol that involved contractions at 3.5 times higher velocity against reduced loads. Muscles were sampled by needle biopsy before and after the 14-wk PRT program, and functional tests were performed on permeabilized individual fiber segments isolated from the biopsies. We tested the hypothesis that, compared with low-velocity PRT, high-velocity PRT results in a greater increase in the cross-sectional area, force, and power of type 2 fibers. Both types of PRT increased the cross-sectional area, force, and power of type 2 fibers by 8-12%, independent of the sex or age of the subject. Contrary to our hypothesis, the velocity at which the PRT was performed did not affect the fiber-level outcomes substantially. We conclude that, compared with low-velocity PRT, resistance training performed at velocities up to 3.5 times higher against reduced loads is equally effective for eliciting an adaptive response in type 2 fibers from human skeletal muscle.

Dynamic balance and stepping versus tai chi training to improve balance and stepping in at-risk older adults

OBJECTIVES: To compare the effect of two 10‐week balance training programs, Combined Balance and Step Training (CBST) versus tai chi (TC), on balance and stepping measures.

Maternal and Infant Behavior in Japan and America A Partial Replication

Maternal and infant behaviors were compared for 30 American and 52 Japanese mother-infant dyads from middle-class homes in Japan and America. The major differences in caretaker behavior were (1) the Japanese mother spent more time being with or in the presence of her baby than the American mother, and (2) the American mother was more active in positioning the body of the infant. Infant behaviors between the two cultures were strikingly similar. Significant differences were found in sucking behavior, with the American babies displaying more than the Japanese babies. Across cultures male babies were awake more and received more rocking. Several culture-by-sex interactions were found. Japanese males displayed significantly higher unhappy vocal and total vocal behavior than Japanese females, but the American males displayed significantly lower total vocal behavior than the American females. Comparisons were made with findings from a study conducted in 1969. The findings highlight the importance of cultural context in investigating early behaviors.

Chair and Bed Rise Performance in ADL‐Impaired Congregate Housing Residents

OBJECTIVES: To examine the ability of activity of daily living (ADL)‐impaired older adults to successfully rise, and, when successful, the time taken to rise, from a bed and chair under varying rise task demands.

Floor‐Rise Strategy Training in Older Adults

OBJECTIVES: To determine the effect of a 2‐week (six‐session) training intervention to improve the ability of disabled older adults to rise from the floor.

Bath Transfers in Older Adult Congregate Housing Residents: Assessing the Person–Environment Interaction

OBJECTIVES: To examine environmental feature utilization (EFU) and the types and prevalence of performance difficulties during a videotaped bath transfer and to determine the personal characteristics associated with total EFU and performance difficulties.

Development of Adaptive Competence in Adulthood

This paper summarizes research on adult development guided by a theoretical perspective that assumes general types of developmental processes deriving from different sources of input and resulting in