Calibrating and adjusting expectations in life: A grounded theory on how elderly persons with somatic health problems maintain control and balance in life and optimize well-being

Aim: This study aims at exploring the main concern for elderly individuals with somatic health problems and what they do to manage this. Method: In total, 14 individuals (mean = 74.2 years; range = 68–86 years) of both gender including hospitalized and outpatient persons participated in the study. Open interviews were conducted and analyzed according to grounded theory, an inductive theory-generating method. Results: The main concern for the elderly individuals with somatic health problems was identified as their striving to maintain control and balance in life. The analysis ended up in a substantive theory explaining how elderly individuals with somatic disease were calibrating and adjusting their expectations in life in order to adapt to their reduced energy level, health problems, and aging. By adjusting the expectations to their actual abilities, the elderly can maintain a sense of that they still have the control over their lives and create stability. The ongoing adjustment process is facilitated by different strategies and result despite lower expectations in subjective well-being. The facilitating strategies are utilizing the network of important others, enjoying cultural heritage, being occupied with interests, having a mission to fulfill, improving the situation by limiting boundaries and, finally, creating meaning in everyday life. Conclusion: The main concern of the elderly with somatic health problems was to maintain control and balance in life. The emerging theory explains how elderly people with somatic health problems calibrate their expectations of life in order to adjust to reduced energy, health problems, and aging. This process is facilitated by different strategies and result despite lower expectation in subjective well-being

Cerebral vein thrombosis in patients with Philadelphia-negative myeloproliferative neoplasms : an European Leukemia Net study

To investigate the characteristics and clinical course of cerebral vein thrombosis (CVT) in patients with myeloproliferative neoplasms (MPN) we compared 48 patients with MPN and CVT (group MPN-CVT) to 87 with MPN and other venous thrombosis (group MPN-VT) and 178 with MPN and no thrombosis (group MPN-NoT) matched by sex, age at diagnosis of MPN (\ub15 years) and type of MPN. The study population was identified among 5,500 patients with MPN, from January 1982 to June 2013. Thrombophilia abnormalities were significantly more prevalent in the MPN-CVT and MPN-VT than in MPN-NoT group (P = 0.015), as well as the JAK2 V617F mutation in patients with essential thrombocythemia (P = 0.059). Compared to MPN-VT, MPN-CVT patients had a higher rate of recurrent thrombosis (42% vs. 25%, P = 0.049) despite a shorter median follow-up period (6.1 vs. 10.3 years, P = 0.019), a higher long-term antithrombotic (94% vs. 84%, P = 0.099) and a similar cytoreductive treatment (79% vs. 70%, P = 0.311). The incidence of recurrent thrombosis was double in MPN-CVT than in MPN-VT group (8.8% and 4.2% patient-years, P = 0.022), and CVT and unprovoked event were the only predictive variables in a multivariate model including also sex, blood count, thrombophilia, cytoreductive, and antithrombotic treatment (HR 1.97, 95%CI 1.05-3.72 and 2.09, 1.09-4.00, respectively). \ua9 2014 Wiley Periodicals, Inc

Escarificação ácida, temperatura e luz no processo germinativo de sementes de Senna alata (L.) Roxb

O objetivo deste trabalho foi determinar o tempo ótimo de escarificação das sementes de Senna alata em ácido sulfúrico e verificar o efeito da temperatura, em condição de luz e escuro, na germinação de sementes dessa espécie. As sementes foram imersas em ácido sulfúrico concentrado por períodos de 0, 15, 30 e 60 minutos, e o teste de germinação realizado em BOD a 25ºC, utilizando quatro repetições de 50 sementes em cada período de tempo, sendo o delineamento estatístico inteiramente casualizado com 4 tratamentos. No segundo experimento, para verificar o efeito da temperatura e da condição de luz mais adequada a germinação, utilizou-se temperaturas de 10 a 45ºC, com intervalos de 5ºC, em condição de luz fluorescente branca ou escuro contínuo (gerbox preto). Utilizou-se o delineamento experimental inteiramente casualizado, disposto em esquema fatorial 8x2, com 4 repetições, de 50 sementes cada. Em todos os testes as avaliações da porcentagem e índice de velocidade de germinação foram feitas diariamente, durante 10 dias, onde as sementes foram consideradas germinadas quando apresentaram 2 mm de raiz. Os dados foram submetidos à análise de variância e as médias comparadas pelo teste de Tukey a 5% de probabilidade. A escarificação do tegumento com ácido sulfúrico durante 60 minutos, foi ideal para as sementes de Senna alata, por proporcionar maiores valores na porcentagem e velocidade de germinação. A germinação ocorre entre 15 e 40ºC, sendo consideradas fotoblásticas neutras entre 20 e 40ºC e fotoblásticas negativas preferenciais a 15ºC. O melhor desempenho germinativo foi obtido nas temperaturas de 25, 30 e 35ºC, onde ocorreram maior porcentagem e velocidade de germinação.The aim of this study was to establish the optimum scarification time for Senna alata seeds in sulfuric acid, as well as to verify the effect of temperature on seed germination for this species under conditions of light and darkness. Seeds were immersed in concentrated sulfuric acid for periods of 0, 15, 30 and 60 minutes, and the germination test was carried out in a BOD chamber at 25ºC, using four replicates of 50 seeds for each time period. Experimental design was completely randomized with 4 treatments. In the second experiment, temperatures from 10 to 45ºC, with 5ºC intervals, were used under conditions of fluorescent white light or continuous darkness (black "gerbox") in order to verify the temperature effect and the most suitable light condition for germination. Experimental design was completely randomized, in an 8x2 factorial arrangement, with 4 replicates of 50 seeds each. In all tests, germination percentage and speed index were daily evaluated for 10 days. Seeds were considered germinated when the radicle length was 2 mm. Data were subjected to analysis of variance and means were compared by Tukey's test at 5% significance. The tegument scarification with sulfuric acid for 60 minutes was optimal for Senna alata seeds since it led to higher values of germination percentage and speed. Germination occurs between 15 and 40ºC, and seeds are considered neutral photoblastic between 20 and 40ºC and negative photoblastic especially at 15ºC. The best germination performance was observed at 25, 30 and 35ºC, at which germination percentage and speed were higher