Malnutrition and Quality of Life in Chinese Cancer Patients: a Clinical Study of 23,994 Subjects

Background Malnutrition is common in patients with cancer,and can negatively impact their quality of life(QoL)and even survival.However,there is currently no large data available on the prevalence of malnutrition in Chinese cancer patients.This study evaluated the prevalence of malnutrition and the QoL of Chinese patients with locoregional,recurrent or metastatic cancer.Methods We conducted a nationwide observational,multi-center,hospital-based cross-sectional study within the Chinese Society of Nutritional Oncology(CSNO)Network.All of the patients were diagnosed with one of the following 18 different types of malignant tumors:lung cancer,gastric cancer,liver cancer,colorectal cancer,breast cancer,esophageal cancer,cervical cancer,endometrial cancer,nasopharyngeal carcinoma,malignant lymphoma,leukemia,pancreatic cancer,ovarian cancer,prostate cancer,bladder cancer,brain cancer,biliary tract malignant tumors or gastrointestinal stromal tumors.These patients were enrolled from 72 hospitals located in different regions of China.The patients’nutritional status was evaluated based on the body mass index(BMI),loss of bodyweight,laboratory measurements and patient generated-subjective global assessment(PG-SGA)scores.The cancer patients’physical status and QoL were assessed by the Karnofsky Performance Status(KPS)questionnaire and the European Organization for Research and Treatment of Cancer(EORTC)QLQ-C30 questionnaire,respectively.Results From December 2013 to April 2016,23,994 patients hospitalized for cancer treatment(such as surgery,chemotherapy or radiotherapy)were enrolled in the study.The patients included 12,494(52.9%)males and 11,124(47.1%)females.The mean age was 55.8±13.7 years.The proportions of patients in cancer stagesⅠ,Ⅱ,Ⅲ,Ⅳand uncertain were 11.5%,20.3%,27.5%,30.2%and 10.5%,respectively.Among the 23,994 inpatients,the proportions of patients who were underweight(BMI<18.5 kg/m2),normal(18.5 kg/m2<BMI<24 kg/m2),overweight(24 kg/m2≤BMI<28 kg/m2)and obese(BMI≥28 kg/m2)were 9.3%,59.9%,26.1%and 4.7%,respectively.A total of 18.3%(4,101/22,424)of patients had lost 5%or more of their bodyweight within the past month and 19.6%(2,463/12,538)of patients had lost 10%or more of their bodyweight within the past 6 months.According to the PG-SGA scores,26.6%of the patients were severely malnourished(score≥9),31.3%were moderately malnourished(scores 4~8).A total of 22.2%of patients had a serum albumin level lower than 35g/L.Only 8.6%(2056/23,991)of the patients had severe KPS scores(≤60).The patients with these severe KPS scores were most frequently among those with cancers of the brain(19.7%),prostate(18.0%),pancreas(15.5%)and bladder(15.0%).Based on the QLQ-C30 score,11.6%of patients had a poor QoL.The PG-SGA score and global QoL were correlated(r=-0.593,P<0.001).Conclusion The prevalence of malnutrition in patients with cancer is relatively high,and is related to a poorer QoL.The present findings should be kept in mind when assessing cancer patients,because addressing the patient’s problems in nutritional status would be expected to improve both the clinical outcomes and QoL in cancer patients with malnutrition.

Suicidal Ideation and Attempts during Middle Childhood: Associations with Subjective Quality of Life and Depression

Background: Confronted to the increasing suicide rate in children, clinicians have to better understand and predict suicide-related behaviours (SRBs) in children with and without depressive symptoms. Aims: To investigate associations among suicidal tendencies (thoughts and/or attempts), depression and children’s perceptions of subjective quality of life. Methods: This was a cross-sectional study of 157 children of 6 - 13-year-old. Results: Children who attempted or thought of suicide reported goodless subjective quality of life than nonsuicidal children did, and children who thought of or attempted suicide reported higher levels of depressive symptoms than nonsuicidal children. Limitations: A more rigorous approach to investigating suicidal ideation and depressive symptomatology as a diagnostic interview based on the DSM-IV-TR will be valuable to future progress in understanding children’s suicidality. Conclusions: Results may reflect the confirmation of depressive symptoms as risk factors for suicidality and underline the high importance of social and emotional life context among suicidal children. For this reason, more effective recognition and comprehension of the underlying affective and social conditions of children with suicidality have special importance to prevent future suicidal behaviour during adolescence.

Subjective Cognitive Concerns and Attitudes toward Genetic Testing Are Associated with Depressive Symptoms and Quality of Life after Genetic Testing for the Cerebral Cavernous Malformation Common Hispanic Mutation (CCM1)

Purpose: This study aimed to characterize mood and quality of life and to examine the associations of these areas with subjective cognitive concerns and attitudes toward genetic testing for the Common Hispanic Mutation, a gene that has been associated with increased risk for CCM1. Method: Fifty-four adults with previous genetic testing for the Common Hispanic Mutation completed a mail survey that included assessments of the above identified areas. Results: Self-reported depressive symptoms and quality of life did not differ between those with positive and negative genetic test results. The negative group expressed a more favorable attitude toward genetic testing (p p = 0.06). Using generalized linear regression, more subjective cognitive concerns were associated with poorer quality of life and more depressive symptoms (p p Conclusions: Subjective cognitive concerns and negative attitudes toward genetic testing may influence emotional well-being after genetic testing for the Common Hispanic Mutation. Additional research is needed that uses objective neuropsychological measures to understand the associations of subjective cognitive concerns, emotional well-being, and cognitive test performance in individuals with CCM1. There is also a need for research that focuses on protective factors and resiliency following genetic testing for CCM1 and the development of mental health interventions to preempt psychosocial difficulties.

Living Kidney Donation – Subjective Experiences of Donors before and Two Years after Donation

Little is known about long-term quality of life of kidney donors. We studied subjective experiences of donors before and two years after kidney donation using in-depth interviews of eleven subjects. Interviews were audiotaped, transcribed, and analyzed by qualitative content analysis (grounded theory). Resulting categories of this process were grouped in order to construct ideal types of subjective experiences after kidney donation. Of our donors, 64% were female, mean age was 40.4 years. Donors reported that they had had no medical problems after donation. Most displayed psychological problems, e. g. difficulties adjusting to the new situation, hypochondriacal complaints, and fear of rejection of the recipient’s kidney. Psychological complaints were particularly troublesome in case of complications of the recipient. All donors wished extended counselling after kidney donation. Identifying problems of kidney donors may be easier when doctors are trained in typical experiences. This may also guide the tailoring of individual psychological interventions.

On the Wisdoms of Human Life Embodied in Robert Frost's Poems-A Brief Analysis of Motifs of Robert Frost's Poems

Robert Frost is one of the famous poets of the 20th century American literature who won the Pulitzer Prize for four times. The reason for his popularity is partially because he employs traditional verse form and iambic pentameter pattern in poem writing, but the most important reason for the reputation of his poems lies in the thematic concern of something universal, such as death and life, love and hate, war and peace, the good and the evil, the wisdom of human life and etc. . A brief analysis will be given in the following text about the wisdoms of human life embodied in Robert Frost's poems from three aspects: 1. Relaxation and responsibility of man. 2. The decisions in life.

The Life Wisdom of Chinese Traditional Filial Piety

Filial piety is not only the core concept of Confucianism,but also an important category of Mohism,Legalism,Taoism and Buddhism.To analyze the essence of Chinese traditional filial piety,we should explore it from the vast classical works of hundreds of schools of thought,and also from the long-term practice of social life of all nationalities and folk culture.I think that although the content of"filial piety"is constantly changing with the times,the wisdom of life contained therein,especially the dialectical thinking of thinking and dealing with filial piety,is the essence of the most universal and lasting value.

Investigating short- and long-term transfer effects of a Taiji beginner course in participants' daily life

in recent years research investigating various health benefits of Taiji practice has markedly increased. Despite this growing scientific interest, essential questions such as to what extent a Taiji course may exert noticeable effects in participants＇ everyday life, what these effects are, and how and where potential transfer effects occur, have hardly been considered. The aim of our study was to explore transfer effects from a Taiji course into participants＇ daily lives. METHODS： We conducted a longitudinal observational study in 45 healthy participants at the end of their three-month Taiji beginner course （tpl） and at two months （tp2） as well as one year after course completion （tp3）. Participants were asked to report their Taiji practice behavior at all time points, as well as to rate and describe perceived transfer effects of Taiji course contents on their daily life at tpl and tp3. RESULTS： Transfer effects were reported by 91.1% of all respondents after course completion （tpl） and persisted in 73.3% at the one-year follow-up assessment （tp3）, counting ＂increase of self-efficacy＂, ＂improvement of stress management＂, and ＂increase of body awareness＂ as the most frequently mentioned effects. Transfer effects predominantly occurred in participants＇ work and social environments, as well as during everyday activities in public areas. While self- reliant Taiji practice frequency significantly decreased from 82.2% at tpl to 55.6% at tp3 （P 〈 0.001）, the magnitude of self-reported transfer effects did not （P = 0.35）. As explorative analyses revealed, regular Taiji course attendance was highly correlated with stronger transfer effects at tpl （r = 0.51; P 〈 0.001） and tp3 （r = 0.35; P = 0.020）. Participants reporting high self-reliant Taiji practice frequency at tp2 were likely to maintain a regular practice routine at tp3 （r = 0.42; P 〈 0.004）, whereas self-reliant practice frequency and transfer effects at tpl were positively correlated with self-reliant practice frequency at tp3 on a trend level （r 〈 0.27; P 〉 0.08）. CONCLUSION： Our data underline the importance of regular course participation for pronounced and long lasting transfer effects into participants＇ everyday life. We discuss that several context and process-related aspects of a Taiji intervention are potentially relevant factors for enhancement of transfer effect.

Malnutrition negatively impacts the quality of life of patients with cirrhosis: An observational study

AIMTo verify how malnutrition is related to health-related quality of life (HRQL) impairment in patients with cirrhosis. METHODSData was retrospectively abstracted from medical records and obtained by direct interview. We included patients with cirrhosis from any etiology, evaluated at the Liver Clinic from Gastroenterology Department in a tertiary healthcare center, from June 2014 to June 2016. Child-Pugh score, data about complications, and demographic, clinical and anthropometric characteristics of patients were obtained. Nutritional status was evaluated by the Subjective Global Assessment (SGA). HRQL was evaluated through the Chronic Liver Disease Questionnaire. Patients were requested to assess their global HRQL with the following code: 0 = impairment of HRQL, when it was compared with other healthy subjects; 1 = good HRQL, if it was similar to the quality of life of other healthy subjects. To compare the primary outcome between malnourished and well-nourished groups, the χ2 test, Fisher’s exact test or Student’s t-test were used, based on the variable type. Associations between predictor variables and deterioration of HRQL were determined by calculating the hazard ratio and 95% confidence interval using Cox proportional hazards regression. RESULTSA total of 127 patients with cirrhosis were included, and the mean age was 54.1 ± 12.3 years-old. According to Child-Pugh scoring, 25 (19.7%) were classified as A (compensated), 76 (59.8%) as B, and 26 (20.5%) as C (B/C = decompensated). According to SGA, 58 (45.7%) patients were classified as well-nourished. Sixty-nine patients identified HRQL as good, and 76 patients (59.8%) perceived impairment of their HRQL. Multivariate analysis to determine associations between predictor variables and self-perception of an impairment of HRQL found strong association with malnutrition (P P CONCLUSIONMalnutrition is a key factor related to impairment of HRQL in patients with cirrhosis.

The Life Values of Greek Mythology

The difference between human and animals is that human not only obey the rules of nature and history but also possess subjective attitude and spirit of life, which are presented as life values by reflecting directly on ideology. According to it,Greek mythology pours out its life values based on its subjective attitude and spirit of life.

The Obscuration and Reinstatementof Teachers’Subjectivity in the Era of Artif icial Intelligence

In the era of artificial intelligence,teachers’subjectivity presents new characteristics,such as the interweaving of virtual and reality,the integration of individual and groups,and the coexistence of exuberance and disorientation.While reshaping teachers’subjectivity,intelligent technologies also easily make teachers fall into the subjectivity dilemmas,such as self-crisis,distortion of interaction,and alienation of action.Therefore,to reinstate teachers’subjectivity,it is necessary to know oneself in pursuit of truth by sticking to the nature of life,to become oneself by constructing the nature of choice in practical activities,and to achieve oneself by returning to the nature of creation in lifelong learning.

The better future projections the more childbirth:the association between subjective social status and fertility desire of the Chinese population

Previous research has detailed how social status affects the willingness to have children.However,subjective social status(SSS)derived from a comparison with a reference group also has an important impact on fertility desire.This study explores the relationship between the past,present,and future SSS and fertility desire,using data from the Chinese General Social Survey,a nationally representative population survey conducted in 2017(N=4,864).The study found that the individual’s fertility desire is positively enhanced by the current SSS,the expected SSS in the future,and the upward trend of SSS throughout the course of life.Compared with the group with a low level of SSS and with little change in SSS,the fertility desire of the group with"Rising first and then stable"SSS and"Rising"SSS significantly increased.The results suggest that the expectation of positive changes in social status will stimulate fertility desires and produce long-term family plans.With the rapid development of China’s social economy and the positive response to the low fertility rate,social policies should be adopted to open up channels for the protection and improvement of the social status of citizens and to achieve an increase of fertility desire.

At the Origin of the Art of Money-Making （Conversation With Aristotle About Wealth and the Good Life）

This paper aims, first of all, to examine the two fundamental treatments of the complex and very broad notion of chrematistikd （money-making） and its links with the notion of oikonomia （economics）, outlining a fundamental division between natural and unnatural art of money-making. The two different arts of money-making are based on two very different psychological attitudes： in the first case, desire is channeled, managed, and organized by practical wisdom with a view to a further end; in the second case, desire is an end unto itself, insatiable, boundless and contrary to the commands of practical wisdom. Only in the first case there is a ＂true wealth＂, that is a wealth oriented toward a good life that constitutes the end （telos） and the limit （peras） of the wealth itself. The conclusion is that, for the Stagirite, wealth is not an evil, nor, in itself, is the pursuit of wealth, that is, the art of money-making, because if it is rightly organized and oriented in function of the end, it constitutes the conditio sine qua non of a life that is good, ordered and happy for the individual and for the city

Emptiness （Sunyata） for Caring the Self in the Middle Path： Reinvestigating the Middle Path Philosophy of Ngggrjuna

Classical Indian Buddhist philosopher Nfigfirjuna is known for his philosophical interpretations of the central conception of Buddha＇s teachings, the philosophy of Middle Path （Mfidhyamika）. Notably he had introduced the unique concept of ＂emptiness＂ （gnyata） to explain the Middle Path philosophy： the philosophical meaning of ＂emptiness＂ is dependent co-arising of various elements that support the worldly experience. This study investigates how this concept is used in explaining the subjectivity of a human person and how it is used for interpreting the unique process of human existence. The discussions on subjectivity are imprecise in modern and contemporary philosophy. But Ngrjuna＇s philosophy enables us to explain subjectivity conclusively, without it having to be explained using metaphysical positions. Sunyata may introduce a new definition for the concept of non-self： not for negating the self but for caring self from the problems of life by making it centered in the Middle Path （madhyama-pratipat）, where one may naturally be able to use his wisdom （prajh） as the guiding principle： not mere knowledge （na）. Sanyat is understood using fourfold （catus.kot.i） logical analysis, not twofold analysis employed normally by other philosophers. Here, the Buddhist notion of self as the co-dependent evolution process of five aggregates （pahcaskandhas） is reinterpreted using the unique method of tetralemma （catus.kot. i）. This critique explores the Western philosophy＇s conceptions on ＂human reasoning, ＂logocentrism,＂ and the objective analytical method of modern science.＂ After careful cross examination of the rival philosophical positions, it reasons out why the ＂rationale of nature＂ is always superior to ＂human reasoning＂ and ＂logocentrism,＂

Cities Make Life Better:Hukou and Household Satisfaction about Life

This paper examines the relationship between a change of hukou and househoM satisfaction about life based on large-sample China Family Panel Studies （CFPS） data. As horizontally shown by cross-section data, significant hukou identity differences exist in the subjective happiness of households reflected in life satisfaction. However, the traditional view that ＂rural residents are subjectively happier than urban residents＂ is not verified in this study. From a vertical perspective of tracing data, the estimation results of the DID model and the PSM model indicate that a change of hukou identity for rural residents has a significantly positive effect on their subjective happiness, lending credence to the saying that ＂cities make life better＂.

Subjective well-being and mortality among the older people in China

The present study investigates the effects of subjective well-being(SWB)on mortality risk using a large sample from the Chinese Longitudinal Healthy Longevity Study conducted in 1998,2000,2002,2005,2008,2011 and 2014.SWB is measured by life satisfaction,positive affect and negative affect.We found that positive affect,negative affect,life satisfaction and the change of life satisfaction significantly have predicted mortality risks of the older people with control of social demographic characteristics,physical health,social support,cognitive ability,and social participation.The higher the positive affect,the lower the negative affect,the improvement the life satisfaction,the lower the mortality risk.Marital status plays a decisive role in the influence of life satisfaction on the mortality risk.The married persons have lower mortality risk even if they rate their life bad.In further analyses,we found that the effects of SWB on mortality risk were underestimated in short-term study compared with those in long-term study.SWB is essentially a time-dependent variable and changes with age,so treating SWB as time-independent variable underestimated its impact on mortality risk.

My School Life

I am a student at Luoyang Middle School. I love my school.Our school starts at eight in the morning from Monday to Friday. Usually we do morning exerises first. Our lessons begin at 8:15. My favourite subject is English. I am very good at it.

基于主观整体营养评估量表评分的营养干预对结直肠癌患者化疗期营养摄入和生活质量的影响

目的探究基于主观整体营养评估量表(PG-SGA)评分的营养干预对结直肠癌患者化疗期营养摄入和生活质量的影响。方法本研究为随机对照试验。选取2021年4月至2024年4月在河南省人民医院化疗的102例结直肠癌患者作为研究对象。采用随机数字表法,将患者分为对照组(51例)和观察组(51例)。对照组男30例,女21例;年龄(59.62±6.00)岁;肿瘤类型:结肠癌19例,直肠癌31例;临床分期:Ⅰ期12例,Ⅱ期20例,Ⅲ期19例。观察组男28例,女23例;年龄(59.45±6.18)岁;肿瘤类型:结肠癌16例,直肠癌35例;临床分期:Ⅰ期10例,Ⅱ期22例,Ⅲ期19例。对照组采用常规营养干预,观察组采用基于PG-SGA评分的营养干预。两组均干预至化疗周期结束。比较两组干预前后营养摄入情况(能量、蛋白质)、营养状况[血清白蛋白(ALB)、血红蛋白(Hb)、血清前白蛋白(PA)、血清总蛋白(TP)]、生活质量[生活质量综合评定问卷(GQOL-74)]。采用独立样本t检验、配对t检验和χ2检验进行统计学分析。结果干预后,观察组能量、蛋白质摄入量均高于对照组[(1110.78±256.90)kcal/d比(1001.23±231.78)kcal/d、(57.78±10.04)g/d比(43.15±9.26)g/d](均P<0.05);观察组ALB、Hb、PA、TP水平均高于对照组[(42.18±3.01)g/L比(39.00±2.89)g/L、(110.89±11.34)g/L比(105.28±11.00)g/L、(0.48±0.09)g/L比(0.33±0.07)g/L、(59.98±4.63)g/L比(55.17±4.38)g/L](均P<0.05);观察组GQOL-74中的躯体功能、社会功能、物质生活、心理功能评分均高于对照组[(70.12±6.53)分比(63.44±6.00)分、(67.19±6.82)分比(63.16±6.08)分、(73.22±7.03)分比(61.89±6.27)分、(71.26±7.90)分比(66.01±6.82)分](均P<0.05)。结论基于PG-SGA评分的营养干预可增加结直肠癌化疗期患者营养摄入,提高生活质量。