Average Quality Of Life Score Research Articles

Quality of life of children with idiopathic nephrotic syndrome according to clinical types

Idiopathic nephrotic syndrome (INS) is a major manifestation of chronic idiopathic glomerulonephritis and a common disease in children. The cause and pathogenesis of the disease have not been clarified so far. The treatment is usually a long-term process, from a few months to several years, even decades, including the period of hospitalisation, outpatient treatment period and follow-up period after treatment. The INS patients are negatively affected by the disease and its treatment process. The aim of this study is to assess the health-related quality of life (QOL) of children with INS according to clinical types in Haiphong Children's Hospital. Object: Describe some factors related to the QOL of children with INS. Subjects: 71 patients diagnosed with INS, who are being monitored and treated at Haiphong Children's Hospital from 10/2015 to 05/2016. Methods: Prospective studies, descriptive cross-sectional. QOL of the patients is assessed by the PedsQL 4.0 scale; the higher score shows that the lower QOL. Results: The general QOL score of children with INS (21.24±13.91) was higher than normal children (16.98±10.20). Children with steroid-resistant INS have a higher score (31.62±14.32) than children with steroid-dependent (20.57±9.08) and responsive INS (14.58±6.83). The QOL score of children with one of the symptoms Cushing's face, hirsutism or acne are significantly higher than children without the corresponding symptoms. Children who finished their treatment had a lower score (15.47±7.42) than children being treated (21.33±10.23). The average QOL score has a linear correlation with the duration of INS. Conclusion: The general QOL of children with INS substantially declined compared with that of healthy children. The QOL of children with steroid-dependent and resistant INS is lower than that of the children with steroid-responsive type. The QOL of children with one of the symptoms Cushing's face, hirsutism or acne is significantly lower than that of children without the corresponding symptoms. The QOL of children who completed treatment is higher than the group being treated. The longer the duration of treatment, the more the children's QOL declined.

Assessment of quality of life in type II diabetic patients using the modified diabetes quality of life (MDQoL)-17 questionnaire

Diabetic complications, comorbidities, and cost of treatment affect the quality of life (QoL) of an individual. The QoL assessment is considered an important measure of outcome in chronic disease management. The objective of our study was to assess the quality of life in Type II diabetes mellitus patients with and without complications using the modified diabetes quality of life (MDQoL)-17. A prospective descriptive study was conducted over 6 months, after taking ethical committee approval. As per the inclusion criteria from medicine wards of tertiary care hospital, 250 patients were selected. Demographic characteristics were documented in the data collection form and the patients were administered with the MDQoL questionnaire in different languages. The data was analyzed using IBM SPSS version 20. Majority of the patients were male (64.4%). The average age of the study population was 60.34±12.04 years. Most of the patients had a diabetes history of more than 10 years and HbA1c > 8%. The average QoL score was 65.47±15.07. Majority of the diabetic patients had the QoL score between 70 and 50. Patients without complication had a better QoL. As the number of complications increased, there was a decrease in the QoL. The presence of comorbidity also decreased the QoL. There was a statistically significant correlation with various parameters such as age, duration of diabetes history, HbA1c, number of complications and type of complication verses QoL of diabetic patients (p<0.05). The overall QoL in diabetic patients is reduced. Thus, proper management and strict glycemic control is necessary to prevent progression and occurrence of complications to maintain a better QoL in diabetes patients.

Walking and talking activities as nursing therapy for improving quality of life among older adults

The most prominent problem resulting from decreased body function in older adults is declining quality of life. Walking and talking among older adults in peer group may become a nursing therapy to improve their quality of life. The objective of this study was to identify the impact of walking and talking intervention of quality of life among community dwelling older adults in Depok, Indonesia. This study applied quasi-experimental design with 43 and 40 older adults in the intervention and control group, respectively. The participants were selected using multistage random sampling method. Based on t test, the average quality of life score of older adults improved more significantly in the intervention group than that in the control group, with p value of 0.003, its mean p value < α, respectively. An ANCOVA analysis was used to detect confounding factors. The result showed that all characteristics have a p value of > 0.05, which means there were no confounding factors warranting further investigation. It was concluded that walking and talking therapy in peer group significantly increase the quality of life of older adults.

Effects of physical activity on the quality of life among adult women

Abstract Aim: the purpose of our study was to analyze the effect of a physical activity program on the quality of life of adult women. Methods: The study involved 95 adult women from Oradea, practitioners of physical exercises in a fitness center. Period of the study: February 2015 - June 2016. Anthropometric measurements were made (height, weight) and it was calculated the body mass index (BMI). The SF-36 short form questionnaire was used to assess the quality of life. The physical activity program consisted of Step - aerobics, Pilates and strength training in the gym, 3 times a week for 60-90 minutes, for 12 months. Results: BMI revealed that of the 95 women enrolled in the initial evaluation 71% were normal weight, 16% were overweight, 8% underweight, 4% obese class I and 1% obese class II. At the final assessment 74% were normal weight, 13% were overweight, 9% underweight, 4% obese class I and no one had class II obesity. The analysis of the answers to the questionnaire revealed the following: the initial average quality of life score was 85.01 and the final score was 89.40; the initial average score of the physical health component was 87.54 and the final score was 92.10; the initial average score of the mental health component was 82.48 and the final score was 86.69. Conclusion: Applying the physical activity program for 12 months led to an improvement in the quality of life, so we can conclude that practicing physical exercise on a regular basis has the effect of increasing the quality of life.

Comorbidity and quality of life in childhood cancer survivors treated with proton beam therapy.

The rate of childhood cancer survival has recently reached >80%. Various adverse events among childhood cancer survivors (CCS) have been reported. Proton beams are able to avoid unnecessary irradiation to normal/vital organs. We conducted a quality of life (QOL) study for CCS who were treated with proton beam therapy (PBT). We included those patients treated with PBT to the brain, head, or neck and who were ≤15years old at the University of Tsukuba Hospital between 1983 and 2011. Clinical information was collected from medical records. Questionnaires including the Pediatric Quality of Life Inventory (PedsQL) 4.0 Generic Core Scales (which assess health-related quality of life) were sent to the families/patients. Sixty patients were included. Median age at treatment was 6.2years. The number of patients with status alive/dead/unknown was 32/24/4. Median follow-up period was 63.0months (range, 48-340months) for survivors. Questionnaires were sent to 25 families/patients and 19 were returned. PedsQL was assessed for 17 patients. Eleven of 32 living patients had at least one comorbidity grade 3/4. Average QOL score was above that for Japanese schoolchildren and adolescents. There was no correlation with comorbidity, and only longer time from treatment was correlated with a higher PedsQL score (P=0.006). CCS who were treated with multimodal treatment using PBT had a higher QOL score. Higher score was related to longer time since treatment, regardless of comorbidity.

Effects of self-efficacy theory on coping style and quality of life of bladder cancer patients underwent the targeted therapy

Objective To explore the effects of self-efficacy theory on coping style and quality of life of patients with bladder cancer underwent the targeted therapy. Methods A total of 84 advanced bladder cancer patients in our hospital from May 2011 to May 2016 were selected in the study using convenience sampling method. All patients were randomly divided into control group and observation group, each 42 cases. Patients in both groups were given the combination of conventional chemotherapy and targeted therapy with trastuzumab intravenous injection. The therapy was observed for 4 cycles. Patients in the control group were given routine nursing during the treatment, while patients in the observation group received additional nursing intervention based on self-efficacy. The prognosis and curative effect, coping style and quality of life scores of patients were recorded in the two groups. Results The total curative effective rate of patients in the observation group was 52.38%, which was higher than that in the control group (28.57%) . The difference was statistically significant between two groups (P<0.05) . After the intervention, the positive coping scores of two groups significantly increased (P<0.05) , while the negative coping scores significantly decreased (P<0.05) . The changes in the observation group was significantly better than that in the control group (P<0.05) . The average quality of life score of the observation group after the intervention was significantly higher than that of the control group (P<0.05) . Conclusions The application of self-efficacy theory in the bladder cancer patients underwent the targeted therapy can promote the transformation of positive coping style and improve the quality of life of patients, which is beneficial to the improvement of the overall total effectiveness. Key words: Bladder neoplasms; Molecular targeted therapy; Quality of life; Coping style; Self-efficacy

Quality of Life of Patients on Maintenance Hemodialysis in Relation to Hemoglobin Level: A Multicenter Study from a Developing Country

Background: Anemia is common in patients with end stage renal disease (ESRD) and is associated with impaired quality of life (QOL). This study was done to evaluate the QOL of ESRD patients on maintenance hemodialysis (MHD) with different levels of hemoglobin (Hb).Methods: This cross-sectional study was conducted from January to December 2013 on 135 adult ESRD patients on MHD for ?4 months, at hemodialysis units of three tertiary care hospitals in Dhaka, Bangladesh. The patients were divided into three groups based on Hb levels (Group 1: Hb &lt;9 gm/dl, n=45, 33%; Group 2: Hb 9-11 gm/dl, n=53, 39% and Group 3: Hb &gt;11 gm/dl, n=37, 28%), provided their Hb levels were stable [ie. maintained with erythropoietin (EPO) or blood transfusion (BT) or both] over the previous four months. Subjects were interviewed by principal investigator using Kidney Disease Quality of Life Short Form Tool (KDQOL-SF-36 version 1.3) consisting of two domains with 38 questions with each item put on a 0 to 100 range, higher scores indicating better QOL.Results: The mean age was 50+12 years with male predominance (male:female = 1.5:1). Mean duration of hemodialysis was 12±11.8 months (range 9 to 66 months). The average QOL score was 50. Comparison of QOL parameters between the three groups showed that symptoms/problems, effects of kidney disease, burden of kidney disease, cognitive function, quality of social interaction and sleep in the kidney disease specific domain as well as pain, emotional well-being, social function and energy/fatigue scale scores in the general health related domain were significantly higher in the group 2 and group 3 than group 1 patients (each with p&lt;0.001). Comparison of QOL parameters between anemia correction measures like EPO (n=65, 48.2%), BT (n=42, 31.1%) or both (n=28, 20.7%) showed that the group receiving EPO alone had better QOL [symptom/ problem (p 0.043), burden of kidney disease (p 0.000), sexual function (p 0.000), pain (p 0.008) and energy/ fatigue (p 0.036)] compared to those getting BT or even BT plus EPO.Conclusion: Patients were found to have better QOL with higher Hb levels. The overall QOL can be improved significantly by correction of anemia.Birdem Med J 2017; 7(3): 198-204

Prevalence and Possible Risk Factors for Urinary Incontinence: A Cohort Study in the City of Izmir

Introduction: This study aimed to evaluate the prevalence and possible risk factors of urinary incontinence (UI) among women aged 18 or older living in the city of Izmir, located in the Aegean coast of Turkey. Methods: A questionnaire and the validated International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) were filled by urologists (O.D., V.S., A.E., O.B., and B.I.) with face-to-face interview. The participants with urge UI (UUI) and stress UI (SUI) were compared in terms of risk factors, quality of life (QoL) scores, severity of incontinence, status of doctor consultation, and total ICIQ-SF scores. Results: A total of 719 women were included and the prevalence of UI was 50.3% in our study. The key risk factors for UUI were hypertension and diabetes mellitus; the key risk factors for SUI were hypertension, multiparity, body mass index, and lower education level. Average QoL (ICIQ-SF 5) score for UUI was worse than SUI (3.8 ± 2.5 vs. 3.3 ± 2.4; p = 0.042) and seeking treatment for UI was significantly higher in participants with UUI when compared to those with SUI (45.1 vs. 24%; p ≤ 0.001). Conclusions: Physicians should be aware that risk factors may differ according to specific UI subtypes when evaluating patients with UI.

Quality of life in patients with colorectal cancer in Iran

Background and study aimsColorectal cancer is a major health problem primarily affecting the quality of life (QoL) of both patient and family. With the advances in surgery and novel chemotherapeutic drugs and modalities, survival has increased and the QoL has improved. The aim of this study was to assess QoL in patients with colorectal cancer taking the situation in the Iranian city Yazd from 2006 to 2011 as an example. Patients and methodsThis study was conducted on 120 patients who were diagnosed with colorectal cancer within the 5-year period of the study. Different aspects of the patients’ lives were assessed using the EORTC Quality of Life Questionnaire (QLQ)-C30 questionnaire, and the results were reported in average aligned score compared with the maximum score of 100. ResultThe mean age of the patients was 60.31±15.71years (range 14–88years). Sixty-three patients were male and 57 female. Further, 85 patients (70.8%) suffered from colon cancer and 34 (28.3%) had rectal cancer. All patients had undergone partial or total colectomies as treatment followed by chemotherapy. The average QoL score was 77.37±8.7 in women and 76.64±8.7 in men. No significant relationship was found between the average QoL score and gender. The average QoL score was 77.28±8.86 for colon cancer and 76.5±8.47 for rectal cancer, which was not statistically significant. The maximum average QoL score was 77.89±8.79 for stage 2 of the disease and the minimum score for stage 3 (75.81±7.66), indicating no significant relationship between the average QoL score and stage of cancer (p=0.89). ConclusionThe results of the present study revealed that despite clinical efforts in the city of Yazd, the QoL of patients with colorectal cancer is still very poor in physical, social, clinical, and financial aspects.

The comparison of EMG-biofeedback and extracorporeal magnetic innervation treatments in women with urinary incontinence

Purpose: This study aimed to compare the effectiveness of EMG-biofeedback (EMG-BF), extracorporeal magnetic innervation (ExMI), and pelvic floor muscle training (PFMT) treatments on women with stress urinary incontinence (SUI). Materials and Methods: The study included 67 women with SUI. Pelvic floor muscles (PFMs) were evaluated with electromyography and the quality of life (QoL) with Incontinence Quality of Life (I-QoL) questionnaire; afterwards, the subjects were divided into three groups; EMG-BF group (n=23), ExMI group (n=20), and PFMT group (n=24). EMG-BF group and ExMI group were given training in urogynecological physiotherapy clinic. PFMT group were given eight-week home exercises. Each group was assessed before training and after eight weeks. Results: All three groups showed a significant improvement in EMG activity values and average QoL scores. The greatest improvement was observed in the EMG-BF training group for QoL scores. Conclusions: This study demonstrated that all of the three methods performed with the purpose of increasing PFM strength were effective. The increase in PFM strength reduces incontinence associated symptoms and thus improves QoL.

Quality of Life Predictors and Glycemic Control among Type 2 Diabetic Patients Attending Primary Health Care Centers in Qatar

Introduction: Diabetes is one of the most worldwide prevalent chronic diseases that impact the quality of life. The aim of treatment in diabetes must go beyond glycemic control to include quality of life. The aim of this study is to assess quality of life and glycemic control among diabetic patients attending Primary Health Care Centers in Qatar. Methods: Descriptive cross sectional study was conducted to assess quality of life in 281 adult patients with type 2 diabetes attending non-communicable disease clinics in Primary Health Care Centers in Qatar. patients completed SF- 36 checklist and information about socio demographic data and disease characters which include some measurements from patient files (BMI,HBA1C,LDL). Data analysis was applied to identify the significant predictors of quality of life with significant limit of P<0.05. Results: Total sample include 281 patients adult diabetics of whom mean age 53 ± 10.4, 62.1% were males while 37.9% were females, 28.6% were Qatari patients, diabetics with duration more than 10 years represent 37.2%, the average quality of life score is 64.4 ± 24.6, increasing age is significantly associated with less quality of life scores, males were having significantly higher scores than females. Single patients, higher education, type of medications (tablets), controlled LDL and employed were having significant high scores in different quality of life domains. Prolonged duration of diabetes and complications is significantly associated with less quality of life scores, while obesity and HBA1c were not significantly associated with quality of life domains. Conclusion: Complications, insulin users and women appear to be the most incremental correlate for poor quality of life so special consideration before shifting to insulin and future research on gender specific attributes to improve quality of care to this vulnerable group.

Assessment of an established dialysis nurse practitioner model of care using mixed methods research

Aims and Objectives: To assess a dialysis nurse practitioner (NP) model of care by examining satisfaction, quality of life (QOL) and clinical outcomes of haemodialysis patients and explore experiences of dialysis nurses.Design: Mixed methods.Methods: Database analyses of dialysis indices amongst a sample (n = 45) of haemodialysis patients; a survey (n = 27) examining patient experience, satisfaction and QOL; and in-depth interviews with a sample (n = 10) of nurses.Results: Nurses commended the NP role, with five themes emerging: “managing and co-ordinating”, “streamlining and alleviating”, “developing capability”, “supporting innovation and quality” and “connecting rurally”. Patients’ average age was 66 years and 71% were male. Patients’ satisfaction with the care they received was rated 3.5/4 or higher across seven parameters and the average QOL score was 7.9/10.Conclusion: The NP model of care is effective in enhancing patient care within a collaborative framework. The challenge is to sustain, and enhance the model, through mentorship programs for potential candidates.

Intravenous Hydration for Management of Medication-Resistant Orthostatic Intolerance in the Adolescent and Young Adult.

Orthostatic intolerance (OI) is common in teenagers (T) and young adults (A). Despite treatment with oral fluids, medication, and exercise, a significant number have symptoms from multiple organ systems and suffer low quality of life (QOL). Previous studies showed that acute intravenous (IV) hydration (IH) could help restore orthostatic tolerance; however, no data are available about the intermediate-term effects of IH. We therefore studied the efficacy of IH to improve QOL and manage medication-refractory OI patients. Our study population consisted of 39 patients (mean age = 16.1 ± 3.3) years; thirty-two were female. Average number of medications failed = 3.1. Average QOL score on self-reported OI questionnaire was 4.2 (normal QOL = 10). IV hydration consisted of normal saline (1-2 l/day, 3-7 days/week). 1) Orthostatic testing revealed Postural Orthostatic Tachycardia (24), Neurally Mediated Hypotension (14) or OI (1). 2) Average orthostatic change in heart rate was 48 ± 18 bpm. 3) IH was performed via intermittent IV access (10), PICC line (22), and Port (7). 4) Duration of IH varied from 1 week to 3.8 years (mean = 29 ± 47 weeks). 5) Overall, 79 % (n = 31) demonstrated clinically improved self-reported QOL. 6) Six patients who discontinued IH requested to restart treatment. (7) Complications consisted of upper extremity deep vein thrombosis (n = 3) and infection (n = 4). IH is an effective therapy to improve QOL in T&A with medication-resistant OI. Most patients continued to report improved QOL once IH was discontinued. IH should be considered a therapeutic option in medication-resistant OI patients with low QOL.

Quality of life for glaucoma patients

Visual impairments are a serious problem due to the limitations that they impose in everyday life and the loss of independence. Aim of the study: to analyze the way the demographic variables (gender, age, place of residence, education, marital status and employment status) affect the quality of life; the way the quality of life changes and which activities are affected by the impairment of the visual functions. Material and methods: 54 individuals with proven glaucoma and permanent low vision have been surveyed (assessment criteria of the impairment degree is the correction of the better eye). With a view to do this we used LWQOL Wolffson J S 2000. The questionnaire contains four chapters: demographic, general diseases, ophthalmological status and psychometric section including four dimensions (Distance, mobility and illumination vision; Adaptation; Reading and fine work and Everyday activities). We have determined the reliability of the questionnaire with the help of the Cronbach`s alpha coefficient. Results: The average quality of life score is 81,5 ± 17,4. The quality of life impairs with ageing (94,5±13.6 for individuals above 80 years of age). Although the difference in terms of place of residence is insignificant, the worst quality of life is shown by the village residents (82,8 ± 13,1). For the married individuals a higher quality of life is observed contrary to those who live alone. The lowest quality of life is observed for the individuals who live with their children (87,8 ± 19,7). The low educational degree correlates with a low quality of life. Regarding the employment status the worst indicators are observed for the retired individuals followed by those who have retired due to an illness. The most affected activities are those related to illumination, mobility and fine work. Conclusions: the quality of life impairment for glaucoma patients is directly associated to the demographic indicators and the visual impairment degree. The low percentage of usage of auxiliary means (7,40 %) by the questioned patients shows low motivation and insufficient level of information.

Quality of life and type 1 diabetes: a study assessing patients' perceptions and self-management needs.

PurposeThe main objective of this study was to assess quality of life (QoL) and treatment satisfaction in a group of patients with type 1 diabetes (T1D) and explore their needs regarding and their perception of QoL living with diabetes.Materials and methodsPatients with type 1 diabetes attending the outpatient endocrinology clinics of a reference hospital were invited to participate in a cross-sectional study. Clinical and sociodemographic data were obtained (interview and clinical records), and diabetes-related QoL was assessed using a standardized questionnaire. In 67 participants, satisfaction with treatment was also assessed, and an open interview was performed, assessing the impact of diabetes, long-term worries, flexibility, restrictions, and self-perception of QoL. Descriptive statistical analysis, bivariate analysis, and multivariate analysis were performed in order to find factors associated with QoL. Interviews were analyzed and summarized questionwise.ResultsMean patient age was 31.4±11.6 years, diabetes duration 14.2±9.3 years, and glycated hemoglobin (HbA1c) 8.5%±1.9% (69±20.8 mmol/mol International Federation of Clinical Chemistry [IFCC]). The questionnaires showed good average QoL scores (94.6+22.9) and treatment satisfaction scores (25.7±6.7). QoL worsened with increasing HbA1c, female sex, severity of complications, and lower education (r2=0.283, P<0.005). In the open interview, 68.5% of the patients reported that diabetes had changed their lives, 83.5% identified complications as their most important long-term concern, and 59.7% said that they needed more training to manage the disease.ConclusionPoor glycemic control, lower education, complications, and female sex are associated with worse QoL. Semi-structured interviews identified aspects not included in the standardized questionnaires.

Caregivers and Left Ventricular Assist Devices as a Destination, Not a Journey

BackgroundThe quality of life (QOL) of caregivers of patients with LVAD-DT (Left Ventricular Assist Device as Destination Therapy) has not been well explored. MethodsWe used a concurrent mixed methods design. Caregivers (n = 42; average 60 years old, 82% female, 75% white) of patients (n = 39; average 68.3 years old, 83% male, 90% white) and providers (n = 27) from 6 LVAD-DT programs were recruited. We used the City of Hope Quality of Life Family Caregiver instrument, modified for LVAD-DT. Lower scores indicate poorer QOL. We analyzed open-ended questions with the use of Nvivo 10.0, using a modified grounded theory approach. ResultsThe Psychologic subscale had the lowest average QOL score, followed by Social, Spiritual, and then Physical subscales. The composite mean average QOL score across the subscales was highest in caregivers <40 years of age and ≥70 years of age. There was a nonsignificant trend toward better QOL in male caregivers (P = .06). We sorted QOL items into tertiles based on the percentage of responses <5 (10-point Likert scale). Scores <5 in the 2nd tertile (items from Social and Spiritual subscales) were reported by many fewer respondents than the 1st tertile (items from the Psychologic subscale). In the 3rd tertile, <10% of respondents scored <5 on 15 of the items. In qualitative interviews psychologic and social themes predominated in discussing requisites for competent caregivers, stress in pre-implantation decision making, lack of psychologic preparation, impact on freedom/independence, daily worry about pump performance, and value of psychologic and social support. ConclusionSupport interventions for caregivers of patients with LVAD-DT should address the psychologic and social aspects that lead to poor QOL.

Impact de la réhabilitation respiratoire sur l’anxiété et la dépression après chirurgie thoracique pour cancer

Pulmonary rehabilitation (PR) for patients undergoing lung resection for cancer remains controversial. We studied the effects of PR, its impact on quality of life and the level of anxiety and depression. In 2011 and 2012, PR was offered to all patients referred to our institution after lung resection for cancer. Patients were evaluated between admission and discharge by a 6 minutes walking test (6MWD), a Visual Analogue Pain Intensity Scale, a quality of life questionnaire (EORTC QLQ C30) and by the Hospital Anxiety and Depression Scale (HAD). The same questionnaires were mailed 6 months after completing PR. Between early 2011 and late 2012, 133 patients were admitted to our institution following lung resection for cancer. Of these, 59 (44%) patients completed PR and returned their questionnaires 6 months after discharge. During PR of these 59 patients, the mean quality of life score increased from 56.3 to 65.9 (P<0.05), the median anxiety score decreased from 5.5 to 4 (P<0.05) and that of depression from 3 to 2 (P<0.05). At 6 months post-discharge, the mean quality of life score remained stable at 66.3 (P=0.8), the median anxiety score reverted to 6 (P<0.05) and the median depression score reverted to 4.5 (P<0.05). This observational study during PR, showed that quality of life and the levels of anxiety and depression were improved at the end of the course. After returning home, the average quality of life score remained stable but the level of anxiety and depression increased.

Identifying environmental and management factors that may be associated with the quality of life of kennelled dogs (Canis familiaris)

This paper describes the use of a validated quality of life assessment tool (described elsewhere) to identify environmental and management factors that may affect quality of life in dogs kennelled in rehoming centres. Dogs were allocated to one of the four treatment groups, all of which had a positive (0.0–1.0) average quality of life score: long stay dogs with an enriched routine had a mean score of 0.477; long stay dogs with a standard routine had a mean score of 0.453; newly admitted dogs with an enriched routine had a mean score of 0.399; and newly admitted dogs with a standard routine had a mean score of 0.362. Only 2% of the dogs had a negative score (−1.0–0.0). Thirteen rehoming centre managers completed a questionnaire relating to the kennel environment and management practices of their rehoming centres. The environmental and management factors’ associations with quality of life scores, collected from 202 dogs from the 13 rehoming centres using this scoring system, were analysed as fixed factors in a linear mixed-effect model, with rehoming centre fitted as a random factor, and a multiple linear regression model. There was a statistically significant association between quality of life scores and rehoming centre (H(12)=54.153, p<0.001), however, the fitted linear mixed-effect model did not improve upon the null model and therefore cannot be used to explain the 29% variance in quality of life scores attributed to rehoming centre. The multiple linear regression model explained 42% of the variation in quality of life scores (F(10,131)=9.318, p<0.001): the provision of bunk beds increased quality of life scores by 0.3 (t=3.476, p<0.001); provision of 30min or more of staff or volunteer interaction increased scores by 0.26 (t=−2.551, p=0.012); grooming dogs decreased scores by 0.404 (t=3.326, p=0.001); exercising dogs more than once a day decreased scores by 0.173 (t=−3.644, p=<0.001), whereas exercising dogs for 30min or more increased quality of life scores by 0.213 (t=−2.374, p=0.019) and the provision of less common types of exercise increased scores by 0.504 (t=5.120, p<0.001); training dogs for 30min or more every day increased scores by 0.688 (t=3.040, p=0.003) and training dogs less than daily decreased scores by 0.393 (t=−4.245, p<0.001); feeding a diet of dry and wet food compared to dry food alone decreased scores by 0.08 (t=−2.331, p=0.021); and a quiet environment increased scores by 0.275 (t=−3.459, p<0.001). These results suggest that environmental design and kennel management have an impact on the quality of life of kennelled dogs and should be considered carefully in decision-making processes. However, further study may be required as grooming and exercising dogs more than once per day decreased quality of life scores, which are not obviously intuitive results.

Quality of Life of Patients Undergoing Cancer Treatment in B.P. Koirala Memorial Cancer Hospital, Bharatpur, Chitwan, Nepal

This research entitled “Quality of Life of Patients Undergoing Cancer Treatment in B.P. Koirala Memorial Cancer Hospital, Bharatpur, Chitwan” was conducted to assess the quality of life of cancer patients. It was carried out among patients attending B. P. Koirala Memorial Cancer Hospital, Bharatpur, Chitwan. Background: In patients with different type of cancers and the quality of life (QoL) improvement is the main goal, since survival can be prolonged marginally. A diagnosis is very stressful for people, affecting all aspects of their being and quality of life. Up to date, knowledge on QoL impairments throughout the entire treatment process, often including several treatment modalities is scarce. One objective of this study was to assess the quality of life of cancer patient undergoing cancer treatment. Methods: A quantitative, cross-sectional, descriptive, design was adapted. A total of 245 cancer patients above 20 years old, were enrolled in the studies during August-September, 2013. Inclusion criteria were patients who had already received at least one type of cancer treatment and had attended the hospital for receiving the same or next type of treatment again. Exclusion criteria were any other chronic co-morbidity condition that could be influenced their QoL. The most commonly listed medical co-morbidities were: diabetes mellitus, hypertension, coronary artery disease. Cancer patients who have Eastern Co-operative Oncology Group (ECOG) performance status of 4 (i.e. fully bed-ridden) were excluded from the study. The data was collected by interview, using modified, structured scale of European Organization for Research and Treatment of Cancer Quality of life Questionnaire (EORTC QLQ- C30), prepared by the EORTC group. Information about the patient’s disease condition and treatment were obtained from the patient’s medical records. The collected data was analyzed by using SPSS version 16. Descriptive and inferential statistics were used to describe the respondent’s quality of life (QoL) scores and to identify the factors affecting it respectively. Results: The study findings revealed the quality of life of cancer patients to be influenced by many factors such as: site of cancer, stage of cancer, time elapsed since diagnosis and Eastern Co-operative Oncology Group (ECOG) performance status. The average QoL scores (out of 100) for different scales were 85.54 (global health/QoL), 77.03 (functional), and 16.14 (symptom). Loss of appetite was the most frequent complaint (mean = 20.27) and was present in almost all the patients. As the overall QoL of the patients was significantly correlated with different QoL scales as-, cognitive, emotional, physical, social, role functioning, pain, fatigue, dyspnoea, loss of appetite and nausea/vomiting and financial problem. Conclusion: Hence, in average, the quality of life of cancer patients was found to be relatively better, although there were higher ratings for some (as: cognitive, physical, role and emotional functioning) and lower for others (like social functioning). Additional research should be done in this area for improving the quality of life of specific type of cancer patients in Nepal, though the findings of this study are expected to provide the baseline knowledge regarding it.

Long Term Update on Phase I/II Trial with Immucin Anti-MUC1 Signal Peptide Vaccine for Multiple Myeloma Patients with Residual Disease or Progression

Background:ImMucin is a 21-mer long peptide therapeutic vaccine encoding the entire signal peptide (SP) domain of the MUC1 tumor-associated antigen, which is over expressed by most hematological tumors including multiple myeloma (MM).Results from first in man phase I/II study (VAXIL-001) demonstrated that 100 micrograms (ug) ImMucin combined with 250ug hGM-CSF is highly tolerable and can induce a robust, diversified MUC1 SP-specific T cell and B cell immunity in most patients, across major histocompatibility complex barrier. ImMucin vaccination also led to a significant decline in soluble MUC1 (sMUC1) in 9/10 patients with abnormal prevaccination levels, accompanied with disease stabilization.Methods:This current follow–up phase I/II study investigated the long term safety, quality of Life (QOL) (primary endpoint) and efficacy (both immunity and clinical response a secondary endpoint), of ImMucin, obtained in VAXIL-001 study, in participant MM subjects that didn’t required further treatment post vaccination. Patients were being evaluated once every 3 months in the first year and twice a year at the following years till progression or Q4-2015. QOL easement was assessed every visit using the SF-36 questionnaire. Immunomonitoring analysis included; CD62L+effecter memory marker, ImMucin-specific IFN-g production in CD4+ and CD8+ T-cells and anti-MUC1 SP antibody production. Clinical response was assessed according to the international myeloma working group response criteria sMUC1 levels were also evaluated every visit.Results:Long- term safety was encouraging, with no evidence for any adverse events. Additionally, the average QOL score was maintained throughout the study. Immunity, determined by INF-g production by both CD4+ and CD8+ T-cells and anti-MUC1 SP antibodies, was maintained for 6-10 and 10-12 months post vaccination respectively. The predominant T-cell phenotype during the post vaccination period was characterized with CD62L+ CD4 and CD8+ T-cells. At 13-41.3 months after the completion of the VAXIL-001 study (measured for first and last patients, respectively), 12/15 patients are alive. Median time from first vaccination was 24 months (range 2.5-41.3), at which time 10/15 patients had a PD. Disease progressed during the vaccination period (up to week 26) in 4/15 patients and during the follow up period in 6/15 patients. Notably, 5/15 patients maintained their CR (n=3) or SD (n=2).Notably, clinical response was associated with low-intermediate PDL-1 bone marrow (BM) levels prior and post vaccination, while high PDL-1 BM levels were associated with temporary response and progression. Moreover, sMUC1 levels have moderately increased during the follow up period (x>600pg/ml), though didn’t reach initial prevaccination values.ConclusionsImMucin demonstrated an encouraging short and long-term safety profile. Vaccination induced a remarkable anti-MM immune response. However, immunity was transient suggesting a need for boosting. Interestingly, durable disease stabilization was achieved in third of the patients, continuing despite loss of immune response in peripheral blood. Moreover, the encouraging responses to subsequent therapies employed at clinical progression, suggest this novel approach to be potentially valuable in the setting of maintenance and/or early biochemical progression. DisclosuresCarmon:Vaxil BioTherapeutics Ltd. : Employment, Equity Ownership, Membership on an entity’s Board of Directors or advisory committees, Patents & Royalties. Kovjazin:Vaxil BioTherapeutics Ltd. : Employment. Shapira:Vaxil BioTherapeutics Ltd. : Consultancy.