Changes In Health Scores Research Articles

Randomized Control Trial on the Effect of Health Education on Health Related Quality of Life Among Tuberculosis Patients in Kenya

Although health education is incorporated in tuberculosis treatment in Kenya, its role in improving quality of life of the patient is unknown. The main objective of the study was to determine effect of health education on the health related quality of life of tuberculosis patients in Kenya. To achieve this goal the health education program was designed using the PRECEDE-PROCEED model of study. Randomized controlled trial design with pre- and post-test assessments was adopted. The study was conducted between September 2019 and February 2020 in Nairobi and Murang’a Counties. A sample size of 450 patients was calculated with 373 meeting the eligibility criteria. Before introducing health education the patients were assigned into experimental and control groups. Health education was administered to the experimental group but no such intervention was given to the control group. After six months the two groups were compared. A standard questionnaire was used to collect demographic data while data on health related quality of life adopted EQ-5D-5L and EQ-VAS instruments. MANOVA was used to analyze domains of health and scores on the test of perceived poor health. 15% of the changes in the domains of health were accounted for by health education while 39.3% of changes in health scores were attributed to health education. The study concluded that improved knowledge on TB by patients as a result of health education enhanced the health related quality of life. It was recommended that the health education model be adapted in other health facilities providing tuberculosis services in Kenya.

Assessment of health-related quality of life in cancer patients undergoing treatment using Health Utilities Index (HUI-3®) in East Delhi, India.

Health-related quality of life (HRQOL) is a construct that focuses on the capacity for living afforded by the health status of a patient. Measurement of HRQOL allows a composite estimation of the capacity for living of a patient and can help capture the suffering experienced by the patient due to adverse effects of therapeutic interventions. This study was conducted to understand the health-related quality of life of cancer patients undergoing various modalities of treatment to generate evidence source for need-based intervention, to assess patients diagnosed with cancers, using Health Utilities Index - 3 (HUI-3®) and assign them single-score values to gauge HRQOL and to measure the various domains of HRQOL and change in HRQOL after a period of three months of treatment. A descriptive, longitudinal study was conducted amongst patients aged more than 18 years, who were diagnosed with cancer at a tertiary care multispecialty hospital in New Delhi. They were administered a standardized HUI-3 Questionnaire® and their responses were recorded, simultaneously. Statistical significance for change in HRQOL score was assessed with paired t-test. Multivariate linear regression was used to identify the various correlates of HRQOL. The mean (± standard deviation) overall HRQOL score for all participants was 0.71 (± 0.262) [range=-0.09 to 1.00]. A follow-up assessment was carried out after three months and changes in health scores were subsequently recorded. A significant decrease in mean overall HRQOL score was seen for the entire group after three months of having been administered treatment. Single-attributes of emotion and ambulation were maximally affected amongst cancer patients after three months of treatment. On linear regression analyses, baseline HRQOL was a significant correlate of HRQOL at follow-up after three months. ">Addressing the HRQOL of a cancer patient before starting treatment would address morbidity that might be present even after three months.

Salivary Biomarkers in College Female Basketball Players during the Late Competition Season

The college basketball season involves multiple competitions and strenuous practice that have been linked to signs of overtraining. During the late competition period, evaluation of stress and recovery can assist coaches in determining player loads to ensure optimal performance. PURPOSE: To assess factors that reflect on stress and recovery through the study of salivary biomarkers. METHODS: Fifteen members of the college women’s basketball team volunteered to participate. Saliva samples (0.75mL) was collected 24 hours before (pre) and 24 hours after (post) a competition during the last three weeks of the regular season. Salivary samples were stored frozen and then sent to a laboratory for analyses at the end of the study period. Biomarker concentrations were determined using indirect ELIZA for testosterone, cortisol and secretory immunoglobulin A. In addition, at the time of the saliva collection, subjects were asked to report their perception of overall health, level of anxiety, and mood. ANOVA were used to test for significance (95 level of confidence) for pre-post measures and weekly variance. Correlations between perceptions of health, anxiety, mood, and salivary biomarkers were conducted. RESULTS: The means (SD) of the biomarkers and subjective measures are reported below.None of the salivary biomarkers were significantly different in pre-post comparisons nor across the three weeks. Changes in health scores, anxiety, or mood were not significantly different. Overall the testosterone showed significant correlations with cortisol (r=0.51), sigA (p=0.46), and health score (p=-.31). In addition, cortisol was significantly related to health score (p=-0.24). Health score showed a negative relationship with anxiety ranking (r=-.30) while no other relationships were evident. CONCLUSION: The lack of significance between these variables might indicate that these players did not show indication of stress or lack of recovery during this period of competition.

Health related quality of life in patients with epilepsy in Turkey.

[Purpose] This study measured the quality of life in epilepsy and determined associated demographic and clinical factors by means of the Short Form-36 health survey. [Subjects and Methods] 124 consecutive epilepsy patients were enrolled and their demographic variables and clinical characteristics recorded. The Short Form-36 questionnaire was completed independently by each participant. Short Form-36 dimensional and composite scores were computed and scaled with data from an extensive survey of the healthy population. [Results] Short Form-36 scores for physical dimensions were similar to healthy values, but those for mental dimensions except for energy/vitality were remarkably and significantly lower than normal. All Short Form-36 average scores for women were lower than those for men and significantly so for mental health composite scores. Patients responding well to treatment were aware of their improving health as measured by the Change in Health score and had better dimensional scores than those with a poor response. [Conclusion] Patients with epilepsy do not perceive impaired physical health status. However, their mental health appears vulnerable, especially in women. Therefore, the major burden in epilepsy is in the mental health category. A positive treatment response is also an important determinant of the related quality of life measure.

Surgery for the treatment of obesity in children and adolescents.

Child and adolescent overweight and obesity have increased globally, and are associated with significant short and long term health consequences. To assess the effects of surgical interventions for treating obesity in childhood and adolescence. We searched the Cochrane Library, MEDLINE, PubMed, EMBASE as well as LILACS, ICTRP Search Portal and ClinicalTrials.gov (all from database inception to March 2015). References of identified studies and systematic reviews were checked. No language restrictions were applied. We selected randomised controlled trials (RCTs) of surgical interventions for treating obesity in children and adolescents (age < 18 years) with a minimum of six months follow-up. Interventions that specifically dealt with the treatment of eating disorders or type 2 diabetes, or included participants with a secondary or syndromic cause of obesity were excluded. Pregnant females were also excluded. Two review authors independently assessed risk of bias and extracted data. Where necessary authors were contacted for additional information. We included one RCT (a total of 50 participants, 25 in both the intervention and comparator group). The intervention focused on laparoscopic adjustable gastric banding surgery, which was compared to a control group receiving a multi component lifestyle programme. The participating population consisted of Australian adolescents (a higher proportion of girls than boys) aged 14 to 18 years, with a mean age of 16.5 and 16.6 years in the gastric banding and lifestyle group, respectively which was conducted in a private hospital, receiving funding from the gastric banding manufacturer. The study authors were unable to blind participants, personnel and outcome assessors which may have resulted in a high risk of performance and detection bias. Attrition bias was noted as well. The study authors reported a mean reduction in weight of 34.6 kg (95% confidence interval (CI) 30.2 to 39.0) at two years, representing a change in body mass index (BMI) of 12.7 (95% CI 11.3 to 14.2) for the surgery intervention; and a mean reduction in weight of 3.0 kg (95% CI 2.1 to 8.1) representing a change in BMI of 1.3 (95% CI 0.4 to 2.9) for the lifestyle intervention. The differences between groups were statistically significant for all weight measures at 24 months (P < 0.001). The overall quality of the evidence according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE) was low. Adverse events were reported in 12/25 (48%) participants in the intervention group compared to 11/25 (44%) in the control group (low quality evidence). A total of 28% of the adolescents undergoing gastric banding required revisional surgery. No data were reported for all-cause mortality, behaviour change, participants views of the intervention and socioeconomic effects. At two years, the gastric banding group performed better than the lifestyle group in two of eight health-related quality of life concepts (very low quality evidence) as measured by the Child Health Questionnaire (physical functioning score (94 versus 78, community norm 95) and change in health score (4.4 versus 3.6, community norm 3.5)). Laparoscopic gastric banding led to greater body weight loss compared to a multi component lifestyle program in one small study with 50 patients. These results do not provide enough data to assess efficacy across populations from different countries, socioeconomic and ethnic backgrounds, who may respond differently. This systematic review highlights the lack of RCTs in this field. Future studies should assess the impact of the surgical procedure and post operative care to minimise adverse events, including the need for post operative adjustments and revisional surgery. Long-term follow-up is also critical to comprehensively assess the impact of surgery as participants enter adulthood.

Cohort study on the effects of everyday life radio frequency electromagnetic field exposure on non-specific symptoms and tinnitus

Background There is public concern regarding potential health effects of radio frequency electromagnetic fields (RF-EMF) exposure, as produced by mobile phones or broadcast transmitters. The objective of this study was to investigate the association between RF-EMF exposure and non-specific symptoms and tinnitus in a prospective cohort study. Methods In 2008, 1375 randomly selected participants from Basel, Switzerland, were enrolled in a questionnaire survey with follow-up after one year (participation rate 82%). A score for somatic complaints (von Zerssen list) and headache (HIT-6) was assessed. Far-field environmental RF-EMF exposure was predicted using a validated prediction model. Regarding near-field exposure, self-reported mobile and cordless phone use as well as mobile phone operator data were collected. In multivariate regression models, we investigated whether exposure at baseline (cohort analysis) or changes in exposure between baseline and follow-up (change analysis) were related to changes in health scores. Results For participants in the top decile of environmental far-field RF-EMF exposure at baseline, in comparison to participants exposed below the median value, the change in the von Zerssen- and HIT-6-scores between baseline and follow-up was − 0.12 (95%-CI: − 1.79 to 1.56) and − 0.37 (95%-CI: − 1.80 to 1.07) units, respectively. Exposure to near-field sources and a change in exposure between baseline and follow-up were not related to non-specific symptoms. Similarly, no association between RF-EMF exposure and tinnitus was observed. Conclusions In this first cohort study using objective and well-validated RF-EMF exposure measures, we did not observe an association between RF-EMF exposure and non-specific symptoms or tinnitus.

The impact of continuous subcutaneous insulin infusion on health‐related quality of life in children and adolescents with type 1 diabetes

To study the impact of continuous subcutaneous insulin infusion (CSII) therapy on health-related quality of life in children and adolescents with type 1 diabetes. 31 children and adolescents with poorly regulated type 1 diabetes (mean HbA1c 10.4%, SD 1.8), mean age 14.4 (1.5) y (range 9.7-17.1) and mean diabetes duration of 6.8 (3.2) y (range 1.3-14.6) were consecutively assigned to CSII therapy. Data for generic (CHQ-CF87) and diabetes-specific quality of life (DQOL) were obtained before initiating pump therapy and twice during 15 mo of treatment. HbA1c, BMI and episodes of severe hypoglycaemia and ketoacidosis were recorded over 15 mo prior to and 15 mo during pump therapy. Analysis showed improvements on the family activity scale (p=0.041) and change in health score (p=0.042) (CHQ-CF87). Mean HbA1c decreased from 10.4% (1.8) to 9.0% (0.9) after 3 mo, increasing to 9.6% (1.2) after 15 mo. The number of overweight and obese children increased from 4 and 2 before CSII, to 6 and 3 after 15 mo (IOTF criteria). There was a reduction in severe hypoglycaemia episodes from 43.8 to 5.2 per 100 patient years, but no change in ketoacidosis episodes. The degree of limitation experienced by families due to adolescents' general health and well-being was significantly reduced. Expected improvement in metabolic control and frequency of severe hypoglycaemia was observed.

Improved quality of life among patients with symptomatic carotid artery disease undergoing carotid endarterectomy

Background: Few studies have examined how carotid endarterectomy affects patients' view of their quality of life. Methods: Patients undergoing carotid endarterectomy from January 1996 to March 1997 at the John Radcliffe Hospital completed the United Kingdom Short Form 36 (SF-36) Health Survey Questionnaire before undergoing the procedure and again at 3 months afterward. Scores were compared with population normal values. Results: In 50 patients with symptomatic carotid artery disease, there was significant improvement in the SF-36 overall “change in health” score after the procedure compared with beforehand (61.0 ± 3.7 vs 44.5 ± 3.4, P =.003, Wilcoxon signed rank test). There were, however, no statistically significant differences in the group's mean SF-36 subscores after operation compared with before the procedure. The physical subscores were below age-adjusted healthy population means but similar to those for chronically ill patients (physical function subscore P =.015 vs normal, P =.89 vs ill; role limitation-physical subscore P =.007 vs normal, P =.89 vs ill). Patients with postoperative complications did not have an improved change in health score (–12.5 vs 22.0, P =.03, Mann-Whitney U test). There was no effect on change in health score because of other risk factors or in patients with contralateral carotid artery occlusion or a history of preoperative stroke. Conclusions: Patients with symptomatic carotid artery disease undergoing an uncomplicated carotid endarterectomy perceive improved quality of life and overall health. There is no perception of worsened pain, energy, or physical or mental function after the procedure. These results confirm that patients believe that performance of carotid endarterectomy improves their overall health, supporting the surgical approach to carotid artery disease. (J Vasc Surg 2001;33:329-33.)

The Effects of Dietary Patterns on Quality of Life: A Substudy of the Dietary Approaches to Stop Hypertension Trial

Few studies have examined the effects of dietary changes, particularly modifications of whole dietary patterns, on quality of life. The Dietary Approaches to Stop Hypertension (DASH) trial compared the effects of 3 dietary patterns on blood pressure. In this substudy, we examined the effect of these diets on health-related quality of life. All DASH participants ate a control diet for 3 weeks and then were randomly assigned to continue the control diet, to a fruits and vegetables diet or to a combination diet for 8 weeks. The combination diet emphasized fruits, vegetables, and low-fat dairy products. It included whole grains, poultry, fish, and nuts, and was reduced in fats, red meat, sweets, and sugar-containing beverages. The control diet was similar to typical American intake; the fruits and vegetables diet was rich in fruits and vegetables but was otherwise similar to the control diet. Both the fruits and vegetables diet ( P<001) and the combination diet ( P<.001) significantly lowered blood pressure. At the Duke University Medical Center, Durham, NC, site, participants completed the Medical Outcomes Study Short Form-36 questionnaire to assess their health-related quality of life at baseline and at the end of the dietary intervention. Eighty-three participants completed the questionnaires at both time points. In general, health-related quality of life improved in all treatment groups except for the control group in perceptions of change in health, which diminished. In the combination diet group all the subscales were improved or unchanged compared with baseline values. However, only the change in health score improved significantly ( P<.05) as compared with that of the control diet group. When all the subscales were summed into a total score, the control diet was associated with mean improvement of 4.0%, the fruits and vegetables diet with 5.0%, and the combination diet with 5.9% from baseline. These data suggest that the fruits and vegetables diet and particularly the combination diet cannot only lower blood pressure, but may also improve the perception of health-related quality of life. J Am Diet Assoc. 1999;99(suppl):S84–S89.