Changes In Self-reported Quality Of Life Research Articles

Early Change in Quality of Life in the Treatment of Anorexia Nervosa

This study aimed to examine whether early change in self-reported quality of life (QoL) was a predictor of outcomes in the treatment of anorexia nervosa (AN). Given suggestions that people with AN overestimate their QoL when unwell, we hypothesised that any early change in self-reported QoL, be it an early improvement or early worsening, would predict better outcomes in terms of end-of-treatment body mass index (BMI), eating disorder (ED) psychopathology, and QoL. Participants were 78 adult outpatients engaged in cognitive behaviour therapy for anorexia nervosa (CBT-AN) either with or without the embedded compulsive exercise module “compuLsive Exercise Activity TheraPy” (LEAP). Polynomial regression was utilised to examine the effects of varying combinations of baseline and 10-week self-reported physical-health-relatedr QoL (SF-12; PHRQoL subscale), mental-health-related QoL (SF-12; MHRQoL subscale), and eating-disorder-specific QoL (EDQoL; global, psychological, cognitive/physical, financial, and school/work subscales) on end-of-treatment BMI, ED psychopathology, and QoL. Greater magnitudes of early change in global EDQoL scores, both positive and negative, predicted better MHRQoL but not BMI or ED psychopathology at the end of treatment. Psychological EDQoL ratings also accounted for 38.1% of the variance in end-of-treatment ED psychopathology, although tests examining the 6ratings may be meaningful in predicting treatment outcomes. The positive impact of early worsening in QoL ratings suggests that early QoL ratings are inflated due to denial and poor insight. Clinicians should be reassured that early QoL decline does not indicate treatment failure.

Assessment of a Multispecies Probiotic Supplement for Relief of Seasonal Allergic Rhinitis: A Randomized Double-Blind Placebo-Controlled Trial

Background: Early phase clinical research provided initial support for the use of a multispecies probiotic supplement to improve quality of life (QoL) in adults with seasonal allergic rhinitis (AR) and reduce the use of AR symptom relieving medication. This study aimed to confirm these early phase findings in a double-blind randomized placebo-controlled trial. Methods: Individuals, aged 18-65 years, with a minimum 2-year history of AR, moderate-to-severe AR symptoms, and a positive radio-allergosorbent test to Bermuda (Couch) Grass were randomized to receive either a multispecies probiotic supplement (total colony-forming units 4 × 109/day) or placebo twice daily for 8 weeks. A mini-rhinoconjunctivitis quality of life questionnaire (mRQLQ) scale was administered at screening, days 0, 28, and 56. The proportion of participants with a >0.7 improvement in mRQLQ was the primary outcome. Participants also completed a daily symptom and medication diary during the supplementation period. Results: There were 165 participants randomized, with 142 included in the primary outcome analysis. The percentage of participants meeting the threshold for a clinically meaningful reduction in the mRQLQ from days 0 to 56 was not significantly different between groups (61% vs. 62%, p = 0.90). However, 76 participants had a clinically meaningful improvement in QoL (decrease in mRQLQ >0.7) prior to the start of supplementation (screening to day 0). Conclusion: Changes in self-reported QoL and other disease severity metrics between screening and the start of supplementation limited the ability to discern an effect of supplementation and highlight the need for adaptive clinical trial designs in allergy research. Clinical Trial Registration: The trial was registered with the Australia and New Zealand Clinical Trials Registry (ACTRN12619001319167).

EPCT-12. PNOC015: PHASE 1 STUDY OF MTX110 (AQUEOUS PANOBINOSTAT) DELIVERED BY CONVECTION ENHANCED DELIVERY (CED) IN CHILDREN WITH NEWLY DIAGNOSED DIFFUSE INTRINSIC PONTINE GLIOMA (DIPG) PREVIOUSLY TREATED WITH RADIATION THERAPY

OBJECTIVETo determine safety and distribution of MTX110 delivered by CED in newly diagnosed DIPG patients.METHODSDIPG patients (3–21 years) were enrolled after radiation. CED of MTX110 combined with gadoteridol was completed based on dose levels (DL) (30–90 µM with volumes ranging from 3 cc (single dose) to 2 consecutive doses of 6 cc; total number of DL=7). Catheter position was chosen to maximize tumor coverage. Distribution of infusate was monitored with real-time MR imaging. Repeat CED was performed every 4–8 weeks if tolerated. Quality of life (QOL) assessments using PedsQL Generic Core and Brain Tumor modules were obtained at baseline (n=5), 3-months (n=3), and end of therapy (n=2). Single-cell RNA sequencing and analysis of histone modifications was performed to assess pharmacodynamic effects on DIPG cells.RESULTSBetween May 2018-Dec 2019, 6 patients were enrolled (median age 8 years, range 5–21). Dose limiting toxicities included: grade 3 gait disturbance (DL7; cycle 1); grade 3 muscle weakness/vagus nerve disorder (DL5; cycle 4) and grade 2 intolerable dysphagia (DL7; cycle 4). Twelve CED procedures were completed at DL7 and repeated cycles ranged from 2 to 7. Infusion to distribution volume ratio was approximately 1:3.5. There were no significant changes in self-reported QOL. Parent ratings of patients’ worry (p = 0.04) and overall QOL (p = 0.03) significantly decreased at 3-months.CONCLUSIONRepeat CED of MTX110 at the highest dose is tolerable. Tissue concentrations are likely to be substantially higher compared to oral dosing. Pharmacodynamic effects will be presented.

DDRE-21. PNOC015: PHASE 1 STUDY OF MTX110 DELIVERED BY CONVECTION ENHANCED DELIVERY (CED) IN CHILDREN WITH NEWLY DIAGNOSED DIFFUSE INTRINSIC PONTINE GLIOMA (DIPG) PREVIOUSLY TREATED WITH RADIATION THERAPY

Abstract OBJECTIVE To determine safety and distribution of MTX110 delivered by CED in newly diagnosed DIPG patients. METHODS DIPG patients (3–21 years) were enrolled after radiation. CED of MTX110 combined with gadoteridol was completed based on dose levels (DL) (30–90 µM with volumes ranging from 3 cc (single dose) to 2 consecutive doses of 6 cc; total number of DL=7). Catheter position was chosen to maximize tumor coverage. Distribution of infusate was monitored with real-time MR imaging. Repeat CED was performed every 4–8 weeks if tolerated. Quality of life (QOL) assessments using PedsQL Generic Core and Brain Tumor modules were obtained at baseline (n=5), 3-months (n=3), and end of therapy (n=2). Single-cell RNA sequencing and analysis of histone modifications was performed to assess pharmacodynamic effects on DIPG cells. RESULTS Between May 2018-Dec 2019, 6 patients were enrolled (median age 8 years, range 5–21). Dose limiting toxicities included: grade 3 gait disturbance (DL7; cycle 1); grade 3 muscle weakness/vagus nerve disorder (DL5; cycle 4) and grade 2 intolerable dysphagia (DL7; cycle 4). Twelve CED procedures were completed at DL7 and repeated cycles ranged from 2 to 7. Infusion to distribution volume ratio was approximately 1:3.5. There were no significant changes in self-reported QOL. Parent ratings of patients’ worry (p = 0.04) and overall QOL (p = 0.03) significantly decreased at 3-months. CONCLUSION Repeat CED of MTX110 at the highest dose is tolerable. Tissue concentrations are likely to be substantially higher compared to oral dosing. Pharmacodynamic effects will be presented.

Disrupting the disruption cycle – A longitudinal analysis of aggression trajectories, quality of life, psychopathology and self-efficacy in closed youth residential care

BackgroundA substantial amount of youths living in youth residential care demonstrate clinical levels of aggression during the course of their placements, which poses a major risk to care continuity. Yet developmental trajectories of aggressive behavior can vary. ObjectiveWe investigated if changes in quality of life (QoL), psychopathological symptoms and perceived self-efficacy predict aggressive behavior trajectories in youths with clinical aggression levels living in closed youth residential care in Germany. MethodYouths (n = 63; 76.2% female; ages 11–17, M = 14.4, SD = 1.30) answered well-established questionnaires at two data collection points (T1 and T2) over an average of 6.5 months. Professional caregivers rated youths’ aggressiveness in the ‘aggressive behavior’ subscale of the Child Behavior Checklist (CBCL). Two trajectories were retrospectively identified for youths demonstrating aggressive behavior at or above the borderline clinical range – ‘stable-high’ trajectories with persevering aggressive behavior ratings (CBCL T ≥ 67 at T2) and ‘improved’ trajectories with improved aggressive behavior ratings (CBCL T < 67 at T2). We conducted binary logistic regression analyses to calculate if changes in self-reported QoL, psychopathology and perceived self-efficacy might predict trajectories of aggressive behavior. ResultsYouths were more likely to belong to the ‘improved’ than ‘stable-high’ aggressive behavior trajectory if they reported greater QoL improvements in regards to relationship with peers (B = 0.89, SE = 0.45, p = 0.014) and managing school requirements (B = 0.69, SE = 0.69, p = 0.010), greater reductions in substance use (B = −0.26, SE = 0.16, p = 0.029) and suicide ideation (B = −0.32, SE = 0.17, p = 0.020), as well as improvements in perceived self-efficacy, dependent on initial aggression level (B = 0.05, SE = 0.03, p = 0.034). Those with ‘improved’ trajectories were also less likely to experience placement disruptions. ConclusionIn light of our exploratory findings, incorporating various life domains into closed residential care plans, focusing on emotion regulation, substance use prevention, and providing an environment that encourages self-efficacy could reduce aggressive behavior and subsequent placement disruptions. Implications for youth welfare policy and future research are discussed.

Therapeutic Efficacy and Quality of Life Improvement in Women with Detrusor Underactivity Following Transurethral Incision of the Bladder Neck

Aims: To investigate the effects of transurethral incision of the bladder neck (TUI-BN) on long-term outcomes and quality of life (QoL) improvements in women with detrusor underactivity (DU) refractory to standard medical treatment. Materials and Methods: Data were retrieved for female patients with treatment-refractory DU who underwent TUI-BN between 2007 and 2018. Urodynamic parameters were measured at baseline and follow-up and were analyzed for surgical outcome. Patients who were capable of spontaneously voiding with a voiding efficiency (VE) of ≥50% with or without the aid of abdominal pressure were considered to have achieved satisfactory outcomes. Changes in self-reported QoL were measured based on the International Prostate Symptom Score QoL (IPSS-QoL), and treatment improvements were measured based on the global response assessment (GRA) index. Moreover, the voiding statuses of patients before and after TUI-BN were compared. Results: Overall, 82 women, with a mean age of 60.8 ± 17.9 years (range 12–102), were included. Most patients experienced chronic urinary retention or large postvoid residual (PVR) urine. Median follow-up period was 5 years (range 1–12). Following TUI-BN, 40 (48.8%) patients achieved satisfactory outcomes, with a mean GRA of 1.4 ± 0.93. Mean maximum flow rate, voided volume, PVR volume, VE, and IPSS-QoL were all significantly improved. Among all patients, 50 (61%) were subsequently able to spontaneously void with or without the aid of abdominal pressure without the need for catheterization. Indwelling catheters were required in 19 (23.2%) patients at baseline and in 5 (6.1%) following TUI-BN (P &lt; 0.01). Moreover, 5 (6.1%) patients developed stress urinary incontinence and 2 (2.4%) experienced vesicovaginal fistulae following TUI-BN procedures, all of whom recovered satisfactorily after treatment. Conclusions: TUI-BN is an effective procedure for reducing the bladder outlet resistance and improving VE and QoL. Moreover, the procedure is durable with an acceptable incidence of complications.

Headache intensity and quality of life in adolescents. How are changes in headache intensity in adolescents related to changes in experienced quality of life?

To investigate the relationship between changes in actual presence of headache and the experience of different subdomains of quality of life (QoL) in adolescents. Diary entered measurements of headache intensity and frequency were related to simultaneously recorded data on a QoL questionnaire for adolescents. Subjects completed both the QoL questionnaires and the headache diaries at home. Subjects were selected by screening the total population of two secondary schools (N = 1566) for headache and migraine symptoms. Sixty-four students subject to chronic headache or migraine participated in the study. All subjects were diagnosed by a neurologist, following the IHS criteria for migraine. Changes in headache intensity and frequency were related to changes in self-reported QoL within all QoL subdomains. More headache coincided with a lower self-reported QoL.