Comprehensive Quality Of Life Research Articles

Quality of life and thalassemia in India: A scoping review

ABSTRACT In recent years, a multitude of studies have been conducted to investigate the assessment of quality of life (QoL) among individuals affected by thalassemia. This scoping review aimed to examine the existing knowledge regarding the QoL and its associated factors among individuals with thalassemia in India. Databases, such as PubMed, SCOPUS, Web of Science, and the Preferred Reporting Items for Systematic Review and Meta-Analysis Extension for Scoping Reviews (PRISMA-ScR) guidelines, were searched. A total of nine articles were included in the review. The included studies mainly investigated children. The Pediatric Quality of Life Inventory (PedsQL) is the most common instrument used most often. Overall, the research findings indicate that individuals who underwent blood transfusion exhibited a lower QoL than those who did not receive blood transfusion. Additionally, it was observed that children diagnosed with thalassemia reported a lower QoL than adults. Nevertheless, the studies exhibited notable methodological deficiencies that constrained the validity and generalizability of the results. Hence, it is imperative to undertake comprehensive QoL research encompassing all regions of India and various thalassemia populations within the country to bridge this evidentiary void.

Biomedical Application of CT Assisted CBCT 3D Imaging Technology in Oral Implantation

In the field of oral implantology, our goals were to investigate the diagnostic utility of traditional CT imaging technology and 3D CBCT imaging technology based on the Internet of Things (IoT) dental Computed Tomography assisted CBCT, as well as to compare and contrast their respective advantages. 72 patients were split evenly between two groups: a control group with 35 participants and a study group with 37 participants. (1) Surgical indexes: The operation time of the control group was (27.96+4.64) minutes and (14.08+3.14) minutes, and the intraoperative blood loss was (16.36+2.95) ml and (5.85+0.64) ml, respectively. The time it took to do the procedure in the experimental group was (14.08+3.14) minutes. In the group that was under examination, both the total amount of time spent operating and the amount of blood lost during the procedure were significantly lower (P <0.05). (2) Dental function: There were no statistically significant variations in dental beauty, comfort, chewing, or retention between the two groups before surgery (P >0.05). This was determined by comparing the results of the dental examinations. After surgery, the dental function of the research group was significantly greater than that of the control group, and the difference between the two groups was statistically significant (P <0.05). (3) Theraputic effect: the effective rate of the treatment in the control group was 85.71 percent, while the effective rate in the study group was 94.59%. (4) Quality of life: when compared with the control group, the comprehensive quality of life of physiological, social, emotional, and cognitive functions in the research group was higher, and the difference was statistically significant (P < 0.05); (5) Satisfaction: the control group’s level of satisfaction was 80.00%, while the study group’s level of satisfaction was 94.59%. (6) Cost: the cost of the treatment in the research group was significantly lower than the cost of the treatment in the control group. As a result, the dental computed tomography assisted cone beam computed tomography (CBCT) 3D imaging technology based on the internet of things should be considered for implementation.

Middle-aged and older people’s preference for medical-elderly care integrated institutions in China: a discrete choice experiment study

BackgroundWith the continuing impact of the aging population, medical-elderly care integrated institutions, as a way to bear the pressure of medical and elderly care, effectively ensure the quality of life of the elderly in their later years.ObjectivesTo explore the preferences of medical-elderly care integrated institutions among Chinese middle-aged and older people and to provide a reference for establishing elderly-oriented development of medical-elderly care integrated institutions.MethodsIn this study, a discrete choice experiment (DCE) was used to investigate the preferences of people aged 45 years and older in medical-elderly care integrated institutions in China from October 20, 2022, to November 10, 2022. A mixed logit regression model was used to analyze the DCE data. Participants’ willingness to pay for each attribute was also calculated.ResultsData from 420 participants who provided valid responses were included in the analysis. In terms of the choice preference, moderate service quality (vs. poor service quality: β = 1.707, p < 0.001, 95% CI 1.343 ~ 2.071) and high medical technology level (vs. low medical technology level: β = 1.535, p < 0.001, 95% CI 1.240 ~ 1.830) were the most important attributes to middle-aged and older people, followed by monthly cost, environmental facilities, the convenience of transportation, and entertainment activities. Regarding the willingness to pay, participants were more willing to pay for service quality and medical technology level than for other attributes. They were willing to pay $3156 and $2838 more for “poor service quality” and “low medical technology level,” respectively, to receive “moderate service quality " (p = 0.007, 95% CI 963 ~ 5349) and “high medical technology level” (p = 0.005, 95% CI 852 ~ 4824).ConclusionsThe state should attach great importance to the development of medical-elderly care integrated services industry, actively optimize the model of the medical-elderly care integrated service, improve the facilities, and create a healthy environment. At the same time, give full play to the role of medical insurance, long-term care insurance, and commercial insurance, so as to improve the comprehensive quality of life of the elderly.Public contributionThe design of the experimental selection was guided by 10 experts in the field, 5 Chinese government officials, and interviews and focus group discussions, without whose participation this study would not have been possible.

[Evaluation of the clinical effect of acupuncture in treatment of neck pain in cervical spondylosis based on propensity score matching].

To observe the clinical effect and safety of acupuncture in treatment of neck pain due to cervical spondylosis. According to the patients' preference and acceptance for the interventions of neck pain induced by cervical spondylosis, an acupuncture group (221 cases) and a non-acupuncture group (251 cases) were divided. After the control of confounding factors with propensity score matching, 218 cases were included in either acupuncture group or non-acupuncture group. In the acupuncture group, acupuncture was applied to Dazhui (GV 14), Baihui (GV 20), ashi points, bilateral neck-Jiaji (EX-B 2), Fengchi (GB 20), Houxi (SI 3), Shenmai (BL 62), etc. The treatment was given once daily, one course of intervention was composed of 5 treatments and 3 courses were included. In the non-acupuncture group, the oral administration of imrecoxib tablets and cobalt tablets was prescribed for 2 weeks. Before and after treatment, the scores of Northwick Park questionnaire (NPQ) and the simplified McGill pain questionnaire (SF-MPQ) were observed, and the safety was assessed in patients of the two groups. After treatment completion, the scores of NPQ and SF-MPQ were all reduced when compared with those before treatment in each group (P<0.001), and the scores of NPQ and SF-MPQ in the acupuncture group were lower than those of the non-acupuncture group (P<0.001). The incidence of adverse reactions was 6.0% (13/218) in the acupuncture group and was 10.1% (22/218) in the non-acupuncture group, without statistical significance in comparison (P>0.05). Acupuncture is effective and safe in the relief of neck pain and the improvement of comprehensive quality of life in the patients with cervical spondylosis.

Patient Experience and Quality of Life in Mexican Patients with Neuromyelitis Optica Spectrum Disorder: A Sub-analysis of an International Multicenter Cross-sectional Survey in Latin America (P13-5.007)

<h3>Objective:</h3> To describe and assess patient experiences and quality of life (QoL) in Mexican patients diagnosed with neuromyelitis optica spectrum disorder (NMOSD). <h3>Background:</h3> The perceived impact of NMOSD on daily living has been described in North America, Europe, and Asia. However, little is known about how patients experience their disease in Latin America. <h3>Design/Methods:</h3> This study employed a comprehensive disease burden and QoL assessment implementing validated instruments previously used by The Guthy-Jackson Charitable Foundation in North America and Asia. <h3>Results:</h3> In Mexico, 66 patients were included (55 women; median age: 46.5, IQR: 31–52.2 years; median disease duration: 6, IQR: 4–10 years; 87.8% of them seropositive for anti-AQP4 antibodies). Almost three-quarters of participants (74.2%) reported an initial diagnosis of a disease other than NMOSD. NMOSD imposed a significant negative effect on the QoL (median: 4.0, IQR: 3–6; 6-point Likert-type scale [1 = least impact, 6 = greatest impact]); more than one-quarter of participants (25.7%) reported QoL to be greatly affected by NMOSD. Most participants (69.6%) agreed that the NMOSD diagnosis made them uncertain about their future (median: 4, IQR: 3–5; 5-point Likert-type scale [1 = strongly disagree, 5 = strongly agree]). The impact of NMOSD on QoL and future uncertainty due to NMOSD were positively correlated (Spearman’s rho: 0.39). Financially, more than one-third of participants (39.3%) believe their monthly expenses due to NMOSD were a significant burden. The impact of NMOSD on QoL and perceived financial burden were also positively correlated (Spearman’s rho: 0.33). No correlation was demonstrated between the impact of NMOSD on QoL and disease duration. <h3>Conclusions:</h3> Mexican patients reported their QoL is negatively affected by NMOSD. Uncertainty about the future as well as NMOSD-related clinical and financial burden are associated with this negative impact. These findings suggest that non-medical factors are also relevant in the psychosocial management of people with NMOSD. <b>Disclosure:</b> Dr. Delgado-Garcia has received research support from Consejo Nacional de Ciencia y Tecnologia (Mexico). Dr. Delgado-Garcia has received research support from Consejo Nacional de Ciencia y Tecnologia (Mexico). Dr. Delgado-Garcia has a non-compensated relationship as a Editorial Team Member with Neurology Resident &amp; Fellow Section that is relevant to AAN interests or activities. Dr. Delgado-Garcia has a non-compensated relationship as a Editorial Board Member with Brain and Life en Espanol that is relevant to AAN interests or activities. Dr. Delgado-Garcia has a non-compensated relationship as a Editorial Board Member with Neurology Clinical Practice that is relevant to AAN interests or activities. Dr. Garcia Sarreon has nothing to disclose. Dr. GOMEZ FIGUEROA has nothing to disclose. Veronica Rivas has nothing to disclose. Ms. Behne has nothing to disclose. Ms. Behne has received personal compensation for serving as an employee of The Guthy-Jackson Charitable Foundation. Ms. Behne has received personal compensation in the range of $50,000-$99,999 for serving as a Independent Contractor with The Guthy-Jackson Charitable Foundation. Dr. Yeaman has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genentech. Dr. Yeaman has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Genentech-Roche. Dr. Yeaman has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Alexion. The institution of Dr. Yeaman has received research support from National Institutes of Health. The institution of Dr. Yeaman has received research support from U.S. Department of Defense. Dr. Yeaman has received intellectual property interests from a discovery or technology relating to health care. Dr. Yeaman has received intellectual property interests from a discovery or technology relating to health care. Dr. Corona Vazquez has received research support from Consejo Nacional de Ciencia y Tecnologia.

Clinical Efficacy of Erlotinib Combined with Probiotic Intervention in Treating Advanced Non-Small Cell Lung Cancer

This study aimed to assess the clinical efficacy of erlotinib combined with probiotic intervention in treating patients with advanced non-small cell lung cancer. The control group (n = 50) received nedaplatin combined with pemetrexed, while the observation group (n = 50) received erlotinib and nedaplatin combined with probiotic intervention. The total response and disease control rates were higher in the observation group than in the control group (P &lt; 0.05), whereas the occurrence of adverse reactions in the observation group was lower (P &lt; 0.05). The serum levels of matrix metalloproteinases-2, angiopoietin-like-2, and miR-25 in the observation group were lower than those in the control group (P &lt; 0.05), and the improvement rate of comprehensive quality of life was higher (P &lt; 0.05). After therapy, CD3+, CD4+, and CD4+/CD8+ in the observation group were higher than in the control group (P &lt; 0.05). CD8+ in the observation group was lower than in the control group (P &lt; 0.05). Serum hemoglobin and albumin levels were higher in the observation group than in the control group (P &lt; 0.05). Briefly, erlotinib combined with probiotic intervention can promote the nourishment state, immune function, and quality of life of patients with non-small cell lung cancer, expanding the therapeutic choices for advanced non-small cell lung cancer.

Patient-reported outcomes for the Intergroup Sentinel Mamma study (INSEMA): A randomised trial with persistent impact of axillary surgery on arm and breast symptoms in patients with early breast cancer.

In clinically node-negative breast cancer patients, the INSEMA trial (NCT02466737) assessed the non-inferiority of avoiding sentinel lymph node biopsy (SLNB) or axillary lymph node dissection (ALND). Here we present patient-reported outcomes (PROs) as a secondary endpoint. PROs were assessed for patients with no axillary surgery, SLNB alone, and ALND. Quality of life (QoL) questionnaire EORTC QLQ-C30 and its breast cancer module (BR23) were used at baseline (pre-surgery) and 1, 3, 6, 12, and 18 months after surgery. The QoL scores were compared using repeated measures mixed models based on the safety set. Between 2015 and 2019, 5502 patients were recruited for the first randomization, and 5154 were included inthe intent-to-treat set (4124 SLNB versus 1030 no SLNB). In the case of one to three macrometastases after SLNB, 485 patients underwent second randomization (242 SLNB alone versus 243 ALND). Questionnaire completion response remained high throughout the trial: over 70% at all time points for the first randomization. There were significant differences for the BRBS (breast symptoms) and BRAS (arm symptoms) scores favoring the no SLNB group in all post-baseline assessments. Patients in the SLNB group showed significantly and clinically relevant higher scores for BRAS (differences in mean values ≥5.0 points at all times), including pain, arm swelling, and impaired mobility in all postoperative visits, with the highest difference at one month after surgery. Scoring of theQLQ-C30 questionnaire revealed no relevant differences between the treatment groups, although some comparisons were statistically significant. This is one of the first randomized trials investigating the omission of SLNB in clinically node-negative patients and the first to report comprehensive QoL data. Patients with no SLNB benefitted regarding arm symptoms/functioning, while no relevant differences in other scales were seen. Supported by German Cancer Aid (Deutsche Krebshilfe, Bonn, Germany), Grant No. 110580 and Grant No. 70110580 to University Medicine Rostock.

Rationale and design of a multicenter, double-blinded, randomized, placebo-controlled trial to investigate the effects of naldemedine on opioid-induced constipation for patients with cancer pain: A study protocol

BackgroundIt is unclear which laxatives are appropriate to prevent opioid-induced constipation (OIC). This study will evaluate whether prophylactic use of naldemedine prevents OIC in patients with cancer who start opioid administration. MethodsThis study is a multicenter, double-blinded, randomized, placebo-controlled trial. Patients who meet the eligibility criteria and give consent will be randomly assigned to the naldemedine or placebo group. Both groups will take each drug once a day after breakfast for 14 days. ResultsThe primary endpoint is the proportion of patients with a Bowel Function Index of less than 28.8 on Day 14. The secondary endpoints include assessment scales of the impact of constipation on comprehensive quality of life. ConclusionsThis is the first study proposed to assess the superiority of naldemedine over placebo in the prevention of OIC. If naldemedine is found to be effective in reducing OIC compared with the placebo, it will be regarded as a new standard for OIC prophylaxis at opioid initiation. Trial registrationjRCT identifier: jRCTs031200397. Registered March 5, 2021, https://rctportal.niph.go.jp/en/detail?trial_id=jRCTs031200397.

Comprehensive Quality-of-Life Outcomes With Invasive Versus Conservative Management of Chronic Coronary Disease in ISCHEMIA.

ISCHEMIA (International Study of Comparative Health Effectiveness with Medical and Invasive Approaches) compared an initial invasive treatment strategy (INV) with an initial conservative strategy in 5179 participants with chronic coronary disease and moderate or severe ischemia. The ISCHEMIA research program included a comprehensive quality-of-life (QOL) substudy. In 1819 participants (907 INV, 912 conservative strategy), we collected a battery of disease-specific and generic QOL instruments by structured interviews at baseline; at 3, 12, 24, and 36 months postrandomization; and at study closeout. Assessments included angina-related QOL (19-item Seattle Angina Questionnaire), generic health status (EQ-5D), depressive symptoms (Patient Health Questionnaire-8), and, for North American patients, cardiac functional status (Duke Activity Status Index). Median age was 67 years, 19.2% were female, and 15.9% were non-White. The estimated mean difference for the 19-item Seattle Angina Questionnaire Summary score favored INV (1.4 points [95% CI, 0.2-2.5] over all follow-up). No differences were observed in patients with rare/absent baseline angina (SAQ Angina Frequency score >80). Among patients with more frequent angina at baseline (SAQ Angina Frequency score <80, 744 patients, 41%), those randomly assigned to INV had a mean 3.7-point higher 19-item Seattle Angina Questionnaire Summary score than conservative strategy (95% CI, 1.6-5.8) with consistent effects across SAQ subscales: Physical Limitations 3.2 points (95% CI, 0.2-6.1), Angina Frequency 3.2 points (95% CI, 1.2-5.1), Quality of Life/Health Perceptions 5.3 points (95% CI, 2.8-7.8). For the Duke Activity Status Index, no difference was estimated overall by treatment, but in patients with baseline SAQ Angina Frequency scores <80, Duke Activity Status Index scores were higher for INV (3.2 points [95% CI, 0.6-5.7]), whereas patients with rare/absent baseline angina showed no treatment-related differences. Moderate to severe depression was infrequent at randomization (11.5%-12.8%) and was unaffected by treatment assignment. In the ISCHEMIA comprehensive QOL substudy, patients with more frequent baseline angina reported greater improvements in the symptom, physical functioning, and psychological well-being dimensions of QOL when treated with an invasive strategy, whereas patients who had rare/absent angina at baseline reported no consistent treatment-related QOL differences. URL: https://www. gov; Unique identifier: NCT01471522.

[The Effect of Clinical Research by Community Pharmacists on the Medical Field -The Perspective of Scientists in the Community Can Improve a Patient's Circumstances].

Our pharmacy, with a sterile dispensary, is a support center for home-care dispensing; we are actively participating in a regional collaboration in combination with medical treatment, nursing, and social care. We have supported about 1000 home care patients so far: most of these have been elderly people living at home, but roughly two dozen were pediatric patients. Although the primary diseases of the children varied, they shared in common both a high dependence on medicine, and great difficulty in moving them. With our pediatric patients, a caregiver had to be in constant attendance because the child's medical care was intermittent. In addition, at the pharmacy, due to the volume of medication for these pediatric patients, caregivers have had to wait a long time for prescription fulfillment, and often receive so much medicine they need a cart to carry it home. Through providing pharmacist-led home guidance on medicines, we are able to offer some support in the pharmacotherapy of children with extreme symptoms who remain under the supervision of a doctor from an advanced medical institution, even after returning home. Through my experience visiting both elderly people and children under home care, I have keenly realized the importance of a community pharmacist's research in improving pediatric formulation and home medical care systems. We must aim to reduce the burden of medication management for both patients and caregivers, and to improve a patient's "comprehensive quality of life, including (his or her) family".

Multicenter, randomized double-blind placebo-controlled trial of definitive concurrent chemoradiotherapy plus megestrol acetate/placebo in local-advanced esophageal cancer.

275 Background: To determine Quality-of-Life (QoL) improvement by Megestrol Acetate (MA) in local advanced esophageal squamous cell carcinoma (ESCC) with definitive concurrent chemoradiotherapy (DCRT). Secondary aims were to examine the safety and the impact of MA on the efficacy of DCRT. Methods: Patients (with previously untreated T1bN+M0 or T2-4aN0-2M0 ESCC) were randomly assigned at a one-to-one ratio to receive MA or placebo (blind). All received 5-FU based chemotherapy with concurrent radiotherapy (50Gy/25F). QoL was measured using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30) questionnaires at pretreatment and 3, 6, 16 weeks of DCRT. The good status (GS) rate of appetite loss (AL), nausea and vomiting (NV), weight (WT) and performance status (PS) were chosen as predefined primary end points. GS defined as the score were ≤ 0 for AL or NV and ≥ 0 for WE or PS when the designed time points compared with last one. Secondary end points were the comprehensive QoL (remaining items of QLQ-C30 changes analysis at 16th week), myelosuppression (MS), and deep vein thrombosis (DVT). The exploratory end points were the objective response rate (ORR), 1-year overall survival (OS) and progression-free survival (PFS). Results: 84 completed the follow-up and were analyzed from which 120 patients randomly assigned. The GS rates of AL (3th week: P = 0.011; 6th week: P &lt; 0.001; 16th week: P = 0.001), NV (6th week: P = 0.001) and PS (6th week: P = 0.01) were higher in MA than Placebo. There were no statistical differences between MA and Placebo on WT. At 16th week, the change degree analysis shown the fatigue was worse in MA than Placebo ( p = 0.031). There were no differences on MS, DVT, ORR, OS and PFS between two arms. Nevertheless the rate of DVT was slightly higher in MA than Placebo (12.5% vs. 2.8%, P = 0.113). Conclusions: MA is helpful for ESCC patients receiving DCRT as well as the risk of DVT needed be careful.

Neurocognition, functional outcome, and quality of life in remitted and non-remitted schizophrenia: A comparison with euthymic bipolar I disorder and a control group.

There are discrepancies about if the severity of the symptomatology in schizophrenia is related to neurocognitive performance, functional outcome, and quality of life (QoL). Also, there are controversial data about the comparison between euthymic bipolar patients and different subgroups of schizophrenia in neurocognition, functioning, and QoL level. The present study aimed to compare the neurocognitive performance, functional outcome, and QoL of remitted and non-remitted patients with SC with respect to a group of euthymic patients with BD, and a control group. It included 655 subjects: 98 patients with schizophrenia in remission (SC-R), 184 non-remitted patients with schizophrenia (SC-NR), 117 euthymic patients with bipolar I disorder (BD), and 256 healthy subjects. A comprehensive clinical, neurocognitive (six cognitive domains), functional, and QoL assessment was carried out. Remission criteria of Andreasen were used to classify schizophrenia patients as remitted or non-remitted. Compared with control subjects all groups of patients showed impaired neurocognitive performance, functioning and QoL. SC-R patients had an intermediate functioning between control subjects and SC-NR, all at a neurocognitive, functional, or QoL level. There were no significant differences between SC-R and BD. These results suggest that reaching clinical remission is essential to achieve a better level of psychosocial functioning, and QoL. Likewise, the results of this study suggest that euthymic patients with bipolar disorder and patients with schizophrenia in remission are comparable at the neurocognitive and functional levels, which might have implications in the pathophysiology of both disorders.

Obesity: Overview of a Universal Health Conundrum

Obesity is a worldwide health issue which is displaying increasing prevalence trend. World Health Organisation (WHO) has already given it a epidemic status. Many physiological parameters such as Body Mass Index (BMI), Waist Circumference (WC), Waist to Hip Ratio (WHR) are used for measurement of obesity. This review was written with the aim to give an inclusive picture of current prevalence of obesity along with discussing the physiology and function of different adipocytes and the numerous chemical messengers released by them. The manifold impact of obesity on various body systems can be elucidated by exploring the adipocytes, adipokines its functions and signalling mechanism. The adipokines enlist as key players in numerous systemic diseases. Obesity has a significant pathophysiological role in morbidity and mortality causing conditions globally. Obesity can potentially be the leading reason of economic burden on global health care, adversely impacting the comprehensive quality of life. This review is an effort to provide a better understanding of the current obesity status and emphasise further researches on its diverse aspects.

The Impact of Acne, Atopic Dermatitis, Skin Toxicities and Scars on Quality of Life and the Importance of a Holistic Treatment Approach.

Skin conditions such as acne, atopic dermatitis, skin toxicity from oncology treatment, and scars are among the most common health conditions and negatively impact quality of life (QoL). Yet the physician perception of this impact often varies greatly from the patient perception. This is important because patient illness perception is closely linked with seeking help and treatment adherence behaviors. The objective of this review is to better understand the impact of these four highly prevalent skin conditions on QoL including their health-related economic factors to improve treatment outcomes. The literature search included literature published on QoL with acne, atopic dermatitis, scars (from any cause) and skin toxicities on PubMed between 2015 and 2020. We found that patients with skin conditions have a much higher frequency of altered QoL and psychological distress than those without. Also, skin conditions negatively impact self-image and can cause feelings of isolation, loneliness, lower self-esteem, and lower body satisfaction. Additionally, physical discomfort adds to the psychological distress. These physical and psychological impacts are an enormous financial burden on patients, their families and society. We found evidence that holistic treatment including treating the skin condition itself, providing wider peer and psychological support as well as shared decision-making, therapeutic patient education and dermatologist involvement improves outcomes. Holistic history-taking, checklists, or the use of more formal QoL scoring tools can be incorporated into routine consultations to better assess patient well-being and provide clinicians with important information for adapting treatment to individual patient requirements. In conclusion, this review highlights the overall impact of skin conditions (including psychological and QoL impacts) and the importance of providing holistic care to optimize treatment outcomes. A comprehensive QoL screening tool would be useful to help provide patient-centered treatment.

Selecting a Contextualized Set of Urban Quality of Life Indicators: Results of a Delphi Consensus Procedure

Although indicators are commonly used to measure/assess urban quality of life (QOL), there is no consensus in the literature on the core indicators of urban QOL. This paper aims to identify a set of key indicators that will be used to assess/measure urban QOL in the Saudi Arabia (SA) context. For this purpose, a three-round online Delphi procedure is used. A group of 92 local experts were asked to rate the importance of a set of pre-defined indicators in assessing/measuring urban QOL. The results reveal that the panel of experts reached consensus and agreed on the high importance of 53 indicators for assessing/measuring urban QOL. These indicators provide appropriate coverage of the three core dimensions of urban QOL: environmental, social and economic. However, the results also show that the social indicators are perceived as more essential than economic and environmental indicators. This finding has practical implications for designing and developing QOL assessment tools to better capture and measure urban QOL in the SA context. Furthermore, research findings also identified some methodological limitations associated with using the Delphi approach, which need to be addressed to ensure the development of comprehensive QOL assessment tools.

A spatial study of quality of life in the USA

This study's main goal was to develop a comprehensive Quality of Life (QoL) Index based on 31 demographic variables for the 3108 counties in the contiguous USA. Counties were ranked worst in QoL to best, and spatial cluster analysis is used to identify counties with significant low/high QoL clusters. GIS-based mapping was used to create informative heat maps with significant clusters shown. The rate of African Americans, diversity in a race within counties, and upward mobility were studied in a regression analysis in which QoL was predicted from these three covariates. The QoL Index was adjusted for the covariates, and a new spatial heat map with clusters is obtained. It was concluded that as the rate of African Americans increases in a county, the QoL decreases, while the QoL increases when diversity or upward mobility increases.

Longitudinal Assessment of Frailty and Quality of Life in Patients Undergoing Head and Neck Surgery.

To understand changes in frailty and quality of life (QOL) in frail versus non-frail patients undergoing surgery for head and neck cancer (HNC). Prospective cohort study of patients (median age 67 (50, 88)) with HNC undergoing surgery from December 2011 to April 2014. Fried's Frailty Index, Vulnerable Elders Survey (VES-13), and comprehensive QOL assessments (EORTC QLQ-C30 and HN35) were completed at baseline and 3, 6, and 12-month post-operative visits. Change in frailty and QOL over time was compared between frailty groups (non-frail (score 0), pre-frail (score 1-2), and frail (score 3-5)) using a mixed effects model. Predictors of long-term elevated frailty (12 months > baseline) were analyzed using logistic regression. The study had 108 patients classified as non-frail (47%), 104 pre-frail (mean (SD) 1.3 (0.4), 45%), and 17 frail (3.4 (0.6); 7%). Frailty score decreased significantly for frail patients 3 months post-operatively (2.1 (1.0); P=.002) and remained significantly lower than baseline at 6 and 12 months (2.1 (1.4); P=.0008 and 2.2 (1.5); P=.005, respectively) while frailty score increased for non-frail patients at 3 months (1.1 (1.0); P < .001) and then decreased. Forty-eight patients (21%) had long-term elevated frailty, with baseline frailty and marital status identified as predictors on univariate analysis. The frail population had significantly worse QOL scores at baseline, which persisted 12 months post-operatively. Frail patients demonstrate a decrease in frailty score following surgical treatment of HNC. Frail patients have significantly worse QOL scores on longitudinal assessment and would benefit from supportive services throughout their care. 3 Laryngoscope, 131:E2232-E2242, 2021.

How Does Quality of Life Relate to Auditory Abilities? A Subitem Analysis of the Nijmegen Cochlear Implant Questionnaire.

Objective speech recognition tasks are widely used to measure performance of adult cochlear implant (CI) users; however, the relationship of these measures with patient-reported quality of life (QOL) remains unclear. A comprehensive QOL measure, the Nijmegen Cochlear Implant Questionnaire (NCIQ), has historically shown a weak association with speech recognition performance, but closer examination may indicate stronger relations between QOL and objective auditory performance, particularly when examining a broad range of auditory skills. The aim of the present study was to assess the NCIQ for relations to speech and environmental sound recognition measures. Identifying associations with certain QOL domains, subdomains, and subitems would provide evidence that speech and environmental sound recognition measures are relevant to QOL. A lack of relations among QOL and various auditory abilities would suggest potential areas of patient-reported difficulty that could be better measured or targeted. A cross-sectional study was performed in adult CI users to examine relations among subjective QOL ratings on NCIQ domains, subdomains, and subitems with auditory outcome measures. Participants were 44 adult experienced CI users. All participants were postlingually deafened and had met candidacy requirements for traditional cochlear implantation. Participants completed the NCIQ as well as several speech and environmental sound recognition tasks: monosyllabic word recognition, standard and high-variability sentence recognition, audiovisual sentence recognition, and environmental sound identification. Bivariate correlation analyses were performed to investigate relations among patient-reported NCIQ scores and the functional auditory measures. The total NCIQ score was not strongly correlated with any objective auditory outcome measures. The physical domain and the advanced sound perception subdomain related to several measures, in particular monosyllabic word recognition and AzBio sentence recognition. Fourteen of the 60 subitems on the NCIQ were correlated with at least one auditory measure. Several subitems demonstrated moderate-to-strong correlations with auditory measures, indicating that these auditory measures are relevant to the QOL. A lack of relations with other subitems suggests a need for the development of objective measures that will better capture patients' hearing-related obstacles. Clinicians may use information obtained through the NCIQ to better estimate real-world performance, which may support improved counseling and development of recommendations for CI patients.

A study of quality of life in people with mycosis fungoides and Sézary syndrome

Mycosis fungoides (MF) is the commonest type of skin lymphoma and is part of a group of conditions known as cutaneous T-cell lymphomas (CTCL). MF can appear as flat/raised, smooth/scaly red lesions known as patches and plaques, making it difficult to tell apart from eczema or psoriasis. Raised “lumps” called tumours can appear and the disease can become more serious. Sézary syndrome (SS) is a leukaemic form of CTCL and has an extensive red, itchy rash over most of the body, the presence of cancerous cells in the blood, and enlarged lymph glands. MF/SS can reduce patient quality of life (QoL) due to symptoms including itch and pain, poor self-esteem secondary to cosmetic disfigurement, and can impair interpersonal relationships. In this article, we examine QoL in patients with MF/SS in a large international research study called PROCLIPI, using a questionnaire called Skindex-29 which asks patients to comment on skin related questions which may affect their life enjoyment. We identified a number of important determinants of worse QoL in MF/SS including: female gender, patients diagnosed with SS and those with more widespread disease. Disease features which were associated with more impaired QoL included alopecia (hair loss) and confluent erythema (red patches and plaques merging together to form larger areas of affected skin). Combining all these factors together, we found that female patients, alopecia and confluent erythema were the most important. Given that females had worse QoL, we examined more closely which items in the Skindex-29 questionnaire differed between males and females. Female patients experienced more burning, stinging, itch and irritation on their skin and greater feelings of depression, shame, embarrassment and annoyance with their diagnosis of MF/SS. Our research study has highlighted important aspects of QoL in MF/SS and emphasizes the urgent need for a more comprehensive QoL questionnaire to address not only the skin related aspects of the disease, but also the effects of cancer and its treatment on patient QoL. This is a summary of the study: Characteristics associated with significantly worse quality of life in mycosis fungoides/Sézary syndrome from the Prospective Cutaneous Lymphoma International Prognostic Index (PROCLIPI) study

Quality of life in people with dementia living in nursing homes: validation of an eight-item version of the QUALIDEM for intensive longitudinal assessment

PurposeOur aim was to examine whether quality of life which was repeatedly assessed over time is related with the comprehensive assessment of quality of life (QoL) and thereby to validate a brief QoL assessment.MethodThis longitudinal study used a comprehensive assessment of quality of life at baseline (QUALIDEM; 37 items) to validate an eight-item version of QUALIDEM to assess momentary quality of life which was repeatedly administered using a tablet device after baseline. In all, 150 people with dementia from 10 long-term facilities participated. Momentary quality of life and comprehensive quality of life, age, gender, activities of daily living (Barthel Index), Functional assessment staging (FAST), and Geriatric Depression (GDS) have been assessed.ResultsComprehensive and momentary quality of life showed good internal consistency with Cronbach’s alpha of .86 and .88 to .93, respectively. For multiple associations of momentary quality of life with the comprehensive quality of life, momentary quality of life was significantly related to comprehensive quality of life (B = .14, CI .08/.20) and GDS (B = − .13, CI − .19/− .06). More specifically, the comprehensive QUALIDEM subscales ‘positive affect’, ‘negative affect’, ‘restlessness’, and ‘social relationships’ showed significant positive associations with momentary quality of life (p < .001).ConclusionWe found that momentary quality of life, reliably assessed by tablet, was associated with comprehensive measures of quality of life and depressive symptoms in people with dementia. Broader use of tablet-based assessments within frequent QoL measurements may enhance time management of nursing staff and may improve the care quality and communication between staff and people with dementia.