Physical Health Domains Research Articles

Meaningful score changes for SF-36v2, FACIT-fatigue, and RASIQ in rheumatoid arthritis

BackgroundInterpretation thresholds for patient-reported outcome (PRO) scores are of crucial importance, particularly when interpreting treatment benefit. This study was designed to determine the within-patient meaningful improvement (WPMI) thresholds for the Short-Form 36 Health Survey version 2 (SF-36v2), the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-Fatigue), and the novel Rheumatoid Arthritis Symptoms and Impact Questionnaire (RASIQ) among patients with rheumatoid arthritis (RA).MethodsIn this post-hoc analysis, anchor-based and supportive distribution-based methods were used to derive WPMI based on blinded data from all treatment arms in two Phase 2 RA trials with otilimab. Patient’s Global Assessment of Disease Activity (PtGA) was the general anchor for all SF-36v2 scales. SF-36 Patient’s Global Impression of Status (PGIS), PtGA, and VT03 (an SF-36v2 item) were used as anchors for FACIT-Fatigue. SF-36 PGIS, PtGA, and Patient’s Assessment of Arthritis Pain (PAIN) were anchors for RASIQ. Mean change was calculated for the anchor category associated with minimal meaningful improvement from baseline to Week 24 for SF-36v2 and FACIT-Fatigue, and to Week 12 for RASIQ. Sensitivity and specificity were used to evaluate the accuracy of estimated WPMI values.ResultsFor the SF-36v2 physical functioning, role physical, bodily pain, general health, vitality, social functioning, role emotional, and mental health domains, anchor-based estimates of WPMI based on 0–100 scores were 24.5, 24.5, 25.4, 13.6, 21.5, 20.5, 16.9, and 14.3, respectively. Anchor-based WPMI estimates were 9.7 for the Physical Component Summary score and 7.6 for the Mental Component Summary score (using norm-based T-score metric). For FACIT-Fatigue (range 0–52), WPMI estimates ranged from 9.7 to 11.3 points. For RASIQ (range 0–100), anchor-based WPMI was determined as a change between -32.7 and -21.7 points for the Joint Pain scale, -26.7 to -23.7 for the Joint Stiffness scale, and -21.1 to -17.4 for the Impact scale.ConclusionsThis study derived WPMI thresholds for SF-36v2, FACIT-Fatigue, and RASIQ among patients with RA, using multiple anchors. Derivation of WPMI thresholds for these PRO instruments will enable their broader use in evaluating and interpreting treatment benefit in future RA studies.

Analysis of the Correlation between Physical Activity, Nutritional Status, and Learning Achievement with the Health Quality of Adolescents Life in East Bolaang Mongondow Regency

Quality of life is one of the criteria currently used to evaluate healthcare interventions. The aim of this study is to assess the relationship between physical activity, nutritional status, and academic performance with the health-related quality of life of adolescents in East Bolaang Mongondow Regency. This research is a correlational study with a cross-sectional approach conducted in junior high schools and high schools in East Bolaang Mongondow Regency in October 2023, with a total sample size of 430. The instrument used in this study is a questionnaire, and the data were analyzed using univariate and bivariate analysis with the Chi-Square test. The results of the study showed that the variable of physical activity had a p-value < 0.05 in the domains of physical health (p=0.000), psychological health (p=0.000), and environment (p=0.000). However, for the social relationships domain, the p-value was > 0.05 (p=0.100). The variable of nutritional status had a p-value < 0.05 in the domains of physical health (p=0.000), psychological health (p=0.002), social relationships (p=0.000), and environment (p=0.000). The academic performance variable had a p-value > 0.05 for all domains. The conclusion of this study is that physical activity is associated with the quality of life in the domains of physical health, psychological health, and environment. Nutritional status is associated with all domains of quality of life, while academic performance is not associated with the quality of life in any domain.

Health-related quality of life in children after surgical repair of esophageal atresia: a cross-sectional study in China.

To investigate health-related quality of life (HRQOL) in patients after surgical repair for esophageal atresia (EA) and identify its potential influencing factors. A total of 102 EA children who had previously visited our hospital participated in this cross-sectional study. Basic data and disease data of the patients were collected. The HRQOL was measured with the Pediatric Quality of Life Inventory™4.0 (PedsQL™4.0) and EA-QOL questionnaire and ranked on a reverse 0-100 scale, with a higher number indicative of a better HRQOL perception. The scores of PedsQL™4.0 in children with EA were collected and compared with that of the demographically matched healthy control group. Meanwhile, the condition-specific HRQOL of EA was analyzed by the EA-QOL questionnaire, and the potential clinical factors that influenced the HRQOL were determined by the generalized linear model. The group of EA and control reached a similar score in the generic PedsQL™4.0 (EA group: 86.55 ± 9.69; control group: 89.41 ± 6.54; p = 0.670). There was no significant difference between the EA group and the control group in other domains except the school functioning. Condition-specific HRQOL in the 2-7-year-old group had the highest score in social isolation and stress domain and the lowest score in the physical health and treatment domain, with an overall quality of life score of 83.48 ± 10.22. The scores of the 8-17-year-old group were relatively high in social relationships and health and well-being and lowest in the eating domain, with an overall quality of life score of 89.43 ± 8.57. Heart malformation, complicated esophageal surgery history, respiratory symptoms,and digestive symptoms in the past 1 month were the main factors affecting the HRQOL of children aged 2-7 years. Complicated esophageal surgery history, respiratory symptoms, and digestive symptoms in the past 1 month were the main factors affecting the HRQOL of children aged 8-17 years. The findings suggest that patients with EA generally had a good HRQOL. However, EA children with postoperative complications and associated symptoms have lower scores in the EA-QOL questionnaire.

Effects of a lower limb walking exoskeleton on quality of life and activities of daily living in patients with complete spinal cord injury: A randomized controlled trial.

In recent years, lower limb walking exoskeletons have been widely used in the study of spinal cord injury (SCI). To explore the effect of a lower limb walking exoskeleton on quality of life and functional independence in patients with motor complete SCI. This was a multi-center, single blind, randomized controlled trial. A total of 16 SCI patients were randomly assigned to either the exoskeleton-assisted walking (EAW) group (n= 8) or the conventional group (n= 8). Both groups received conventional rehabilitation training, including aerobic exercise and strength training. The EAW group additionally conducted the exoskeleton-assisted walking training using an AIDER powered robotic exoskeleton for 40-50 minutes, 5 times/week for 8weeks. World Health Organization quality of life-BREF (WHOQOL-BREF) and the Spinal Cord Independence Measure III (SCIM-III) were used for assessment before and after training. There was an increasing tendency of scores in the psychological health, physical health, and social relationships domain of WHOQOL-BREF in the EAW group after the intervention compared with the pre-intervention period, but there was no significant difference (P> 0.05). SCIM-III scores increased in both groups compared to pre-training, with only the conventional group showing a significant difference after 8weeks of training (P< 0.05). A lower limb walking exoskeleton may have potential benefits for quality of life and activities of daily living in patients with motor complete SCI.

Long-term Sexual Function and Quality of Life in Women Following Substitution Urethroplasty.

To assess the long-term quality of life (QOL) and sexual function (SF) in women who underwent either dorsal on-lay (DO) or ventral inlay (VI) urethroplasty for urethral stricture disease. Between January 2016 and September 2022, women who underwent either dorsal on-lay (DO) or ventral inlay (VI) urethroplasties and had at least a six-month follow-up been included. Using the Female Sexual Function Index (FSFI) and WHO-QOL bref questionnaires, the QOL and SF were evaluated. Scores were compared between the two groups after being examined for internal validity. A sub-group analysis was carried out based on the procedure's success. With follow-up periods ranging from 6 to 86months, 25 patients who received VI urethroplasty and 10 patients who underwent DO urethroplasty were included. Both scores demonstrated strong internal consistency. The cumulative QOL and FSFI scores were comparable in both groups (p = 0.53 and p = 0.83, respectively). Significantly high scores were noted in the physical health domain (76.5 ± 9.9 vs 62.33 ± 10.97; p = 0.03; (95% CI = 0.72-24.4)) and the environmental domain (75.75 ± 3.84 vs 66.00 ± 4.24; p = 0.01 (95% CI = 2.64-16.85) in patients with successful VI and DO urethroplasties respectively. Addictions, low socioeconomic status and protracted symptom duration were associated with low QOL scores. Old age was related to low FSFI scores. Substitution urethroplasty, despite the approach, showed good QOL and SF scores. Long symptom duration, addictions, and poor socioeconomic status were associated with low QOL whereas old age independently influenced low FSFI scores.

Assessing Quality of Life: A Comparative Study among Patients with Schizophrenia, Bipolar Affective Disorder, and Healthy Control in a South Indian Tertiary Care Setting

Aim: To assess and compare the quality of life (QOL) of patients with schizophrenia, bipolar affective disorder (BPAD) patients and healthy control.&#x0D; Methods: This is an observational study carried out in MVJ Medical College and Research Hospital, Bengaluru, India. The WHOQOL-BREF questionnaire was administered to 139 patients with schizophrenia and 139 patients with BPAD that were diagnosed according to the ICD-10 diagnostic criteria, as well as 139 healthy subjects all of whom gave their informed consent. The data were analyzed using SAS 9.2 software.&#x0D; Results: On comparing the three groups, the schizophrenia group scored the least in the physical (53.51±19.36), psychological (51.32±21.37) and environmental health domains (55.59±17.78). The QOL of the BPAD group was comparable to that of the healthy control group and significantly better as compared to that of the schizophrenia group (P&lt;0.0001).&#x0D; Conclusion: The study shows that patients with schizophrenia had significantly lower QOL than patients with BPAD and healthy subjects. Our study emphasizes the significance of addressing psychiatric patients' overall health and QOL in addition to symptom management.

Examining the Trajectory of Health-Related Quality of Life among Coronavirus Disease Patients.

Recent studies have reported a reduction in health-related quality of life (HR-QoL) among post-coronavirus disease 2019 (COVID-19) patients. However, there remains a gap in research examining the heterogeneity and determinants of HR-QoL trajectory in these patients. To describe and identify factors explaining the variability in HR-QoL trajectories among a cohort of patients with history of COVID-19. A prospective study using data from a cohort of COVID-19 patients enrolled into a registry established at a health system in New York City. Participants were enrolled from July 2020 to June 2022, and completed a baseline evaluation and two follow-up visits at 6 and 12months. We assessed HR-QoL with the 29-item Patient Reported Outcomes Measurement Information System instrument, which was summarized into mental and physical health domains. We performed latent class growth and multinomial logistic regression to examine trajectories of HR-QoL and identify factors associated with specific trajectories. The study included 588 individuals with a median age of 52years, 65% female, 54% White, 18% Black, and 18% Hispanic. We identified five physical health trajectories and four mental health trajectories. Female gender, having pre-existing hypertension, cardiovascular disease, asthma, and hospitalization for acute COVID-19 were independently associated with lower physical health. In addition, patients with increasing body mass index were more likely to experience lower physical health over time. Female gender, younger age, pre-existing asthma, arthritis and cardiovascular disease were associated with poor mental health. We found significant heterogeneity of HR-QoL after COVID-19, with women and patients with specific comorbidities at increased risk of lower HR-QoL. Implementation of targeted psychological and physical interventions is crucial for enhancing the quality of life of this patient population.

Cross-Cultural Adaptation and Validation of the German Version of the Upper Limb Functional Index.

The Upper Limb Functional Index (ULFI) is a popular tool with valid psychometric properties to assess upper limb function in patients with musculoskeletal conditions. The aim of the study was to cross-culturally adapt and validate the German version of the ULFI. Cross-cultural validation. A 2-stage cross-cultural adaptation of the ULFI was performed according to international guidelines through consecutive forward and backward translations. Psychometric properties of internal consistency, test-retest reliability, criterion, face and content validity, and factor structure were determined from the included German participants suffering from upper limb conditions (n = 100), who fulfilled the following inclusion criteria: (1) older than 18years old, (2) German as native language, and (3) medical diagnosis of musculoskeletal upper limb condition. Participants completed the ULFI; Disabilities of the Arm, Shoulder, and Hand; EuroQol Health Questionnaire 5 Dimensions; and Short Form-12 questionnaires. The ULFI-G showed good internal consistency (α = .88); excellent test-retest reliability (intraclass correlation coefficient2:1 = .98); directly strong correlation with Disabilities of the Arm, Shoulder, and Hand (r = .84); fair correlation with Disabilities of the Arm, Shoulder, and Hand-sport (r = .54); inversely fair correlation with EuroQol Health Questionnaire 5 Dimensions (r = -.62); and Short Form 12's physical health domain (r = -.7). A single-factor structure was revealed. The ULFI-G showed adequate psychometric properties and proved to be a valid tool for upper limb functional assessment in German population.

Prospective observational study on quality of life in painful neuropathic pain conditions

Background: Neuropathic pain is the most complicated, disabling condition due to varied etiologies and clinical presentations, and with substantial global problem on the individual suffering with pain as well as the society he thrives in. The consequences of long effects of pain are so huge that it has an impact on one’s social, physical, psychological, behavioral domains, etc., and mainly leads to substance abuse, mood disorders, sleep disturbances, and increased suicidal tendencies which have an enormous and detrimental effect on patient’s quality of life (QOL). Aims and Objectives: The aim of this study was to assess the effect of neuropathic pain on the QOL and to determine the extent of socioeconomic burden on subjects with neuropathic pain conditions. Materials and Methods: This prospective, observational study was done on 100 successive subjects including both the gender aged 18–65 years, diagnosed with neuropathic pain conditions, who attended pain clinic (Outpatient Department) at Kempegowda Institute of Medical Sciences, Hospital and Research Centre, Bangalore, and subjects assessed for the impact of neuropathic pain conditions on the QoL and its influence on overall health using short-form (SF) 12 QoL. Results: The assessment of health-related QoL in the study subjects, regarding age group, gender, and duration of pain, concluded that scores with physical health (PH) and mental health (MH) were low in the age group of 31–50 years (54%) in both sexes. Lower scores in PH and MH dimensions were noted more in women (31%) than men. It was also noted that the scores were low in PH and MH components with increasing duration of illness. Conclusion: The health-related QoL in subjects with NP was assessed by SF-12 QoL questionnaire that evaluated the eight domains of Health, that is, PH and MH scores that summed up to PH composite scale-12 and MH composite scale-12 scores with respect to age group, gender, duration of pain, etc. and ongoing drug therapy, the results of which were statistically significant.

Comparative Evaluation of Depression, Anxiety and Quality of Life between Clinical and other than Clinical Branch Postgraduate Medical Students: A Cross-sectional Study

Introduction: Medical training has been reported to be stressful. Clinical branch residents were found to be more anxious when compared to other than clinical branch residents. Heavy workloads and long working hours usually contribute to stress, resulting in fatigue, depression, and anxiety. Aim: To compare depression, anxiety, and Quality of Life (QoL) between clinical and other than clinical branch postgraduate medical students. Materials and Methods: The present cross-sectional study was conducted in the Department of Psychiatry at the Institute of Medical Sciences (IMS), Banaras Hindu University (BHU), in Varanasi, Uttar Pradesh, India. The data were collected from 150 residents through face-to-face interviews and by applying the Hamilton Anxiety Rating Scale (HAM-A), Hamilton Depression Rating Scale (HDRS), and World Health Organisation Quality of Life Brief Version (WHOQOL-BREF). The data were analysed using International Business Machines (IBM) Statistical Package for the Social Sciences (SPSS) Statistics 23.0 software. Results: The present study found that the majority of residents were male 108 (72%), belonged to the Hindu religion (134, 89.33%), were unmarried (150, 83.33%), and resided in the hostel (118, 78.67%) during their residency tenure. The prevalence of depression among clinical branch residents was 52 (50.0%), and in other than clinical branch residents, it was 17 (36.96%) (p=0.633). The prevalence of anxiety among clinical branch residents was 65 (62.5%), and in other than clinical branch residents, it was 18 (39.14%) (p=0.002). QoL was better in other than clinical branch residents compared to clinical branch residents in physical health, social, and environmental domains (p&lt;0.04). Conclusion: The study concluded that clinical branch residents were experiencing significantly higher levels of anxiety. Overall, the QoL of residents in other than clinical branches was better than their counterparts in clinical branches.

Mental health and frailty in people with multiple sclerosis: unraveling a complex relationship.

People with multiple sclerosis (MS) have up to a 15 times higher risk of being frail compared to age-matched individuals without MS. Frailty is a biological syndrome of decreased physiological reserve and resilience that increases the vulnerability to adverse clinical outcomes and leads to a lower quality of life. Recent studies have begun investigating frailty in the context of MS, highlighting several associations between frailty and adverse events, such as falls, and common MS-related symptoms involving the physical health domain, such as walking and sleeping problems. However, there is a critical knowledge gap regarding the relationship between mental health and frailty in people with MS. This mini-review article aimed to shed light on the potential relationships between MS, frailty, and mental health. Despite the dearth of studies on this topic, indirect evidence strongly suggests that the association between frailty and mental health in people with MS is likely bidirectional in nature. Specifically, mental health disorders such as depression and anxiety may be involved in the etiology of frailty in people with MS. However, they could also be exacerbated by the detrimental effects of frailty on overall health. The complex relationship between frailty and mental health in MS underscores the multifaceted challenges people with MS face. Conducting further research to untangle such a relationship is critical to developing early detection and intervention strategies for improving well-being and medical outcomes in people with MS.

Quality of life among Saudi Arabian Patients Receiving Private Healthcare: Household-Based Survey

Background: As an alternative to hospitalization, home healthcare programs are assuming greater significance on a global scale due to the expanding geriatric population and the prevalence of chronic and acute diseases that require ongoing monitoring and care. In describing and evaluating the quality of life (QOL) and associated determinants of patients enrolled in the Home Health Care (HHC) program affiliated with the Ministry of National Guard Health Affairs in Riyadh, Saudi Arabia, was the overarching purpose of this study. Methods: Participants in this cross-sectional study were HHC program enrolled patients. Utilizing the World Health Organization QOL questionnaire (WHOQOL-BREF), information regarding the various domains of patients' QOL was gathered. By fitting logistic regression models, factors associated with a low QOL score were identified. Results: In the research, 253 patients participated. Age distribution: 67.05 (± 20.0). Morbid and sociodemographic characteristics had a substantial impact on the overall quality of life of HHC patients. The final multivariate logistic regression models identified independent associations between marital status, psychological disorders, stroke, and number of illnesses and the overall quality of life (QOL) of HHC patients (p =.022, p =.002, p =.031, and.057, respectively). In a retrospective analysis, the physical health domain score exhibited significant associations with educational attainment, psychological issues, and stroke (p =.028, p =.002, p =.007). Conversely, the psychological domain score demonstrated a significant association with age (p &lt; 0.001) and three distinct forms of chronic ailments—pulmonary (p =.002), psychological problems (p = 0.001), and p =.002. Only the marital status exhibited a significant association with the social domain score (p =.026). There was a significant association between the environmental domain and both education level and stroke incidence (p =.017 vs..027). Conclusions: Multiple factors are substantially correlated with the overall QOL and its domains. A significant number of these factors can be monitored and improved by enhancing the efficacy of HHC services; consequently, this will enhance patients' QOL.

Creating a patient reported outcome measure for medication-related quality of life: a concept mapping brainstorming study in Ontario, Canada

Introduction: Persons with mobility limitations generally take multiple medications to manage their conditions; however, healthcare providers across different settings do not currently have a way to measure the impact that medication taking has on patients’ quality of life (QoL). Current tools are limited, narrowly focused on few QoL domains and none focus on persons with mobility limitations. &#x0D; Target Audience: The target audience for our study findings are healthcare providers working with individuals with mobility limitations across different healthcare settings. &#x0D; Who was involved: This study included patient and caregiver partners. They were involved in the grant application, study participant recruitment, data collection, and final data analysis. This study also involved healthcare providers who supported participant recruitment and will be knowledge users, including pharmacists, physicians, and physical therapists. &#x0D; Aims and Methods: The aim of this study was to identify a list of potential items for the creation of a patient reported outcome measure (PROM) from the perspectives of individuals with mobility limitations who take medications. We used a mixed methods concept mapping approach to gather perspectives from across Canada. Here, we report on the results of the qualitative brainstorming phase of the study. Participants created a list of statements reflecting what matters to them about their medications in their everyday life. The statements were de-duplicated and condensed, following which, they were thematically analyzed and mapped onto common quality of life domains. &#x0D; Results: Twenty-two persons with mobility limitations across Canada participated in this study. Six hundred and ninety-four statements were condensed into 80 final statements. The final statements mapped onto common quality of life domains (physical health; mental health; employment/social/leisure activities; daily activities; interactions with providers; navigating the healthcare system; autonomy and decision-making; financial health) indicating a comprehensive list of items for the creation of the PROM. In addition, we identified some mobility limitation specific concepts relating to barriers to physically accessing medications and necessary testing, and to perceived health plan or policy restrictions.&#x0D; Learnings for the international audience: Results from this study emphasized the importance of including patient autonomy, decision-making and financial concerns, which are often excluded from other measures related to medication taking and QoL. Additionally, we identified other topics that matter to individuals such as impact on lifestyle activities, patient self-management, ease of access to medications and necessary testing, as well as financial challenges associated with medication taking. &#x0D; Next Steps: The next phases of concept mapping will be conducted, which will identify statements that are important and realistic to individuals with mobility limitations and a final conceptual mapping session. Statements that are rated highly on both scales will inform the development of items for the PROM, which will be validated in future work. In developing and validating a PROM for medication-related QoL, we aim to provide clinicians with an invaluable tool to enhance and monitor clinical care and patient outcomes. We envision this PROM might be used to inform overall medication management.

A cross-sectional study to assess the drug utilization pattern and pharmacotherapeutic adherence among patients with schizophrenia and quality of life of patient’s caregiver in a tertiary care teaching hospital

Background: Schizophrenia is a chronic severe psychiatric illness affecting nearly 0.4 to 1.4% of people in India. Many newer anti-psychotic drugs are used now-a-days in schizophrenia. Poor adherence to the treatment given to patients of schizophrenia is observed very often. Although, the quality of life of schizophrenia patients is very much compromised; at the same time, quality of life of the caregiver is also compromised. Methods: A cross-sectional Observational study was conducted among patients already diagnosed with Schizophrenia and on treatment, after ethical approval. Data relevant to study variables was collected in a pre-designed case record form. Evaluation of drug utilization pattern was done by WHO core drug prescribing indicators. Medication adherence was assessed through modified Morisky scale. Quality of life of relative or caregiver was assessed through WHO-QOL BREF questionnaire scale. Results: Patients of 18 years and above were enrolled. Among them, average age was 35.8±5.5 years. In my study, female patients were 64.7% and male patients were 35.3%. Average number of drugs per prescription was 3.8. Drugs prescribed by generic name were around 86.2%. Around 56.9% of drugs were prescribed from national list of essential medicines. Atypical antipsychotics were prescribed in 32% of all prescriptions for Schizophrenia; Whereas Benzodiazepines were prescribed in 19% of all prescriptions. Average Medication adherence score using MMS scale was 3.7±2.2. Patients with high adherence to the medications prescribed were nearly 71% and patients with low adherence to the medications prescribed were 29%. Mean total WHOQOL-BREF score was 75.2±6.5 out of 120. Conclusions: Most prescribed class of drugs was atypical anti-psychotics. Pharmacotherapeutic adherence among patients with schizophrenia was relatively high. Quality of life of patients’ relative or caregiver was impaired to some extent, more impaired in physical health and social relationships domain.

The Impact of Obesity on the Health of the Older Population: A Cross-Sectional Study on the Relationship between Health-Related Quality of Life and Body Mass Index across Different Age Groups.

The SF-36 survey was sent to 500 randomly assigned Austrian adults (response rate: 80.6%). This study assessed HRQoL subscale and component scores based on gender, level of education, smoking status, and alcohol consumption in 403 participants. Increasing BMI is associated with a negative impact on all domains of physical health and social function. The study uncovered substantial variations in the impact of increasing BMI on HRQoL across different age groups, with a pronounced effect observed in the physical components, particularly among individuals aged 65-74. BMI is negatively associated with the physical aspects of HRQoL and social function, affecting various adult age groups differently. Consequently, our results emphasize assessing different age groups and possible influencing factors on HRQoL, such as BMI, for further optimization in designing prevention programs against obesity.

Supplementation with probiotics, prebiotics, and synbiotics in patients with chronic functional constipation: a randomized, double-blind, placebo-controlled pilot clinical trial

Abstract Background Functional constipation includes a set of gastrointestinal symptoms unexplainable by an identifiable underlying physical cause or pathology. The prevalence of this condition is high and there is a need to develop strategies to reduce it. Probiotics, prebiotics, and synbiotics may be an alternative treatment for chronic functional constipation. Methods To compare the efficacy of dietary supplementation on symptoms of patients who suffer from chronic functional constipation. An exploratory, randomized, double-blind, placebo-controlled pilot clinical trial was conducted with 74 patients diagnosed with chronic functional constipation who were divided into four treatment groups—Group A: probiotics; Group B: prebiotics; Group C: synbiotics; Group D: placebo. Each patient was treated for 8 weeks. At the beginning and end of treatment, data were collected by administering questionnaires and scales, including the Bristol stool scale, on gastrointestinal symptoms, bowel movements, and sociodemographic and anthropometric characteristics. Results Stool frequency increased in all four study groups, and greatest difference was observed in the synbiotics group (2.8 ± 1.3 vs. 5.9 ± 2.6; P &amp;lt; 0.001). Stool consistency improved only in the active treatment groups. Based on the evaluation of gastrointestinal symptoms, participants treated with prebiotics, probiotics and synbiotics showed the greatest improvement in abdominal pain (8.28 ± 2.63 vs. 6.56 ± 2.62; P = 0.009), gastroesophageal reflux (4.60 ± 2.66 vs. 3.45 ± 2.42; P = 0.039) and constipation symptoms (13.00 ± 3.97 vs. 8.71 ± 3.35; P = 0.003), respectively. As for quality of life, the main changes were observed in physical health domains, with a placebo effect. Conclusions The present study provides evidence supporting the efficacy of dietary supplementation with probiotics, prebiotics, and synbiotics in patients with chronic functional constipation after 8 weeks of treatment.

MEDICARE ADVANTAGE (MA) PLAN CHARACTERISTICS ON PHYSICAL AND MENTAL HEALTH OUTCOMES OF MA BENEFICIARIES

Abstract With growing demands for better and cost-effective care delivery by Medicare Advantage (MA) plans, comparison of self-reported health outcomes is more important because those outcomes capture patients’ experiences and perspectives. The purpose of the study is to examine the characteristics of MA plans on Medicare beneficiaries’ physical and mental health status. Methods: I used the Medicare Health Outcomes (HOS) survey, a random sample of Medicare beneficiaries surveyed from each MA plan with a minimum of 500 enrollees conducted by the CMS. The current study included 3 baseline cohorts from 2015 (n=195,800), 2016 (n=178,973), and 2017 (n=172,047). I used physical component summary (PCS) and mental component summary (MCS) scores as two outcomes which include various domains of physical (exercise, pain, activity limitation) and mental health (social functioning, emotional status, depression) status. Plan characteristics include plan ownership status (for-profit (FP) vs. not-for-profit (NFP), plan types (PPO vs. HMO/cost contract), and the number of plan members. I used the linear regression method with clustering at the plan contract level due to the correlation of multiple beneficiaries within the same plan. Results: Adjusted for beneficiary level characteristics, beneficiaries in PPO plans experienced greater physical and mental health scores than HMO or cost contract plans. MA plan with less than 5k beneficiaries is associated with a lower physical health score than plans with more than 100k beneficiaries. For-profit ownership was significantly associated with lower mental health scores. Discussion: The characteristics of MA plan insurers are important factors for beneficiaries’ enrollment decisions and quality improvement efforts.

THE RELATIONSHIP BETWEEN SELF-REPORTED QUALITY OF LIFE AND SMARTPHONE GPS DATA

Abstract Patients with advanced cancer and their family caregivers often experience poor quality of life. Self-reported measures are commonly used to quantify quality of life of family caregivers but may have limitations such as recall and social desirability bias. Variables derived from passively obtained smartphone GPS data are a novel approach to measuring quality of life that may overcome these limitations, and enable detection of early signs of deteriorating mental and physical health. The purpose of this study was to examine the temporal directionality of the correlations between self-reported quality of life (i.e., PROMIS Global 10: physical and mental health domains) at 3 timepoints and passively acquired smartphone GPS data among 7 family caregivers and 4 advanced cancer patients over a 12-week period. We extracted variables (i.e., total distance, time spent at home, transition time, and number of significant locations) with algorithms applied to the raw GPS sensor data. Uncertainty measures for the correlation estimates were computed as uncorrected 95% Bootstrap confidence intervals. We found a medium-to-large correlation between quality of life and the daily smartphone GPS data averaged by week in certain time periods (e.g., temporal correlations between physical health and transition time for 0–6 weeks; r’s ranging from 0.30 to 0.53). Additionally, we found a medium-to-large correlation between quality of life and within-person variability (standard deviation) in daily smartphone GPS data. Our findings indicate that variation in within- and between-person behavior patterns captured by GPS data may signal potential changes in individuals’ physical and mental health outcomes.

Quality of life and depression among patients with high myopia in Nigeria: a cross sectional study.

To evaluate the quality of life (QOL) and level of depression among participants with high myopia in Nigeria and the demographic factors associated with these outcomes. This cross-sectional study was conducted on 100 adult participants with high myopia (defined as refractive error ≤-5.00 D or worse, and uncorrected visual acuity worse than 6/18 in the better seeing eye) attending ophthalmology centres in Nigeria from 2 October 2021 to 30 August 2022. The means and standard deviations were calculated for each of the four domains of World Health Organization Quality of life scale (WHOQOL-BREF) using the transformed scores. The Beck Depression Inventory (BDI) scale was used to assess the level of depression. The highest and the lowest mean scores of WHOQOL-BREF domains were found for the psychological and physical health domains (mean percentage scores were 67.0 [95% confidence intervals (CI) 64.1-68.9] and 55.3 (95%CI 51.8-58.8, P<0.001), respectively. One-way analysis of variance (ANOVA) revealed significant differences in physical health with educational status (higher among those with tertiary education: mean difference 0.9, 95%CI -0.2-2.1; P=0.049), differences in psychological health with working status (higher among those who were working 1.2, 95%CI 0.3-2.1; P=0.012). Also, the result showed a statistically significant association between environmental health and marital status (higher among non-married: 1.7, 95%CI -0.9-2.3; P=0.012) while overall health was associated with place of residence (higher in urban areas: 2.3, 95%CI 1.2-3.5; P=0.024). For depression, one in every nine participants reported major depressive symptom, mostly younger people (aged 16-29 vs 30-49y: 17.0% vs 0, P=0.019), and slightly more women than men (14.3% vs 0, P=0.064). There were significant negative correlations between the depression scores and psychological health (r=-0.48, P<0.001), physical health (r=-0.29, P=0.002), social and relationship (r=-0.49, P<0.001), environmental (r=-0.48, P<0.001) and overall health (r=-0.49, P<0.001). People with high myopia have a relatively moderate QOL, but poor physical health, particularly the younger age group, and women who are more likely to experience clinically relevant depression. Eye care professionals should consider possible referrals for counselling for people with high myopia.

Impact of welding occupation on serum aluminium level and its association with physical health, cognitive function, and quality of life: a cross-sectional study.

There is an occupational health concern about welders' inhalation of toxic aluminium fumes. We investigated whether serum aluminium level (SAL) and demographic variables can significantly predict physical health parameters, cognition, and quality of life (QoL) among welders. The cross-sectional study involved 100 age- and location-matched men (50 welders and 50 non-welders). SAL obtained using a graphite furnace atomic absorption spectrometer, and data collected using blood pressure and body mass index (BMI) apparatuses, biodata form, pain rating scale, General Practitioner Assessment of Cognition, WHOQoL-BREF, and Nordic musculoskeletal symptoms (MSS) questionnaire were analysed using independentsamplest test, chi-square, Pearson's correlation, and hierarchical linear regression. Welders had significantly higher SAL (mean difference [MD] = 1.77µg/L, p < 0.001), lower QoL (MD = 3.92, p = 0.039), and higher prevalence of MSS on the neck (χ2 = 10.187, p = 0.001), shoulder (χ2 = 9.007, p = 0.003), upper back (χ2 = 6.832, p = 0.009), and knee (χ2 = 12.190, p < 0.001) than non-welders. There was a significant bivariate association between SAL, systolic blood pressure (β = 0.313, p = 0.002), and BMI (β = 0.279, p = 0.005), but not pain intensity, cognition, or QoL. SAL remained a significant predictor of systolic blood pressure after adjustment for physical health and QoL parameters (β = 0.191, p = 0.044). The association between SAL and social QoL became significant after adjustment for physical health and other QoL domains (β = - 0.210, p = 0.032) and demographic variables (β = - 0.233, p = 0.046). Welders had significantly higher SAL, musculoskeletal symptoms, blood pressure, and lower QoL than non-welders. SAL was associated with adverse physical health parameters and social-related QoL, not cognition. We recommend routine aluminium bioavailability and physical health checks among welders.