Body Image Domains Research Articles

Impact of Active Maintenance Treatment (MT) Compared to No MT on the Quality of Life (QoL) of Patients with Multiple Myeloma (MM) Following First Autologous Stem Cell Transplant (ASCT)

Background: Evidence supports that MT after ASCT provides a progression free and overall survival advantage in MM compared to placebo in phase III trials. Lenalidomide was recently approved for this purpose by both the Food and Drug Administration and the European Medicines Agency in 2017. However, there is the potential that continual treatment will have a negative impact on patient QoL. Very few studies have assessed this; although a recent study found no significant QoL differences between patients receiving MT vs no MT post ASCT. Further data are required to confirm this.Objective: To assess the impact of active MT vs. no MT on the QoL of patients with MM following first ASCT.Methods: A non-interventional, cross-sectional study was conducted with patients recruited from 13 centers in the United States and Canada. All patients had received a single ASCT and three groups were identified and compared: •Patients within 30-100 days of ASCT and had not commenced any MT (baseline patients)•Patients at >100 days post ASCT and currently receiving any MT therapy (MT patients)•Patients at >100 days post ASCT and currently not receiving MT (no MT patients)Patients were excluded from this analysis if they had experienced clinical progression post ASCT.Demographics, clinical characteristics, comorbidities, treatment and symptoms were captured via a case report form. Patients completed a questionnaire containing the EuroQoL five dimension (EQ-5D), the European Organization for Research and Treatment of Cancer QoL Questionnaire Core 30 (EORTC QLQ-C30) and the QoL Questionnaire Myeloma 20 module (QLQ-MY20). Differences in QoL between baseline, MT and no MT patients were explored with ordinary least squares regressions, controlling for age, sex, body mass index, time since diagnosis, stage at diagnosis, comorbidities, Eastern Cooperative Oncology Group performance status and country.Results: Between 2016 - 2017, 13 sites in the US and Canada enrolled 303 patients (excluding 3 patients who had progressed). Mean age was 62.0 years, 45% were female. There were 84, 141 and 78 baseline, MT and no MT patients respectively. Baseline patients were a mean of 83.7 days post ASCT whereas mean days post-transplant was 868.6 for MT patients and 905.2 for no MT patients. The majority of MT patients (81.6%) received lenalidomide either as monotherapy or combination therapy. Unadjusted mean EQ-5D scores were 0.77 for baseline patients, 0.81 for MT patients and 0.79 for no MT patients, with higher scores indicating better QoL.In the adjusted analysis, EQ-5D and the majority of EORTC scores did not significantly differ between the three patient groups. However, EORTC global scores demonstrated a significant QoL improvement relative to baseline for both MT (+9.62, p=0.0178) and no MT (+10.06, p=0.0435) patients. A similar pattern was observed for social functioning (MT vs. baseline; +12.65, p=0.0106. No MT vs. baseline; +16.94; p=0.0055) and the MY-20 body image domain (MT vs. baseline, +16.78, p=0.0053; No MT vs. baseline, +19.31, p=0.0083). Only the diarrhea domain from the EORTC-QLQ C30 and future perspectives from the MY-20 (measuring concerns about outlook and future health) differentiated between MT vs. no MT patients; with patients on MT reporting higher scores for diarrhea (greater problems, [+9.43; p=0.0358]) and lower scores for future perspectives (poorer outlook, [-11.39; p=0.0196]).Conclusion: QoL after ASCT improves from baseline for both MT and no MT patients as measured by the global health status and social functioning domains of the EORTC QLQ-C30, and the body image domain from the MY-20. Only outcomes on future perspectives and diarrhea differentiated between MT and no MT patients. Collectively, the results suggest that MT is not associated with a notable QoL detriment. DisclosuresVij:Takeda: Honoraria, Research Funding; Abbvie: Honoraria; Bristol-Meyers-Squibb: Honoraria; Janssen: Honoraria; Jazz: Honoraria; Celgene: Honoraria; Amgen: Honoraria, Research Funding; Konypharma: Honoraria. Norkin:Celgene: Honoraria, Research Funding. Kumar:Celgene, Millennium, BMS, Onyx, Janssen, Noxxon, AbbVie, Amgen, Merck, Oncopeptides, Skyline Diagnostics, Takeda: Consultancy; Skyline: Honoraria; Celgene, Millennium/Takeda, Onyx, AbbVie, Janssen, Sanofi, Novartis, Amgen, Genentech, Merck, Oncopeptides, Roche, Skyline Diagnostics: Research Funding. Roberts:Adelphi Real World: Employment. White:Amgen, Celgene, Janssen, Takeda: Honoraria, Membership on an entity's Board of Directors or advisory committees. Wood:Adelphi Real World: Employment. Blanthorn-Hazell:Adelphi Real World: Employment. Rossi:Thrassos: Consultancy; Celgene: Consultancy. Dhanasiri:Celgene Corporation: Employment, Equity Ownership. Zafar:Celgene Corporation: Employment. Newhouse:Celgene: Employment. Arleigh:Celgene: Honoraria.

Quality of Life for Women with Breast Cancer-Related Lymphedema: The Importance of Collaboration between Physical Medicine and Rehabilitation and General Surgery Clinics

Background: The aim of this study was to examine the clinical characteristics and quality of life (QOL) of patients with BCRL (breast cancer-related lymphedema).Methods: In this cross-sectional descriptive study, patients' characteristics such as age, body mass index (BMI: kg/m²), history of chemotherapy (CT), radiotherapy (RT), hormone replacement therapy (HRT), neoadjuvant therapy (NT), cancer stages, and types of surgery were recorded. Patients were evaluated using the ‘Disabilities of the Arm, Shoulder and Hand questionnaire’ (DASH), the ‘Lymphedema Quality of Life Questionnaire’ (LYMQOL-ARM), and a visual analogue scale (VAS). Results: A total of 68 women with the mean age of 52.50±9.33 and BMI 29.240 ± 5.05 kg/m² were recruited after breast cancer surgery in this study: thirty-three patients (48.5%) in Stage 0; 24 (35.3%) in Stage 1; 10 (14.7%) in Stage 2; and 1 (1.5%) in Stage 3. No statistically significant difference was found in the QOL according to treatments received after the diagnosis of breast cancer surgery, RT (except the appearance domain of QOL), CT, HRT, or NT. In patients who had received axillary dissection in combination with RT, a statistically significant association was observed between QOL related to body image and symptoms (p=0.009 and p=0.017, respectively). A statistically significant difference was found only in body image and clinical symptom domains according to the lymphedema stage (p=0.027 and p=0.002, respectively). It was observed that as shoulder pain (VAS) and disability (DASH) scores increased, scores of all domains of QOL increased except the overall domain in QOL (p<0.05). Conclusion: It was observed that clinical symptoms and body image parameters in QOL were associated with the lymphedema stage and the number of lymph nodes dissected. It was concluded that axillary dissection with axillary RT and RT alone after breast cancer surgery is associated with body image. Our study revealed that body image perception is related to the quality of life in patients with BCRL. Optimal management of the negative effects of self-reported lymphedema evaluated in the latency phase on quality of life requires coordination between Physical Medicine and Rehabilitation and General Surgery Clinics.

Body Image as a Mediator Between Gender and Quality of Life Among Patients With Diabetic Foot Ulcers in Indonesia.

Foot ulcers cause women in Indonesia to lose opportunities to participate in religious and cultural activities due to the inability to wear certain footwear. This study examined body image as a mediator in the relationship between gender and quality of life (QoL) among patients with diabetic foot ulcer (DFU) in Indonesia. A cross-sectional design with convenience sampling was used to recruit participants at the Surgical Outpatient Department and Wound Care Clinic in Bali, Indonesia. The Diabetic Foot Ulcer Scale-Short Form and the body image domain of the Body Investment Scale were administered. We found gender differences in participants' (n = 201) QoL and body image (p < .05). Body image fully mediated the effect of the relationship between gender and QoL (B = 6.68; 95% confidence interval [3.14, 10.52]) and explained 39.13% of the variance. Health care providers should consider patients' religious beliefs in DFU education and consider women's body image issues. Diabetes foot ulcer may prevent women from performing religious rituals, thus, influencing their QoL. Protective strategies to prevent DFU among women in Indonesia warrant further development.

Imagem corporal de pessoas com úlceras venosas

OBJETIVOS: Avaliar a imagem corporal em pessoas com úlcera venosa. MÉTODOS: Estudo descritivo realizado em um Ambulatório de Feridas, localizado na cidade de Pouso Alegre, Minas Gerais. Participaram do estudo 30 pessoas com úlceras venosas. Dois instrumentos foram utilizados: um questionário para a coleta de dados sociodemográficos e clínicos e a escala Body Investment Scale (BIS). RESULTADOS: Entre os 30 participantes, 16 (53,3%) eram do sexo feminino e 14 (46,7%), masculino; 25 (83,3%) tinham idade acima de 60 anos e 20 (66,7%) eram casados. A média do escore total na escala BIS foi de 34,0; e as médias dos escores para os domínios imagem corporal, cuidado pessoal, proteção corporal e toque corporal foram 16,30, 23,93, 5,53 e 18,30. Tais achados caracterizam que esses indivíduos com úlcera venosa que participaram do estudo apresentaram sentimentos negativos relacionados à própria autoestima, autoimagem e à piora na qualidade de vida. CONCLUSÃO: Os resultados do estudo apontaram que os indivíduos com úlceras venosas apresentavam alterações nos domínios imagem corporal, proteção corporal e no toque corporal, ou seja, manifestaram ter sentimentos negativos com relação ao seu corpo.

Quality of life outcomes after minimally invasive repair of pectus excavatum utilizing a new set of metallic bars and stabilizers

Background/PurposeThe aim of the study was to evaluate the postoperative quality of life (QoL) of patients who underwent minimally invasive repair of pectus excavatum (MIRPE) with a newly designed bar and bar stabilizers. MethodsWe conducted a prospective randomized study in which patients were operated either with standard perpendicular stabilizers (control group) or with the newly designed oblique stabilizers (intervention group). All patients were evaluated 6 months after the operation with the Pectus Excavatum Evaluation Questionnaire (PEEQ). ResultsThere were 16 patients in the control group and 14 in the intervention group. Mean age was 17 (SD: 3.3, range 14–27) years. There were no demographic differences between groups. Two patients in the control group and one in the intervention group were repaired with two bars instead of one. There was one reoperation in each group. There was a significant difference between the pre- and postoperative scores, in both groups, in the patient body image domain (control group: 9.5 to 3; p < 0.01; intervention group 10 to 3; p < 0.01), as well as in the psychosocial domain (control group: 13.5 to 24, p < 0.01; intervention group: 15 to 24, p < 0.01). With regards to the patients' perception of physical difficulties before and after MIRPE, the difference between pre- and postoperative scores was greater in the intervention group (8 to 12, p < 0.01) than in the control group (10 to 11, p = 0.04). The mean length of stay was 4.5 and 5 days in the intervention group and the control group, respectively. ConclusionOur study showed that patients who underwent MIRPE with the newly designed bars and stabilizers had non-inferior outcomes than patients reported in the literature who underwent MIRPE with standard bars and stabilizers. We found slightly better outcomes in patients in the intervention group compared to the control group, but larger studies will be needed to confirm if those differences are statistically significant. Level of evidenceII

Are We There Yet? Progress in Depicting Diverse Images of Beauty in Instagram’s Body Positivity Movement

As the literature on the narrowly defined standards of beauty portrayed in social media has increased, a newer focus on body positivity messages has also emerged. Body positivity challenges the unrealistic standards of beauty present in the media by the promotion and acceptance of diverse body sizes and appearances. In an effort to further understand the messages of body positivity in social media, this study examined the content of 246 body positive posts from the broad Instagram community. Results demonstrated an inclusion and appreciation of diverse physical appearances, as well as themes consistent with messages promoting body positivity. In contrast to content on popular body positivity accounts, several of the posts from the broader Instagram community did, however, contain contradictory messages, such as the promotion of weight loss or the praise of extreme thinness. Future research examining such contradictory messages in body positivity posts and their effects on body image and other related domains is warranted.

Is body image a predictor of women\u2019s depression and anxiety in postmenopausal women?

BackgroundWomen in perimenopausal and postmenopausal period are at increased risk of depression and anxiety. Physiologic changes in menopause can change body’s appearance and function that may disturb body and then lead to anxiety and depression. This study aims to assess the relationship between body image with anxiety and depression among postmenopausal women.MethodsThis descriptive study was performed on 307 women attending to the health centers in Tehran- Iran. Sampling was performed by a multi-staged randomized method. Data were collected by using Beck Depression questionnaire, Spielberger Anxiety Questionnaire, Fisher Body Image Questionnaire and Socio-demographic questionnaires. Data were analyzed by SPSS 21 and using t-test, Pearson and Spearman correlation tests and multiple linear regression methods.ResultsThe average age of the participants was 55.19 ± 4.034 years. Mean scores for body image, anxiety and depression were 163.26 ± 20.38, 12.00 ± 7.71 and 42.70 ± 8.40 respectively. Fifty five percent of women had mild to severe depression and 83.7% of them had mild to severe anxiety. Total score and all domains of body image had a negative correlation with depression and anxiety scores (P < 0.001). Multiple linear correlation showed that body image is a predictor for depression and anxiety (P < 0.001).ConclusionsBody image of women can be effective on occurrence of depression and anxiety in menopause. Therefore, women’s health policies should consider body image to control cognitive problems including depression and anxiety in menopause.

The Effect of the Inflammatory Bowel Disease Classroom in Nature on the Quality of Life of Patients With Inflammatory Bowel Disease.

"The IBD Classroom in Nature" is an initiative that combines training and leisure activities in an ideal environment where families and patients can interact with each other. The objective of the present study was to quantify the effect that "The IBD Classroom in Nature" had on the health-related quality-of-life of patients with Inflammatory bowel disease (IBD). We conducted a prospective, analytical study with a pre-post design to demonstrate the impact on health-related quality-of-life (measured with the IMPACT-III questionnaire) of 3 days together in the context of The IBD Classroom in Nature. The study included 13 patients with IBD with a mean age of 12.3 years (interquartile range 11.9-14.5). After "The IBD Classroom in Nature" there was an improvement in the IMPACT-III score with significant improvements in the emotional functioning and body image domains. The present study objectively shows the beneficial effect of group activities focused on the most diverse aspects of their disease.

Development and initial psychometric testing of a body-image domain within an electronic pelvic floor questionnaire (ePAQ-pelvic floor).

Urogynaecological conditions have been shown to negatively impact on body image in a number of previous studies. ePAQ-Pelvic Floor (ePAQ-PF) is a patient-reported outcome measure used in clinical practice to assess urogynaecological conditions and their impact on quality of life. This study aimed to develop and undertake initial psychometric testing of a new domain to assess urogynaecological body image within ePAQ-PF. A patient involvement group, analysis of free-text data from ePAQ-PF and a systematic review of existing PROMs assessing urogynaecological body image informed the content of a new body-image domain within ePAQ-PF. This was administered to 208 patients who consented to the use of their anonymised ePAQ-PF responses for research purposes. These data underwent factor analysis, internal consistency reliability and item-total correlation testing. Evidence-based hypotheses were formulated to test construct validity. Criterion validity was assessed against the Body-image Scale (BIS). Patients completed a separate questionnaire (QQ-11) to measure the face validity of ePAQ-PF. Factor analysis revealed a four-item body-image domain with good internal consistency reliability (Cronbach's α= 0.899) and item-total correlation (Spearman's rank r> 0.40). ePAQ-PF body-image domain scores correlated significantly with the BIS scores (r= 0.501). Age, prolapse, sexual dysfunction, pelvic pain and urinary incontinence scores correlated significantly with body-image domain score. QQ-11 value scores demonstrated good acceptability. Body-image assessment should form part of routine care in urogynaecology. Preliminary results support the validity, reliability and functionality of the body-image domain in ePAQ-PF. Further psychometric testing of this is required, including tests of responsiveness and stability.

Specific cognitive correlates of the quality of life of extremely preterm school-aged children without major neurodevelopmental disability.

We examined how specific cognitive behavioral impairments impacted quality of life (QoL) within a large multicenter cohort of 7-10 year olds surviving extremely preterm (EPT) without major neurodevelopmental disability. Between 7 and 10 years of age, two generic, self-proxy, and parental evaluations were obtained. QoL measurement questionnaires (Kidscreen-10/VSPA (Vécu et Santé Perçue de l'Enfant et de l'Adolescent)) were used and compared to a reference population. The general and specific cognitive functions, such as executive functions, behavior and anxiety, and clinical neurologic examination, were also assessed. We analyzed 211 school-aged EPT children. The mean gestational age was 26.2 (±0.8) weeks, birth weight was 879 g (±181) and the mean age was 8.4 years (±0.87). Children with a Full-Scale Index Quotient ≥89, who were considered as normal, had a lower QoL. Specific cognitive impairments: comprehensive language delay, visuo-spatial integration defect, and dysexecutive disorders) were the QoL correlates in the domains of school performance and body image. School and health care professionals need to increase their focus on EPT children's lower so as to recognize the preterm behavioral/cognitive phenotype and their potential need for supportive measures. Research on preventive interventions is warranted to investigate if these long-term effects of an EPT birth can be attenuated in neonatal period and after.

Restoring the body: changes in body self in the course of a focusing and arts-based therapy program for female interpersonal trauma survivors

BackgroundThe goal of this study was to assess the effectiveness of a therapeutic program for female survivors of interpersonal trauma, among others, of domestic violence. The participating women took part in four two-day modules in a group setting during which they were offered focusing training and arts-based Gestalt therapy. The effectiveness of the interventions was evaluated in terms of improvements in body image and body experience, according to the model of body self as developed by Sakson-Obada.Participants and procedureThe Body-Self Questionnaire, the Affective Body Image test and the Draw-a-Woman test were administered to 21 participants before and after the program.ResultsAfter the therapy, the participants reported a reduction of disturbances in their body experience (interpretation and regulation of emotions and bodily needs and in body identity). In the body image domain, increased body satisfaction was observed using both declarative and projective tools – the women were also more likely to draw uncovered parts of the female body. Although improvements were noted in most of the women, three of them reported an increase in difficulties, mainly in the body image domain.ConclusionsThe study demonstrated that: (1) a combination of the two techniques, i.e., focusing training and art included in the Gestalt group therapy program, resulted in satisfactory changes in body image and body experience; (2) the therapy’s effects should be monitored in the context of a woman’s various life situations; and (3) the use of both declarative and non-declarative methods can be recommended to assess the effectiveness of body-centered therapy.

Endoscopic Axillary Approach Improves Patient Satisfaction of Gynecomastia Subcutaneous Mastectomy: A Cross-Sectional Study Using the BODY-Q Chest Module.

Gynecomastia is a common condition that refers to the benign enlargement of male breasts. Several minimally invasive techniques were invented to avoid visible scars in the chest area, but have limited effects on the dense fibroglandular breast tissue, and open excision remains the mainstay of treatment. Endoscopic subcutaneous mastectomy has the superiority of visualization, facilitating accurate dissection and hemostasis, also enabling inconspicuous scars. This study was designed to evaluate the patient-reported outcomes of the endoscopic axillary approach in treating gynecomastia, to interpret the differences between it and the conventional periareolar open excision method, and to present our experience utilizing this technique as a reliable alternative for Simon I and II gynecomastia. Eighty-three participants diagnosed with Simon I or II gynecomastia were included in this cross-sectional study, among which 31 were preoperative and 52 were postoperative patients. Postoperative participants were divided into two groups according to whether endoscopic axillary subcutaneous mastectomy (axillary group, n = 25) or periareolar open excision (periareolar group, n = 27) was performed. Patient-reported outcomes were assessed using the BODY-Q questionnaire, including the chest, nipples, body image, social, appearance-related distress, and scar domain, with scores ranging from 0 to 100. The BODY-Q score of both axillary and periareolar postoperative groups showed significant improvement on chest (p < 0.001), nipples (p < 0.001), body image (p < 0.001), and appearance-related distress (p < 0.005) scales, compared with the preoperative group. Of the scar scale, the axillary group rated higher scores than the periareolar group (p = 0.019), analysis of the individual scale items showed more positive responses in questions "Location of your scars?" (p < 0.001) and "How your scars look when they are not covered by clothes?" (p < 0.001), the item "Having to dress in a way to hide your scars?" also had a somewhat more positive responses from participants (p = 0.095). The present findings indicate that compared with the periareolar excision, patients who underwent gynecomastia subcutaneous mastectomy through endoscopic axillary approach have higher scar satisfaction with postoperative outcomes, this probably because of the well-hidden scar at the axilla, which leverages the psychologic burden of the patient after surgery. Future prospective studies are needed to measure changes over the entire patient journey, to find out the predictable factors of postoperative patient satisfaction, and determine how the objective outcomes relate to changes in patient's health-related quality of life. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine Ratings, please refer to Table of Contents or online Instructions to Authors www.springer.com/00266 .

Quantifying Burn Injury-Related Disability and Quality of Life in the Developing World: A Primer for Patient-Centered Resource Allocation.

Untreated or undertreated burns are commonly encountered by plastic surgeons on medical trips in India and represent a major cause of disability. We sought to utilize validated patient-reported outcomes instruments to identify the patient population with the greatest burn-related disability in order to appropriately allocate plastic surgery resources to those in greatest need. The Quick Disability of the Arm, Shoulder, and Hand, RAND 36-Item Short Form Health Survey, and Burn-Specific Health Scale-Revised, Brief, and Adapted questionnaires were administered via an interpreter during a plastic surgery trip to Jharkhand, India, in January 2018. Demographics, comorbidities, and burn-specific history were recorded. Twenty-eight postburn patients were surveyed (mean age, 17.0 ± 9.2 years; male:female ratio, 1:2.5). Mean time from injury was 4.74 years. No patient had received formal, primary burn care. Mechanism of injury: flame (39%), oil (32%), scalding water (14%), and other (14%). Fifty-four percent were extremity burns; 25%, facial; and 18%, neck burns. The Burn-Specific Health Scale-Revised, Brief, and Adapted demonstrated that the most significantly impacted domains for all patients were body image and skin sensitivity, with more than 80% of patients complaining of issues with skin sensitivity. In addition, children (aged <18 years) had diminished body image domain scores. RAND SF-36 scores were lowest in the energy (73.1 ± 25.0) and general health (76.5 ± 13.8) domains, and females with extremity burns demonstrated statistically significant decreases in their physical limitation domain scores (85.9 ± 17.3, P < 0.05). Females with extremity burns also had statistically significant lower scores in the energy domain (64.09 ± 25.75) as compared with their male counterparts with extremity burns (100 ± 0, P = 0.045). In general, females scored lower than did males in multiple domains, and those results reached statistical significance in the energy (65.9 ± 24.6 vs 93.6 ± 10.9), emotional (77.2 ± 21.5 vs 95.4 ± 11.2), and general health domains (71.1 ± 11.9 vs 90.0 ± 7.5) with P < 0.05. Children demonstrated significantly diminished scores in the emotional (75.5 ± 24.6) and general health (79.1 ± 11.8) domains. These data demonstrate the significant impact on quality of life that untreated burns have in this population. Male and female children with extremity burns and adult women with extremity burns were most significantly affected in multiple domains. Consequently, children and adult women with extremity burns appear to be the patient cohort with the greatest opportunity to impact their quality of life. These data may be utilized to improve patient triage and resource allocation for future surgical trips but could also be of significant benefit to internal health agencies and ministries for the same purpose.

074 Why Women Choose Vulvovaginal Plastic/Cosmetic Surgery, and What is to be Learned from the Literature. Personal Experience with 1000 Cases, and a Complete Review of the Literature, 2000-2018

Improving an individual women’s sexual response and sexual satisfaction may involve work in multiple domains, according to the individual situation. A domain rarely acknowledged in the Sexual Medicine community is the area of surgical genital remodeling and reconstruction. Based on the Author’s experience as both a sexual medicine practitioner and genital plastic/aesthetic surgeon having performed > 1000 genital plastic reconstructions, this presentation will categorize and discuss the rationale for and outcome of women’s genital plastic surgical procedures, including labiaplasty, reduction of redundant clitoral hood, and perineal/vaginal reconstruction, and review the extant literature on rationale and outcome in the domains of body image, sexuality, and complication occurrence. A complete review of all major prospective and retrospective contributions to the literature, 2000-2018 in the fields of genital plastics, especially as this discipline relates to women’s sexuality and body image domains, plus the author’s personal experience with 1000 surgical procedures.

Machine learning classification of first-onset drug-naïve MDD using structural MRI

Hands are the most commonly burnt body part given humans’ innate response to guard their face from injury, and are known to have detrimental functional and psychological consequences. Conflicting evidence exists regarding the impact of hand burns on long-term health status and global functioning. The objective of this study was to identify patient and clinical characteristics that predict health status and hand function of people at 12–24 months after hand burn.The Burns Specific Health Scale-Brief (BSHS-B) and the Brief Michigan Hand Outcome Questionnaire (Brief MHQ) were administered to community-dwelling adults who were between one and two years after admission to a statewide burns service for burns including one or both hands. Demographic, injury, and treatment data were collected to identify which factors predict health status and hand function in the second year after admission. Linear regression analyses adjusted for total burn surface area and burn depth were conducted to identify important predictors or outcomes.The sample (n = 41) was 80.5% male, with a mean age of 44.5 years and total body surface area (TBSA) of 8.4%. Psychiatric illness (regression coefficient −56.6, confidence interval (95% CI) −76.70, −36.49) and female gender (−20.3; 95% CI −0.77, −40.29) were key predictors of poorer global health status on the BSHS-B. Females also scored worse on body image (−5.35; 95% CI −1.83, −8.87) and work (−4.13; 95% CI −0.64, −7.62) domains of BSHS-B. The need for reconstructive or secondary surgery (−38.84; 95% CI −58.04, −19.65) and female gender (−16.30; 95% CI −4.03, −28.57) were important predictors of poorer hand function.Women and those with a history of psychiatric illness are particularly vulnerable to poorer outcomes in health status and/or hand function after burns, and may benefit from more intensive rehabilitation support and long-term follow-up.

Genital Self-Image: Associations with Other Domains of Body Image and Sexual Response

Genital self-image is an emerging aspect of body image relevant to sexual functioning and sexual satisfaction. The aims of the present study were to (1) examine the association between body image and genital self-image with a broad range of sexuality-related outcomes; (2) explore whether genital self-image is a more salient influence on sexual satisfaction and functioning than body image and (3) determine whether this would hold true for both men and women. The analytic sample (6,228 cis-gendered, heterosexual men and women between the ages of 18 and 40) was recruited from reddit.com online communities. Participants completed a survey that assessed genital self-image, body image, sexual satisfaction, and sexual functioning. Among women and men, positive genital self-image was associated with positive feelings about one’s body overall and reduced body-related concerns specific to sexual encounters (e.g., sexual performance). In female respondents, as genital self-image increased, so did sexual satisfaction. Although genital self-image did not significantly predict sexual satisfaction among men, exploratory analysis indicated a mediating relationship with body image concerns. Findings from the current study may inform interventions to facilitate the development of a healthy sexual self-concept as well as a more positive outlook on genital appearance among men and women.

How good is quality-of-life for children receiving home parenteral nutrition? – A pilot study

Children on home parenteral nutrition and their parents not only engage with complex nutritional issues but also have to manage difficult social and financial problems with social and clinical support that may not always meet their needs. Baxter's HPN-QOL questionnaire, assesses the QOL of adult patients treated with HPN, and has been developed rigorously using standard guidelines, measuring various dimensions of QOL. Our aim was to use this tool to explore how HPN influences the QOL of paediatric patients. The HPN-QOL questionnaire was modified to suit a paediatric HPN population. Data on demographics, aetiology of intestinal failure and duration of HPN were collected from a departmental database. Quality-of-Life grading of functional and symptom scales, HPN specific items and overall QOL Numerical Rating Scales were determined. Fourteen out of 17 families returned the completed questionnaires. QOL was significantly impaired by increased dependency regarding items of daily living such as eating, dressing, washing, and mobility, but was not affected in the domains of school attendance, general fatigue, pain and body image. There were no significant differences in QOL when patients with and without enterostomy were compared. Patients felt well supported by the hospital nutrition team in managing logistics related to HPN. QOL in HPN patients was not significantly affected by the medical aspects of care. This descriptive study highlights the need for further integration of medical and social care in order to support families of children receiving HPN as QOL was impaired in relation to activities of daily living and social functioning.

The Relationship Between Body Image and Sexual Functioning Among Gay and Bisexual Men

ABSTRACTGay and bisexual men report high body dissatisfaction compared to heterosexual counterparts, but no studies to date have examined how this may impact their sexual functioning. The present study investigated body image domains as predictors of sexual functioning problems (inhibited desire, erectile dysfunction, and premature ejaculation) among an online community sample of 185 gay and bisexual men, ages 18–40. Participants reported moderate to high body image satisfaction and sexual functioning consistent with previous literature with nonclinical male samples. Overall, the total variance accounted for by regression models was low. Body image variables were not predictive of sexual desire. However, increased drive for muscularity and lower affective body esteem were predictive of erectile difficulties. Additionally, negative behavioral body image in sexual situations and evaluative body dissatisfaction were associated with premature ejaculation. Understanding this relationship may have implications for gay and bisexual men’s health and wellbeing. Future research directions are discussed.

Clinical characteristics and health related quality of life (HRQoL) in Egyptian patients with systemic lupus erythematosus

Aim of the workTo study the clinical characteristics and health related quality of life (HRQoL) in systemic lupus erythematosus patients. Patients and methods94 adult SLE patients were included from those attending Zagazig University Hospitals. SLE disease activity index (SLEDAI) and Systemic Lupus International Collaborative Clinics damage Index (SLICC/DI) were recorded. The health-related quality of life (HRQoL) was assessed using the lupus-QoL (LQoL) questionnaire. ResultsThe mean age of the patients was 36.9 ± 14.1 years and disease duration 5.8 ± 4 years. All LqoL domains were reduced. LQoL was significantly related to the gender, SLEDAI, SLICC/DI, erythrocyte sedimentation rate (ESR), anti-nuclear antibody (ANA) and anti-double stranded deoxyribonucleic acid (ds-DNA) (p < 0.0001, p < 0.0001, p = 0.03, p = 0.002, p = 0.02, p < 0.0001 respectively). The LQoL was not related to the age, disease duration and level of education. All 8 domains significantly correlated with SLEDAI and SLICC/DI. Mucocutaneous manifestations lowered emotional health (43.3 ± 5.7), body image (45.3 ± 6.9) and fatigue (47.3 ± 9.3) domains; neuropsychiatric manifestation lowered the emotional health (43.4 ± 9.7), planning (47.3 ± 8.8) and intimate relationship (49.2 ± 11.7); musculoskeletal manifestations mainly worsened burden to others (31.3 ± 10.5), pain (47.6 ± 10.4) and physical health (50.3 ± 11.3) while lupus nephritis mainly decreased physical health (60.4 ± 11.4), fatigue (61.2 ± 5.7), burden to others (62.4 ± 11.4) and emotional health (67.4 ± 20.3). ConclusionsSLE is a condition associated with high unmet need and considerable burden to patients. To our knowledge, no previous study has systematically examined the clinical features as well as HRQoL of SLE patients in Sharkia Governorate, Eastern Egypt. HRQoL is a multidimensional concept that encompasses physical, emotional and social components associated with SLE manifestations.

The complexity of body image following bariatric surgery: a systematic review of the literature.

Poor body image is common among individuals seeking bariatric surgery and is associated with adverse psychosocial sequelae. Following massive weight loss secondary to bariatric surgery, many individuals experience excess skin and associated concerns, leading to subsequent body contouring procedures. Little is known, however, about body image changes and associated features from pre-to post-bariatric surgery and subsequent body contouring. The objective of the present study was to conduct a comprehensive literature review of body image following bariatric surgery to help inform future clinical research and care. The articles for the current review were identified by searching PubMed and SCOPUS and references from relevant articles. A total of 60 articles examining body image post-bariatric surgery were identified, and 45 did not include body contouring surgery. Overall, there was great variation in standards of reporting sample characteristics and body image terms. When examining broad levels of body image dissatisfaction, the literature suggests general improvements in certain aspects of body image following bariatric surgery; however, few studies have systematically examined various body image domains from pre-to post-bariatric surgery and subsequent body contouring surgery. In conclusion, there is a paucity of research that examines the multidimensional elements of body image following bariatric surgery.