Evaluate Quality Of Life Research Articles

Disability and Symptom Burden Among the Very Old: Comparison of Survivors and Decedents

How does disability and symptom burden among the very old differ between those who die and those who do not die over 12 months? We explored patterns of disability and symptom burden in the Health ABC cohort study, which involved quarterly phone interviews in 2011-14 (years 15-17). A proxy completed the interview when the proband was unable to participate. We identified a sample of 291 decedents with at least 1-year of follow-up before death and matched a 1:1 sample of survivors at the time of death by race, sex, and age (within ±3 years). 252 decedents (age 90.0±3.03, 65.1% Black, 52.4% female) and 288 survivors (age 90.1±3.03, 64.9% Black, 52.4% female) with at least 3 quarterly interviews were included for analysis. Decedents had a higher proportion of proxy-reported interviews compared to survivors (40.9%vs16.0%, P<0.01). Disability prevalence among decedents was significantly higher (P<0.01) compared to survivors (using an assisted walking device, 62.3%vs37.4%; difficulty getting in/out of bed, 32.0%vs19.4%; difficulty bath/shower, 28.9%vs10.0%; difficulty dressing, 19.0%vs8.7%). Decedents and survivors differed significantly (P<0.05) in self-reported number of symptoms (2.35vs1.78), severity of disability due to shortness of breath (4.09vs2.04), constipation (3.97vs1.74), and difficulty concentrating (1.98vs1.25). Decedents also had a significant higher score (P<0.01) on self-reported loss of appetite (2.24vs1.91) and worse global quality of life rating (3.04vs2.64), compared to survivors. The patterns were similar in proxy-reported group and in the group with a combination of self-and proxy-reported interviews. Even in very late old age, disability and symptom burden increase with the approach of death.

Poverty Risk and Quality of Housing in the EU Regions with a Different Urbanisation Rate

The aim of this article to compare selected parameters of /quality of life in the European Union countries by the degree of urbanization of living space and to verify the validity of three hypotheses aimed at quality of life evaluation in rural EU areas. The main data source the Eurostat statistical data. Comparative analysis, variability, and concentration analysis using the method of adjusted index of geographical concentration have been applied during the processing. The analysis results show that the degree of risk of poverty is split in the EU between rural areas and cities. In this respect, European countries are divided into two roughly equal groups. The degree of concentration of people at risk of poverty in rural areas exceeds half the attainable interval. The extent of the actual geographic concentration of the population, and at the same time the disparities existing between European countries are both involved in it. Cost and quality of housing show the highest variability within European rural areas. The findings are in accordance with those experts who plead for a more effective tool targeting of EU cohesion policy in pursuit of its objectives in the field of poverty decreasement.

Analysis of the quality of life of medical students in Sobral - CE

Objective: The objective of the present study was to analyze the factors determining the quality of life of medical students in Sobral-CE and to compare them with the student’s academic momentum. Method: This is an epidemiological, cross-sectional, quantitative and qualitative study, and a questionnaire was used to collect data from 308 medical students. The questionnaire chosen was the WHOQOL-BREF, which is a Quality of Life Assessment instrument, which will be composed of 20 questions, the answers follow a Likert scale (from 1 to 5, the higher the score the better the quality of life). Results: The students enrolled in the third semester showed a worse quality of life evaluation in all the domains evaluated, which coincided with poorer quality of life and with their own health. The fifth semester showed a better quality of life assessment in all domains. Conclusions: the statistically significant differences found between domains are due to the fact that students, when they enter college, have an enthusiasm that is lost over the years and a desire and search for mutual knowledge that goes away with the routine of the day by day.

Animal-assisted therapy on happiness and life quality of chronic psychiatric patients living in psychiatric residential care homes: a randomized controlled study

BackgroundPsychiatric patients who live in psychiatric residential care homes may often feel a loss of autonomy, decision making, and participation in social activities. They usually have few or no visitors and also do not have any purpose for living. Animals may increase the happiness and quality of life of psychiatric patients. This study aimed to evaluate the effects of Animal-Assisted Therapy (AAT) on happiness and quality of life of chronic psychiatric patients living in psychiatric residential care homes in Tehran, Iran.MethodsThis randomized controlled trial was conducted with 70 males with a chronic psychiatric disorder who were living in psychiatric residential care homes in Tehran, Iran, in 2016. The patients were randomly selected and divided into animal therapy intervention group and control group. Patients in the intervention group received animal-therapy with a bird for eight weeks. Patients in the control group received no intervention. The Oxford Happiness Inventory evaluated all patients pre and post-intervention. To evaluate life quality, the Wisconsin Quality of Life Index was used. Data were statically analyzed using SPSS Ver.19.0. ANCOVA with pretest statistical control. The significance level was set as p < 0.05.ResultsThe mean age in both control and intervention groups were 47.12 and 45.82 years, and the mean age of illness onset for both control and intervention groups was 18.94 and 16.83 years, respectively. The result of this study showed that happiness in the intervention group had significantly increased (p < 0.001). The results also showed that the quality of life in four sub-domains increased significantly.ConclusionTo bring happiness to chronic psychiatric patients living in psychiatric residential care homes is essential and may result in returning them to society and healthy life. The results of this study showed that AAT was helpful for chronic psychiatric patients living in psychiatric residential care homes and not only made them happy but also increased their quality of life.Trial registrationThis was registered in Iranian Registry of Clinical Trials (IRCT) (clinical trial code: IRCT20101013004922N4. Registered 2018-08-19. Retrospectively registered, https://www.irct.ir/trial/32390

Autologous breast fibrofatty flaps for immediate breast reconstruction after excision of small cancer mass (&lt;50 mm) improves surgical and aesthetical outcomes and patients’ quality of life

Background: Evaluation of surgical feasibility, aesthetic outcomes and 6-m postoperative (PO) effect of immediate breast reconstruction (IBR) using autologous fibrofatty flaps after localized small breast mass excision.Methods: Total 29 women had duct carcinoma of &lt;50 mm in diameter with N1-3 regional lymphadenopathy were studied. Through diamond-shape incision, breast gland was removed with 1 cm circumferential free safety margin, then the medial and lateral fibrofatty flaps were undermined and approximated for IBR. Breast measurements; the nipple-to-suprasternal notch distance and the nipple-to-nipple distance were determined preoperatively and 6-m PO. Quality of life (QoL) evaluation was performed preoperatively and 6-m PO using the short-form-36 (SF-36), the multidimensional body self-relations questionnaire appearance assessment and the European organization for research and treatment of cancer breast cancer-specific QoL questionnaire scores in breast cancer. Results: Mean operative time was 94.5±15.4 min; mean intraoperative blood loss was 170.1±34.9 ml and 25 patients had returned home on the same operative day. Two patients had PO wound seroma and one patient had wound hematoma, but were resolved spontaneously. PO breast measurements showed non-significant differences in comparison to preoperative measurements of the same breast, and to measurements of the contralateral breast. PO evaluation of QoL showed significantly improved PO scoring in line with improved body image and future perspectives, and sexual scores in comparison to preoperative scorings. Conclusions: The applied procedure of localized excision of BC mass of&lt;50 mm with IBR using the breast remnant fibrofatty flaps provided acceptable surgical and esthetical outcomes and allowed improvement of patients’ QoL.

Quality of Life After Violent Crime: The Impact of Acute Stress Disorder, Posttraumatic Stress Disorder, and Other Consequences.

Victims of violent crime (VVC) are at risk of developing acute stress disorder (ASD) and subsequent posttraumatic stress disorder (PTSD). In addition, VVC are more likely to have low social support due to stigmatization and victim-blaming, and PTSD is frequently associated with depression, anxiety, and impaired quality of life (QoL). The present study aimed to determine the impact of ASD, PTSD, depressive symptoms, anxiety symptoms, and perceived social support in relation to four domains of QoL among VVC. Individuals were recruited as part of a longitudinal study assessing the efficacy of a brief cognitive behavioral treatment for ASD. Participants (N = 127) were interviewed and completed self-report measures within 30 days of experiencing a violent crime (T0 ) and at assessments 2 months (T1 ) and 6 months (T2 ) after the event. Depressive symptoms, ASD, and PTSD were found to be associated with lower QoL ratings in all four domains. Anxiety symptoms were found to be associated with lower ratings in the physical health and psychological QoL domains. Perceived social support was found to be associated with higher QoL ratings in all domains. The proportions of QoL variance explained by the combined fixed and random effects combined ranged from 70% to 79%. Future research considerations include an examination of how early interventions for VVC could prevent QoL deterioration by targeting ASD and PTSD development, depressive and anxiety symptoms, and social support.

Translation and cultural adaptation of SF Qualiveen questionnaire in Greek.

Most of neurologically impaired persons, who are suffering from spinal cord injury (SCI) or multiple sclerosis (MS), may face important lifestyle restrictions. Urinary disorders can further decrease their quality of life (QoL). SF Qualiveen is a validated questionnaire for the evaluation of QoL in this population related to neurogenic lower urinary tract dysfunction (NLUTD). The cross-cultural adaptation, the reliability check, and the validation of the SF Qualiveen in Greek. The design of this study was the observational cohort study. Between November 2019 and May 2020, we addressed to 136 consecutive neurologic patients with MS or SCI from the outpatient clinic of the Unit of Neuro-urology of the National Rehabilitation Center in Athens. The study was based on 124 patients (68 males and 56 females). There were 55 paraplegics, 16 tetraplegics and 53 MS patients. After a back forward translation of the SF Qualiveen between English and Greek, the patients completed the Greek version of SF Qualiveen and King's Health Questionnaire at baseline and 3 months later. Reliability check and validation were performed by factor analysis with the Explanatory Factor Analysis (EFA) method. Demographic data were collected as well. The Greek version of the questionnaire showed good internal consistency with Cronbach's α >70 for the total score and most of the four sub-scales for the test and retest. Test-retest reliability showed that all domains of the SF-Qualiveen (test) were correlated with the SF-Qualiveen total score (test) and the same applies to the SF-Qualiveen (retest). Domains of SF-Qualiveen (test) were poorly correlated with the domains of SF-Qualiveen (retest). Construct and criterion validity were satisfactory and CFA found that the model had good fit [χ2 (14)=19.133, GFI=0.964, NFI=0.954, RMSEA=0.055, CFI=0.987]. This Greek version of the SF Qualiveen was tested following well-established guidelines on measurement properties and showed good validity and reliability. It is reproducible, reliable, and valid for the Greek population. This Greek version of the SF Qualiveen can be used as a tool to evaluate the impact of NLUTD on QoL in Greek-speaking patients with MS and SCI in research and clinical practice.

QOLP-25. BASELINE QUALITY OF LIFE BURDEN IN PATIENTS WITH CENTRAL NERVOUS SYSTEM (CNS) TUMOURS TREATED WITH PENCIL BEAM PROTON THERAPY AT INDIA’S FIRST PROTON THERAPY CENTRE

Abstract The aim of this study is to evaluate and assess the impact of baseline quality of life (QOL) in adult patients with central nervous system (CNS) tumours treated with pencil beam proton therapy (PT) seen consecutively at India’s first proton therapy centre. Data sets of 50 consecutive adult patients with histologically proven brain neoplasms (both primary and recurrent) who were planned for proton therapy at our centre were during one full calendar year were considered for this study. The study included detailed neurological assessment, evaluation of QOL using EORTC questionnaire (QLQ-C30) and specific Brain Cancer module (BN20). In the present analysis, QOL scores before starting adjuvant treatment were measured and impact of patient and tumour related factors were analysed. Baseline global QOL data of all patients (available in 50) was 58.3 which is relatively low including in all histological tumour types. Physical function, role function, emotion function, cognitive and social function scores were 77.9, 80, 78.5, 80.3, 69.3 (higher values better), respectively. Domains of visual disorder, motor deficit, communication deficit, headache, seizures and drowsiness scores were 21.5, 20.3, 32.3, 31, 20.4, 32.6 and 14.5 (lower values better), respectively. Elderly patients (&amp;gt; 50 years) had poorer global score (p &amp;lt; 0.05). Patients with lower performance status (KPS &amp;lt; 70) had a lower global QOL (KPS &amp;gt; or = 80 vs. &amp;lt; or= 70; 42 vs. 75; p &amp;lt; 0.05) including in all histological types of high-grade gliomas (HGG) (HGG vs. LGG; 67 vs. 59; p &amp;lt; 0.05). Patients undergoing re-irradiation had poorer global score as compared to ones who had not received any radiation previously (p &amp;lt; 0.05). Patients with malignant, recurrent tumours, poor performance status and patients who had previously been irradiated had significantly lower QOL scores even before starting adjuvant treatment.

A Baseline Measurement of Quality of Life in 322 Adults With Osteogenesis Imperfecta.

ABSTRACTOsteogenesis imperfecta (OI) is characterized by bone fragility and secondary features such as blue sclerae, dentinogenesis imperfecta, hearing loss, ligamentous laxity, and short stature. It was thought that health‐related quality of life (QoL) in patients with OI mainly depends on the severity of the skeletal deformities. However, it has become clear that additional factors can affect the QoL in all patients with OI. In this study, we compare dimensions of QoL in adults with OI with a control population. The SF‐36 questionnaire was distributed among 330 adult patients with different OI types. Results were compared with two control populations from the Netherlands. Age‐matched comparisons were made with one of the two control populations. The results were summarized in eight domains: general and mental health, physical and social function, bodily pain, vitality, and physical and emotional role. General health and physical function in all types of OI are low compared with controls, except patients with OI type 4 aged 55+ years. Bodily pain in patients with OI appeared significantly worse than in the control population. There was no significant difference between OI types regarding pain and vitality. Vitality was only in the OI type 1 group significantly lower compared with controls. Patients with OI type 1 had a significantly reduced mental health. Social functioning appeared most effective in type 3 around 20 years of age. QoL in adult patients with OI should be an important outcome measure in every OI clinic, but the amount of baseline data on this subject is sparse. This baseline measurement study is the largest study to date investigating QoL in adult patients with OI. The mean scores indicate that people with OI generally have a significantly lower QoL than the control population. Further qualitative evaluation of QoL and its influences is important for future management. © 2020 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.

Gender differences in clinical presentation and prognosis of thyroid eye disease.

To examine the clinical differences in manifestation, treatment, and prognosis of thyroid-eye-disease (TED) between men and women. This is a longitudinal cohort study. Men and women, who diagnosed with TED and treated at a multidisciplinary TED clinic, were compared regarding differences in demographics, eye examination, disease activity, and quality of life evaluation. TED was diagnosed in 132 patients during the study period, and they included 38 men (28.78%) and 94 women (71.21%). There were six men and 20 women with active disease (Clinical-Activity-Score (CAS) ⩾ 3) during the entire follow-up period (p < 0.01). The mean time from TED diagnosis to CAS ⩾ 3 was 4.50 years for men and 2.35 years for women (p = 0.05). There were no significant differences in mean total Graves' Orbitopathy-Quality-of-Life questionnaire (GO-QOL) score. However, mean GO-QOL subtotal score of external appearance of women was significantly lower compare to men in the first and last visit (p = 0.04, 0.03, respectively). Active disease was more common in women and the time-from-diagnosis of TED to CAS ⩾ 3 was shorter among women. Moreover, the appearance QOL score of women was poorer. These findings should be taken into consideration when planning the timing of treatment and when choosing the best treatment for TED patients.

Quality of Life Evaluation After Trans-Nasal Endoscopic Surgery for Skull Base Tumors.

The excellent surgical results obtained with transnasal endoscopic approach to the anterior skull base (ASB) are universally recognized; less is known about the quality of life of patients after surgery. The aim of this study is to analyze the quality of life of patients after endoscopic transnasal surgery for the treatment of neoplasms of the ASB. We conducted a retrospective review of patients who underwent transnasal endoscopic surgery for treatment of ASB tumors at the Tertiary Referral Center University Hospital of Verona. All patients were asked to complete the Anterior Skull Base Questionnaire (ASBQ), the Skull Base Inventory (SBI), and the Sino-nasal Outcome Test - 22 Items (SNOT-22) after surgical treatment. The study population was divided into subgroups; a statistical analysis of the overall results and of the different questionnaire domains was performed. 51 patients were enrolled in this study. The average score was 3.04 for ASBQ, 4.05 for SBI and 28.88 for SNOT-22. Analysis of the overall results for the ASBQ showed a lower quality of life in patients after recurrent surgery and in female patients. The SBI showed similar results in relation to recurrent surgery and radiotherapy. Similarly, the results for SNOT-22 highlighted the negative impact of recurrent surgery and radiotherapy. Our results confirmed that the endoscopic transnasal approach shows excellent results not only in terms of surgical outcome, but also for the possibility of ensuring a good QoL after treatment. Recurrent surgery and radiation treatments were the most important negative prognostic factors.

Low prognostic nutrition index predicts poorer quality of life in late-stage lung cancer.

Quality of life (QOL) is one of the most important endpoints in lung cancer care. Both nutritional and immune status reportedly correlate with QOL, so we investigated whether the prognostic nutritional index (PNI), a reliable marker of nutritional and immune status, can predict QOL in late-stage lung cancer. We enrolled 80 lung cancer patients and their clinical data including PNI were obtained. The FACT-L questionnaire in Chinese version 4 was administered to every patient. Of the 80 lung cancer patients, 16 were stage III and 64 were stage IV. The average PNI value was 44.24±5.53. The average FACT-L score was 99.58±21.84, indicating impaired QOL. The FACT-L score in the stage IV group was significantly lower than that in the stage III group (P=0.001), especially for the four subscales of physical, social/family, emotional, and functioning well-being. In the stage IV group, the FACT-L score in the high PNI group was significantly higher than that in the low PNI group (P=0.042), with especially higher score for the physical well-being subscale. PNI was significantly related to both the FACT-L score (r=0.3265, P=0.0085) and physical well-being subscale (r=0.4746, P<0.0001). PNI is a simple but valuable biomarker of QOL in stage IV lung cancer patients. A lower PNI may indicate the need for detailed QOL evaluation and intervention.

Evaluation of life quality, anxiety, and depression in patients with skin diseases.

To investigate the incidence of skin diseases, the factors affecting the life quality, anxiety, and depression of patients with skin diseases and the correlation among the 3.A total of 1127 patients with skin diseases were selected online from March 2018 to June 2018. Logistic regression was used to analyze the factors influencing life quality, anxiety, and depression. Spearman rank correlation was used to analyze the correction among the life quality, anxiety, and depression.There was no significant difference in ethnicity, education, and time of question among patients (P > .05). Sex ratio, age, marital status, and occupation were statistically significant difference among patients with different skin diseases (P < .05). The life quality index of patients with psoriasis, atopic dermatitis, acne, steroid-dependent dermatitis, and alopecia were 11.96 ± 6.74, 9.84 ± 6.99, 11.57 ± 6.85, 13.86 ± 6.31, 7.86 ± 6.82, respectively. The differences were statistically significant (P < .05). The main factors affecting quality of life included age, family history, and types of skin diseases. The age, ethnicity, education, and family history of skin diseases were the main factors affecting anxiety of patients with different skin diseases. Additionally, sex, marital status, education, and family history of skin diseases were the main factors influencing depression. Spearman rank correlation analysis showed that the life quality, anxiety, and depression were positively correlated.Psoriasis, atopic dermatitis, acne, steroid-dependent dermatitis, and alopecia have a certain impact on the life quality of most patients, and may cause different degrees of anxiety and depression.

External Validation of Early Quality of Life (QOL) Declines Correlated with Late QOL after Intensity Modulated, Low Dose Rate Brachytherapy, or Stereotactic Radiation for Prostate Cancer within a Prospective Trial

There is data on early toxicity associated with late toxicity, but there is currently a lack of data on quality of life (QOL) outcomes and evaluation for possible surrogacy between early and late toxicity. This is an evaluation of early QOL for prostate cancer across RT options with a validation within QOL from a SBRT prospective trial. An initial cohort of 898 patients (PROSTQA study and 3 institutions with prospective QOL data were pooled for analysis for IMRT (n = 162), LDR brachytherapy (n = 271), or SBRT (Robotic n = 392 and Linac n = 72) to the prostate with or without seminal vesicles) were evaluated for patient reported outcomes. Expanded Prostate Cancer Index (EPIC) QOL data for urinary, bowel, vitality, and sexual function was evaluated by pre-specified relevant thresholds for meaningful clinical differences (MCD) compared to baseline. Patients were evaluated for QOL at 1-2 month from the start of radiotherapy and at 24 months from the start of radiotherapy. Multivariate analysis (MVA) used general linear models to assess the correlation between QOL changes. This was then externally validated with QOL analysis from a prospective trial of robotic SBRT to the prostate alone to 38 Gy in 4 fractions of 259 patients assessing QOL at 1-month post-radiotherapy to predict late declines QOL at 24 months. A total of 898 patients were within the initial cohort, 94% had evaluable QOL at 24 months. On MVA, after controlling for age, baseline function, PSA, Gleason score, T-stage, prostate volume, and RT technique, an early MCD was the strongest predictor of late MCD at 24 months in all assessed domains and radiation modalities: odds ratio (OR) 3.7 [95% CI 2.2-6.4] for urinary irritation, OR 4.5 [2.9-6.9] for urinary incontinence, OR 2.4 [1.6-3.5] for bowel, OR 3.7 [2.5-5.5] for sexual function, and OR 3.4 [2.3-4.9] for hormone. Within the validation cohort of 259 patients, 83% had evaluable QOL at 24 months. Early declines of a MCD were again associated with late declines noted across all domains of QOL: OR 3.1 [95% CI 1.7-5.8] for urinary irritation, OR 2.7 [1.5-4.8] for urinary incontinence, OR 2.0 [1.1-3.7] for bowel, OR 4.0 [2.1-7.7] for sexual function, and OR 3.0 [1.2-7.3] for hormone. Early QOL decline was the strongest predictor of QOL impacts at 2 years across all domains and this appeared consistent across standard radiation treatment modalities. This was externally validated within these domains suggesting early declines in QOL are surrogates and predict for late declines.Abstract 141; TableIncidence and Correlation of an MCD in Early and Late QOLEPIC DomainEPIC MCD ThresholdEarly Decline MCDLate Decline MCDOR [95% CI]Early Decline MCDLate Decline MCDOR [95% CI]Initial CohortValidation CohortUrinary Irritative678%36%3.7 [2.2-6.4]63%39%3.1 [1.7-5.8]Urinary Incontinence7.537%24%4.5 [2.9-6.9]32%41%2.7 [1.5-4.8]Bowel554%29%2.4 [1.6-3.5]41%26%2.0 [1.1-3.7]Sexual1136%41%2.9 [2.3-3.8]30%49%2.4 [0.89-6.6] Open table in a new tab

Impact of Pacemakers and Implantable Cardioverter Defibrillators on the Psychosocial Functioning of Paediatric Patients.

Although implanted cardiac devices improve patients' physical health, long-term psychosocial effects especially in the paediatric population are still unknown. The aim of this study was to evaluate the psychosocial effects of cardiac devices in a paediatric population.Pediatric Quality of Life Questionnaire (PedsQoL) was used to evaluate life quality, Connor-Davidson Resilience Scale was used to evaluate resilience and Brief Symptom Inventory was used to evaluate psychiatric symptoms in a paediatric population with cardiac devices.Seventy-one patients were enrolled in the study. Fifty of them (70.5%) had a cardiac pacemaker and 21 of them (29.5%) had implantable cardioverter defibrillator. When compared to the control group both implantable cardioverter defibrillator and pacemaker using patients had lower quality of life (79.5 ± 12.4 versus 86.7 ± 12.1, p = 0.001) but no difference was observed in resilience and psychological pathologies. Age, gender, family size, and education level had no effect on quality of life. Implantable cardioverter defibrillator bearing patients had higher levels of anxiety than pacemaker patients (0.58 versus 0.30 p = 0.045), and implantable cardioverter defibrillator patients who had received shock in the last year had higher levels of somatisation than the group that did not receive device shock (0.17 versus 0.44 p = 0.022).In conclusion study showed that cardiac devices have negative effects on the psychosocial health of children. Cardiologist working with these patients should be aware of these pathologies and monitor not only physical health but also psychosocial health too.

Spinal cord stimulation for chronic intractable trunk or limb pain: study protocol for a Chinese multicenter randomized withdrawal trial (CITRIP study)

BackgroundAlthough effective results of many studies support the use of spinal cord stimulation in chronic pain patients, no randomized controlled trial has been undertaken in China to date. CITRIP is a multicenter, prospective, randomized, withdrawal study designed to evaluate the clinical effectiveness and safety of spinal cord stimulation plus remote programming management in patients with intractable trunk or limb pain.MethodParticipants will be recruited in approximately 10 centers across China. Eligible participants with intractable trunk or limb and an average visual analog scale (VAS) score ≥ 5 will undergo a spinal cord stimulation test. Participants with VAS score reduction ≥ 50% could move forward to receive implantation of an implanted pulse generator. In the withdrawal period at 3-month follow-up visit, participants randomized to the experimental group (EG) will undergo continuous stimulation while ceasing the stimulation in the control group (CG). The outcome assessment will occur at baseline and at 1, 3 (pre- and post-randomization), and 6 months. The primary outcome is the difference of maximal VAS score between EG and CG in the withdrawal period compared with baseline before the withdrawal period. Additional outcomes include VAS score change at 1-, 3-, and 6-month follow-ups; responder rate (VAS score improving by 50%); achievement rate of a desirable pain state (VAS score ≤ 4); awake times during sleep; Beck Depression Inventory for depression evaluation; short-form 36 for quality of life evaluation; drug usage; and satisfaction rating of the device. Adverse events will be collected. The primary analysis will follow the intention-to-treat principle.DiscussionThe CITRIP study seeks to evaluate the effectiveness and safety of a randomized withdrawal trial of spinal cord stimulation for patients with intractable trunk or limb pain.Trial registrationClinicalTrials.gov NCT03858790. Registered on March 1, 2019, retrospectively registered

Humanistic demand and spatiotemporal perspective in the evaluation of urban life quality—A case study of Shandong Province in China

The study of the quality of life needs to be guided by theoretical basis, especially the theory embodying humanism, because the fundamental significance of the study of quality of life is to improve human happiness. A brand-new evaluation system is creatively established in this article based on people-environment relationship by combining Maslow’s Hierarchy of Needs with urban development. Geographical analysis is also conducted to figure out the evolution of the spatiotemporal dynamics of quality of life, with the results indicating that urban life quality in Shandong Province have remarkable differences between areas are illustrated in the spatiotemporal evolution pattern. The growth rate of safety factors, social factors, and respect factors has differences between cities and regions, while the changes in survival factors and potential development factors are smaller, that reflecting different degrees of urban supply and demand in different periods and the real reason for the uneven life quality. In this article, the feasibility of the research method is confirmed, and a new research perspective for the evaluation of quality of life is provided.

Quality of life after laparoscopic trans-abdominal pre-peritoneal inguinal hernia repair: spinal vs general anesthesia.

The aim of the present study was to evaluate the effect of the anesthesia type on the postoperative quality of life in patients who underwent trans-abdominal pre-peritoneal (TAPP) inguinal hernia repair. In this study, 70 patients submitted to TAPP for inguinal hernia repair, were randomized between spinal and general anesthesia. Overall, 58 patients completed the follow-up process and were, therefore, included. The quality of life evaluation was based on the SF-36 questionnaire. Significance was considered at the level of P < 0.05 RESULTS: General anesthesia was applied to 31 patients, whereas 27 operations were performed under spinal anesthesia. Except gender, the two study subgroups were similar in terms of demographics. Although spinal anesthesia displayed higher energy, emotional health, and general health scores these findings were not statistically significant. A positive correlation was identified between age and physical and emotional role. Operative time was associated with the estimated energy and general health. Our study could not identify a difference between spinal and general anesthesia on the postoperative quality of life. Spinal anesthesia is as effective as general anesthesia and remains an attractive anesthetic alternative for TAPP inguinal hernia repair. Given several study limitations, further high-quality trials are required.

Bipolar radiofrequency thermotherapy treatment of the prostate in urinary catheter-dependent men.

In this study, for the first time in the literature, we evaluated patients with benign prostatic hyperplasia (BPH) who had undergone permanent urinary catheterization for urinary retention and who were treated with radiofrequency (RF) thermotherapy as an alternative method due to their inoperability based on the high risk associated with anesthesia. We aimed to investigate these patients' posttreatment parameters concerning the catheter-free rates, quality of life (QoL) changes, and retrospective treatment efficacy. RF thermotherapy was applied to 62 permanent patients catheterized within the last 3 months due to urinary retention. The follow-up data of the patients were retrospectively analyzed. The patients who were free of catheters and those who required permanent catheterization were determined. The changes in the International Prostate Symptom Score (IPSS), QoL, postvoiding residue (PVR), and maximal flow rate (Qmax ) values were analyzed. A total of 52 patients were evaluated in terms of treatment success in relation to the elimination of the need for a urinary catheter, which was calculated as 73.07%. The Qmax , IPSS, QoL, and PVR values of 38 patients who no longer required a catheter were monitored for 24 months, and statistically significant changes were observed in all parameters. Bipolar RF thermotherapy was found to be beneficial for men dependent on catheters due to BPH. It can be recommended as a safe, minimally invasive treatment method for elderly patients with a high anesthesia risk.

Grandparental and overall social support as resilience factors in coping with parental conflict among children of divorce

Abstract The quality of life (QoL) evaluations of children of divorced parents have been little studied. The literature focuses on the consequences of divorce for their wellbeing as reported by adults or examined using tools designed from the adult perspective. This study examines how risk (parental conflict) and resilience factors (perceived overall social support, closeness to grandparents, and open discourse with them about divorce) are related to the self-reported QoL of children of divorce. Cross-sectional online questionnaires for a child and one parent were completed by 122 children aged 7–17, from 86 Israeli families. Hierarchical linear models were employed, with mixed models accounting for the interdependency of children's data within each family. All risk and resilience factors were examined from the children's perspective, except parental conflict that was examined also from the parent’s perspective. Parental conflict was found to be negatively associated and overall social support and close relationship with grandparents were positively associated with children's QoL evaluations. The more the children were involved in parental conflict, the more QoL measures were associated with it. The study also supported three models in which perceived overall social support and perceived grandparental support moderated the association between parental conflict and QoL evaluations. The importance of examining the wellbeing of children of divorce from their own perspective is discussed. In terms of practical implications, the findings suggest the need to reduce the involvement of children of divorce in parental conflict and to strengthen their social support systems, particularly their relations with grandparents.