Functional Well-being Research Articles

Impact Of Malocclusion On Oral Health-Related Quality Of Life Of Early Adolescents in Erbil city

Background: Malocclusion is a frequent dental problem whose consequences are impact on functions such as speech and mastication, aesthetics of the face, and general health. The present study aimed to assess the effect of malocclusion on the oral health-related quality of life among early adolescents in Erbil City, Iraq. Methods: Cross-sectional survey in which included 800 students aged between 7 and 18 years, divided into primary, middle, and high school groups. Data were collected by use of a bilingual questionnaire (English and Kurdish), which included 15 questions with Likert type answers and addressed all sociodemographic factors and dental-related difficulties, such as problems in talking, problems eating, and embarrassment. The data will be sorted and analyzed with the SPSS program version 28, with a level of statistical significance of p≤0.05. Results: The females were 60.9%, and the male percentage was 39.1%, with a mean age of 14.33 years. By malocclusion pattern: Class I 55%, Class II 33%, Class III 12% were found. It was predictable that different malocclusion types were significantly related to some kinds of dental-related problems. For instance, 54.3% of the participants had an on-and-off worsening in the sense of taste, 39.8% of them had painful aching, and 36.1% of them had pronunciation problems very often. Interpretation: The study revealed that the malocclusion status significantly affects the OHRQoL related to functional and psychosocial well-being. Conclusion: A high prevalence of malocclusion among early adolescents in Erbil City significantly impairs OHRQoL. This has given impetus to advise early diagnosis and correction of malocclusion to alleviate the problems of adolescents in their day-to-day activities.

StrokeCog-R: Protocol for a Pilot Randomised Controlled Trial Of A Novel Cognitive Rehabilitation Intervention For Post-Stroke Cognitive Impairment

Abstract Background Post-stroke cognitive impairment (PSCI) affects 50% of patients six months post-stroke and is associated with increased disability, reduced quality of life, diminished independence, and a higher risk of long-term care and dementia. Addressing cognitive impairment is crucial to maximise patient recovery, facilitate the return to pre-stroke activities, and optimise secondary prevention efforts. However, cognitive rehabilitation is underrepresented in standard stroke rehabilitation protocols. This pilot randomised controlled trial (RCT) aims to evaluate a novel cognitive rehabilitation intervention, StrokeCog-R, designed to enhance cognitive function in stroke survivors with PSCI. The primary aims are to assess the feasibility of patient recruitment and retention and to determine the statistical power needed for a definitive trial. A secondary aim is to evaluate the efficacy and acceptability of the intervention for individuals with mild-to-moderate PSCI. Methods Sixty-four consecutive stroke patients with mild-to-moderate PSCI will be recruited and randomly assigned to either the intervention group (StrokeCog-R) or the control group (usual care). The intervention involves five weeks of group-based cognitive rehabilitation using “Rehearsal-Based” and “Compensatory-Based” strategies, supplemented with tailored home activities. Cognitive function, self-efficacy, and caregiver psychological wellbeing will be assessed pre- and post-intervention (or control) and at a four-month follow-up. Intervention acceptability will be documented through focus groups following each intervention. Recruitment is ongoing, and the first intervention group has concluded. Results Recruitment and retention rates, the feasibility of randomisation, patient acceptability, and resource utilisation will be evaluated. Additionally, the effectiveness of various communication techniques for retaining participants between the intervention period and the four-month follow-up will be assessed. These data will inform recruitment strategies and the determination of necessary effect sizes to power a definitive trial. Conclusion This study will provide critical insights for a definitive trial, potentially making a substantial contribution to the evidence base for cognitive rehabilitation in stroke patients.

Neuropsychological Performance after Extended N-Pep-12 Dietary Supplementation in Supratentorial Ischemic Stroke.

Background: Cognitive deficits following ischemic stroke significantly impair quality of life, highlighting the need for effective interventions. This study evaluates the efficacy and safety of extended N-Pep-12 dietary supplementation in enhancing cognitive recovery post-stroke. Methods: In this randomized, open-label, controlled study, 106 patients with supratentorial ischemic stroke were enrolled to receive either 90mg N-Pep-12 or no supplementation daily for 360 days and were followed-up for 360 days. Cognitive function and emotional well-being were assessed using established neuropsychological scales at baseline, 90 days, and 360 days post-stroke. Safety was monitored through adverse events and mortality rates. Results: Significant improvements were observed in the N-Pep-12 group compared to controls, particularly in the Montreal Cognitive Assessment scores at both 90 and 360 days, and in the Digit Symbol Coding scores at 360 days, suggesting enhanced cognitive recovery with extended N-Pep-12 supplementation. A linear regression for a composite outcome analysis at day 360 further confirmed the efficacy of N-Pep-12 in contributing to cognitive improvement. Safety profiles were favorable, with no significant adverse effects attributed to N-Pep-12. Conclusions: Extended dietary supplementation with N-Pep-12 appears to offer a safe and effective approach to support cognitive recovery in ischemic stroke survivors. These findings underscore the potential of the supplement as an add-on intervention for managing post-stroke cognitive impairments.

Dose-dependent relationship between levothyroxine and health-related quality of life in survivors of differentiated thyroid cancer

BackgroundLong-term survival for patients with differentiated (papillary, follicular, and Hürthle cell) thyroid cancer exceeds 95% but self-reported health-related quality of life scores remain low compared with survivors of cancers with worse prognoses. There are reports that thyroid hormone replacement therapy is associated with lower health-related quality of life. This hypothesis was tested in a sample of Medicare Advantage survivors of differentiated thyroid cancer. MethodsData were obtained from the linked 2007–2017 Surveillance, Epidemiology and End Results-Medicare Health Outcomes Survey for patients with differentiated thyroid cancer to conduct a cross-sectional study. Levothyroxine 6-month defined daily dose was calculated from claims data. Defined daily dose was classified as low, average, or high on the basis of standard deviations around body mass index–specific means. Veterans RAND 12-item Quality of Life Survey measures were categorized by T score as low health-related quality of life (T scores ≤25), moderately low (25< T scores ≤50), and high (T scores >50). The association of defined daily dose and health-related quality of life was tested using multinomial logistic regression. ResultsAmong patients with differentiated thyroid cancer (n = 782), 67.5% were prescribed levothyroxine for thyroid hormone replacement therapy (mean defined daily dose 123 μg; standard deviation 44.1 μg). Greater defined daily dose was associated with greater relative risk of low (compared with moderately low) health-related quality of life on several measures including Role Limitation (relative risk, 4.9, 95% confidence interval, 2.1–11.6) and Social Functioning (relative risk, 5.6, 95% confidence interval, 2.5–12.5), as well as greater relative risk of multiple low-scoring health-related quality of life measures. ConclusionResults suggest greater-than-average thyroid hormone replacement therapy dosages may be associated with lower health-related quality of life among survivors of differentiated thyroid cancer. Given the prevalence of thyroid hormone replacement therapy among survivors of differentiated thyroid cancer, thyroid hormone replacement therapy dose adjustment warrants close attention to address the functional and psychosocial well-being of patients.

Psychological and emotional profiles of Australian uterine transplant potential recipients: A comparison with international trials.

Uterus transplant (UTx) has emerged as a groundbreaking solution for individuals with uterine factor infertility (UFI). This study is the first in Australia to explore the psychosocial functioning of potential recipients assessed for the nation's initial UTx clinical trial and to compare their psychological profiles with those from international UTx trials. This is a mixed methods prospective study incorporating standardized psychological measures and semi-structured interviews. Conducted at a tertiary hospital in Sydney, Australia, the study involved 10 female Australian UTx potential recipients with UFI undergoing assessment for UTx surgery. Participants underwent comprehensive psychological evaluation using validated measures and in-depth semi-structured interviews. Quantitative measurement tools included the Hospital Anxiety and Depression Scale, Short Form-36 Health Survey, Fertility Quality of Life, and the Stanford Integrated Psychosocial Assessment for Transplantation. Thematic analysis was conducted on qualitative data from semi-structured interviews. The Australian UTx potential recipients reported significantly higher Short Form-36 (SF-36) scores compared to the Australian general population in general health (p < 0.04), bodily pain (p < 0.02), social functioning (p < 0.02), and emotional well-being (p < 0.01). Compared with international UTx cohorts, the Australian UTx group showed comparable SF-36 outcomes, with minor variations observed for general health and physical function domains. Hospital Anxiety and Depression Scale scores revealed lower anxiety, but slightly higher depression levels compared to international UTx trial cohorts. Fertility quality-of-life scores were significantly higher in the Australian UTx group compared to women experiencing primary infertility across four domains (p < 0.001). Thematic analysis of interviews highlighted the complex emotional impact of infertility, strong family and social support, and the perception of UTx as a transformative opportunity to achieve wholeness and motherhood. UTx represents a novel treatment option for women with UFI. This is the first qualitative study in Australia, it demonstrates the connection between women with UFI and their motivations for parenthood. These findings highlight the importance of tailored psychological assessments and establish a foundation for future research exploring the psychological characteristics of patient candidacy for UTxs.

Residents’ Perceptions of Urban Greenspace in a Shrinking City: Ecosystem Services and Environmental Justice

Although urban greenspace enhances ecological functioning and human well-being through ecosystem services (ES), it is oftentimes inequitably distributed. Environmental justice (EJ) encompasses aspects of distributive, procedural, and interactive justice related to accessibility and allocation of environmental benefits. Vacant land in shrinking cities has the potential to address greenspace inequalities and provide ES. This study investigated the perceptions of residents regarding urban ES and EJ in their communities in St. Louis (MO, USA)—a shrinking city that was undergoing green development, through semi-structured interviews. Altogether, 27 residents were selected from socio-economically disadvantaged neighborhoods characterized by high levels of vacancy due to legacies of redlining and systemic racism. Interview analysis revealed four themes: green benefits (including recreation opportunities), green costs (e.g., concerns for increased crime and nuisance animals), injustice issues (e.g., access to community greenspaces), and changes in the community (e.g., higher property taxes). Results revealed that residents perceived ES as closely connected with EJ when it comes to urban greening projects in their city. This study helps inform the process of urban greening projects, particularly in shrinking cities at risk of inequities.

Nutritional Status and Cardiometabolic Markers to Determine Athlete’s Achievement: A Cross-Sectional Study

The health, physiological, and nutritional status of an athlete is a top priority in achieving success and career sustainability. Information about an athlete's health, such as blood biochemistry, anthropometry, and adequate nutritional intake, might indicate their ability to perform exceptionally well in different levels of competition. Objective: This research objective is to examine the correlation between athletes' sports achievements in Bandung and their anthropometric traits, nutritional status, and blood biochemical indicators. Methods: This study utilised a cross-sectional design and incidental data collection techniques. Participants: The study comprised 84 athletes from 27 different sports who received achievement allowances from KONI Bandung City. Instruments: n this study, we employed reliable and validated techniques to assess anthropometrics, body composition, somatotype, blood biochemistry, nutritional intake adequacy, and energy adequacy. Data analysis: Both the bivariate and multivariate analyses used logistic regression. Results: The findings of the analysis indicate a significant relationship between athlete performance and two variables: blood pressure (p=0.026) and dietary diversity (p=0.048). The findings from the multivariate analysis revealed a significant relationship between blood pressure and dietary variety, which influences the achievement of athletes. The calculation of the odds ratio (OR) revealed that among all the variables examined, the athlete's blood pressure exhibited strongest correlation with their performance. Conclusion: Blood pressure is a physiological measurement that can serve as an indicator of cardiac function and overall well-being. As a result, it is critical to regularly assess the physical well-being of athletes in Bandung to ensure their consistent optimal performance.

Role of vitamin D in COVID-19 and other viral infections.

Vitamin D is a steroid hormone that is naturally produced in the body or obtained through dietary sources, primarily under the influence of UVB radiation. This essential nutrient has a vital role in numerous physiological processes, encompassing immune function, cell growth, differentiation, insulin regulation, and cardiovascular well-being, along with its pivotal role in sustaining the delicate equilibrium of calcium and phosphate concentrations in the body. Moreover, vitamin D reinforces mucosal defense and bolsters the immune system through immunomodulation, making it a critical component of overall health. Numerous studies have unveiled the profound connection between vitamin D and the predisposition to respiratory tract infections, including well-known viruses such as influenza and the novel severe acute respiratory syndrome coronavirus 2. Vitamin D deficiency has been consistently linked to increased severity of coronavirus disease 2019 (COVID-19) and a heightened risk of mortality among afflicted individuals. Retrospective observational studies have further substantiated these findings, indicating that levels of vitamin D are linked with both the occurrence and severity of COVID-19 cases. Vitamin D has its influence on viral infections through a multitude of mechanisms, such as promoting the release of antimicrobial peptides and fine-tuning the responses of the immune system. Additionally, vitamin D is intertwined with the intricate network of the renin-angiotensin system, suggesting a potential impact on the development of complications related to COVID-19. While further clinical trials and extensive research are warranted, the existing body of evidence strongly hints at the possible use of vitamin D as a valuable tool in the prophylaxis and management of COVID-19 and other viral infectious diseases.

Abstract C060: Social isolation and secondary appraisal mediate the association between race and functional well-being among prostate cancer survivors

Abstract Background: Disparities in prostate cancer (PCa) incidence and mortality persist among African Americans. Functional well-being plays a crucial role in the prognosis and survival of PCa patients. Prior studies show the association between African American race and health-related quality of life among PCa patients. However, no studies have examined possible mediational processes linking race to functional well-being in this population. Objective: To assess the association between race and functional well-being and the mediating pathways of clinical, social determinants, and psychological factors in PCa patients. Methods: We used clinic-based cohort data of PCa patients treated with radical prostatectomy from April 2017 through September 2021. We measured functional well-being, socioeconomic factors, social stressors, perceived stress, and primary and secondary appraisal by self-report. We obtained clinical variables such as disease stage, prostate-specific antigen (PSA) levels, and comorbidities through electronic medical records. We first conducted a path analysis based on linear regression to test the direct association between race and functional well-being, adjusting for age, marital status, education level, employment status, and income. We concurrently examined the mediational pathways linking race to functional well-being via mediators, including stage, PSA, primary appraisal, secondary appraisal, perceived stress, and social isolation. Results: A total of 163 participants (48 African American, 115 White) with a mean age of 66.7 years (SD=6.31) were included in the study. Participants' mean score of functional well-being was 20.32 (SD=6.70; Range=0-28). Compared to White individuals, African American participants exhibited significantly lower levels of functional well-being (b [95% CI] = -3.09 [-5.48, -0.72]). Mediation analyses linking race to functional well-being revealed that, compared to Whites, African Americans displayed significantly lower levels of secondary appraisal (b [95% CI] = -1.45 [-2.85, -0.05]), which, in turn, were associated with higher levels of functional well-being (b [95% CI] = 0.27 [0.01, 0.53]). In addition, African Americans also displayed higher levels of social isolation (b [95% CI] = 0.55 [0.14, 0.97]), which were significantly associated with lower levels of functional well-being (b [95% CI] = -0.91 [-1.64, -0.17]). Both indirect effects of race → secondary appraisal → functional well-being (b [95% CI] = -0.39 [-0.88, -0.01]) and race → social isolation → functional well-being (b [95% CI] = -0.50 [-1.06, -0.02]) were significant and explained 12.6% and 16.2%, respectively, of the total relationship between race and functional well-being. Conclusion: Social isolation and secondary appraisal mediate the association between race and functional well-being among prostate cancer survivors. There is a need to understand the lived experiences of Black men and develop interventions that mitigate the impact of social barriers and psychological stressors on functional well-being to advance health equity. Citation Format: Fatimata Sanogo, Junhan Cho, Trista Beard, Chanita Hughes Halbert. Social isolation and secondary appraisal mediate the association between race and functional well-being among prostate cancer survivors [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr C060.

Abstract C034: Impact of survivorship care plans on self-reported health and functional well-being

Abstract Introduction: Cancer survivors have varying physical, psychosocial, and informational needs. Organizations such as American Society of Clinical Oncology have developed survivorship care plans (SCP) for cancer screening, treatment side effect management, and care coordination. There is a need to better understand SCP utilization among underserved and diverse patient communities. Methods: Adults ages 18+ years with breast or colorectal cancer diagnosed between 2019 and 2021 were recruited from the Greater Bay Area Cancer Registry. Participants completed a 30-minute survey about their survivorship plans, quality of life, health behaviors, and social support. Analysis: Overall comparisons between groups were evaluated with chi-square tests. Associations between demographic characteristics and receipt of any type of survivorship plan were evaluated with univariate binomial logistic regression models, and associations between receipt of any type of survivorship plan and health/well-being outcomes were assessed using univariate ordinal regression models. Multivariable models will be built using relevant variables. Results: Participants (n=872) were on average 59 years (range=24-95) and mostly female (70.2%). Participants had either breast (41.3%) or colorectal cancer (58.7%). Participants were American Indian/Alaska Native (AIAN) (1.0%), Asian American (18.2%), NH Black (12.8%), NH White (38.0%), LatinX (29.0%), and Native Hawaiian or Pacific Islander (0.8%). Receipt of a SCP was reported by 258 (29.6%) participants, 328 (37.6%) had another type of post-treatment guide provided to them, and 224 (25.7%) were not offered any kind of survivorship plan. There were no differences in race/ethnicity, nativity status, non-English language spoken at home, marital status, or educational attainment between those who received any kind of survivorship plan vs. no plan. Being female was associated with 40% lower odds of receiving any kind of survivorship plan (OR=0.60, 95%CI=0.42-0.87). Being on public insurance was also associated with lower odds of receiving a survivorship plan than being on private insurance (OR=0.59, 95%CI=0.43-0.81). Receipt of a survivorship plan was associated with 52% higher odds of reporting a higher level of overall current health (OR=1.52, 95%CI=1.14-2.02) compared to those who did not receive any plan. Receiving a survivorship plan was also associated with higher odds of reporting a higher level of ability to work (OR=1.58, 95%CI=1.18-2.11), more fulfilling work (OR=1.69, 95%CI=1.27-2.23), ability to enjoy life (OR=1.55, 95%CI=1.17-2.06), ability to sleep well (OR=1.35, 95%CI=1.03-1.79), and contentment with their current quality of life (OR=1.51, 95%CI=1.14-1.99). Conclusion: Receipt of any survivorship plan was associated with higher levels of self-reported current overall health and measures of functional well-being. Women, as well as people on public insurance, are less likely to receive a survivorship plan, highlighting disparities in survivorship care planning for these populations. Citation Format: Aly M. Cortella, Katarina Wang, Debby Oh, Niharika Dixit, Zinnia Loya, Kathie Lau, Michelle Wadhwa, Chris Duffy, Salma Shariff-Marco, Kristan Olazo, Vlad Honcharov, Marika Dy, Urmimala Sarkar, Scarlett Lin Gomez. Impact of survivorship care plans on self-reported health and functional well-being [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr C034.

Online eurythmy therapy for cancer-related fatigue: a prospective repeated-measures observational study exploring fatigue, stress, and mindfulness.

Cancer is a debilitating disease with an often chronic course. One of the most taxing and prevalent sequelae in this context is cancer-related fatigue (CRF) resulting from the disease and/or associated treatments. Over the last years mindfulness-based interventions such as eurythmy therapy (ERYT), a mindful-movement therapy from anthroposophic medicine, have emerged as promising adjunct therapies in oncology. This prospective study investigated an online implementation of ERYT for CRF using a single arm repeated-measures design based on two consecutive studies. Study 1 consisted of an initial assessment before, during, after, and at follow up of a 6-week online ERYT-based program in a mixed sample of N = 165 adults with or without cancer diagnosis. Study 2 involved a similar design with an adapted 8-week online ERYT-based program in a sample of N = 125 adults who had been diagnosed with cancer. Outcomes were assessed using the Functional Assessment of Chronic Illness Therapy-Fatigue, Perceived Stress Scale, Mindful Attention Awareness Scale, and Insomnia Severity Index (for Study 1 all, for Study 2 only the former three). We additionally performed an exploratory analysis regarding practice frequency and duration. Data were analyzed using Linear Mixed-Effect Models per outcome; ANOVA was used for practice times. For Study 1, mixed-effects model estimates showed no significant effect on fatigue, but pointed to significantly improved emotional and physical well-being, reduced stress, as well as increased mindfulness (mixed subjects). Functional and social well-being or sleep quality did not change significantly. Study 2 model estimates on the other hand showed significantly improved CRF in conjunction with the ERYT-based online intervention, as well as improved stress and mindfulness scores (cancer-diagnosed subjects). Taken together, while our results should be interpreted with caution given the single-arm design and relatively high dropout, they suggest online ERYT may be associated with a reduction in fatigue for individuals diagnosed with cancer, an increase in mindfulness, and benefits for stress and certain well-being indicators. The online group format is advantageous in view of affordability and accessibility, the latter being particularly relevant for individuals who due to high symptom severity cannot leave their homes. Randomized-controlled studies will be needed to confirm these findings.

Clomiphene Citrate Treatment as an Alternative Therapeutic Approach for Male Hypogonadism: Mechanisms and Clinical Implications.

Male hypogonadism, which is characterized by low testosterone levels, has a significant impact on male sexual function, overall health, and fertility. Testosterone replacement therapy (TRT) is the conventional treatment for this condition, but it has potential adverse effects and is not suitable for men seeking to conceive. Testosterone plays an essential role in male sexual function, metabolism, mood, and overall well-being. Clomiphene citrate, a drug originally developed for female infertility, has recently gained attention as an off-label treatment for male hypogonadism. By blocking the negative feedback of estrogen on the hypothalamus and pituitary glands, clomiphene stimulates gonadotropin secretion, leading to increased endogenous testosterone production, which, in turn, improves sperm parameters and fertility and alleviates the symptoms of hypogonadism. Regarding the safety profile of clomiphene compared with TRT, clomiphene appears to confer a lower risk than TRT, which is associated with adverse effects such as polycythemia. Furthermore, combination therapy with clomiphene and anastrozole or human chorionic gonadotropin has been investigated as a potential approach to enhancing the effectiveness of treatments for improving hypogonadism symptoms. In conclusion, clomiphene citrate may offer a promising alternative to TRT for men with hypogonadism, particularly those desiring fertility preservations. However, its long-term efficacy and safety remain inadequately understood. Future research should focus on exploring the benefits of combination therapies and personalized treatment strategies based on individual patient characteristics.

The Efficacy of a Culturally-Adapted Group-based Parent Coaching Program for Autistic Children in China via Telehealth: A Randomized Controlled Trial.

The study aimed to examine the efficacy of a culturally-adapted, group-based parent coaching program for autistic children in China delivered via telehealth. A randomized controlled trial was conducted, with 18 parents allocated to the self-directed group that received the intervention through an online learning platform, and 19 parents allocated to the web + group therapy group, which included the same program along with weekly 1.5-hour group coaching sessions via videoconferencing. The primary outcomes were parents' mental health and children's adaptive functioning, while the secondary outcomes focused on the child behaviors, parenting stress and parenting style, and family quality of life. Linear Mixed Models were used to evaluate treatment effects across time and to model longitudinal trajectories of outcomes in both children and parents. Both intervention groups showed significant improvements in children's communication skills (F (1, 60.27) = 29.86, p < 0.001) and social engagement (F (1, 60.07) = 11.73, p = 0.001), as well as reductions in parenting stress (F (1, 59.07) = 8.76, p = 0.004) and anxiety levels (F (1, 57.62) = 4.84, p = 0.032). Additionally, the group-based parent coaching via videoconferencing was associated with greater improvements in children's quality of life (F (1, 59.95) = 5.90, p = 0.018) and parents' anxiety outcomes (F (1, 57.62) = 4.84, p = 0.032). This study demonstrated the efficacy of a culturally adapted telehealth intervention for both autistic children and their parents. The preliminary findings suggest positive outcomes in children's adaptive functioning and parents' mental well-being. Group-based parent coaching through videoconferencing could be a promising and practical model for in-home services, particularly for families with limited access to in-person services.

Quality of life and its determinants in patients with chronic respiratory diseases in the Fes-Meknes region, Morocco.

Chronic respiratory diseases (CRDs) pose a serious public health issue, affecting social functioning and psychological well-being and leading to a deterioration in the quality of life. The aim of this study was to assess the quality of life of patients with CRDs and determine the factors associated with their impairment in Morocco. A cross-sectional study was conducted in the Pulmonology Department of the Hassan II University Hospital in Fez in 2021. Data collection was carried out using an anonymous questionnaire containing sociodemographic, clinical, and therapeutic information. We employed the Moroccan version of the 12-item short-form (SF-12) scale to assess the mental and physical quality of life of patients. Bivariate analysis was performed to investigate the association between various factors and quality of life, using tests appropriate to the types of variables studied. Subsequently, multivariate analysis through multiple linear regression was employed to determine factors associated with quality of life, taking into account confounding factors. The threshold for inclusion in the model was set at 20%. Significant associations are presented as β values along with their 95% confidence intervals (CI). Our study included 209 patients, with 50.7% being female and 74.2% aged over 50 years. The most frequent clinical symptom was coughing. The average physical quality of life was estimated at 34.45±13.78, and the mental quality of life was 33.72±19.79. Multivariate analysis revealed that the deterioration of physical quality of life was associated with marital status (single) [β=-6.84; 95% CI (-11.43; -2.25); p=0.004], stage II dyspnea on the Modified Medical Research Council scale [β=-4.94; 95% CI (-9.41; -0.52); p=0.029], and the presence of cyanosis [β=-9.65; 95% CI (-15.64; -3.67); p=0.002]. The factors negatively associated with mental health in our patients were age ≥50 [β=-7.84; 95% CI (-15.05; -0.62); p=0.033], marital status (single) [β=-7.81; 95% CI (-15.14; -0.48); p=0.037], and presence of cyanosis [β=-10.70; 95% CI (-20.08; -1.32); p=0.026]. The SF-12 calculation reflected an impairment in the quality of life of patients with CRDs. It is imperative to integrate the assessment of quality of life into the management strategy for this pathology.

SP9.9 - Psychological recovery after emergency laparotomy; Giving patients Grief

Abstract Aims Recent work demonstrated 8% of emergency laparotomy (EmLap) survivors were referred to mental health following surgery, suggesting it carries a significant psychological burden. This exploratory work aims to describe patients’ psychological response 1 year after EmLap using a qualitative approach. Methods POLO is a prospective cohort multicentre, mixed methods study on EmLap patients. (IRAS 301310, ClinicalTrials.Gov NCT05281627). Purposive sampling identified a subgroup to undergo 2 semi-structured interviews at 6 and 12-months post-discharge, either in person/videoconferencing, using a pre-formulated topic guide. Interviews were recorded, transcribed verbatim, and analysed using Braun and Clark’s six-step approach. Results 12 participants provided interviews at both time points. 75% were female; average age was 52 years. Patients underwent significant psychological adjustment following EmLap, similar to the Kuber-Ross Grief Reaction model; transitioning through shock, anger, bargaining, depression to eventual acceptance. Patients’ recollection of early response was disbelief, followed by anger towards their care. Bargaining centred around having restorative surgery. Depression was exacerbated by physical issues; fatigue, stoma stigma and ongoing medical treatment. Most patients reached acceptance stage by the 12-month interview. Conclusion This is the first study to describe the psychological response following EmLap. This work parallels the psychological response with other significant traumatic events, such as grief. These findings may suggest that the negative effect on patients’ mental health following surgery, observed by an increase in referral, are part of a “normal” trajectory, rather than pathological. More work is needed to understand how, and when, the response becomes problematic to functioning and long-term wellbeing.

The program of comprehensive personalized rehabilitation after surgical treatment for endometrial cancer: the results of a prospective randomized comparative study

Background. The problems of diagnosis, treatment and rehabilitation of patients with endometrial cancer (EC) remain relevant for the entire medical community. Radical surgical intervention shows high efficiency among the existing methods of EC treatment. However, it causes many complications that require rehabilitation support for patients. The development of new instruments and protocols for rehabilitation of EC patients is necessary.Objective: to evaluate the effectiveness of comprehensive personalized rehabilitation program in patients after radical surgical EC treatment.Material and methods. A prospective randomized comparative study included 61 patients with histologically verified stage IA endometrioid adenocarcinoma of high or moderate differentiation degree. The patients were divided into two groups: the group of “active” rehabilitation (n=29), and the group of “passive” rehabilitation (n=32). During 1 year, their physical, mental health and social engagement were assessed using questionnaires.Results. The survey showed a low level of physical, functional, emotional and social well-being of EC patients at the first 3–7 days after surgery. After 12 months, a recovery in the quality of life of all participants was observed. However, patients undergoing “active” rehabilitation recovered significantly faster, and their quality of life was significantly higher compared to patients undergoing “passive” rehabilitation.Conclusion. The obtained results indicate the effectiveness of a personalized approach in rehabilitation of EC patients. It is expected that its implementation will considerably reduce the incidence of complications and the burden on the healthcare system.

Effectiveness of a game-based high-intensity interval training on executive function and other health indicators of children with ADHD: A three-arm partially-blinded randomized controlled trial

BackgroundChildren with ADHD demand for effective intervention with minimum side effect to improve executive function (EF) and health well-being. MethodThis study used a three-arm partially-blinded randomized controlled trial to test the effects of two different kinds of 8-week game-based training programs (game-based HIIT program, GameHIIT; and game-based structured aerobic exercise program, GameSAE) on EF and other health indicators of children with ADHD, which was compared with a non-treatment control group. ResultsA total of 49 children with ADHD completed the program. Analyses of EF tests and parental survey indicated that (i) there is no significant intragroup difference among all measures between pre-/post-intervention tests for two game-based intervention groups. The only significant intergroup difference was observed in self-monitor score of parent-reported child's EF between GameSAE group and the control (large effect). Similarly, cerebral hemodynamic responses also found no significant group effect for all EF tests. However, the time effects were observed in several channels in the GameHIIT group in two EF tests (Color Words Stroop Test and Tower of London Test). No significant change of participants' overall ADHD symptoms was found in the pre-/post-tests for three groups. Nonetheless, further analyses revealed that both of two game-based training programs exhibited the significant positive effects on child's PA levels and the large effects on levels of physical fitness, when they were compared to the control. ConclusionBy this study, a significant enhancement in physical fitness and PA levels were found in both game-based PA interventions when they were compared with control group. However, the effectiveness of game-based PA interventions on improving EF or reducing ADHD symptoms remains unclear. This implies that a larger intervention dosage or a tailored intervention design may be warranted to improve the EF of children with ADHD.

Health-related quality of life of cancer patients: Findings from Western Rajasthan.

Cancer is one of the major public health concerns leading to high trends of mortality and morbidity in India. Health-related quality of life (HRQoL) is an indicator of the sense of well-being applicable, which includes all the domains of physical, social, emotional, and functional well-being. The inferences can strengthen the palliative care needs of patients. This study was conducted to assess the HRQoL of patients on anticancer therapy and to measure the perceived palliative care needs amongst diagnosed patients on cancer therapy. Mixed method approach was used to assess the objectives of the study. FACT-G questionnaire was used to assess the HRQoL of patients among a sample size of 290 participants for quantitative analysis and 9 for in-depth interviews. Data were generated and analyzed in SPSS version 23. Spearman correlation coefficient was used to test the association between the well-being score and demographic factors. The mean age of the study population was 52.46 ± 13.83 years with 65% females. The mean FACT-G score was 61.1 ± 17.1 with mean domain values of 14.97 (physical well-being), 16.55 (social well-being), 16.21 (emotional well-being) and 13.35 (functional well-being). FACT-G score was significantly associated with education level, type of cancer and type of anticancer therapy. Qualitative themes described pertaining to delayed diagnosis, financial distress, side effects, social isolation (factors worsening QoL) and support, and attitude (factors improving QoL). HRQOL scores were found low in all types of cancer and early referral for palliative care might have a positive effect on the quality of life of cancer patients. Cancer is the leading cause of morbidity and mortality with its profound social and economic consequences leading to impoverishment and societal inequity.

Current Trends in Modalities of Pain Assessment: A Narrative Review.

Pain is a common complaint among a spectrum of diseases. Although an ideal objective method of pain assessment is lacking, several validated tools are available for use in clinical research and practice. The tool considerations are based upon the parameters to be assessed and factors specific to patient, disease, and availability of instruments. This review classifies and brings the key aspects of currently available pain assessment tools on a single platform to ease the selection process for researchers/practitioners. The tools utilized for pain assessment were collected from articles available in PubMed and Google Scholar databases and classified into the following domains: unidimensional, multi-dimensional, investigation-based, and computerized algorithm-based tools. Their purpose of use and limitations are reviewed. The unidimensional scales are used to describe only the characteristics of pain, like intensity (e.g. numerical rating scale), type (e.g. neuropathic pain questionnaire), or pattern. In contrast, multi-dimensional tools, like Mc Gill Questionnaire, assess not only pain as an individual symptom but also its influence on physical functioning and general well-being. However, certain components like ethnicity, age, cognitive impairment, sedation, and emotion become a limiting factor in selecting the scale. In addition to these scales, a potential role of parameters such as biopotentials/markers has also been shown in pain assessment. Last, artificial intelligence is also being applied in evaluation of pain. Pain measurement is subjective in nature as assessed through questionnaires and observational tools. Currently, multi-dimensional approaches of pain assessment are available, which can lead to precision pain management.

468. CALCULATING THE MINIMAL CLINICALLY IMPORTANT DIFFERENCE FOR THE FACT-E FROM ESOPHAGECTOMY TO RECOVERY USING DISTRIBUTION-BASED METHODS

Abstract Background The Functional Assessment of Cancer Therapy-Esophageal (FACT-E) is a validated patient-reported outcome instrument that measures four subscales of general cancer health and one subscale specific to esophageal cancer. To make the instrument more clinically useful, therapeutic thresholds known as minimal clinically important differences (MCID) are needed. The purpose of this study was to calculate the MCID for the FACT-E and its subscales for patients undergoing an esophagectomy. Methods The study was based on a retrospective analysis of a registry maintained by a high volume North American tertiary care referral centre, which includes the FACT-E collected between August 2004 and September 2023. The FACT-E was administered at nine time points over the course of a patient’s care, ranging from the time of first presentation to 5 years post-esophagectomy. This study used two distribution-based approaches – the standard error (SE) and the standard deviation (SD) – to calculate the MCID for the FACT-E’s total score and its five subscales. Nonparametric bootstrapping was used to generate 95% confidence intervals for each MCID. Results There were 731 participants included in this study but not all of those completed each subscale at each time point. The MCID for physical well-being ranged from 2.2-3.1 using SE and 2.3-3.4 using SD, from 2.1-3.6 using SE and 2.2-3.6 using SD for social well-being, 1.2-1.7 using SE and from 1.4-2.0 using SD for emotional well-being, 2.1-2.4 using SE and 3.2-3.6 using SD for functional well-being, and from 3.2-4.3 using SE and from 4.3-6.4 using SD for the esophagus cancer subscale. The MCID for the total score ranged from 6.7-8.3 using SE and from 8.9-11.2 using SD. Conclusion The MCID thresholds for the FACT-E subscales vary depending on when they are collected and how they are measured. In general, smaller thresholds of change are needed in the social and emotional well-being subscales, while larger ones are needed for the esophagus cancer subscale. Overall, the MCID for the FACT-E total score ranged from 6 to 11. Clinicians should consider these MCID if using the FACT-E to assess changes in patients’ symptom severity before and after esophagectomy.