Functional Well-being Research Articles

Assessing the impact of complex rehabilitation on peripheral polyneuropathy incidence and quality of life in patients with colorectal cancer

The article examines the impact of comprehensive rehabilitation on the degree of polyneuropathy and quality of life in patients with colorectal cancer receiving adjuvant chemotherapy. It has been shown that the use of complex rehabilitation can improve physical functioning and general well-being and prevent the development of grade 3/4 polyneuropathy according to CTCAE 5.0. The results obtained prove the effectiveness of complex medical rehabilitation, including the use of nutritional support, physical therapy, magnetic therapy, exposure to alternating electric current, and psychotherapy.

Cognitive outcomes in Susac syndrome: A 2-year neuropsychological follow-up study.

Susac syndrome (SuS) is a rare, autoimmune, neurological disease characterized by a clinical triad of branch retinal artery occlusion, sensorineural hearing loss and encephalopathy. Neuropsychological functioning in SuS is little researched and the prevalence, nature, and evolution over time of cognitive deficits in SuS remain unclear. This study aimed to better understand the long-term neuropsychological outcomes of patients with SuS. Thirteen patients with SuS (mean [SD] age 39.5 [11.1] years) were enrolled at the Ghent University Hospital by their treating neurologist. The cognitive functioning and emotional well-being of each patient was evaluated by means of a thorough neuropsychological test battery at baseline and after 2 years. Follow-up testing after 2 years was performed in 11 patients (mean [SD] age 42.2 [11.5] years). Patients showed normal neuropsychological test results at a group level, both at baseline and follow-up testing. Significant improvements over time were found for information processing speed, verbal recognition, and semantic and phonological fluency. Individual test results showed interindividual variability at baseline, with most impairments being in attention, executive functioning and language, which improved after a 2-year period. In addition, patients reported significantly lower mental and physical well-being, both at baseline and follow-up testing. Our results suggest that neuropsychological dysfunction in SuS is limited at a group level and improves over time. Nonetheless, individual test results reveal interindividual variability, making cognitive screening essential. Furthermore, a high psycho-emotional burden of the disease was reported, for which screening and follow-up are necessary.

Effets médiateurs de la symptomatologie de stress post-traumatique et des symptômes de dissociation somatoforme sur la relation entre l’attachement et la qualité de vie liée à la santé après un infarctus du myocarde

Myocardial infarction (MI) is a particularly frequent coronary disease: the number of new cases of MI recorded each year amounts to nearly 90,000 in France and nearly 790,000 in the United States. Over the past 15 years, the number of people who can survive this major cardiac event has substantially increased, as a result of advances in medical treatment and a reduction in delay to intervention. However, patients often report a decrease in their health-related quality of life following myocardial infarction. In other words, some patients perceive that the disease negatively affects various aspects of their daily lives, including physical functioning, emotional state, social relationships, and overall well-being. Furthermore, studies have shown that health-related quality of life is a prognostic indicator of the evolution of patients’ health status: the more health-related quality of life is reduced, the greater the risk of all-cause mortality, recurrence of cardiovascular events, and re-hospitalization for heart disease. In view of these elements, the identification of potentially modifiable factors, and in particular psychological factors, having an impact on health-related quality of life is particularly relevant. More specifically, insecure attachment, post-traumatic stress symptomatology and somatoform dissociation symptoms could have an impact on the health related-quality of life of people who have experienced a major cardiac event. ObjectivesThe objective of this study was to investigate the mediating role of posttraumatic stress symptoms and somatoform dissociative symptomatology in the relationship between insecure attachment and health related-quality of life after a myocardial infarction. Materials and methodsA total of 73 participants, having suffered a myocardial infarction and participating in a cardiovascular rehabilitation program, completed questionnaires to assess the degree of insecurity of their attachment (Experiences in Close Relationship Scale-12; ECR-12), the severity of post-traumatic stress symptoms (Post-Traumatic Stress Disorder Checklist Scale; PCL-5) and somatoform dissociation symptoms (Somatoform Dissociation Questionnaire; SDQ-20), and their health related-quality of life (MacNew Heart Disease-Health Related Quality of Life; MacNew). Mediation analyses were conducted according to the recommendations formulated by Baron and Kenny. ResultsOur results showed that only anxious attachment was positively and significantly associated with the severity of posttraumatic stress symptomatology, whereas such a link was not observed for avoidant attachment. The importance of posttraumatic symptomatology fully explained why individuals with high levels of fear of abandonment also have the poorest emotional, physical, and social quality of life after myocardial infarction. The importance of dissociative somatoform symptomatology partially explained why individuals with an insecure attachment style characterized by a high level of abandonmen were also those with the poorest health-related quality of life following myocardial infarction. ConclusionsThe results of this study tend to demonstrate the importance of taking into account the specificities of attachment, posttraumatic stress symptoms and somatoform dissociation phenomena in the context of interventions aimed at improving the health related-quality of life of people after a myocardial infarction. Insofar as secure attachment appears to be a protective factor against the risk of developing posttraumatic stress disorder, a psychotherapeutic approach aimed at promoting this form of attachment seems to be well justified. Specifically, it may be helpful to provide patients with a psychotherapeutic framework that takes into account their attachment experiences to allow them to change their beliefs about themselves and others, while helping them develop coping strategies appropriate to the stress. Psychotherapeutic interventions aimed jointly at increasing of the degree of attachment security and reducing the symptoms of posttraumatic stress and somatoform dissociation could be relevant to improve the health-related quality of life after a myocardial infarction.

Health-related quality of life, jaw function and sleep-disordered breathing among patients with dentofacial deformity.

Patients with dentofacial deformity (DFD) requiring orthognathic treatment have poor aesthetics, jaw function and psychological well-being, which potentially affect the quality of life. This study aimed to investigate the health-related general, oral and orthognathic quality of life, jaw function and sleep-disordered breathing at different stages of orthognathic surgical treatment. A total of 120 consecutive patients with DFD were recruited and grouped as pre-orthodontic treatment (group 1), pre-surgery (group 2), 4 months post-surgery (group 3), 24 months post-surgery (group 4) and in addition 30 controls without DFD (group 0). Outcomes were assessed using general health Short Form Survey (SF-36), Oral Health Impact (OHIP-14), Orthognathic Quality of Life Questionnaire (OQLQ), STOP-Bang and Jaw Function Limitation Scale (JFLS) questionnaires. In addition, presence or absence of pain was recorded. Data were tested with analysis of variance, Kruskal-Wallis test, Tukey post hoc test and structural equation modelling (SEM). Results revealed SF-36 (p = .814) and STOP-Bang (p = .143) total scores did not differ between control and treatment groups. In contrast, OHIP-14, OQLQ and JFLS total scores differed between groups (p = .001). Higher scores were observed in groups 1 (p = .001), 2 (p = .001) and 3 (p = .041) compared to group 0, indicating poor oral health in patients with DFD. Importantly, in group 4, oral health-related quality of life was better, and OHIP-14 (p = .936) and JFLS (p = .572) scores did not differ from controls. OQLQ scores of group 4 were significantly lower than group 1 (p = .001) but higher than group 0 (p = .013). SEM results revealed a significant negative associations of pain with JFLS and OQLQ; OHIP-14 with OQLQ; OHIP-14 with SF-36; and finally STOP-Bang with SF-36. Positive associations were observed between JFLS and OHIP-14; OHIP-14 and OQLQ. Oral health-related quality of life and jaw function appears to be improved 24 months after orthognathic surgery. Pain and limitation in jaw function had a negative association with health-related quality of life.

Hematopoietic Stem Cell Transplantation Impact on Patients' Perceived Quality of Life: A Longitudinal Study.

The aim of this paper was to evaluate the quality of life of adult patients with onco-hematological disease treated with hematopoietic stem cell transplantation up to two years post-transplantation. A quantitative, observational, longitudinal, and analytical study was conducted with 121 participants diagnosed with onco-hematological cancer who underwent hematopoietic stem cell transplantation between October 2017 and September 2019, with a 2-year post-transplantation follow-up, of whom only 39 completed the study. The Functional Assessment of Cancer Therapy-Bone Marrow Transplantation (FACT-BMT) questionnaire and its subscales, Functional Assessment of Cancer Therapy-General (FACT-BMT) and Functional Assessment of Cancer Therapy Trial Outcome Index (FACT-TOI), developed by the Functional Assessment of Chronic Illness Therapy (FACIT) and validated for Spain, were used to assess quality of life. The average age for hematopoietic stem cell transplantation was 54 years, with a majority of male participants. The evaluation of quality of life showed a decrease at the time of hospital discharge, followed by a progressive improvement up to one year after the transplantation. There was a significant difference in the quality of life questionnaire scores between both sexes during all stages of the research, with higher scores in male participants. The length of hospital stay significantly affected patients' physical and functional well-being, and marital status was related to differences in the perception of quality of life. Despite the initial decrease in quality of life for patients undergoing hematopoietic stem cell transplantation, levels of quality of life similar to baseline are regained one year after the transplantation. Sociodemographic variables are related to how these patients perceive their quality of life. However, further studies with a larger sample size are needed for more precise results.

Management of Frostbite Injury in Primary Care

Frostbite is cold-related tissue ischemia and damage that occurs after exposure to freezing temperatures. Appropriate classification of frostbite injury allows for timely diagnosis and early intervention, which can affect long-term sequelae, function, and overall well-being. Severe frostbite injury is irreversible and requires in-hospital interventions to maximize tissue salvage. Superficial frostbite injury is reversible and can be effectively managed in primary care settings. In collaboration with a multidisciplinary team, nurse practitioners can effectively manage frostbite-related complications with pharmacologic and adjunctive treatments.

A BIONIC HAND VS. A REPLANTED HAND.

Evaluation of the hand function affected when replacing a malfunctioning hand by a bionic hand. Case report. One individual that wished for a better quality of life after unsatisfying hand function following a replantation. A quantitative and qualitative evaluation of body functions as well as activity performance and participation before and after a planned amputation and prosthetic fitting is presented. Improvements were seen in the patient-reported outcome measures (PROMs) that were used regarding activity (Disability of the Arm, Shoulder and Hand [DASH] and Canadian Occupational Performance Measure [COPM]), pain (Neuropathic Pain Symptom Inventory [NPSI], Brief Pain Inventory [BPI], Visual Analogue Scale [VAS]), cold intolerance (CISS) and health related quality of life (SF-36), as well as in the standardised grip function test, Southampton Hand Assessment Procedure (SHAP). No referred sensations were seen but the discriminative touch on the forearm was improved. In the qualitative interview, a relief of pain, a lack of cold intolerance, improved appearance, better grip function and overall emotional wellbeing were expressed. The planned amputation and subsequent fitting and usage of a hand prosthesis were satisfying for the individual with positive effects on activity and participation. When the hand function after a hand replantation does not reach satisfactory levels, a planned amputation and a prosthetic hand can be the right solution.

Physical activity and sedentary behaviors and the impact on college student’s stress, depression, and anxiety

University students are at a significant risk for mental health issues, including stress and depression. Negative mental health among college-aged adults continues to rise, impacting students’ cognitive function, academic performance, social development, and overall well-being. Rather than offering support through medication, physical activity has demonstrated a potential behavioral approach to reduce students’ stress and anxiety. The current study examined the influence of young adults’ physical activity and sedentary behavior levels and their self-reported stress, depression, and psychological well-being. Participants were undergraduate and graduate students recruited from a Midwestern university and a Mid-Southern university. Multiple linear regressions estimated mean differences in participants’ self-reported stress, depression, and psychological well-being based on their physical activity levels and sitting minutes. Moderate levels of physical activity improved participants’ growth psychological well-being (p = .01). Vigorous physical activity had an effect on participants’ relations, purpose, and self-acceptance (p<0.05). Daily sitting minutes significantly affected participants’ stress, perceived stress, depression, and environmental psychological wellness (p<0.05). Results demonstrate how physical activity can be a natural medicine for symptoms of stress and depression. Current outcomes support the development of future programs to prevent and react to mental health via physical activity.

Comparative Study of Quality of Life After Surgery in Sigmoid and Rectal Cancers: A Single-Center Prospective Study

Background: Sigmoid and rectal cancers are common malignancies that necessitate surgical resection as the primary treatment modality. However, surgery can significantly impact the quality of life (QoL) of patients, particularly in terms of bowel function, sexual function, and psychological well-being. This study aimed to compare the QoL of patients who underwent surgery for sigmoid and rectal cancers
 Methods: A prospective study was conducted on 90 patients who underwent elective surgery for sigmoid or rectal cancer between January 2019 and December 2021 at the center. The QLQ-C30 and QLQ-CR29 questionnaires were utilized to assess the QoL of patients post-surgery. The QoL scores between the two groups were compared using t-tests and repeated measures ANOVA.
 Results: The average age of the patients was years, and 57.8% were females. The sigmoid group comprised 44 patients (48.8%) who underwent sigmoid colectomy, and the rectal group consisted of 46 patients (51.2%) who underwent low anterior resection. There were no significant differences in the baseline characteristics and QLQ-C30 scores between the two groups and also in other categories (sex, age groups, and cancer stages) (p > 0.05). However, a significant difference was observed between the QLQ-CR29 scores of the two surgical groups (p < 0.05). QLQ-CR29 was not significantly different between sex and age groups and cancer stages (p > 0.05).
 Conclusions: The study demonstrated that surgery for sigmoid and rectal cancers deteriorated the QoL of patients, irrespective of the type of surgery or the location of the tumor. There was no significant difference in the QoL between the sigmoid and rectal groups measured by QLQ-C30. However, QLQ-CR29 showed significantly better QoL for the rectal group.

A latent class analysis of community-based rehabilitation needs among Chinese older adults: a mixed study protocol.

Geriatric diseases (e.g., chronic diseases and geriatric syndromes) may result in impaired physical performance and a decline in the quality of life. The results of previous studies reported the positive effects of comprehensive community-based rehabilitation (CBR) services on physical and social functioning and psychosocial wellbeing. However, to provide adequate and personalised rehabilitation services, it is essential to understand the needs of the older adults population. There have been no studies on the need for CBR in older adults populations that consider their heterogeneity. Therefore, high-quality studies are required to recognise the heterogeneity and latent classes of CBR needs in older adults population groups. This study aims to identify the heterogeneity of the rehabilitation needs of older adults in the community and explore whether older adults with similar characteristics have similar needs through a cross-sectional survey and latent class analysis (LCA) to provide support for personalised rehabilitation services. The study is structured into four phases. The first phase will focus on constructing a comprehensive questionnaire to assess rehabilitation needs. In the second phase, a pilot study will be conducted to evaluate the reliability and validity of the completed questionnaire. This step ensures the robustness of the instrument for data collection. The third phase will involve cross-sectional surveys using the finalised questionnaires to collect the necessary data from the targeted population. The fourth phase will focus on conducting LCA to determine the CBR needs of the older adult population. The results of this study will provide novel and critical information for a better understanding of the rehabilitation needs, potential categories, and influencing factors of older adults in the community. The study will be conducted in Guizhou Province in western China, where economic and social development is relatively low, and the results will inform and benefit other regions and developing countries facing similar challenges. However, because of the complete social security and rehabilitation service systems in developed areas, our research results may not fully reflect the situation in these areas. Future studies may need to be conducted in places with different levels of social development. https://www.chictr.org.cn/showproj.html?proj=191398, ChiCTR2300071478.

Quality of life of older adults diagnosed with cancer in Palestine: A cross sectional study

The majority of new cancer diagnoses and cancer deaths occur in the elderly making cancer primarily a disease of older adults. Due to the heterogeneous ageing process and complications resulting from therapy and toxicity, the treatment of older patients with cancer remains challenging. The current study aims to evaluate the quality of life (QOL) of cancer patients over the age of 60 and identify the factors associated with QOL in Palestine. A cross-sectional and descriptive design was employed for this study. The sample included 136 older patients with cancer attending hospitals in East Jerusalem and the West Bank. Data were collected between June and July 2022 using self-reported questionnaires, including socio-demographic data and the Functional Assessment of Cancer Therapy - General (FACT-G). Binary logistic regression was used to identify factors associated with QOL. The age of patients ranged from 60 to 90 years (mean 66.62 years, SD ± 5.46) of which 64.7% (n=88) were females, and 35.3% (n=48) were males. More than half of the participants (64.7%, n=88) had good QOL whereas 35.3% (n=48) had poor QOL. The overall QOL of participants was reported as 2.34 (SD = 0.47), which indicates a good QOL. The highest mean score was found in the social and family well-being domain (2.93 ± 0.76) followed by the physical well-being (2.31 ± 0.82). The difference was significant for functional well-being (t= -2.86, P=.005). Gender was significantly associated with the QOL. Males were about 0.40 times more likely to have lower QOL than females (OR: 0.40; 95 CI%: 0.20-0.98; P = 0.04). In contrast, no significant associations were found for the other factors. A deeper understanding of older patients' QOL and its predictors is essential for comprehending the issues facing the ageing population, and being aware of these variables may be useful for establishing programs to promote QOL.

Lymphedema self-assessment among endometrial cancer survivors.

Lower extremity lymphedema (LEL), which causes ankle, leg, and feet swelling, poses a significant challenge for endometrial cancer survivors, impacting physical functioning and psychological well-being. Inconsistent LEL diagnostic methods result in wide-ranging LEL incidence estimates. We calculated the cumulative incidence of LEL based on survivor-reported Gynecologic Cancer Lymphedema Questionnaire (GCLQ) responses in addition to survivor- and nurse-reported leg circumference measurements among a pilot sample of 50 endometrial cancer survivors (27 White, 23 Black) enrolled in the ongoing population-based Carolina Endometrial Cancer Study. Self-leg circumference measurements were perceived to be difficult and were completed by only 17 survivors. Diagnostic accuracy testing measures (sensitivity, specificity, positive and negative predictive value) compared the standard nurse-measured 10% difference in leg circumference measurements to GCLQ responses. At a mean of ~11 months post-diagnosis, 54% of survivors met established criteria for LEL based on 4 GCLQ cutpoint while 24% had LEL based on nurse-measurement. Percent agreement, sensitivity, and specificity approximated 60% at a threshold of 5 GCLQ symptoms. However, Cohen's kappa, a measure of reliability that corrects for agreement by chance, was highest at 4 GCLQ symptoms (κ = 0.27). Our findings emphasize the need for high quality measurements of LEL that are feasible for epidemiologic study designs among endometrial cancer survivors. Future studies should use patient-reported survey measures to assess lymphedema burden and quality of life outcomes among endometrial cancer survivors.

Quality of life and its predictors among patients with metastatic cancer in Bangladesh: the APPROACH survey

BackgroundThis study aimed to assess the health-related quality of life (HRQOL) (physical, functional, emotional, social, spiritual) and psychological (anxiety and depression) well-being and their associations with patient characteristics among patients with metastatic cancer in Bangladesh.MethodsA convenience sample of 386 Bangladeshi patients with stage IV solid cancers was recruited from a palliative care outpatient department and an inpatient palliative center. Dependent variables included the physical, functional, emotional, social, and overall scores of the Functional Assessment of Cancer Therapy-General (FACT-G) scale, the Functional Assessment of Chronic Illness Therapy-Spiritual Well-being (FACIT-SP) scale, the anxiety, depression, and overall scores of the Hospital Anxiety and Depression (HADS) scale. Linear regressions examined the association between dependent variables and patient characteristics.ResultsA substantial proportion of Bangladeshi patients reported anxiety (59% of outpatients and 55% of inpatients) and depression (60% of outpatients and 73% of inpatients) symptoms. Generally, greater financial difficulty and symptom burden scores were associated with worse health outcomes. Older patients reported poorer functional and spiritual well-being but better anxiety scores. Females reported worse anxiety and depressive symptoms and physical well-being but better spiritual outcomes.ConclusionsAdditional efforts must be directed at improving the HRQOL of patients with metastatic cancer in Bangladesh. Furthermore, assistance should be made more accessible to vulnerable groups, including women, the elderly, and those with financial difficulty.

Yoga Therapy as an Intervention to Improve Patient-Reported Outcomes Among Adults After Treatment for Cancer: Preliminary Findings From a Trial Using Single-Subject Experimental Design.

Cancer is a chronic condition associated with a substantial symptom burden, which can impair recovery after treatment. Investigating interventions with potential to improve self-reported disease and/or treatment effects-known as patient-reported outcomes (PROs)-is paramount to inform cancer care. The objective of this study was to evaluate the effects of a yoga therapy (YT) intervention on key PROs (ie, cancer-related fatigue, anxiety, cognitive function, depression, stress, quality of life [QoL]) among adults after treatment for cancer. Data from 20 adults (Mage = 55.74 years, 85% female; Mtime since diagnosis = 2.83 years) who had completed treatment for cancer were analyzed for this study. In this single-subject exploratory experimental study, the YT intervention comprised a 1:1 YT session (ie, 1 participant with 1 yoga therapist) followed by 6 weekly small (ie, 2-3 participants) group YT sessions. Group sessions were facilitated by the same yoga therapist who delivered participants' 1:1 session to ensure an in-depth personalized approach. PROs were assessed before (ie, pre-intervention) and after the 1:1 YT session (ie, during the intervention), as well as after the last group YT session (ie, post-intervention). Hierarchical linear modeling was used to analyze the data. Participants showed improvements in cancer-related fatigue, state anxiety, trait anxiety, perceived cognitive impairments, impacts of perceived cognitive impairments on QoL, and 1 dimension of QoL (ie, functional wellbeing) over time. Notably, cancer-related fatigue and state anxiety increased immediately after the 1:1 session, but showed greater improvements over time afterward (ie, during the intervention phase). No changes were observed for the remaining PROs. Although results require confirmation in future trials, this study highlights the importance of continuing to investigate YT as an intervention to enhance important PROs (ie, cancer-related fatigue and state anxiety) after treatment for cancer. More research is needed to identify additional beneficial effects and factors that influence participants' responses to 1:1 and group YT (ie, moderators and mediators). ISRCTN64763228. December 12, 2021. This trial was registered retrospectively. https://www.isrctn.com/ISRCTN64763228. Brunet, J., Wurz, A., Hussien, J., Pitman, A., Conte, E., Ennis, J. K., . . . & Seely, D. (2022). Exploring the Effects of Yoga Therapy on Heart Rate Variability and Patient-Reported Outcomes After Cancer Treatment: A Study Protocol. Integrative Cancer Therapies, 21, 15347354221075576.

Factors Associated with Functional Well-Being and Psychological Parameters among Cancer Patients Receiving Chemotherapy Admitted to a Select Cancer Hospital in Bagalkot District - An Exploratory Study

Factors Associated with Functional Well-Being and Psychological Parameters among Cancer Patients Receiving Chemotherapy Admitted to a Select Cancer Hospital in Bagalkot District - An Exploratory Study

Poor sleep quality and associated factors among adult chronic kidney disease patients.

Poor sleep quality is a common concern in chronic kidney disease (CKD) patients, which can accelerate the progression of chronic renal disease and negatively impact their health-related quality of life, potentially leading to greater morbidity and mortality rates. It can also have an effect on the immune system, cognitive function, and emotional well-being of CKD patients. Furthermore, poor sleep quality may contribute to drug noncompliance and decreased participation in the entire treatment plan. Nonetheless, no research has been undertaken in Ethiopia on the prevalence of poor sleep quality and its associated factors among CKD patients. This study aimed to assess the prevalence of poor quality of sleep and associated factors among chronic kidney disease patients at the University of Gondar Comprehensive Specialized and Felege Hiwot Referral Hospitals in 2020. A cross-sectional study design was implemented at the University of Gondar Comprehensive Specialized and Felege Hiwot Referral Hospitals between February and April 2020. The study participants were chosen through systematic random sampling techniques. The Pittsburgh Sleep Quality Index (PSQI), a validated assessment tool, was utilized to measure sleep quality. A PSQI total score > 5 was used as an indicator of poor sleep quality. Subsequently, the data obtained were entered into Epi Data version 3.0 and then transferred to STATA 14 for analysis. Both bivariable and multivariable binary logistic regression analyses were performed to recognize factors associated with poor sleep quality. In the multivariable logistic regression analysis, variables demonstrating a p-value of ≤0.05 were considered statistically associated to poor sleep quality. In this study, 424 CKD patients were included. Among screened CKD patients, 42.9% tested positive for poor sleep quality with a 95% CI (38 to 47%). Independent predictors of poor sleep quality among CKD patients were common mental disorder [AOR = 1.8, 95% CI (1.19-2.89)], anemia [AOR = 2.7, 95% CI (1.71-4.36)], declined eGFR between 60 and 89.9 [AOR = 1.6; 95% CI (2.28-5.54)], 30-59.9 [AOR = 2.6, 95% CI (1.53-4.43)], and ≤ 30 [AOR = 3.8, 95% CI (1.17-12.61)], age > 50 years [AOR = 1.7(1.11-2.69)] and duration of disease 2.9 [AOR = 2.9, 95% CI (1.77-4.90)]. In our study, almost 1 out of 2 CKD patients assessed for poor sleep quality tested positive. It was noted that poor sleep quality was more frequent among CKD patients with common mental disorders, anemia, decreased eGFR levels, individuals aged over 50 years, and those with a longer duration of the disease. Consequently, it's advised to regularly screen these CKD patients for poor sleep quality.

Epidemiology of cerebral palsy among children in Ghana.

The epidemiology of cerebral palsy (CP) is poorly described in Ghana. These data are crucial for evidence-based intervention for children with CP in the country. We aimed to describe the epidemiology of CP among children in Ghana. We established the first institution-based register of children with CP in Ghana (Ghana CP Register-GCPR). Children with confirmed CP aged < 18 years were registered following a detailed neurodevelopmental assessment. Socio-demographics, risk factors, predominant motor type and topography, gross motor function classification system (GMFCS), associated impairments, education and rehabilitation status were documented. Between October 2018 and February 2020, 455 children were registered (mean [standard deviation {s.d.}] age at assessment: 5.9 [4.1] years). Preterm birth and low birthweight were reported in 52.0% and 21.1% children respectively. Most children (79.6%) had a pre- or perinatally acquired CP and the mean (s.d.) age of CP diagnosis was 22.2 (21.6) months. Overall, 55.9% of children had spastic tri- or quadriplegia, 60.5% had GMFCS level III-V and 70.3% had ≥ 1 associated impairment. However, 20.5% had never received rehabilitation services and 69.6% of school-aged children in the GCPR were not enrolled in schools. The study findings indicate a high burden of severe motor and associated impairment among children with CP in Ghana which highlights the need for tailored interventions to improve health and well-being of children with CP in the country. The study highlights the need for interventions to improve functional outcome, health and well-being of children with CP in Ghana.

Actigraphy methodology in the Kids Mod PAH trial: Physical activity as a functional endpoint in pediatric clinical trials.

Pulmonary vasodilator treatment can improve hemodynamics, right ventricular function, symptoms, and survival in pediatric pulmonary hypertension (PH). However, clinical trial data are lacking due to many constraints. One major limitation is the lack of relevant trial endpoints reflective of hemodynamics or functional status in patients in whom standard exercise testing is impractical, unreliable, or not reproducible. The Kids Mod PAH trial (Mono- vs. Duo Therapy for Pediatric Pulmonary Arterial Hypertension) is an ongoing multicenter, Phase III, randomized, open-label, pragmatic trial to compare the safety and efficacy of first-line combination therapy (sildenafil and bosentan) to first-line monotherapy (sildenafil alone) in 100 pediatric patients with PH across North America. Investigators will measure participants' physical activity with a research-grade, wrist-worn actigraphy device at multiple time points as an exploratory secondary outcome. Vector magnitude counts per minute and activity intensity will be compared between the treatment arms. By directly and noninvasively measuring physical activity in the ambulatory setting, we aim to identify a novel, simple, inexpensive, and highly reproducible approach for quantitative assessment of exercise tolerance in pediatric PH. These data will increase the field's understanding of the effect of pulmonary vasodilator treatment on daily activity - a quantitative measure of functional status and wellbeing in pediatric PH and a potential primary outcome for future clinical trials in children with cardiopulmonary disorders.

Major Dietary Patterns, Exercise Addiction, and Eating Disorders Among a Sample of Physically Active Young Adults.

Regular exercise has been widely acknowledged for its numerous health benefits, including improvements in physical fitness, body function, and mental well-being. However, excessive exercise and unhealthy dietary patterns can lead to adverse effects on individuals' physical and psychological well-being. This study aimed to examine the association of dietary patterns, exercise addiction, and eating disorders among physically active young adults. In this cross-sectional study, a total of 200 physically active young adults aged 18-35 years were included. The participants' dietary intake was assessed using a validated semi-quantitative food frequency questionnaire (FFQ) consisting of 80 food items. To determine dietary patterns, factor analysis was employed. Exercise addiction was evaluated using The Exercise Addiction Inventory (EAI) and Exercise Dependence Questionnaire (EDQ), and eating disorders were assessed using The Eating Disorder Examination-Questionnaire Short (EDE-QS). Three main dietary patterns were identified: western, healthy, and traditional dietary patterns. The western dietary pattern was associated with increased waist-to-hip ratio (P = .01) that remained significant after adjustment for confounders (eg, age, gender, BMI, and physical activity P = .03), while the adherence to traditional dietary pattern was linked to higher waist circumference and body shape index (P < .05). Participants that followed the healthy dietary pattern showed a higher score of EAI and body shape concern (P = .04). Furthermore, in structural equation modelling (SEM), eating disorder was identified as a significant positive predictor of exercise addiction (r = .17, P < .05). According to our finding, those with the higher adherence to healthy dietary pattern had higher scores of exercise addiction and body shape concern. Also, eating disorder was a potential predictor of exercise addiction among young physically active individuals. Further research and targeted interventions are needed to better understand these complex relationships and develop effective strategies to promote healthy behaviors and mitigate the risk of adverse outcomes.

Evaluating the influence of a structured nursing protocol on targeted outcomes in rheumatoid arthritis patients

Objective: Rheumatoid arthritis (RA) requires comprehensive management. Structured nursing protocols may enhance outcomes, but evidence is limited. This study evaluated the effect of a structured nursing protocol on RA outcomes. Materials and Methods: In this one-group pre-post study, 30 Egyptian RA patients completed assessments before and after a 12-week nursing protocol comprising education, psychosocial support, and self-management promotion. Assessments included clinical evaluation of joint counts, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) and patient-reported Arthritis Self-Efficacy Scale (ASES), Health Assessment Questionnaire (HAQ), Visual Analog Scale (VAS) for pain, and Hospital Anxiety and Depression Scale (HADS). Results: The study demonstrated significant improvements in both clinical- and patient-reported outcomes. Joint count decreased from 18.4 ± 4.2 to 14.2 ± 3.8 (P &lt; 0.001), ESR from 30.1 ± 6.8 mm/h to 25.5 ± 6.8 mm/h (P &lt; 0.01), and CRP levels from 15.2 ± 3.6 mg/L to 11.8 ± 2.9 mg/L (P &lt; 0.01) postintervention. Patient-reported outcomes showed a marked increase in ASES score from 140 ± 25 to 170 ± 30 (P &lt; 0.001) and reductions in HAQ from 1.6 ± 0.4 to 1.3 ± 0.3 (P &lt; 0.01), VAS pain score from 7.8 ± 1.7 to 6.2 ± 1.2 (P &lt; 0.001), and HADS anxiety and depression scores from 11 ± 3 to 8 ± 2 (P &lt; 0.05) and 10 ± 2 to 7 ± 1 (P &lt; 0.05), respectively. Conclusion: A structured nursing protocol significantly improved clinical disease activity, physical functioning, pain, self-efficacy, and emotional well-being in RA patients. A multifaceted nursing intervention appears beneficial for optimizing RA outcomes.