General Physical Health Research Articles

A Multimodal Ayurveda and Mind-Body Therapeutic Intervention for Chronic Symptoms Attributed to a Postinfectious Syndrome: A Pilot Study.

Objective: Evaluate feasibility and impact of a multimodal integrative therapeutic intervention in patients presenting with chronic symptoms attributed to a postinfectious syndrome. Design: This was a prospective longitudinal single-center pilot study conducted from January 2019 to December 2020. Setting/Location: University of Maryland Lyme Program, Baltimore Maryland. Subjects: Persons presenting for Lyme evaluation for symptoms attributed to Lyme disease. Interventions: Participants attended two 1-h individual instructional sessions consisting of Ayurveda-based dietary intervention and breath-coordinated mind-body practice to be used for home practice. Outcome measures: Standard measures of impact were obtained at baseline, 1, 3, 6, and 12 months using the following validated survey instruments: Perceived Stress Scale (PSS), PROMIS Global Health v1.2 (GH), and PROMIS 29 v2.0 survey. Results: From 216 patients presenting for Lyme evaluation, 19 participants enrolled with 84% completing the study (N = 16). Baseline PROMIS GH scores consisting of general Physical Health (GPH) and general Mental Health (GMH) scores were lower in the study population than in the general U.S. population. PROMIS 29 scores were higher for fatigue, anxiety, and pain than those in the general U.S. population. Over 12-month period, improvement in both the GPH and GMH was 6.09 (confidence interval [95% CI] = 2.71-9.46; p < 0.001) and 4.65 (95% CI = 1.50-7.80; p = 0.004), respectively. PROMIS 29 scores showed the greatest improvement in fatigue at -7.91 (95% CI = -12.34 to -3.48; p < 0.001), pain interference -5.08 (95% CI = -9.20 to -0.96; p = 0.016), and ability to participate in social roles and activities 7.48 (95% CI = 3.21-11.75; p = 0.001) and least with depression -1.82 (95% CI = -4.74 to 1.10; p = 0.223). Employment status had significant effects on almost all outcome scores. Postinfectious state was associated with improvement in anxiety and PSS scores. Conclusions: A multimodal Ayurvedic and breath-coordinated mind-body therapeutic intervention is feasible and a potential nonpharmacologic therapeutic option for persons presenting with pain, stress, fatigue, physical dysfunction, and sleep disturbance attributed to a postinfectious syndrome. Further research is needed to determine efficacy in this population and in other groups with similar symptom complexes due to postinfectious syndromes.

The Fear of COVID-19: Effects on Psychosocial Factors and Quality of Life in Patients with Cystic Fibrosis

Objective: Psychosocial effects have been reported in patients with cystic fibrosis (pwCFs), which is chronic disease, and inconsistent results were observed in pandemic between studies. This study investigated the effects of Coronavirus (COVID-19) pandemic on anxiety, depression and quality of life (QoL) levels among pwCFs. Material and Methods: The data of all participants included in the study were collected through two web-based questionnaires, one for pwCFs and general population (GP) controls. Two questionnaire versions had similar questions, prepared by the researchers. The pwCFs questionnaire augmented with CF targeted questions. Also, both questionnaires included COVID-19 Fear Scale, Hospital Anxiety Depression Scale (HADS) and World Health Organization QoL Scale Short Form (WHOQOL-Bref) question items. Results: Sixty-four pwCFs and seventy GP controls completed the questionnairesCompared to GP controls, pwCFs had increased fear of COVID-19, anxiety, depression, and decreased QoL levels (p&amp;lt;0.001). The fear of COVID-19 had significant effects on anxiety (R2=0.506; p&amp;lt;0.001), depression (R2=0.337; p&amp;lt;0.001), and QoL domains of general health status (R2=0.095; p=0.013), physical (R2=0.239; p&amp;lt;0.001) and psychological health (R2=0.275; p&amp;lt;0.001), and environment (R2=0.179; p&amp;lt;0.001), but not on social relationships (p&amp;gt;0.05) in pwCFs. In GP controls, the fear of COVID-19 had significant effects on anxiety and depression (p&amp;lt;0.05), but not on any QoL domains (p&amp;gt;0.05). Conclusion: According to our study findings, theincrease in fear of COVID-19 had a negative impact on anxiety, depression and QoL in pwCFs.Psychosocial influences in pwCFs need to be further investigated in future cross-sectional studies in case of a possible pandemic and lockdown.

Qualities of Older Adults' Family and Friendship Relationships and Their Association with Life Satisfaction.

While family and friendship relationship qualities are associated with life satisfaction, evidence on how these types of relationships interact to contribute to older adults' life satisfaction is sparse. This study examined how family and friendship relationship qualities may be supportive of (compensatory) or conflict with (competing) older adults' life satisfaction. We adopted a cross-sectional design to analyze data from the Health and Retirement Study (n = 1178, females = 54.8%, mean age = 67.9 years, SD = 9.3 years) to examine compensatory (as in social support) and competing (as in social strain) qualities of family and friendship social relationships and their association with life satisfaction in older adults. For greater explanatory power, we also controlled for life satisfaction by sociodemographic variables of age, gender, education, self-reported general health, physical health and activity, depression, and personality traits. Our findings indicate that the spouse/partner support relationship contributes to older adults' life satisfaction overall and is associated with greater social support and less social strain. Friendship support is associated with improved life satisfaction for older adults reporting spouse/partner strain. Relationship support for the life satisfaction of older adults should consider their need for social support from their social network while minimizing the risk of social strain from adversarial relationships in life situations.

Enhancing Quality of Life in the Elderly: The Impact of Psychosomatic Exercises on Healthy Aging

IntroductionOlder individuals constitute a significant portion of the population, and concerted efforts are underway to enhance the quality of this life stage by minimizing health issues and maximizing opportunities.ObjectivesThis study aims to investigate the impact of psychosomatic exercises, including practices like yoga, meditation, and tai chi, as an alternative approach to promoting healthy aging and ultimately enhancing the quality of life among elderly individuals.MethodsThe study comprised 84 participants, with 51 individuals engaging in various forms of psychosomatic exercises and 33 serving as the control group, having no prior exposure to such practices. Data collection was carried out electronically, with the initial section gathering socio-demographic information and health-related details about the participants. The second part consisted of the WHOQOL-BREF quality of life scale, consisting of 26 questions, which assessed six domains: Overall Quality of Life and General Health, Physical Health, Psychological Health, Social Relationships, and Environment. Statistical analysis was performed with SPSS 26.ResultsThe average age of the participants was 66.7 years. A statistically significant positive correlation was identified within the first subscale of the tool, “Overall Quality of Life and General Health,” with scores of 74.3/100 for those engaging in psychosomatic exercises and 66.7/100 for those who did not (t(82) = -2.513, p = 0.014). However, no statistically significant differences were observed in the remaining subscales.ConclusionsPsychosomatic exercises, including yoga, meditation, and tai chi, hold promise as a means to improve the overall quality of life and general health of elderly individuals. These practices could serve as valuable components of strategies aimed at promoting healthy aging. Further research is needed to explore their effects in greater detail and across various dimensions of well-being.Disclosure of InterestNone Declared

Mental and Physical Health Comorbidities in Traumatic Brain Injury: A Non-TBI Controls Comparison

ObjectiveTo examine whether aging with a TBI was associated with a greater burden of health-related comorbidities compared with a non-TBI control cohort and examine the associations between comorbidity burden, emotional outcomes, and health-related quality of life (HRQoL) after TBI across ages. DesignCross-sectional. SettingResearch center or telephone. ParticipantsThe study included 559 participants (NTBI=291, NControls=268). Participants with TBI were recruited during inpatient rehabilitation and had sustained a moderate-severe TBI 1-33 years previously. Non-TBI controls were a convenience sample recruited through advertisements in the community. InterventionsNot applicable. Main Outcome MeasuresThe number of cardiovascular, general physical health, and mental health comorbidities was compared between cohorts and age strata using Poisson regression. The relationships between comorbidities, age, emotional outcomes (Generalized Anxiety Disorder Scale-7, Patient Health Questionnaire-9), and HRQoL (PROMIS Global Health Measure) were examined with linear regression. Distinct subgroups of comorbidities were identified using latent class analysis. Associations between comorbidity classes with demographic and outcome variables were evaluated using multinomial logistic and linear regressions, respectively. ResultsTBI participants had a significantly higher comorbidity burden than controls, primarily driven by elevated rates of mental health disorders (RR=2.71, 95% confidence interval [1.37, 5.35]). Cardiovascular and physical health comorbidities were not elevated in the TBI group compared with controls. Both cohorts had 3 similar comorbidity subgroups, suggesting consistent patterns of co-occurring health conditions regardless of TBI exposure. Physical and mental health comorbidities were associated with elevated depression and anxiety symptoms and diminished HRQoL after TBI compared with controls. ConclusionTBI was associated with greater mental, but not physical, health comorbidities in the decades after injury. However, physical and mental health comorbidities significantly affected emotional and HRQoL status after TBI, underscoring a greater need for long-term support for individuals with TBI coping with both physical and mental health comorbidities.

The Impact of COVID-19 on Health Behavior Engagement and Psychological and Physical Health Among Active Duty Military Enrolled in a Weight Management Intervention: An Exploratory Study.

The COVID-19 pandemic profoundly affected the health and well-being of people globally. Some studies suggest individuals with overweight or obesity may have been more adversely impacted by pandemic restrictions. Additionally, military personnel may have been more vulnerable to stress during the pandemic because of job demands (e.g., work in close quarters). Our research group was conducting a randomized clinical trial of a weight management intervention in active duty military personnel with overweight or obesity when the COVID-19 pandemic struck. Thus, we collected additional pandemic-related data from participants enrolled during the COVID-19 pandemic and conducted exploratory analyses to understand how the pandemic affected their stress levels and perceived abilities to engage in health behaviors like exercise and healthy eating. The aims of this exploratory study were to: (1) assess associations between pandemic-related stress and health behaviors with body fat percentage (BF%) and psychological and physical health, and (2) explore how pandemic-related stress and health behaviors affected BF% during and after the intervention. A total of 29 active duty Navy personnel (55% female, 69% White) were enrolled after the onset of pandemic restrictions and completed measures assessing pandemic-related stress and health behaviors as well as measures of general psychological and physical health before the intervention. BF% was collected at 5 timepoints, including baseline, during, and following the intervention. Bivariate correlations assessed associations at baseline. Linearmixed-effects longitudinal models explored how pandemic-related stress and health behaviors affected BF%. Post-hoc analyses evaluated the effects of pandemic factors on BF% at each timepoint. Most participants perceived of the pandemic as increasing stress and detracting from their abilities to engage in health behaviors (i.e., exercise and healthy eating). Higher pandemic stress was significantly associated with reporting exercise and healthy eating as more difficult, worse overall health, and more anxiety and general stress. Reporting exercise as harder during the pandemic also was associated with more psychological distress at baseline. A linearmixed- effects model controlling for age, sex, and number of intervention sessions attended revealed endorsing "exercise as harder" was associated with higher BF%. Post-hoc regression analyses revealed rating "exercise as harder" significantly predicted higher BF% 3 months post-intervention (B = 0.65, P = .01), whereas pandemic stress was not significantly associated with higher BF% at 3 month (B =0.14, P = .08) or 6 month (B = 0.21, P = .09) follow-up. As expected, most participants perceived of the pandemic as heightening stress and interfering with engagement in health behaviors. It is possible that pandemic-related stress may have exacerbated weight gain-promoting behaviors and/or interfered with achievement of desired weight management outcomes. Outside the context of the pandemic, it may be beneficial for healthcare providers to screen individuals for stress and perceptions of ease of engagement in health behaviors before enrollment in a weight management intervention. Further, tailoring interventions to mitigate stress and promote perceptions of ease in engaging in health behaviors may promote better weight management outcomes.

Relationship between Postpartum Maternal Characteristics and Fatigue

The most general physical health problem which occurs on postpartum mother is fatigue. Fatigue is a common ongoing condition experienced by postpartum women after childbirth. Symptoms of fatigue occur due to physical and psychological adjustments after childbirth. Fatigue during postpartum period are influenced by various factors included the demography factor. This research was conducted in the working area of Puskesmas Umban Sari Pekanbaru City. This research aimed to find out the correlation between the characteristics of postpartum mother towards fatigue. This research employed correlation method. The research samples were 66 respondents that were selected based on the inclusion criteria by using purposive sampling technique. The research used Postpartum Fatigue Scale. The analysis used was bivariate analysis by using chi-square test. The research result showed that there was a correlation between the mother’s age, latest education and occupation on postpartum fatigue.

Cabozantinib plus atezolizumab versus sorafenib for advanced hepatocellular carcinoma (COSMIC-312): final results of a randomised phase 3 study

The aim of the COSMIC-312 trial was to evaluate cabozantinib plus atezolizumab versus sorafenib in patients with previously untreated advanced hepatocellular carcinoma. In the initial analysis, cabozantinib plus atezolizumab significantly prolonged progression-free survival versus sorafenib. Here, we report the pre-planned final overall survival analysis and updated safety and efficacy results following longer follow-up. COSMIC-312 was an open-label, randomised, phase 3 study done across 178 centres in 32 countries. Patients aged 18 years or older with previously untreated advanced hepatocellular carcinoma were eligible. Patients must have had measurable disease per Response Evaluation Criteria in Solid Tumours version 1.1 (RECIST 1.1), and adequate marrow and organ function, including Child-Pugh class A liver function; those with fibrolamellar carcinoma, sarcomatoid hepatocellular carcinoma, or combined hepatocellular cholangiocarcinoma were ineligible. Patients were randomly assigned (2:1:1) using a web-based interactive response system to a combination of oral cabozantinib 40 mg once daily plus intravenous atezolizumab 1200 mg every 3 weeks, oral sorafenib 400 mg twice daily, or oral single-agent cabozantinib 60 mg once daily. Randomisation was stratified by disease aetiology, geographical region, and presence of extrahepatic disease or macrovascular invasion. Dual primary endpoints were for cabozantinib plus atezolizumab versus sorafenib: progression-free survival per RECIST 1.1, as assessed by a blinded independent radiology committee, in the first 372 randomly assigned patients (previously reported) and overall survival in all patients randomly assigned to cabozantinib plus atezolizumab or sorafenib. The secondary endpoint was progression-free survival in all patients randomly assigned to cabozantinib versus sorafenib. Outcomes in all randomly assigned patients, including final overall survival, are presented. Safety was assessed in all randomly assigned patients who received at least one dose of study drug. This trial is registered with ClinicalTrials.gov, NCT03755791. Between Dec 7, 2018, and Aug 27, 2020, 432 patients were randomly assigned to combination treatment, 217 to sorafenib, and 188 to single-agent cabozantinib, and included in all efficacy analyses. 704 (84%) patients were male and 133 (16%) were female. 824 of these patients received at least one dose of study treatment and were included in the safety population. Median follow-up was 22·1 months (IQR 19·3-24·8). Median overall survival was 16·5 months (96% CI 14·5-18·7) for the combination treatment group and 15·5 months (12·2-20·0) for the sorafenib group (hazard ratio [HR] 0·98 [0·78-1·24]; stratified log-rank p=0·87). Median progression-free survival was 6·9 months (99% CI 5·7-8·2) for the combination treatment group, 4·3 months (2·9-6·1) for the sorafenib group, and 5·8 months (99% CI 5·4-8·2) for the single-agent cabozantinib group (HR 0·74 [0·56-0·97] for combination treatment vs sorafenib; HR 0·78 [99% CI 0·56-1·09], p=0·05, for single-agent cabozantinib vs sorafenib). Grade 3 or 4 adverse events occurred in 281 (66%) of 429 patients in the combination treatment group, 100 (48%) of 207 patients in the sorafenib group, and 108 (57%) of 188 patients in the single-agent cabozantinib group; the most common were hypertension (37 [9%] vs 17 [8%] vs 23 [12%]), palmar-plantar erythrodysaesthesia (36 [8%] vs 18 [9%] vs 16 [9%]), aspartate aminotransferase increased (42 [10%] vs eight [4%] vs 17 [9%]), and alanine aminotransferase increased (40 [9%] vs six [3%] vs 13 [7%]). Serious adverse events occurred in 223 (52%) patients in the combination treatment group, 84 (41%) patients in the sorafenib group, and 87 (46%) patients in the single agent cabozantinib group. Treatment-related deaths occurred in six (1%) patients in the combination treatment group (encephalopathy, hepatic failure, drug-induced liver injury, oesophageal varices haemorrhage, multiple organ dysfunction syndrome, and tumour lysis syndrome), one (<1%) in the sorafenib group (general physical health deterioration), and four (2%) in the single-agent cabozantinib group (asthenia, gastrointestinal haemorrhage, sepsis, and gastric perforation). First-line cabozantinib plus atezolizumab did not improve overall survival versus sorafenib in patients with advanced hepatocellular carcinoma. The progression-free survival benefit of the combination versus sorafenib was maintained, with no new safety signals. Exelixis and Ipsen.

Classification of Depression Expressions on Twitter Using Ensemble Learning with Word2Vec

One of the mental health disorders experienced by people is depression. Depression is a mental disorder characterized by feelings of sadness, loss of interest or pleasure in daily activities, and decreased cognitive function that can affect social life, work, and general physical health. Early detection is needed to prevent the occurrence of bad risks. One of the early detections can be done through social media. This is because social media is one of the tools used to channel expression. This research uses data taken from Twitter social media to create a machine learning model. Before model building, data pre-processing will be carried out using Word2Vec to convert text into a continuous vector representation. The algorithm used is ensemble learning by combining five algorithms: Logistic Regression, Decision Tree, K-Nearest Neighbor, Artificial Neural Network, and Support Vector Machine. The results show that different Word2Vec architectures can give the model another performance. Ensemble Learning can improve the performance of using a single model. The best results were obtained by using a data ratio of 90:10 using the Skip-gram architecture to get an accuracy value and f1-score of 94%.

General practice pharmacist-led antipsychotic physical health monitoring: a prospective intervention scoping study.

People with severe mental health illness die prematurely, often due to preventable cardiometabolic disease, which can be exacerbated by antipsychotic medicines that are effective for treating mental illness. Literature demonstrates that physical health monitoring, as recommended in guidelines, for people receiving antipsychotics is substandard. Therefore, we aimed to scope the potential of a general practice clinical pharmacist (GPCP)-led multidisciplinary intervention optimising adherence to cardiometabolic monitoring guidelines and delivering polypharmacy reviews. Prospective intervention scoping study in three urban general practices; one usual care, two intervention. Patients 18-65 years old prescribed oral antipsychotics were identified from records, and invited for cardiometabolic monitoring and GPCP medication review, from January to December 2022. Interventions and onward referrals were recorded and collated. Anonymised pre- and post-review data were analysed, and actions were graded for clinical importance. In total 1.5% (210/14,159) of patients aged 18-65 years met inclusion criteria; usual care practice (n = 58); and intervention practices (n = 152). From baseline, the usual care practice achieved an absolute 7% increase in the cardiometabolic monitoring care bundle (glucose/glycosylated haemoglobin, lipids, blood pressure plus body mass index) versus 19-58% in the intervention practices. Two-thirds (92/152) of patients participated in medication reviews, requiring pharmacological and/or non-pharmacological clinical actions. The majority of actions were graded as moderate importance. Seven percentage of patients were identified as new pre-diabetic/diabetic and 6% were at high risk of cardiovascular disease requiring statin initiation. A pharmacist-led multidisciplinary general practice-based approach may be effective at optimising cardiometabolic monitoring; identifying and treating diabetic and cardiovascular risk factors.

Impact of smoking status on health-related quality of life (HRQoL) in cancer survivors.

The Health-Related Quality of Life (HRQoL) often declines among cancer survivors due to many factors. Some cancer patients who smoke before the cancer diagnosis continue this harmful habit, potentially contributing to a more significant decline in their HRQoL. Therefore, this study investigates the association between smoking status and HRQoL in cancer survivors. We conducted a cross-sectional study utilizing self-reported cancer history from 39,578 participants of the Behavioral Risk Factor Surveillance System (BRFSS) database, leveraging 2016 and 2020 year questionaries. A multidimensional composite outcome was created to assess HRQoL, integrating four distinct dimensions - general health, mental health, physical health, and activity limitations. After accounting for the complex survey design, logistic regression models were used to analyze the association between smoking status and poor HRQoL, adjusting for demographic, socioeconomic, and health-related confounders. Our study found that, after adjusting for potential confounders, current smokers exhibited a significantly poorer HRQoL than never smokers (OR 1.65, 95%CI 1.40-1.93). Furthermore, former smokers showed a poorer HRQoL than never smokers; however, this association was not as strong as current smokers (OR 1.22, 95%CI 1.09-1.38). Our findings highlight the adverse association of smoking with poor HRQoL in cancer survivors, underscoring the importance of healthcare professionals prioritizing smoking cessation and providing tailored interventions to support this goal.

Changes in Health Behaviour Factors in Response to COVID-19

The coronavirus pandemic caused profound changes in many aspects of people's lives, especially in the area of health behaviour. The restrictions caused by the pandemic have had negative effects on both the physical and mental health of society, while also transforming the way individuals exercise. The aim of our research was to analyse the changes in health behaviour of Hungarian adults, including their sporting habits as well as their mental health, caused by the COVID-19 pandemic. We also focused on comparing the experiences of a population that regularly participates in sport and a population that rarely or never participates in sport. Results of the survey showed that individuals who regularly participate in sport activities rated their general physical health significantly better than those living a more sedentary life. More than half of the sample stated that they did not experience any particular change in their physical health, but the second highest percentage of respondents reported that their health had been affected negatively by the pandemic period. Results also showed that almost half of respondents said that their sporting habits had not changed as a result of the pandemic, while many reported that their sporting frequency had decreased. Finally, we also analysed the changes in sporting habits with regard to the place of residence, finding that those individuals living in an apartment complex building were most likely to choose a different type of exercise from the one they had previously practised, while a higher proportion of individuals living in a suburban area, or with access to garden reported that they had started to doing sports.Our research provided partial confirmation that the pandemic had a negative effect on people's health behaviour, but given the high levels of exercise in the target group,it is not surprising that many did not experience any change in sporting habits or physical health. JEL Code: I12

Impact of Coronavirus Disease (COVID-19) Pandemic on Quality of Life among Adults in Riyadh, Saudi Arabia

Background: The Coronavirus Disease (COVID-19) pandemic indeed had a far-reaching and significant impact on the quality of life (QoL) worldwide. Its implications affected various facets of people\'s lives, including health, social interactions, economy, and mental well-being. Aim of the Study: This study aimed to elucidate the influence of the COVID-19 pandemic on QoL of adults in Riyadh, Saudi Arabia. Methods: A quantitative, non-experimental, descriptive, and correlational cross-sectional design was utilized, 440 adult residents of Riyadh participated in a Microsoft e-survey between October and December 2021 were recruited. The WHOQOL-BREF, a self-administered questionnaire, was employed for data collection; t-tests, one-way ANOVA, and the Kolmogorov–Smirnov test were applied. Results: Results showed the majority of participants were Saudi females, married, aged between 30 and 48, possessing a bachelor\'s degree in education. On average, participants rated their QoL at 4.12 ± 0.86. The highest-rated domain was physical health (67.30 ± 16.89), followed by social relationships (66.55 ± 22.34), psychological well-being (65.62 ± 17.17), and environment (62.86 ± 17.04). Correlation analysis revealed a positive relationship between participants\' perception of QoL and all variables, particularly with their general physical health. Only age emerged as a statistically significant predictor of participants’ perception of QoL. Conclusion: The findings indicate that adults in Riyadh demonstrated a positive perception of their QoL and general health post-COVID-19 pandemic, reflecting a substantial level of satisfaction.

Changes in Health Behaviour Factors in Response to COVID-19

The coronavirus pandemic caused profound changes in many aspects of people's lives, especially in the area of health behaviour. The restrictions caused by the pandemic have had negative effects on both the physical and mental health of society, while also transforming the way individuals exercise. The aim of our research was to analyse the changes in health behaviour of Hungarian adults, including their sporting habits as well as their mental health, caused by the COVID-19 pandemic. We also focused on comparing the experiences of a population that regularly participates in sport and a population that rarely or never participates in sport. Results of the survey showed that individuals who regularly participate in sport activities rated their general physical health significantly better than those living a more sedentary life. More than half of the sample stated that they did not experience any particular change in their physical health, but the second highest percentage of respondents reported that their health had been affected negatively by the pandemic period. Results also showed that almost half of respondents said that their sporting habits had not changed as a result of the pandemic, while many reported that their sporting frequency had decreased. Finally, we also analysed the changes in sporting habits with regard to the place of residence, finding that those individuals living in an apartment complex building were most likely to choose a different type of exercise from the one they had previously practised, while a higher proportion of individuals living in a suburban area, or with access to garden reported that they had started to doing sports.Our research provided partial confirmation that the pandemic had a negative effect on people's health behaviour, but given the high levels of exercise in the target group,it is not surprising that many did not experience any change in sporting habits or physical health. JEL Code: I12

The mood disorders and suicidal thoughts and their impact on the quality of life among people living with HIV treated in Białystok, Poland: a cross-sectional study

Introduction and objective: The aim of the study was to assess the prevalence of mood disorders symptoms and suicidal thoughts among HIV patients treated in Białystok and their impact on quality of life. Materials and methods: A total of 147 participants, including 104 men (70.7%) and 43 women (29.3%), took part in the research. The study used a diagnostic survey method with a modified questionnaire “Psychosocial situation of people living with HIV/AIDS in Poland” by Dr Magdalena Ankiersztejn-Bartczak and the World Health Organization Quality of Life (WHOQOL-BREF), Short Form Health Survey (SF-36), General Health Questionnaire (GHQ-28) and Beck Depression Inventory (BDI). Results: Suicidal thoughts and attempts were reported by 20% and 7% of respondents, respectively. Fear of living with HIV and fear of loneliness were the predominant reasons for suicidal thoughts (38.7% in total). Two-thirds of respondents had no depressive symptoms, while one-fourth of respondents presented with at most moderate depressive symptoms. There were significant differences in the level of health problems depending on marital status. Those who had suicidal thoughts after receiving HIV diagnosis had a lower quality of life. Conclusions: One-third of the respondents reported symptoms of mood disorders, most of which were of moderate intensity, and one-fourth of the respondents had suicidal thoughts and attempts. The quality of life of HIV patients was mainly determined by their general physical and mental health and social support. A higher quality of life was presented by those with better general health status who received social support. Only marital status determinated the prevalence of symptoms of mood disorders in the study group.

Psychosocial Work Conditions as Determinants of Well-Being in Jamaican Police Officers: The Mediating Role of Perceived Job Stress and Job Satisfaction.

Policing is considered a high-stress occupation due to the demanding nature of the job. Addressing police stress requires a detailed understanding of how psychosocial risk factors influence various aspects of their well-being. Moreover, an analysis of the direct effects of work conditions and the mediating effects of cognitive appraisals is also warranted. Using the Demands-Resources-Individual Effects (DRIVE) model of work-related stress this study investigated the direct effects of work conditions on well-being and also examined the intermediate role of perceived job stress and job satisfaction in the relationship between work conditions and well-being. Five hundred and seventy-eight police officers from the Jamaica Constabulary Force (J.C.F.) completed the questionnaire. Data were analyzed using hierarchical regressions and the Hayes Process tool for mediation analysis. Both perceived job stress and satisfaction mediated the relationship between work conditions and general physical health. Perceived job stress was an indirect pathway through which work conditions influenced psychological distress, whereas job satisfaction was not a significant mediator. In contrast, job satisfaction mediated the relationship between work conditions and positive well-being, but perceived job stress did not. These findings provide significant evidence for periodically monitoring and auditing perceptions of stress and job satisfaction, as they are likely precursors to subsequent health problems.

Health-related quality of life among prostate cancer survivors with metastatic disease and non-metastatic disease and men without a cancer history in the USA.

Few studies have comprehensively compared health-related quality of life (HRQoL) between metastatic prostate cancer survivors, survivors with non-metastatic disease, and men without a cancer history. We used the Surveillance, Epidemiology, and End Results-Medicare Health Outcomes Survey (SEER-MHOS) data linkage to identify men aged ≥ 65 years enrolled in Medicare Advantage (MA) plans. Prostate cancer survivors were diagnosed between 1988 and 2017 and completed MHOS surveys between 1998 and 2019. We analyzed data from752 metastatic prostate cancer survivors (1040 survey records), 19,583 localized or regional prostate cancer survivors (non-metastatic; 30,121 survey records), and 784,305 men aged ≥ 65 years without a cancer history in the same SEER regions (1.15 million survey records). We used clustered linear regressions to compare HRQoL measures at the person-level using the Veterans RAND 12 Item Health Survey (VR-12) T-scores for general health and physical and mental component summaries. Compared to men without a cancer history, prostate cancer survivors were older, more likely to be married, and had higher socioeconomic status. Compared to men without a cancer history, metastatic prostate cancer survivors reported lower general health (T-score differences [95% confidence interval]: - 6.26, [- 7.14, - 5.38], p < .001), physical health (- 4.33, [- 5.18, - 3.48], p < .001), and mental health (- 2.64, [- 3.40, - 1.88], p < .001) component summaries. Results were similar for other VR-12 T-scores. In contrast, non-metastatic prostate cancer survivors reported similar VR-12 T-scores as men without a cancer history. Further analyses comparing metastatic and non-metastatic prostate cancer survivors support these findings. Interventions to improve health-related quality of life for men diagnosed with metastatic prostate cancer merit additional investigation. Interventions to improve health-related quality of life for metastatic prostate cancer survivors merit additionalinvestigation.

Ixazomib, Pomalidomide and Dexamethasone (IxPd) in Relapsed or Refractory Multiple Myeloma (RRMM) Characterized with High-Risk Cytogenetics. IFM 2014-01

Background. High risk (HR) cytogenetic remains of poor prognosis, particularly in the RRMM setting. IFM 2010-02 studied pomalidomide and dexamethasone (Pd) and demonstrated limited activity, with a median TTP overall at 5.5 months, and at 7.3 vs 2.8 months in HR RRMM with deletion17p and t(4;14) respectively. We hypothesized that addition of Ixazomib (oral proteasome inhibitor) at increased dose density to Pd (IxPd) in HR RRMM would improve convenience, thus adherence to treatment, and in parallel improve efficacy with no increased toxicity compared to addition of a parental proteasome inhibitor (PI). Methods. Eligible patients had a RRMM, in L2, refractory to lenalidomide, but not to pomalidomide and ixazomib. HR was defined by presence of either del(17p) and/or t(4;14) at diagnosis or study entry. Patients received 17 induction cycles, 21-days long, consisting of ixazomib 3mg/day (d 1, 4, 8 and 11), pomalidomide 4mg/day (d1 to 14) and weekly dexamethasone, followed by a maintenance phase of 28-day cycles with ixazomib 4mg/day (d 1, 8 and 15) and pomalidomide 4mg/day (d 1 to 21), until progression. The primary endpoint was time to progression (TTP). The number of patients to be recruited was initially calculated based on an expected doubling of the median TTP obtained in IFM 2010-02 in either 2 HR RRMM population. No statistical comparison can be done across HR groups given that the study was powered to analyze the 2 groups as a whole. Results. Twenty-six patients were enrolled in the study. Median age at inclusion was 72 years (IQ. 67-78), median age at diagnosis was 70 years (IQ. 63-74). Twelve patients presented with del(17p), 9 with t(4;14), and 5 with del(17p) and t(4;14), all patients refractory to lenalidomide. One patient received the study medication but died with no post baseline efficacy assessment. Analyses were done on the remaining 25 patients and safety analysis were performed on all the 26 patients having received at least one dose of the study medication. Twenty-two patients had progressed on study (of whom 12 had died at end of study), 2 patients died before progression, and one patient had no death and no progression. Study treatment was permanently interrupted in 9 patients before progression or death, including 8 during the induction phase. With a median follow-up time of 27 months, the primary end-point median TTP for the efficacy analysis cohort (n=25) was 10.1 months (CI95%. 4.4;13). The median PFS and OS were 9.9 (CI95%. 4.2;12.7) months and 23.7 (CI95%. 12.7;inf) months, respectively. At end of induction, ORR and VGPR rate was (n=15) 60% and (n=7) 28%, CBR (n=18) 72%; at end of study the response rates were the same as end of induction. The median TTP and OS for del(17p) was 9.9 (CI95%. 3.3;inf) and 23.7 (CI95%.14.3;inf ) months, respectively; and was 10.5 (CI95%. 7.9;inf) months and not reached (CI95%. 27.1;inf), in the t(4;14) cohort respectively. Median TTP and OS for combined del(17p) and t(4;14) was 5.5 (CI95%. 2.7;inf) and 11.1 (CI95%. 9.9;inf) months respectively. The most common adverse events (10% occurrence) were neutropenia (n=15), thrombocytopenia (n=12), asthenia (n=10), anemia (n=8), rash (n=5), back pain (n=5), diarrhea (n=5), peripheral oedema (n=4), dizziness (n=3), general physical health deterioration (n=3), muscle spasms (n=3), pyrexia (n=3) and peripheral sensory neuropathy (n=3). There was no added safety concerns related to the combination of Ixazomib and Pomalidomide in the study protocol. Conclusion. The study IFM 2014-01 /IxPd in HR L2 Len refractory RRMM met its primary end point objective since we observed a doubling of the median TTP with the addition of Ixazomib to pomalidomide and dexamethasone in this very hard to treat population characterized with a very poor outcome. This data confirms the importance of proteasome inhibitors in HR RRMM. This phase 2 study needs confirmation in a larger cohort.

Indication and adverse event profiles of denosumab and zoledronic acid: based on U.S. FDA adverse event reporting system (FAERS).

Objective: To investigate adverse events (AEs) associated with denosumab (Dmab) and zoledronic acid (ZA), compare their association strengths, and explore potential applications to provide clinical reference. Methods: We collected data from FAERS from January 2004 to November 2022 and mined AE signals for Dmab and ZA using ROR values. We compared signal intensity for same AEs and investigated off-label use. We also examined their AEs in adjuvant therapy for breast and prostate cancer. Results: 154,735 reports of primary suspect drugs were analyzed in the FAERS database (Dmab: 117,857; ZA: 36,878). Dmab and ZA had 333 and 1,379 AE signals, with 189 overlaps. The AEs of Dmab included death (ROR:3.478), osteonecrosis of jaw (ROR:53.025), back pain (ROR:2.432), tooth disorder (ROR:16.18), bone pain (ROR:6.523). For ZA, the AEs included osteonecrosis (ROR:104.866), death (ROR: 3.645), pain (ROR:3.963), osteonecrosis of jaw (ROR: 91.744), tooth extraction (ROR: 142.143). Among overlap signals, Dmab showed higher strength in exostosis of the jaw (ROR: 182.66 vs. 5.769), atypical fractures (ROR: 55.589 vs. 9.123), and atypical femur fractures (ROR:49.824 vs. 4.968). And ZA exhibited stronger associations in abscess jaw (ROR: 84.119 vs. 11.12), gingival ulceration (ROR: 74.125 vs. 4.827), increased bone formation (ROR: 69.344 vs. 3.218). Additionally, we identified 528 off-label uses for Dmab and 206 for ZA, with Dmab mainly used in prostate cancer (1.04%), breast cancer (1.03%), and arthritis (0.42%), while ZA in breast cancer (3.21%), prostate cancer (2.48%), and neoplasm malignant (0.52%). For Dmab in breast cancer treatment, AEs included death (11.6%), disease progression (3.3%), and neutropenia (2.7%), while for ZA included death (19.8%), emotional disorder (12.9%), osteomyelitis (11.7%). For prostate cancer treatment, Dmab`s AEs were death (8.9%), prostate cancer metastatic (1.6%), renal impairment (1.7%), while ZA`s included death (34.4%), general physical health deterioration (19.9%), and hemoglobin decreased (18.9%). Conclusion: Our analysis of FAERS database provided postmarketing surveillance data and revealed different strengths of reported AE signals between Dmab and ZA in some of their common AEs. It's also worth noting that both drugs have potential off-label applications, which could introduce new AEs. This highlights the necessity for safety monitoring when using Dmab and ZA off-label.

The Effect of Weaning Practices on the Nutritional and Health Status of Saudi Preschool Children.

Background Weaning is a complex procedure that gradually introduces complementary foods to the baby's diet. Solid food should be started between the ages of 6 and 12 months. Weaning is a challenging and crucial stage in an infant's development. Extreme caution should be used during weaning an infant because delaying it can cause issues like sluggish growth, difficulties feeding, malnutrition, and iron deficiency. Objective The current study aims to determine the impact of delayed or early weaning practices on the nutritional status of preschool children in Saudi Arabia. Data was gathered about the time of complementary food introduction, preferred foods in the initial stages, and a child's health compared to those practices. Methodology By convenient sampling, a cross-sectional study was conducted to gather data from 385 parents of Saudi children at preschool age. Questionnaires were shared online. Data were recorded and analyzed on IBM Corp. Released 2012. IBM SPSS Statistics for Windows, Version 21.0. Armonk, NY: IBM Corp. Descriptive analysis and multivariate ANOVA (MANOVA) tests were performed. Results Only 6.23% of the infants were introduced to complimentary food at optimal age (6 to 12 months), whereas 85% were found to have delayed weaning. As per the BMI, 74.4% of preschool children were severely underweight, 53.6% of infants consumed pureed vegetables early during weaning, and 64% of infants were introduced to eggs and cheese within the first year of life. The timing, pattern, and food items of weaning had a significant (p<0.05) impact on general physical health, as 48.8% of children had pale skin, 46.9% felt tired, 36.5% had swollen joints, and 42% complained of itching and an upset stomach. Conclusion This study couldn't define the direction of significance. Further studies can be done on a larger scale where biochemical tests, and screening can be done on children to find if any significant health problem is prevailing, and the direction of association can be defined.