General Quality Research Articles

Significant pre-post effects on a patient-reported outcome measure in inpatient rehabilitation

Abstract Background We conducted a pilot study for the Swiss National Association for Quality Development in Hospitals and Clinics (ANQ) in the inpatient rehabilitation setting. The aim was to assess the suitability of a generic health-related quality of life patient-reported outcome measure (PROM) as an outcome quality indicator for public reporting across all rehabilitation domains on a national level. Methods In a multi-stage expert-based selection process, the PROMIS Global Health 10 was selected for piloting. We collected data from 29 rehabilitation clinics from April to December 2023. Mean T-scores and effect sizes were analysed across different rehabilitation domains. Patients’ need for assistance in completing the questionnaire was also assessed. Results A dataset of 2261 cases yielded a cleaned sample of 2083, with 1217 complete cases. Mean T-scores for physical health (PHS) and mental health (MHS) significantly differed (p < 0.001) at admission and discharge across all rehabilitation domains. The largest effects were observed in PHS for pulmonary (38.9(7.3); 46.0(7.6); dz = 0.95) and cardiologic rehabilitation (41.7(7.4); 47.9(7.2); dz = 0.85), and in MHS for internal medicine (44.1(6.9); 49.1(5.6); dz = 0.80) and psychosomatic rehabilitation (36.0(7.2); 45.2(8.2); dz = 1.19), while the smallest effects were noted in PHS for paraplegia (36.3(7.2); 39.8(7.2); dz = 0.50) and in MHS for the musculoskeletal rehabilitation domain (46.2(7.9); 48.7(7.4); dz = 0.33). Of all complete cases, 40.5% needed assistance in filling in the PROM and support needs were distributed unequally across rehabilitation domains, ranging from 10.0% in psychosomatic to 70.3% in geriatric rehabilitation. Conclusions The study presents a nuanced understanding of HRQOL across various rehabilitation domains, with notable effects observed across all domains, alongside significant assistance needs. Key messages • PROMIS-GH10 shows significant pre-post effects on physical and mental health in Swiss inpatient rehabilitation, with notable effects observed across all domains. • Observable barriers in implementation are evident due to substantial assistance requirements.

Promoting active ageing: The positive impact of older people’s participation in Urban Gardens

Abstract Background The socio-health and economic consequences of the progressive population ageing constitute a global challenge for public health, which is committed to the promotion of active and healthy ageing as a strategy to mitigate these consequences. The European project U-GARDEN has evaluated from a comprehensive and innovative approach the impact of urban gardens on the promotion of active ageing through the participation of older people in urban agriculture. Methods A qualitative methodology was designed and implemented in order to analyse the information provided by people over 65 years of age, who actively participated in urban gardens, from a personal and subjective perspective through semi-structured in-depth interviews. The benefits obtained from participation in urban gardens were analysed, considering the different dimensions that make up the paradigm of active ageing: physical, psychological, economic, health, behavioural and personal impact. A total of 20 interviews were used to reach the saturation point. Results Qualitative analysis showed multiple benefits of active and healthy aging. Participants reported increased physical activity and psychosocial improvements such as higher personal satisfaction, reduced stress, and enhanced self-esteem, strengthening community connections and fostering a sense of belonging. Economically, they reported savings on food costs and increased food security. Overall, respondents noted improvements in general health and quality of life, highlighting urban gardening as valuable for well-being and social-economic integration. Conclusions The findings reported in the framework of the U-GARDEN project support the importance of implementing innovative strategies that encourage participation in urban gardens as a tool to improve the overall wellbeing and health of older people, effectively addressing some of the main challenges of ageing such as loneliness unwanted frailty and disability. Key messages • The U-GARDEN project is an example of good practice in the use of urban gardens as a platform for promoting active and healthy ageing. • The promotion of green spaces through the establishment of urban gardens should be considered by health and political authorities for their ability to promote the general well-being of society.

Assessment of quality of life using EuroQol 5-Dimension questionnaire level sum score in patients with HFrEF, HFmrEF, and HFpEF: a patient-level meta-analysis of DAPA-HF and DELIVER

Abstract Background The impact of SGLT2 inhibitors on generic quality of life in heart failure (HF) has not been evaluated. Purpose To quantify individual dimension scores and the Level Sum Score of the EQ-5D-5L (EQ-5D-LSS) in patients with HFrEF and HFmrEF/HFpEF, the association between these scores and outcomes, and the impact of treatment with dapagliflozin on these scores. Methods The 5 dimensions of the descriptive section of the EQ-5D-5L include mobility ("walking around"), self-care ("washing or dressing self"), usual activities ("e.g., work, study, housework, family or leisure activities"), pain/discomfort ("pain or discomfort"), and anxiety/depression ("anxious or depressed"). Each dimension is divided into 5 levels (1-5) i.e., no problem, slight problem, moderate problem, severe problem, and extreme problem (cannot do activity/extreme symptom). All dimensions and severity levels contribute equally when calculating the LSS. The individual dimension scores and the LSS were analyzed in patients with HFrEF and HFmrEF/HFpEF in the DAPA-HF and DELIVER trials, which compared dapagliflozin to placebo. Results Scores varied markedly by question with 37/30/33% of patients reporting no, a slight, or a moderate or greater problem for mobility; 67/20/13% for self-care; 40/33/27% for usual activities; 45/32/23% for pain/discomfort; and 57/27/16% for anxiety/depression. Compared to lower (better) LSS, patients with higher (worse) LSS were more often female, had more comorbidities, and had worse HF status. Compared to patients free from any problem across all dimensions (i.e. LSS of 5), the hazard ratios (95% CI) for time to first cardiovascular death or worsening HF were 1.27 (1.10-1.47), 1.70 (1.46-1.98), and 2.31 (1.88-2.85) in those with LSSs of 6-10, 11-15, 16-25 points, respectively. Patients randomized to dapagliflozin experienced greater improvement and less worsening across all EQ-5D-5L dimensions except pain/discomfort (Figure). Conclusions The EQ-5D-5L individual dimension questions revealed problems not often associated with (pain) or quantified in (anxiety/depression) HF and demonstrated the marked limitation of ordinary activities experienced by many patients with HF. Most EQ-5D-5L domain questions, including anxiety/depression, improved with dapagliflozin. The LSS, incorporating these domains was associated with clinical outcomes.

Perinatal loss: attachment, grief symptoms and women’s quality of life

ABSTRACT Aims/Background Perinatal loss may cause intense distress even psychiatric issues, affecting the woman’s quality of life. Attachment may provide a useful perspective in understanding the outcomes of the mourning process. Thus, the objectives of the present study were to evaluate perinatal grief symptoms and the psychological and general quality of life among 137 Italian women (mean age 36,9. ± 6,88 years old) in relation to attachment, specifically measured through parental care and control. Design/Methods About 79.6% of the participants had miscarriages and 20.4% had stillbirths. About 45.3% were childless. The women completed the Parental Bonding Instrument, the Perinatal Grief Scale and the Psychosocial General Well-Being Index online most frequently between 3 and 6 months (56.2%) after the perinatal loss. Results All the study participants showed intense grief and severe grief reactions to loss. Moreover, women experiencing optimal bonding towards their own mothers had a more positive effect on perinatal grief and psychological and general quality of life. Conclusions Attachment-based, tailored interventions for women who have experienced perinatal loss should improve their psychological and overall quality of life.

Assessment of Climate Change Impacts on Hydrology Using an Integrated Water Quality Index

Traditional Water Quality Indices (WQIs) often fail to capture the significant impact of flow velocity on water quality, especially under varying hydrological conditions. In this study, an Integrated Water Quality Index (IWQI) was developed by combining water quality parameters and flow rate, providing a more comprehensive assessment under various flow conditions. Compared to traditional indices, the IWQI showed slightly lower correlations in individual parameter performance, but it performed well in evaluating water quality changes associated with flow variations. Parameters such as Total Phosphorus (TP), Total Coliforms (TC), and Fecal Coliforms (FC), which are prevalent pollutants in the Cheongmi River, significantly influenced IWQI scores. River water quality was evaluated using input data simulated under a climate change scenario. When precipitation was abundant, the IWQI score remained relatively stable even with reduced flow rates. However, during periods of insufficient rainfall, water quality deteriorated sharply. While general water quality parameters exhibited approximately a 10% change as flow decreased, TC and FC showed rapid deterioration, with change rates ranging from 20% to 60%. These findings underscore the importance of managing TC and FC, particularly when insufficient rainfall is predicted, as they are major sources of pollution.

Determining the Severity of Benign Urologic Health States in Men Using Utilities Measures

ObjectivesTo assess a population level perceived health status of common reconstructive urologic conditions using health utilities. MethodsHealth utilities are generic quality of life measures that can help describe overall health status and can quantitatively compare different disease states and the perceived benefits of various interventions. An a priori determined, representative sample of adult men were recruited by Qualtrics™ to review standardized scenarios describing typical patients with reconstructive urologic conditions, surgeries to treat conditions, and control conditions (e.g. blindness, osteoarthritis). Condition-specific health status was measured using four tools: visual analog scale, standard gamble, time-trade off and willingness-to-pay and reported in Quality-adjusted Life Years (QALY; range 0.0 (death) to 1.0 (perfect health)). ResultsWe analyzed 562 completed surveys from condition-naive participants. Condition-specific health status ranged from a mean of 0.52 QALY to 0.66 QALY, with all reconstructive conditions perceived to be worse than osteoarthritis and monocular blindness (QALY 0.68). Health status was lowest for adult acquired buried penis (0.52 QALY) and pelvic radiation disease (0.53 QALY), comparable to binocular blindness (QALY 0.52). Treatment of erectile dysfunction with inflatable penile prosthesis (∆QALY +0.02; p<0.001) and stress urinary incontinence with artificial urinary sphincter (∆QALY +0.04; p<0.001) offered only nominal perceived gain in health status. ConclusionsHealth utilities may improve the ability to discriminate between heterogeneous reconstructive urologic disease states. For non-oncologic disease states in which mortality is not measured, health utilities could improve the ability to measure societal impact and justification for clinical and research investment.

A functional exercise program improves pain and health related quality of life in patients with fibromyalgia: a randomized controlled trial

Background/objectiveFibromyalgia is a non-inflammatory syndrome characterized by generalized muscle pain, with other symptoms. Numerous forms of physical training for this population have been studied through high-quality randomized clinical trials involving strength, flexibility, aerobic conditioning and multicomponent exercise interventions. This research evaluated the effectiveness of a functional exercise program at reducing pain, improving functional capacity, increasing muscle strength as well as improving flexibility, balance and quality of life in individuals with fibromyalgia.MethodsEighty-two women with fibromyalgia were randomized into two groups. The functional exercise group performed functional exercises in 45-minute sessions twice per week for 14 weeks. The stretching exercise group performed flexibility exercises with the same duration and frequency. Outcome measures were: visual analog scale for widespread pain; Fibromyalgia Impact Questionnaire for health-related quality of life; Timed Up and Go test for functional performance; one-repetition maximum for muscle strength, Sit and Reach test on Wells bench for flexibility; Berg Balance Scale for balance; SF-36 for general quality of life.ResultsAfter the intervention, the functional exercise group had a statistically significant reduction in pain (interaction p = 0.002), and improvement in health-related quality of life measured by the Fibromyalgia Impact Questionnaire (interaction p < 0.001) and in general health state domain of SF-36 (interaction p = 0.043) compared to the stretching exercise group. No significant differences between groups were found regarding improvements in functional capacity, muscle strength, flexibility or balance.ConclusionFunctional exercise training was effective at reducing pain and improving quality of life in patients with fibromyalgia compared to stretching exercises.Trial registrationClinicalTrials.gov Identifier: NCT03682588 First prospectively registered in March 2018.

Role of psychooncology in cancer treatment – a literature review

Introduction and objective. Receiving a cancer diagnosis can lead to significant mental distress, highlighting the necessity for comprehensive medical care that includes psychological support. Effective psycho-oncological therapy can help patients find fulfillment regardless of their prognosis, while also improving overall outcomes and treatment adherence. This article aims to review the medical literature on the mental health challenges faced by cancer patients and to explore potential treatment modalities. Review methods. Implementing Google Scholar and PubMed, a literature analysis was conducted, with particular attention paid to terms like "psychooncology," "anxiety," "depression," "cancer," "grief," and "PTSD." The period of consideration for articles was from 2017 to 2024. Brief description of the state of knowledge. Grief, anxiety, PTSD, despair, and other mental health problems can arise after receiving a cancer diagnosis. In order to improve treatment adherence and survival rates, psychological well-being must be addressed. Empirical evidence indicates that psychological disorders can hinder adherence to therapy and elevate the risk of death from cancer. Furthermore, as families often endure significant stress throughout the disease, psychological care is beneficial to both patients and their relatives. It is possible to enhance adherence and reduce symptoms by using an integrated strategy that takes into consideration both physical and mental health. Conclusions. An essential part of holistic cancer care is psycho-oncology, which enhances patients' general health and quality of life. Psycho-oncological therapy must be incorporated into standard cancer care in order to improve treatment outcomes and assist patients in overcoming their condition.

Development and Validation of Yoga Program for Patients with Chronic Kidney Disease

Chronic kidney disease (CKD) is a widespread health issue impacting millions globally. Recognizing the potential benefits of yoga in enhancing physical and mental well-being, this research aims to develop and validate a yoga module tailored for CKD patients, with a specific focus on improving their general health. The yoga module was meticulously crafted through an extensive review of traditional and contemporary literature, incorporating postures, breathing techniques and meditation practices deemed safe and beneficial for CKD patients. Content validity was established through input yoga experts with over 7 years of experience. The study spanned from January 2020 to December 2021. The final version of the yoga module retained 83.33% of the proposed yoga techniques, incorporating modifications suggested by experts. The content validity index for the entire yoga module averaged 0.83. This work establishes the viability, validity and practicality of a yoga module designed for CKD patients. With 35 out of 42 items retained, the module exhibited significant health improvements after 12 weeks of practice. The findings position yoga therapy as a potentially effective complementary treatment for CKD patients, offering improvements in general health and quality of life and potentially slowing disease progression.

Quality Competency of Teachers in the Developing Quality Culture in Public Secondary Schools in a Developing Country

Quality culture has been mentioned as a tool to help improve quality standards and promote the development of educational institutions. Recently, quality culture has begun to be recognized as an interesting research trend in Vietnam, mainly focusing on higher education. Several studies have applied models/types of building and developing quality culture to educational activities and institutions, but not in the national school system. The purpose of this study is to understand the quality capacity of administrators and teachers of public secondary schools in the Southeast region, of Vietnam through the aspect of quality awareness during education. General education implements educational quality accreditation activities. The research uses quantitative research methods combined with qualitative research methods. The survey sample was conveniently selected randomly, information was collected by questionnaire with 749 managers and 3831 teachers, and by interviews with 22 managers and 40 teachers. Quantitative data were calculated by Cronbach's Alpha to eliminate inappropriate variables. Descriptive statistics calculate percentages, mean values, and standard deviations, and inferential statistics test differences using ANOVA and t-test with 2 independent samples. Data analysis results show differences in quality awareness between the three provinces and between managers and teachers, and the results also show that managers and teachers do not have positive views. teacher on educational quality accreditation activities in secondary schools through two contents "Education quality accreditation takes time and resources" and "Education quality accreditation increases achievement problems in education”. Therefore, the study recommends that leaders at all levels research and promulgate quality policies and create conditions for secondary schools to develop quality; Secondary schools build a set of tools and principles for forming and developing a quality culture to improve quality capacity and develop internal quality resources.

Determinants of quality of life decrease in family caregivers of care-dependent patients: a longitudinal study.

Family caregivers of care-dependent patients experience a decline in their Quality of Life (QoL). However, the determinants contributing to this decrease in QoL are still not fully understood. Therefore, this study aimed to estimate prospectively the determinants contributing to decreased QoL among family caregivers of care-dependent patients. This longitudinal study involved 135 family caregivers in Brazil. Data were collected at baseline from October 2016 to August 2017, and at follow-up from December 2021 to July 2022. During both periods, we administered a questionnaire that covered sociodemographic, health, and lifestyle characteristics of the participants; the Barthel Index to assess the dependency level of the patients; and the WHOQOL-bref to assess the caregivers' QoL. Both caregivers and care-dependent patients were more frequently elderly (44.4% versus 74.6%), female (79.3% versus 61.5%), and had non-communicable disease (60.0% versus 94.3%) at baseline. Most patients experienced a worsening in their level of dependency (59.8%), while over a third of family caregivers (34.8%) reported a decline in their General Quality of Life Index. Eight determinants of decreased QoL were identified: four protective factors (religious faith, physical activity, sharing caregiving responsibilities, and sufficient sleep) and four risk factors (patient hospitalization in the past year, patient increased care dependency, older family caregiver age, and longer caregiving duration). Many factors influencing caregiver QoL are modifiable through intervention, underscoring the need for public policies to support family caregivers. Healthcare professionals can play a vital role in promoting protective factors and addressing risk factors to enhance caregiver QoL.

DESIGN AND DEVELOPMENT OF A DAILY BOOK FOR PROLANIS PATIENTS TO INCREASE KNOWLEDGE AND MOTIVATION IN MAINTAINING DENTAL AND ORAL HEALTH

Background: The prevalence of hypertension has increased by 8.3%. The measurement results for the population aged ? 18 years in 2013 were 25.8% and in 2018 it was 34.1%. As much as 8.8% is the prevalence of hypertension in all provinces in Indonesia1. Oral health plays an important role in achieving general health and quality of life in old age. Poor oral conditions disrupt the function and activities of the oral cavity. Elderly people with a history of hypertension and Type 2 DM often seek treatment with loose or cavities in their teeth. Oral hygiene plays an important role in cases of caries in individuals, especially in the elderly who do not maintain oral and dental hygiene. This program aims to ensure that chronic disease sufferers can achieve an optimal quality of life with cost-effective and efficient health services so as to prevent disease complications. One effort to improve prolanis' quality of life is to maintain healthy teeth and mouth. Objective: Create and develop a dental and oral health daily book for prolanis sufferers. The research method: is R &amp; D research and pre-experiment with a one group pretest posttest design to measure knowledge and motivation in prolanis patients. Sampling using purposive sampling technique on prolanis patients amounted to 34 people (Small Group) and 85 people (Big Group). Results: The average value of expert va;idation of 90,55 shows that the interpretation is very high, which means that the media is suitable foe use. Wilxocon test shows an increase in knowledge of prolanis patients with significance (p-value 0.000). Conclusion: Promotional and Preventive Daily Books are effective in increasing knowledge and motivation in Prolanis patients.

Quality of Life Effects of Renal Artery Stenting Versus Medical Therapy for Atherosclerotic Renal-Artery Stenosis: Results from the Randomized CORAL Trial.

Renal-artery stenosis can be associated with difficult to control hypertension, although renal-artery stenting has not been shown to improve clinical outcomes. Alternative antihypertensive medications could potentially result in quality of life benefits with renal-artery stenting. We performed a pre-specified quality of life sub-study of the CORAL trial-multicenter, randomized, open-label trial of renal-artery stenting versus medical therapy in patients with atherosclerotic renal-artery stenosis. Longitudinal growth curve models were used to compare the Physical Symptoms Distress Index (PSDI), SF-36, and EQ-5D scores over time between treatment groups. We also sought to validate the approach of assessing quality of life in hypertension studies. Among 906 patients (mean age 69.2±9.1years, 49.7% men), symptom frequency and distress due to side effects from antihypertensive medications changed minimally over time, with no significant differences between treatment groups. There were also no clinically significant differences between treatment groups for the SF-36 and its subscales or the EQ-5D. In internal validation of the quality of life measures, the PSDI correlated well with number/type of antihypertensive medications, and generic health status measures correlated with late clinical events. In a large, multicenter, randomized clinical trial, we found no significant benefit of routine renal-artery stenting over medical management for the treatment of atherosclerotic renal-artery stenosis in terms of disease-specific or generic quality of life measures. As these quality of life measures are important to patients and are associated with medication compliance, future studies of antihypertensive treatments should consider including these quality of life measures as secondary outcomes. Trial registration: ClinicalTrials.gov: NCT00081731.

Preservative Effect of Alga Flour Extract on Frozen Horse Mackerel (Trachurus trachurus) Lipids.

The aim of this study was to investigate the preservative properties of alga Gelidium sp. flour when included in the glazing medium employed for the frozen storage (-18 °C) of horse mackerel (Trachurus trachurus). Different concentrations (low, medium, and high) of an aqueous extract were tested and compared to a control water-glazing condition. Quality changes (lipid oxidation and hydrolysis, fatty acid (FA) profile, and trimethylamine (TMA) formation) were determined after 3- and 6-month storage periods. A general quality loss (lipid oxidation with hydrolysis development and TMA formation) with the frozen storage period was detected in all samples. The presence of an alga flour (AF) extract in the glazing medium led to a lower (p < 0.05) TBARS and fluorescent compound formation and to higher (p < 0.05) polyene values in frozen fish. Furthermore, a preserving effect on free fatty acids was detected in AF-treated fish. On the contrary, the AF-glazing treatment did not affect (p > 0.05) the TMA formation and the total n3/total n6 FA ratio. In general, preservative effects were found to be higher in frozen fish corresponding to the medium concentration tested. Current results show the potential of Gelidium sp. flour as a natural source of preservative hydrophilic compounds for the quality enhancement of frozen horse mackerel.

Effectiveness of the active communication education program in improving the general quality of life of older adults who use hearing aids: a randomized clinical trial

BackgroundHearing loss in older adults affects general, generic health-related and disease-specific quality of life (QoL). The conventional strategy to address it is through hearing aids, which have been shown to improve disease-specific QoL. However, the long-term results regarding general quality of life are unknown, and communication problems and stigma associated with hearing loss may persist. An effective intervention strategy to address these problems is group communication programs, most notably Active Communication Education (ACE). This program has been shown to increase communication strategies and reduce communication activity limitations and participation restrictions. These precedents allow us to hypothesize that this program could improve general QoL.MethodsA randomized clinical trial was conducted on 114 older adult hearing aid users. Fifty-four subjects composed the intervention group that received the ACE program, while 60 subjects composed the control group that received an informational-lectures type intervention. The WHOQOL-BREF questionnaire was used to measure general QoL. Measurements were taken before and right after the intervention, with follow-ups at 6 and 12 months. Multilevel linear mixed models were estimated, considering the WHOQOL-BREF dimension scores and total score as the outcomes, and an interaction term between time since intervention and group as the predictor. Within- and between-group comparisons were made.ResultsCompared to the baseline time-point, the ACE group showed significant improvements right after the intervention, and at the 6-month and 12-month follow-ups for the dimensions of psychological health, social relationships, environment, and total score. Compared to the control group, the ACE group exhibited significantly greater improvements in the social dimension at all postintervention assessments, as well as in the environment dimension and total score at the 12-month follow-up.ConclusionsThe ACE program improved general QoL in terms of social relationships and environment dimensions, which lasted up to 12 months after the intervention. Therefore, ACE is positioned as an effective complement for HA users, enhancing and delivering new benefits related to broader aspects of QoL not necessarily tied to health.Trial registrationISRCTN54021189 (retrospectively registered on 18/07/2023).

Heatwave events and concurrent ozone concentrations between 2006 and 2022 at two sites in southern and northern Spain.

Hotter-than-usual days are becoming more common, such that heat waves are expected to increase in intensity, frequency, duration, and spatial extent in Spain. Within this framework, this paper looks at the combined effects of extreme temperatures and air pollution in two cities in Spain, Córdoba and Valladolid, over the period 2006-2022. Synoptic patterns and air mass movement were analysed during the eleven coincident heat waves at both locations in order to study what impact orography and local meteorology have on ozone concentrations. Weak flow conditions were the most frequent synoptic pattern in the Iberian Peninsula during heat waves. Moreover, west and local circulations characterised the main air trajectories at low levels (500m agl), while southwest maritime advections and African air mass transport were more frequent at higher levels (1500 and 3000m agl) in Córdoba and Valladolid, respectively. On average, maximum ozone values were higher in Córdoba (105.1µgm-3) than in Valladolid (80µgm-3) and were strongly correlated with extreme temperatures at both locations (r up to 0.8, p-value < 0.05). Mean temperature in Córdoba was 31.9°C, with the maximum value reaching 43.7°C, while temperatures in Valladolid were lower (28.3°C and 37.3°C, respectively). Calculation and assessment of some indices helped to understand the impact of extreme events. Caution actions based on the Heat Index characterised heat wave periods. Moderate risk was the general Air Quality Health Index feature recorded and reached a very high risk of unhealthy air quality in the June 2022 event in Córdoba.

Sociodemographic factors associated with the level of citizen insecurity in the Peruvian population

Introduction: Citizen insecurity is a complex, multidimensional and multi-causal social problem, defined as the spaces where people feel insecure mainly due to organized crime in all nations that suffer from it. Objective: To analyzes the sociodemographic factors associated with public insecurity in a Peruvian population. Methodology: The research employed a non-experimental, quantitative design with a descriptive and cross-sectional approach. A total of 11,116, citizens participated, ranging from 18 to 85 years old (young adults, adults, and the elderly), of both sexes, and with any occupation, education level, and marital status. The study employed purposive non-probability sampling to select the participants. Results: More than 50% of the population feels unsafe, in public and private spaces. All analyzed sociodemographic variables (p &lt; 0.05), showing distinctions in the perception of citizen insecurity based on age, gender, marital status, occupation, area of residence, and education level. It was determined that young, single students, who had not experienced a criminal event and reside in urban areas, regardless of gender, perceive a greater sense of insecurity. Contribution: The study is relevant due to the generality of the results in a significant sample, demonstrating that the study contributes to understanding how various elements of the socioeconomic and demographic context can influence the way in which individuals perceive insecurity in their communities, likewise, the perception of citizen insecurity directly affects the general well-being and quality of life of residents, influencing their behaviors and attitudes towards coexistence and public policies; which will help implement more effective actions in the sector to reduce crime rates.

Sleep quality and emotional eating in college students: a moderated mediation model of depression and physical activity levels

BackgroundEmotional eating is a prevalent maladaptive coping mechanism among college students, which is associated with mental health and sleep concerns. Though previous studies have established a link between sleep quality, depression and emotional eating, most of these have been in Western populations. In addition, few existing studies have taken physical activities into account, and the underlying mechanisms between these four variables remain to be further studied. Therefore, our study investigated the mediating role of depression and the moderating role of physical activity levels in the relationship between sleep quality and emotional eating among Chinese college students. Our study can help to understand the characteristics of this population and provide guidance on the intervention pathways for emotional eating.MethodsA convenience sampling method was employed to select eligible participants for investigation. The General Information Questionnaire, the Pittsburgh Sleep Quality Index Scale, the Patient Health Questionnaire, the Dutch Eating Behavior Scale, and the International Physical Activity Questionnaire were employed to measure the general condition, sleep quality, depression, emotional eating, and physical activity. A total of 813 college students (Mage = 19.14, SD = 1.12, range = 17 ~ 25 years old, 71.1% females) completed the survey. The moderated mediation analysis was carried out using the SPSS PROCESS macro.ResultsAfter controlling for sex, age, and body mass index (BMI), sleep quality positively predicted emotional eating. Depression primarily mediated the association between them. Besides, physical activity levels moderated the relationship between sleep quality and emotional eating via depression. Depression significantly predicted emotional eating among students with low levels of physical activity; however, it was not significant among students with moderate or high levels of physical activity.ConclusionsThe role of depression mediates the link between sleep quality and emotional eating. Regular exercise can ease the symptoms of emotional eating through depression. This implies the importance of offering more sleep hygiene education and physical activity in university settings.

Gender differences in cardiac rehabilitation participation and outcomes: an 18-year retrospective study in Iran

BackgroundCardiac rehabilitation (CR) is crucial for addressing cardiovascular diseases globally, with a specific emphasis on gender differences. Despite its demonstrated benefits for women, there's limited acceptance globally, especially in low- and middle-income countries. The program aims to optimize risk factors and improve overall patient well-being.MethodsA cohort study was performed on those who were candidates for CR programs during 2001–2019. Assessments were performed within one week before and one week after the 8-week CR program. Age, sex, smoking status, clinical data, resting systolic and diastolic blood pressure (SBP and DBP, respectively), echocardiography and laboratory data were obtained. Functional capacity was evaluated using the international physical activity questionnaire, and a treadmill exercise test. Anxiety, depression, general quality of life (QoL), and health-related QoL were selected for psychological status. Then statistical analysis was performed on data.ResultIn this study, the number of male patients was 1526 (73.69%). The average age of patients in the female group was higher than that of males (58.66 ± 9.08 vs. 56.18 ± 9.94), according to the crude model results, the changes in emotional, social and physical scores were significant (P-value:0.028, 0.018, 0.030), as well as the differences in Mets and smoking were significant (P-value for both < 0.001) in the adjusted model, the emotional variables and Mets changes were significant in two groups, so that the emotional score in the female group was higher than that of the male group, and the female Mets score was significantly lower than that of the male group.ConclusionThe CR program can improve cardiovascular outcomes, but the greatest impact was on the quality of life, patient METs and smoking behavers. Also the number of female participants in the CR program was less than the number of males.

Fluoxetine promotes the recovery of dysphagia and improves nutritional status and neurotrophic status in dysphagia patients after acute ischemic stroke.

This study aimed to investigate the effects of fluoxetine on swallowing function, neurotrophic factors, and psychological status in patients with dysphagia after acute ischemic stroke (AIS). A total of 118 patients with dysphagia after AIS who were diagnosed and treated in our hospital from July 2020 to March 2022 were selected as the study objects with 59 cases in each group. Patients in the control group underwent routine treatment and swallowing rehabilitation without fluoxetine. Patients in the study group received routine treatment, swallowing rehabilitation, and fluoxetine treatment. The quality of life was compared according to the Generic Quality of Life Inventory-74 (CQOLI-74). Patients were followed for 90 days, and the grades were compared with the Modified Rankin Scale (mRS). The total effective rate of the study group was 84.75%, which was higher than that of the control group with 62.71% (χ2 = 7.394, P < 0.05). The life quality scores of the two groups were both dramatically elevated compared to those before the treatment, and the study group had a sensibly higher life quality score than the control group (P < 0.05). The proportion of grade 4~5 in the study group was significantly lower than that in the control group (χ2 = 492, P < 0.05). The total incidence of adverse reactions in the control group was 5.08% (3/59), which was significantly lower than that in the study group with 11.86% (7/59) (χ2 = 1.748, P = 0.186). Fluoxetine has a significant effect on the treatment of dysphagia after AIS by enhancing the recovery of dysphagia and promoting the recovery of neurological function.