Health Status Scores Research Articles

Do Migrant Residents Really Achieve Health Equity by Obtaining Urban Hukou? A Comparative Study on Health Service Utilization and Urbanization in Central China

IntroductionWith more than 120 million rural-to-urban migrants, urbanization of the rural population requires deeply exploration in China.ObjectiveThis study focused on settled citizens who obtained urban Hukou (household registration) during urbanization and investigated their perceptions of health services in China.MethodA cross-sectional comparison study with an original, closed questionnaire was conducted in two major cities of Hubei, central China, covering health status and both the satisfaction with and utilization of health services. In total, 863 residents with urban Hukou participated in this study; migrants formed the study group and original city residents formed the control group. Propensity score matching (PSM) was used to reduce choice bias in the analysis steps. Besides basic description of the data, ordinary least squares regression (OLS regression) was used to discover the relationship between basic demographic indicators and health expenditure.ResultsPSM yielded 290 effective pairs for analysis. The results indicated an improvement in health status for migrant residents (study group) with a higher average score of self-reported health status and lower prevalence of chronic diseases than the control group. These scores were also better than the standard urban level in central China. The study group showed a higher clinic visit utility (69.63%), lower hospitalization utility (8.28%), less convenience of health service utility, and lower health expenditure than the control group. For the study group, the biggest difference was observed in satisfaction with health service costs, which was the least improved aspect after they obtained urban Hukou. The regression results demonstrated that age, family size, living expenditures, and marital status impacted health costs in the overall model and the influences of these factors differed between the study and control groups.ConclusionsObtaining urban Hukou helps migrant residents to meet their health service needs and receive equal access to health services. However, after obtaining urban Hukou, migrants also face great pressure in terms of health consumption. This study therefore offers guidance on the next steps for progressing China's urbanization.

Assessment of Psychosocial Effect and Quality of Life in Breast Cancer Patients

Psychological factors and quality of life influence the breast cancer patient (Khan et al., 2010). The aim of this retrospective study is to evaluate the breast cancer patients’ self-esteem, perceived social support, and quality of life. Sixty patients were taken in this, whose age was between twenty to sixty years. A self-esteem scale, social support questionnaire, and EORTC quality of life questionnaires were used to assess breast cancer patients. All statistical analyzes were completed via SPSS 16.0. The majority of the patients (93%) had high self-esteem and social support (90%). There was a significant association was found between self-esteem and social support (.001). Global health status and functional scores were high. Patients had increased complaints of fatigue, systemic therapy side-effect, and arm symptoms. Participants had suffered increased financial difficulties. It was observed that the sexual activity and sexual enjoyment of the participants had decreased. Breast cancer patients’ self-esteem and social support were high. The overall quality of life in breast cancer patients appeared to be good. The participants had felt more tired, difficulty lifting their arms. Therefore, Higher Self- esteem and social support were strongly associated with a good overall quality of life.

Current Status of Fear of Disease Progression in Patients with Advanced Cancer and Usefulness of Dignity Therapy Intervention.

With changes in lifestyle and an increase in bad health habits, cancer has become a noncommunicable and frequently occurring disease that poses a serious threat to human life. Cancer is associated with high rates of morbidity and mortality worldwide. As a major negative life event, advanced malignancies lead to strong mood swings in most patients. Furthermore, various internal and external factors can have a huge impact on patients' physical and mental health and put them in a stressful situation, causing a series of psychological stress responses. To explore the degree of fear of disease progression in patients with advanced cancer and the usefulness of dignity therapy. Overall, 120 patients with advanced malignant tumors admitted to Shijiazhuang No. 1 hospital between January 2019 and January 2020 were enrolled. The selected patients were divided into the test and control groups (60 people per group) using a random number table. All patients received basic treatment. Patients in the trial group also received dignity therapy. The intervention period was 4 weeks. Simplified scales were used for assessing disease progression (FoP-Q-SF) and quality of life (QLQ-C30) before and after the intervention, and the scores were compared between the groups. After the intervention, the degree of fear in the experimental group was lower than that of the control group. Cognitive function, emotional function, and the scores of the overall health status of the experimental group were higher than those of the control group. Additionally, the scores of fatigue, insomnia, loss of appetite, and diarrhea in the experimental group were lower than those of the control group (P < 0.05). The social support level scale scores, depression scores, hospital anxiety and depression scale scores, and patient dignity inventory scores of the experimental group were lower than those of the control group (P < 0.05). Patients with advanced malignant tumors have fear, anxiety, and depression related to disease progression. Dignity therapy is useful for improving the patients' quality of life, increasing dignity, and enhancing social support.

A comparative study on short-term outcomes and quality of life for gastric cancer patients between totally laparoscopic total gastrectomy using an endoscopic linear stapler and laparoscopic-assisted total gastrectomy using a circular stapler

Objective: To explore the differences of short-term outcomes and quality of life (QoL) for gastric cancer patients between totally laparoscopic total gastrectomy using an endoscopic linear stapler and laparoscopic-assisted total gastrectomy using a circular stapler. Methods: A retrospective cohort study was conducted. Clinicopathological data of patients with stage I to III gastric adenocarcinoma who underwent laparoscopic total gastrectomy from January 2017 to January 2020 were retrospectively collected. Those who were ≥80 years old, had serious complications that could affect the quality of life, underwent multi-organ resections, palliative surgery, emergency surgery due to gastrointestinal perforation, obstruction, bleeding, died or lost to follow-up within 1 year after surgery were excluded. A total of 130 patients were enrolled and divided into circular stapler group (CS group, 77 cases) and linear stapler group (LS group, 53 cases) according to the surgical method. The differences of age, gender, body mass index, number of comorbidities, history of abdominal surgery, ASA, tumor location, degree of differentiation, tumor length, tumor T stage, tumor N stage, tumor pathological stage and preoperative quality of life between the two groups were not statistically significant (all P>0.05). The observation indicators: (1) Surgery and postoperative conditions. (2) Postoperative complications: Any adverse conditions that require conservative treatment or surgical intervention after surgery were defined as postoperative complications, of which, complications occurring within 30 days after surgery were defined as early complications; complications occurring within 30 days to 1 year after surgery were defined as late complications. (3) Postoperative quality of life was assessed by the quality of life core scale (QLQ-C30) and gastric cancer specific module scale (QLQ-STO22). The higher the scores of functional scales and global health status, the better the corresponding quality of life. The higher the scores of symptoms scales, the worse the corresponding quality of life. Results: (1) Surgery and postoperative conditions: Compared with the CS group, the LS group presented less intraoperative blood loss [50.0 (50.0-100.0) ml vs. 100.0 (100.0-100.0) ml, Z=-3.111, P=0.002] and earlier time to flatus [(3.1±0.8) days vs. (3.5±1.1) days, t=-2.490, P=0.014]. However, there were no statistically significant differences between two groups of patients in terms of operation time, time to start a liquid diet and postoperative hospital stay (all P>0.05). (2) Postoperative complications: The early complication rates of the CS group and the LS group were 22.1% (17/77) and 18.9% (10/53), respectively, while the late complication rate were 18.2% (14/77) and 15.1% (8/53), respectively, whose differences were not statistically significant (all P>0.05). (3) Postoperative quality of life: After 1-year follow-up, 7 (5.4%) patients were lost, including 5 in CS group and 2 in LS group. One year after operation, the QLQ-C30 scale showed that the score of financial difficulty of the LS group was significantly higher than that of the CS group [33.3 (0 to 33.3) vs.0 (0 to 33.3), Z=-1.972, P=0.049] with statistically significant difference, and there were no statistically significant differences in the scores of other functional fields and symptom fields between the two groups (all P>0.05). The QLQ-STO22 scale showed that the scores of dysphagia [0 (0 to 5.6) vs. 0 (0 to 11.1), Z=-2.094, P=0.036] and eating restriction were significantly lower [0 (0 to 4.2) vs. 0 (0 to 8.3), Z=-2.011, P=0.044] in patients of the LS group than those of the CS group. There were no significant differences in scores of other symptoms between two groups (all P>0.05). Conclusions: Compared with the circular stapler, the esophagojejunostomy with linear stapler for gastric cancer patients can reduce intraoperative blood loss, shorten the time to flatus after operation, alleviate the symptoms of dysphagia and eating restriction but increase the economic burden to a certain degree.

Use of perioperative treatment (tx) among patients (pts) undergoing radical resection (RR) for muscle-invasive urothelial cancer (MIUC) in France, Germany, Italy, Spain, the United Kingdom, the United States, Canada, China, and Japan.

467 Background: Cisplatin-based neoadjuvant chemotherapy (NAC) followed by RR is the standard of care in cisplatin-eligible pts with MIUC. Adjuvant chemotherapy (AC) with cisplatin-based tx may be offered to those not given NAC. The unmet need this survey tried to evaluate is the post-RR burden of disease, quality of life (QoL) and perioperative tx patterns among MIUC pts. Methods: Real-world descriptive data were drawn from Adelphi’s MIUC Disease-Specific Programme: A point-in-time survey conducted with clinical/medical oncologists/urologists and their pts in 9 countries between January and June 2021. Physicians completed a survey on their pts’ clinical characteristics and tx patterns, while pts voluntarily completed a series of patient-reported outcome measures. Results: Of 2178 pts (data provided by 320 physicians), 30% received NAC only, 26% received AC only, 38% received no NAC or AC tx, and 6% received both. 1744 pts had initial tumour in the bladder; 35% received NAC only, 24% AC only, 35% no NAC or AC tx, and 6% received both. Of 387 pts with upper-tract urothelial carcinoma (UTUC), 51% received no NAC/AC tx, 35% received AC only, and 12% NAC only. More pts with T3 disease received no NAC/AC tx (36%) or NAC (35%) than AC (24%). Of 734 pts with nodal disease, 36% received NAC only. Of all pts, 60% experienced symptoms at data abstraction: 50% in pts who received NAC only, 71% in pts who received AC only and 82% in pts of those who received both. Pts reported similar EQ-5D-5L utility index scores (mean = 0.86; range: 0.84 [AC only] to 0.89 [NAC only]). Overall, feeling pain (40%) and stress (39%) were the EQ-5D domains with the worst scores. Pts who received AC only reported nominally lower EQ-5D visual analogue scale scores (71.11) compared with pts who received no NAC/AC (73.17) or pts who received NAC only (75.05). EORTC QLQ-C30 Global Health Status scores were 60.0 in pts who received AC only, 64.1 in pts who received NAC only or no NAC/AC, and 66.7 for pts who received both NAC and AC. Conclusions: Nearly 40% of pts remain untreated in either NAC or AC setting in 9 countries. A higher proportion of pts with UTUC go untreated. AC was more frequently used in UTUC vs BC pts; and in pts with Tis. NAC was implemented more frequently in pts T3 disease and in those with N+ disease. Pts who received AC appear to have nominally worse QOL and more symptoms, further demonstrating the need for efficacious adjuvant tx that does not decrease post-RR QoL.[Table: see text]

Health-related Quality of Life of Patients with Locally Advanced or Metastatic Urothelial Cancer Treated with Enfortumab Vedotin after Platinum and PD-1/PD-L1 Inhibitor Therapy: Results from Cohort 1 of the Phase 2 EV-201 Clinical Trial

BackgroundThe EV-201 trial (NCT03219333) demonstrated a clinically meaningful and durable response rate and a tolerable safety profile with enfortumab vedotin (EV) in patients with locally advanced/metastatic urothelial carcinoma (LA/mUC) treated with prior PD-1/PD-L1 inhibitor therapy and platinum-containing chemotherapy (cohort 1). Patient-reported outcome (PRO) measures were included in EV-201 as exploratory endpoints. ObjectiveTo evaluate PRO data for cohort 1 of EV-201 to better understand the relationship between EV therapy and health-related quality of life (HRQoL). Design, setting, and participantsEnrolled patients with LA/mUC who received EV were invited to electronically complete two HRQoL instruments (EORTC QLQ-C30 and EQ-5D-3L) at baseline and day 1 of each cycle until treatment discontinuation. Outcome measurements and statistical analysisPatient demographics, completion and compliance rates, and PRO scores were analysed using descriptive statistics. Selected EORTC QLQ-C30 scores were analysed post hoc using a repeated-measures mixed model. Results and limitationsAmong treated patients (n = 125), 95% completed both baseline questionnaires. Compliance rates were ≥86% throughout the study. Descriptive analyses showed that global health status, physical functioning, and symptom scores remained stable over time, with average scores similar at each cycle. Lower pain and fatigue scores were observed in responders at cycles following an objective response. Pain was lower at cycle 3 than at baseline in patients with bone metastases. Mean EQ-5D-3L utility score (0.80 at baseline; range from 0.77 at cycle 2 to 0.91 at cycle 10) and visual analogue scale scores (66.9 at baseline; range from 65.5 at cycle 2 to 78.4 at cycle 10) remained similar over time. Variability and the small sample size limited definitive conclusions. ConclusionsPRO scores remained stable throughout EV treatment, further supporting the overall value of EV in the treatment of patients with LA/mUC. The potential benefit of EV therapy on overall HRQoL and symptoms such as pain and fatigue is currently being explored. Patient summaryIn this study of adult patients with advanced cancer of the urinary tract that progressed after previous medications, quality of life, ability to function, and symptoms did not worsen on treatment with enfortumab vedotin, which is an antibody + drug combination. Some improvements in pain and fatigue were reported by patients, but further research needs to be conducted. These data complement the efficacy and safety data from the EV-201 trial.

Health-related quality of life in patients with relapsed/refractory multiple myeloma treated with pomalidomide and dexamethasone ± subcutaneous daratumumab: Patient-reported outcomes from the APOLLO trial.

In the phase 3 APOLLO trial, daratumumab in combination with pomalidomide and dexamethasone (D-Pd) significantly reduced the rate of disease progression or death by 37% relative to Pd alone in patients with relapsed/refractory multiple myeloma (RRMM) who had received ≥1 prior line of therapy including lenalidomide and a proteasome inhibitor. Here, we present patient-reported outcomes (PROs) from APOLLO. Median treatment duration was 11.5months with D-Pd and 6.6months with Pd. PRO compliance rates were high and similar in both groups. No changes from baseline were observed for EORTC QLQ-C30 global health status scores in either group, while physical and emotional functioning, disease symptoms, and adverse effects of treatment remained at baseline levels with D-Pd but worsened with Pd. Reductions (p < 0.05) in pain and fatigue were seen at several time points with D-Pd versus Pd. Overall, these results suggest patients' health-related quality of life remained stable when daratumumab was added to Pd, with several results favoring D-Pd versus Pd. These findings complement the significant clinical improvements observed with D-Pd and support its use in patients with RRMM.

A prospective phase II study of biweekly S-1, leucovorin and gemcitabine in elderly patients with locally advanced or metastatic pancreatic adenocarcinoma.

550 Background: A chemotherapeutic regimen for elderly patients with advanced pancreatic cancer is necessary because of the considerable toxicities associated with current standard regimens. A modified combination of gemcitabine, S-1, and leucovorin (GSL) was used as a first-line treatment for elderly patients with newly diagnosed locally advanced or metastatic pancreatic adenocarcinoma in a prospective, phase II, multicenter clinical trial (NCT03559348). Methods: Patients more than 70 years of age with ECOG performance status score 0-2 were treated with GSL. GSL was administered every 2 weeks, intravenous gemcitabine 800 mg/m2 at a fixed-dose rate of 10 mg/m2/min on day 1 and oral S-1 (80-120 mg/day) plus leucovorin 30 mg twice daily on days 1-7, until disease progression, withdrawal, or intolerable toxicities. The primary endpoint was progression-free survival (PFS). Results: Overall, 49 patients were enrolled into the trial between 10 July, 2018 and 25 March, 2020, with a median follow-up of 12.5 months. The data cut-off point was on 15 June, 2021. The median patient age at diagnosis was 76 years (range, 70–87 years), and thirty-two (65.3%) patients had metastatic lesions before GSL treatment. Patient frailty was evidenced by the Vulnerable Elders Survey (VES)-13 score (median 5, range 0-13) and Geriatric 8 (G8) score (median 10.5, range 3-15) at baseline. Among the 44 evaluable patients, 13 demonstrated a partial response (29.5%) and 24 presented with stable disease (54.5%). The median PFS was 6.6, 6.6, and 6.3 months, and OS was 12.5, 12.7, and 11.6 months for total population, patients with locally advanced disease, and patients with metastatic lesions, respectively. Patients had improved emotional function and global health status score during GSL treatment. The most frequent grade 3 or higher treatment-related toxicities included anemia (20.4%), decreased neutrophils (18.4%), decreased white blood cells (16.3%), and oral mucositis (12.2%). Conclusions: The GSL regimen results in impressive efficacy with tolerable toxicity in this group of frail patients. In addition, quality of life can be maintained during the treatment. GSL could be a treatment of choice for elderly patients with locally advanced or metastatic pancreatic cancer. Clinical trial information: NCT03559348.

Implications of inappropriate prescription of oral nutritional supplements on the quality of life of cancer outpatients: a cross-sectional comparative study

Background and aimsOral nutritional supplements (ONS) are considered a cornerstone in the treatment plan of malnutrition in cancer patients. However, the prevalence of inappropriate prescription of ONS is high. In this study, we aim to investigate the effect of inappropriate oral nutritional supplementation (consisting of prescription of ONS without evident clinical indication, or the absence of ONS when at risk of malnutrition) on the quality of life of cancer outpatients.MethodsA cross-sectional comparative study was conducted in 104 cancer outpatients, receiving ONS without prior malnutrition risk screening (n = 51), and patients not receiving ONS (n = 53). Nutritional risk screening was performed using the abridged patient-generated subjective global assessment (ab-PG-SGA). The quality of life was assessed using EORTC QLQ-C30 version 3.0 questionnaire. Multivariate analysis was conducted to determine the predictors of quality-of-life scales. Age (years), malnutrition (ab-PG-SGA scores), BMI (kg/m2), TSF (mm), MUAC (cm), ONS (yes, no) were entered into the linear regression analysis as predictors (backward stepwise linear regression analysis).ResultsThe prevalence of malnutrition risk (ab-PG-SGA ≥ 6) was 74%. The median score of the ab-PG-SGA for ONS receiving group was significantly higher (p = 0.045). Furthermore, univariate analysis showed that the scores of the global health status (QoL) and the role functioning (RF) scales were significantly lower for the ONS receiving group (p = 0.020 and p = 0.016, respectively). Multivariately, malnutrition, inappropriate ONS prescription, and triceps skin fold were found to be predictors of the RF scale, while malnutrition was the only predictor for the QoL.ConclusionThe inappropriate ONS prescription does not improve nutritional status or quality of life of cancer outpatients.

Prospective non-interventional BELOVA/BGOG-ov16 study on safety of frontline bevacizumab in elderly patients with FIGO stage IV ovarian cancer: a study of the Belgian and Luxembourg Gynaecological Oncology Group

ObjectiveBecause elderly patients with ovarian cancer are underrepresented in randomized studies, this study aimed to expand our knowledge on the safety and effectiveness of frontline treatment with bevacizumab in combination...

Analysis of Prognostic Risk Factors of Sepsis Patients in Intensive Care Unit Based on Data Analysis.

In this paper, a data-enabled analysis of the prognostic risk factors of sepsis patients in the intensive care unit is presented. For this purpose, we have selected 220 sepsis patients, preferably those admitted to the intensive care unit for treatment in a tertiary a hospital in Tianjin from June 2018 to June 2019 and received complete data as the research objects, to explore the prognostic risk factors of sepsis patients in the intensive care unit. All patients met the SSC sepsis diagnosis guidelines and recorded the patients' age, gender, underlying disease, and infection site. Laboratory indicators, such as blood routine, electrolytes, arterial blood gas, liver function, and renal function, were collected within 24 hours of admission. Furthermore, the corresponding specimens were cultured for pathogenic microorganisms according to the site of infection. The LAC value was measured at admission and 24 h after admission, and the 24 h lactate clearance rate was calculated. The Acute Physiological and Chronic Health Status Score II (APACHE-II) and SOFA score were calculated, which were based on the worst value of the index within 24 hours after admission. According to the prognosis of patients during hospitalization, they are divided into two groups: (i) survival group and (ii) death group. We entered all the data into Excel and used SPSS21.0 statistical software for data analysis and processing. Quantitative data are tested for normality. Quantitative data for normal distribution are expressed as mean ± standard deviation, and normal distribution and uniform variance are measured. The factors affecting the prognosis of patients with sepsis were first subjected to a single-factor logistic regression analysis, and a multiple logistic regression analysis was performed on the basis of the significance of the single-factor analysis. The results found that the prognosis of patients with sepsis in the ICU is affected by multiple factors such as underlying diseases, infectious microorganisms, comorbidities, and interventional therapy. APACHE-II score, 24 h lactate clearance rate, ARDS, and DIC are independent risk factors that affect the prognosis of ICU patients.

Odnos između mentalnog distresa i percepcije stresa izazvanog kovidom 19 kod studenata zdravstvene nege

Introduction/Aim: Healthcare students are among the groups affected by the COVID-19 pandemic in various ways. This study aimed to investigate the relationship between mental distress and perceptions of COVID-19 stress in healthcare students. Methods: The present analytical cross-sectional study included all students of Saveh University of Medical Sciences in 2021 as the statistical population. Through convenience sampling, 419 students were included in the study. A 12-item general health questionnaire (GHQ-12) and a 19-item the COVID-19 related healthcare students stress scale were used to collect data. Data analysis was performed using SPSS and descriptive and analytical statistical methods methods (Pearson correlation coefficient, paired t-test and analysis of variance). Results: The mean score of students' mental health status was 12.91, and 41.05% (N = 172) of them had some degree of mental distress. There was a significant relationship between mental distress score with the perception of COVID-19 stress, gender and field of study (P &lt; 0.05). Conclusion: A significant number of students had some degree of mental distress, which had a direct and significant correlation with the perception of COVID-19 stress. Therefore, planning to identify and reduce the stressors associated with COVID-19 is one of the most beneficial actions for the students in restoring their mental health.

Avaliação da fadiga e da qualidade de vida de pacientes com câncer colorretal em quimioterapia

To evaluate fatigue and health-related quality of life of colorectal cancer patients undergoing chemotherapy. Descriptive study conducted with 69 patients between January and September/2019 in a public hospital in Minas Gerais. Instruments used: sociodemographic and clinical questionnaire, Quality of Life Questionnaire-Core30 and Piper Fatigue Scale, analyzed according to measures of frequency, mean and standard deviation by the software PSPP. Most patients were women over 60 years old, married, retired and housewives, with an average level of education. The scores of general health status, social, physical, emotional and role functioning were considered satisfactory (means 50 to 70), cognitive function was good (mean higher than 70); the most prevalent symptoms were loss of appetite, fatigue, pain and insomnia. As for fatigue, all dimensions had a mean value <4, considered mild fatigue. Quality of life had satisfactory scores and fatigue was classified as mild in patients undergoing chemotherapy.

A Prospective Observational Study on Assessment of Quality of Life of Patients on Adjuvant and Neo-adjuvant Therapy for Lung, Breast, and Colorectal Malignancies

Background: Patients with malignancy undergoing chemotherapy, surgery, and radiation therapy experience a variety of symptoms that affect their quality of life (QOL). This necessitate the assessment of QOL on their subjective evidence that can be utilized in diagnosis, predicting prognosis, patient monitoring and clinical decision making. This information will help health care professionals to design interventions and recommend the appropriate treatment, thereby improving the QoL of patients. In this study we aim to assess the QoL of patients receiving adjuvant and neo-adjuvant therapy for Lung, Breast, and Colorectal cancer, in addition to making correlations according to type of treatment and disease stage. Methods: A prospective observational study was carried out in the radiation oncology department from March 2021 to September 2021 in Krishna Rajendra Hospital, Mysuru, India. We used the European Organization for Research and Treatment of Cancer quality of questionnaire [EORTC QLQ – C30] Version 3.0 to assess the QoL of patients. Patients were interviewed twice, when they came to have their chemotherapy regardless of the cycle number and during the next visit. Results: The number of patients enrolled in the study were 107. Most of participants were female 83%. About 73.8% diagnosed with breast cancer. In patients treated with adjuvant versus neo-adjuvant treatment, the functional scores and global health status scores were statistically significant p=0.038 and p=0.010 respectively with mean scores 63.54 in favour of adjuvant therapy. These results represent a better QoL in patients received adjuvant versus neo-adjuvant therapy. The mean values of global health status score in patients diagnosed with lung cancer during the two assessments (47.72, 51.51) were lesser than those in patients diagnosed with breast cancer (63.71,63.50) and colorectal cancer (58.82,58.82), indicating patients with lung cancer had poor QoL compared to breast and colorectal cancer patients. Conclusion: Patients received adjuvant therapy had better QoL compared to those received neo-adjuvant therapy. The QoL in lung cancer patients were majorly affected as compared to QOL in breast and colorectal cancer patients. there is a strong correlation between the type of treatment and disease stage.

ASSOCIATION BETWEEN SOCIAL SUPPORT AND QUALITY OF LIFE IN PATIENTS WITH BREAST CANCER AT HIWA CANCER HOSPITAL IN SULAIMANI CITY/IRAQ

Background: Breast cancer is the most common cancer in women worldwide. During and after treatments, breast cancer patients may vulnerable for problems and in need of support. Receiving social support may reduce patients’ stress, help to cope with the situation, and improve patients' quality of life. Aim: The aim of the study was to assess perceived social support, quality of life, and explore the association between them in a sample of females' breast cancer. Methodology: Three hundred Forty-Two patients with breast cancer who visited the outpatient clinic at Hiwa Hospital in Sulaimani City were recruited to the current cross-sectional study. The data was collected at least 3 months post-chemotherapy, the direct interview was used to fill a questionnaire that includes participants' characteristics, source of social support, types of treatment, Multidimensional Scale of Perceived Social Support to assess perceived social support, and European Organization for Research and Treatment of Cancer (EORTC QLQ C-30, EORTC QLQ BR-23) to assess patients' quality of life. Statistic Package of Social Science 24 software was used for statistical analysis. Results: Participants' mean age was (42.65 ± 7.71), total social support score was (52.68 ± 20.09) on a scale of (12 to 84), about half (47.4%) received it moderately. The family was the highest source of social support (19.89 ± 7.80). Global health state score was (68.52 ± 19.80), emotional was the most affected functional subscale (52.10 ± 29.60). Regarding the symptom’s subscale, the financial deficit (55.95 ± 33.07) was the most disrupted symptom followed by fatigue (43.60 ± 21.16). Furthermore, sex function (32.99 ± 28.79) was a more impaired aspect among breast cancer-specific functions, and hair loss (59.84 ± 41.37) was the most symptom reported by the patients. Moreover, perceived social support is associated and correlated with participants' quality of life, (p ˂ 0.05). Conclusion: Kurdish breast cancer patients perceived moderate social support, the global health status was moderate to good, most affected function was emotional and sex functions, financial deficit, fatigue, and hair loss were most disrupting symptoms. Social support enhanced patients’ QoL in term of enhancing functions and minimized symptoms.

Moving out but not for the better: Health consequences of interprovincial rural-urban migration in China.

Using panel data from a survey conducted by the Research Center for Rural Economy, this study overcomes the selection bias associated with most health status measures by incorporating dialect proximity as an instrumental variable to evaluate the causal effects of interprovincial migration on individuals' health status in China. The results indicate that, compared to an absorbed category, which includes intraprovincial migration and non-migration, interprovincial migration worsens health (measured by the self-reported health status score) by 3%. It is also found that, compared to intraprovincial migrants, interprovincial migrants are more likely to report a lower SHS score, whereas the health effect differences between interprovincial migrants and non-migrants are insignificant. The study identifies two potential mechanisms that explain this result: (i) The increase in income following migration may improve interprovincial migrants' health, and (ii) the exposure to hazardous working environments worsens health to a significant extent. This finding is also linked to the following gender-related finding: Compared to women, men are more likely to be employed in heavy industries with hazardous working environments; the negative effects of interprovincial migration on the health status are stronger for men than for women migrants, suggesting that the industry effect dominates.

P-OGC46 Physiotherapy Regimens in Esophagectomy and Gastrectomy: a Systematic Review and Meta-analysis

Abstract Background Esophageal and gastric cancer surgery are associated with considerable morbidity, specifically postoperative pulmonary complications (PPC), potentially accentuated by underlying challenges with malnutrition and cachexia affecting respiratory muscle mass. Physiotherapy regimens aim to increase the respiratory muscle strength and may prevent postoperative morbidity. This meta-analysis aims to assess the impact of physiotherapy regimens following esophagectomy or gastrectomy. Methods An electronic database search was performed in MEDLINE, EMBASE, CENTRAL, CINAHL and Pedro databases. A meta-analysis was performed to assess the impact of physiotherapy on the functional capacity, incidence of PPC and postoperative morbidity, in-hospital mortality rate, the Length of Hospital Stay (LOS) and the Health-Related Quality of Life (HRQoL). Results Seven RCTs and 7 cohort studies assessing prehabilitation totalling 960 patients, and 5 RCTs and 5 cohort studies assessing peri- or postoperative physiotherapy with 703 total patients, were included. Prehabilitation resulted in a lower incidence of postoperative pneumonia and morbidity (Clavien-Dindo score &amp;gt;II). No difference was observed in functional exercise capacity, and in-hospital mortality following prehabilitation. Meanwhile, peri- or postoperative rehabilitation resulted in a lower incidence of pneumonia, a shorter LOS and better HRQoL scores for dyspnea and physical functioning, while no differences were found for the QoL summary score, global health status, fatigue and pain scores. Conclusions Our meta-analysis shows that implementing an exercise intervention may be beneficial in both the preoperative and peri- or postoperative period. Further investigation is needed to understand the mechanism through which exercise interventions improve clinical outcomes and which subgroup of patients will gain the most benefit.

Excessive Erythrocytosis and Chronic Mountain Sickness in the Highest City in the World: A Longitudinal Study

Excessive Erythrocytosis and Chronic Mountain Sickness in the Highest City in the World: A Longitudinal Study

Health-related quality of life and its associated variables in Chinese patients with Philadelphia-negative myeloproliferative neoplasms

目的评估中国Ph阴性骨髓增殖性肿瘤（MPN）患者生活质量及其影响因素。方法通过横断面研究，在全国范围内向成年MPN患者发放无记名调查问卷，采用骨髓增殖性肿瘤总症状评估量表（MPN-10）评估症状负荷，健康调查简表（SF-36）和欧洲癌症研究与治疗组织生活质量核心30问卷（EORTC QLQ-C30）量表评估生活质量。结果在1405份可评估的调查者问卷中，血小板增多症（ET）、真性红细胞增多症（PV）、骨髓纤维化（MF）受访者分别为645例（45.9％）、297例（21.1％）、463例（33.0％），男性占46.0％（646例），中位年龄56（18～99）岁。ET、PV、MF受访者MPN-10量表评分分别为（13.0±12.7）、（15.0±14.7）、（21.0±16.6）分（P<0.001），SF-36量表躯体健康总评分（PCS）分别为（48.0±8.5）、（47.0±9.0）、（42.0±10.0）分（P<0.01），精神健康总评分（MCS）分别为（51.0±11.0）、（50.0±10.8）、（49.0±11.1）分（P＝0.002）。EORTC QLQ-C30量表中，MF受访者躯体功能、角色功能、情绪功能、认知功能、社会功能和总体健康状况评分最低（P值均<0.05），疲劳、疼痛、呼吸困难、食欲丧失、腹泻和经济困难评分最高（P值均<0.05）。多因素分析结果显示，三种疾病中，MPN-10评分高（PCS：−0.220～−0.277，P值均<0.01；MCS：−0.244～−0.329，P值均<0.01）与MPN受访者PCS和MCS低显著相关，年龄增加（−1.923～−4.869，P值均<0.05）与PCS低显著相关。此外，共存疾病多、初诊时有症状、脾大、贫血、未知基因突变类型和自付治疗费用高与较低的PCS和（或）MCS相关。年龄≥60岁、城镇户籍、有合并用药、MF受访者采用芦可替尼治疗与较高的MCS相关。在ET、PV和MF受访者中，除食欲丧失和便秘外，MPN-10评分与EORTC QLQ-C30多呈低度相关（ET：|r|＝0.193～0.457，P值均<0.01；PV：|r|＝0.192～0.529，P值均<0.01；MF：|r|＝ 0.180～0.488，P<0.001）。结论MPN患者生活质量受损，其中MF患者最差。社会人口学和临床因素显著影响MPN患者的生活质量，其中症状负荷是最重要的影响因素。

Epigenetic marker of telomeric age is associated with exacerbations and hospitalizations in chronic obstructive pulmonary disease

BackgroundChronic obstructive pulmonary disease (COPD) is an age-related condition that has been associated with early telomere attrition; the clinical implications of telomere shortening in COPD are not well known. In this study we aimed to determine the relationship of the epigenetic regulation of telomeric length in peripheral blood with the risk of exacerbations and hospitalization in patients with COPD.MethodsBlood DNA methylation profiles were obtained from 292 patients with COPD enrolled in the placebo arm of the Macrolide Azithromycin to Prevent Rapid Worsening of Symptoms Associated with Chronic Obstructive Pulmonary Disease (MACRO) Study and who were followed for 1-year. We calculated telomere length based on DNA methylation markers (DNAmTL) and related this biomarker to the risk of exacerbation and hospitalization and health status (St. George Respiratory Questionnaire [SGRQ]) score over time using a Cox proportional hazards model. We also used linear models to investigate the associations of DNAmTL with the rates of exacerbation and hospitalization (adjusted for chronological age, lung function, race, sex, smoking, body mass index and cell composition).ResultsParticipants with short DNAmTL demonstrated increased risk of exacerbation (P = 0.02) and hospitalization (P = 0.03) compared to those with longer DNAmTL. DNAmTL age acceleration was associated with higher rates of exacerbation (P = 1.35 × 10–04) and hospitalization (P = 5.21 × 10–03) and poor health status (lower SGRQ scores) independent of chronological age (P = 0.03).ConclusionTelomeric age based on blood DNA methylation is associated with COPD exacerbation and hospitalization and thus a promising biomarker for poor outcomes in COPD.