Higher Quality Of Life Scores Research Articles

Improving Quality of Life with Brachytherapy for Urological Malignancies

Brachytherapy for localised prostate, muscle-invasive bladder and penile cancer is well established, providing high tumour dose delivery and minimising normal tissue doses compared with external beam techniques. In prostate cancer, the main impact on quality of life relates to diminished sexual function and irritative or obstructive urinary symptoms, which are seen up to 15 years after treatment. Significant changes in bowel function are rare. Compared with radical prostatectomy or external beam radiotherapy, irritative or obstructive urinary symptoms are more prominent, whereas incontinence is less than after radical prostatectomy and bowel changes are less than after external beam radiotherapy. For muscle-invasive bladder cancer, when compared with radical cystectomy, although no difference is seen for urinary symptoms or fatigue, role and social functioning scores are higher and there is better post-treatment sexual function in both men and women. Compared with surgical treatment for penile cancer, brachytherapy results in better erectile function scores than after glansectomy and partial penectomy and high quality of life scores, with good satisfaction ratings for cosmetic appearance.

Anxiety, Depression and Stress Among Medical Students in Malaysia During COVID-19: A Cross-Sectional Study

Introduction: This study aimed to determine the prevalence and factors associated with psychological distress following the COVID-19 pandemic among medical students at one of the public universities in Malaysia. Method: From August to October 2020, a web-based cross-sectional study was conducted among undergraduate medical students at a public university. DASS-21, Brief Resilience Scale and WHOQOL-Bref questionnaires were used in this study. Results: The prevalence of depression was 40.5%, anxiety 46.0% and stress 30.9%. Based on multivariate logistic regression, a higher quality of life score is associated with a lower likelihood of depression (AOR=0.583, p<0.001), anxiety (AOR=0.726, p<0.001), and stress, (AOR=0.702, p<0.001) respectively. Likewise, a higher resilience score is less likely to be associated with depression (AOR=0.880, p=0.002), anxiety (AOR=0.880, p=0.002), and stress (AOR=0.850, p<0.001). Older age (OR=0.700, p=0.020) was associated with less stress and being on campus (OR=3.436, p=0.021) was at risk of stress during the COVID-19 pandemic. Conclusion: Our results suggest that medical students with higher quality of life and resilience scores had less depression, anxiety and stress. Older age was associated with less stress, and during the COVID-19 pandemic, being on campus was at risk of stress. Various stakeholders need to keep these findings in mind and identify those who are at risk for developing depression, anxiety, and stress in order to take further action to improve their quality of life and resilience.

Physical Activity Patterns, Satisfaction, and Quality of Life Among Nursing and non-Nursing Staff in an Office-Based Care Coordination Program.

Sedentary work is associated with poor health outcomes. Many healthcare occupations, including office-based care coordination, are largely sedentary. Many nurses do not achieve the recommended levels of daily physical activity, however, the physical activity levels among nurses working in care coordination are not known. To assess the physical activity levels, self-reported health and well-being, overall quality of life, and work-related satisfaction of office-based care coordinators, and compare these among nursing and non-nursing staff. This study collected objective physical activity data using accelerometry along with self-reported information on work-related quality of life and satisfaction from 42 healthcare staff working in a hospital-affiliated office-based care coordination program. Results were compared among nursing and non-nursing staff. Nurses had lower moderate-to-vigorous physical activity levels compared to non-nursing staff (25 min/day vs. 45, p = .007). There were no differences in daily sedentary time, light activity, or steps between nursing and non-nursing staff. Nurses reported high quality of life scores compared to non-nursing staff (4.4 vs. 4.1, p = .02), but similar levels of work-related quality of life, happiness, self-rated health, and well-being. Nurses working in an office-based care coordination program had lower levels of physical activity but reported a higher overall quality of life than non-nurse work colleagues working in a similar environment. Given known health risks associated with sedentary occupational work and the growing number of care coordination programs, health policies and initiatives aimed at increasing the physical activity levels of care coordination workers is of prime importance.

How do determinants of health relate to children's quality of life? A cross-sectional study in Izmir, Turkey.

This study aims to determine health-related quality of life (QoL) and the related factors from the perspective of social determinants of health among children. Childhood is the most intense period of life, and environmental factors surrounding children, as well as individual lifestyle factors, are related to the child's physical and mental well-being. To our knowledge, there is a lack of studies evaluating the relationship between determinants of health and the QoL of healthy children in general. This cross-sectional study was executed in the Bayrakli district of Izmir city. Stratified clustered sampling was used including 24 schools and 3367 7th-grade children, and 1284 students were targeted (50% prevalence, 95% CI, %5 margins of error, 2.25 design effect, and 20% replacement). The response rate was 84.9% (n = 1090). The Turkish KID-KINDL Health-Related Quality of Life Questionnaire for Children was used to assess QoL. Independent variables were examined in four layers using Dahlgren's Determinants of Health Model: basic characteristics, lifestyle factors, family characteristics, and life conditions. The mean QoL score was 71.3 ± 12.6. Our study explained 31.7% of the variance in QoL. Higher QoL scores were associated with better health status, perceived academic achievement, normal/thin body perception, physical activity (PA), and adequate sleep duration. Living with both parents and having fewer siblings positively influenced QoL. Moreover, the presence of structural problems in the household and poorer health perceptions were associated with lower QoL scores (P < 0.05) This study highlighted the multifaceted nature of QoL in Turkish children, revealing the importance of various determinants of health. The results show that in order to improve the general well-being of this population, interventions and policies are required that concentrate on elements including health status, academic accomplishment, body perception, physical activity, family structure, and living situations.

Recombinant factor IX Fc prophylaxis reduces pain and increases levels of physical activity, with sustained, long-term improvements in patients with hemophilia B: post hoc analysis of phase III trials using patient-reported outcomes.

Pain is a common symptom of hemophilia that may adversely affect patients' quality of life (QoL). Previous post hoc analyses of prophylaxis with recombinant factor IX Fc fusion protein (rFIXFc) have been published for adults and adolescents, demonstrating improvements in health-related QoL (HRQoL) when assessed by the haemophilia-specific QoL (HaemAQoL) questionnaire. To describe in depth the evolution of QoL, pain- and activity-related domains and questions for pediatric, adolescent, and adult patients with hemophilia B treated with rFIXFc prophylaxis. A post hoc analysis of data from a series of clinical trials. This post hoc, long-term analysis assessed patient-reported outcomes (PROs) from the Kids B-LONG (NCT01440946: pediatric) and B-LONG (NCT01027364: adults and adolescents) parent studies and the B-YOND (NCT01425723: all age groups) extension study. Ninety-two adult and adolescent patients that started in the B-LONG study were assessed, with a median (range) duration of follow-up of 58.9 (0.0-78.4) months. The Haem-A-QoL total score was significantly reduced from baseline by 4.45 (p ⩽ 0.01), as were the subdomains 'physical health' (9.10; p = 0.001), 'sports and leisure' (11.25; p ⩽ 0.01), 'treatment' (2.69; p = 0.05), and 'view of self' (5.81; p = 0.002). Thirty pediatric patients that started in the Kids B-LONG study were assessed, with a median (min-max) duration of follow-up of 36.7 (9.0-59.9) months. The high level of satisfaction demonstrated by the PROs at baseline was maintained. rFIXFc prophylaxis reduced perceived pain and increased levels of physical activity with sustained, long-term improvements in QoL in adult and adolescent patients with hemophilia B and maintained high QoL scores in pediatric patients.

QUALITY OF LIFE AND ATTITUDES TOWARD AGING IN OLDER ADULTS DURING THE COVID-19 PANDEMIC

Abstract Research has shown that positive or negative views of aging are associated with quality of life. Prior research has found that community dwelling older adults aged 65 and older with more negative views of aging have lower scores on quality of life scales, whereas those with higher views of aging have higher scores on quality of life scales. A group of 264 community dwelling older adults (Mean age = 72.4 years, 62-92 years old) living in Prince Edward Island, Canada, completed a survey measuring attitudes towards aging and quality of life during the COVID-19 pandemic. The sample consisted of a majority of retired (n=206) older adults, living in an urban area (n=151), and approximately 55% receiving a household income of $26,000 to $75,000 per year. Regression analysis found that attitudes towards aging significantly predicted quality of life (F(1,127)=24.9, p&amp;lt; 0.01), with positive attitudes predicting higher quality of life scores and negative attitudes predicting lower quality of life scores. The model showed that the predictor, attitudes towards aging, explained 16.5% of the variance in quality of life (B=-2.7, t=-4.9, p&amp;lt; 0.01). This suggests that attitudes towards aging play a role in predicting quality of life in older adults during the COVID-19 pandemic.

Motor function, muscle strength and health-related quality of life of children perinatally infected with HIV.

Gross motor delays are common in infants and preschool children infected with human immunodeficiency virus (HIV). These delays persist in children of school-going age and may affect participation in classroom and playground activities; however, the extent of the problem is poorly understood in this age group. Our study aimed to determine the motor function, muscle strength and health-related quality of life (HRQoL) in children aged 5-10 years who were perinatally infected with HIV. In our cross-sectional study, participants were recruited using convenience sampling from a Gauteng HIV clinic. Participants were assessed using the Movement Assessment Battery for Children, Second Edition (MABC-2), standing broad jump test (SBJT), Paediatric Quality of Life InventoryTM (PedsQL) and a sociodemographic questionnaire. Thirty children participated in our study. The MABC-2 showed 60% of the children assessed were either at risk of developmental delay or were already delayed, with the domain of manual dexterity being most affected. The SBJT showed female participants had weaker muscle strength than males. The mean total score on the PedsQL was 81%, with the subscales ranging from very high quality of life scores to moderately high quality of life scores, with emotional functioning having one of the lower overall scores. Children who have been perinatally infected with HIV are at significant risk of delayed motor function. Muscle strength is also an area of concern, as is emotional HRQoL. Further research and implementation of holistic rehabilitation programmes are needed. Children with HIV need to be prioritised for developmental screening throughout childhood. Health promotion and early intervention need to be at the forefront of our fight against this pandemic.

Association of pain and clinical factors on disability and quality of life in systemic sclerosis: A cross-sectional study from Turkish League Against Rheumatism Network.

In this study, we aimed to evaluate the factors associated with disability and quality of life (QoL) in Turkish patients with systemic sclerosis (SSc). Between January 2018 and January 2019, a total of 256 SSc patients (20 males, 236 females; mean age: 50.9±12.4 years; range, 19 to 87 years) who were diagnosed with SSc were included in the study. Disability and health-related QoL (HRQoL) were evaluated by the Health Assessment Questionnaire (HAQ), scleroderma HAQ (SHAQ), Duruöz Hand Index (DHI), and Short Form-36 (SF-36). Linear regression analysis methods were used to describe factors associated with disability and QoL of the patients. All disability scores were higher and HRQoL scores were lower in diffuse cutaneous SSc patients compared limited cutaneous SSc, and differentiations were significant (p=0.001 and p=0.007). In multiple regression, pain (VAS) was the strongest predictor for high disability and low QoL scores (p<0.001) as HAQ (β=0.397, 0.386, 0.452), SHAQ (β=0.397, 0.448, 0.372), DHI (β=0.446, 0.536, 0.389), PCS (β=-0.417,-0.499, -0.408) and MCS (β=-0.478, -0.441, -0.370) in combined, lcSSc and dcSSc patients respectively. The factors associated with high disability and low QoL scores were forced vital capacity for HAQ (β=-0.172, p=0.002) and SF-36 PCS (β=0.187, p=0.001); disease duration for HAQ (β=0.208, p<0.001), DHI (β=0.147, p=0.006), and SF-36 PCS (β=-0.134, p=0.014); 6-minute walk test for HAQ (β=-0.161, p=0.005) and SF-36 PCS (β=0.153, p=0.009); and modified Rodnan skin score for SHAQ (β=0.250, p<0.001) and DHI (β=0.233, p<0.001) in SSc patients. Diffusing capacity of the lungs for carbon monoxide for HAQ (β=-0.189, p=0.010) and SHAQ (β=-0.247, p=0.002); erythrocyte sedimentation rate for DHI (β=0.322, p<0.001); age for SF-36 PCS (β=-0.221, p=0.003) and body mass index for SF-36 PCS (β=-0.200, p=0.008) and MCS (β=-0.175, p=0.034) were the other variables associated with high disability or low QoL scores in SSc subsets. Clinicians should consider the management of the pain and its sources as a key to improve better functional state and quality of daily life in SSc.

Exploring the Association Between Resilience and Quality of Life Among Glaucoma Patients: Sleep Disturbance as a Mediating Factor.

Patients with glaucoma may experience many symptoms such as blindness, which seriously affect their quality of life (QoL). Resilience is playing a vital role in enhancing the QoL and well-being of patients with chronic diseases. In addition, sleep disturbance is common in patients with glaucoma, leading to a decline in their QoL. However, there is a dearth of research on whether sleep disturbance plays a mediating role between resilience and QoL among glaucoma patients. The aim of this study is to explore the role of sleep disturbance in the relationship between resilience and QoL among glaucoma patients. From July to December 2019, a cross-sectional survey was conducted on 215 glaucoma patients in an ophthalmic hospital in Liaoning Province. Hierarchical multiple regression (HMR) analyses and structural equation modeling (SEM) were conducted to examine the factors related to QoL and to test the hypothesis that sleep disturbance mediates the relationship between resilience and QoL among glaucoma patients. The average QoL score among glaucoma patients was 43.85 ± 14.97 as reported by the Glaucoma Quality of Life-15 (GQL-15) scale, where a higher scores indicating a poorer QoL. Resilience was found to be linked with a lower QoL score (P < 0.01), while sleep disturbance was associated with a higher QoL score (P < 0.01). When sleep disturbance was included in the model as partial mediator, the path coefficients for the association between resilience and QoL score was significantly decreased (a*b = -0.1, BCa95% CI: -0.154∼-0.045). Findings of this study reflected that QoL among glaucoma patients in China was poor. Resilience was found to be an important positive factor, which could result in the improvement of QoL. Furthermore, sleep disturbance mediated the relationship between resilience and QoL among patients with glaucoma, thereby reducing the positive impact of resilience on QoL in glaucoma patients. Efforts to improve QoL among glaucoma patients may benefit from interventions that enhance the levels of resilience and promote healthy sleep.

Capoeira: hypothesis on health rehabilitation and quality-of-life maintenance.

The aim of this work was to present hypotheses supporting capoeira as an activity aimed at health rehabilitation and maintenance of quality of life. Capoeira players (n=245), residing in Brazil and abroad, were evaluated for quality of life (physical, social, psychological, and environmental domains from WHOQOL-bref). The capoeira players' quality of life scores were compared to normative values and reference values in martial arts. Besides, studies involving capoeira (Medline/Embase/Cinahl/SportDiscus) were also reviewed for health-related hypotheses, describing population, intervention, comparator, and outcome. There are hypotheses on capoeira improving health through (1) body composition, addressed by two studies investigating waist circumference, bone, and muscle mass; (2) functional capacity, investigated by three studies considering performance variables; (3) metabolism, in two studies demonstrating triglycerides and blood glucose reduction, and an enhancement of anaerobic glycolysis; and (4) cardiovascular parameters, addressed by two studies highlighting an increase in maximal oxygen consumption, heart rate, and rate of pressure product reduction, as well as an increase in parasympathetic activity at rest. The sample of this study had higher quality of life scores when compared to normative values for Brazilians, similar quality of life when it comes to social relationships, higher quality of life in the psychological and environmental domains, and lower quality of life in the physical domain when compared to practitioners of other combat sports/martial arts. An analysis of the impacts of capoeira resulted in hypotheses on the rehabilitation of players' biological health. Although the individuals were evaluated within the pandemic period, their quality of life domains were similar or superior to normative or reference values found by studies from before the pandemic.

Dynamic changes in quality of life, psychological status, and body image in women who underwent a mastectomy as compared with breast reconstruction: an 8-year follow up.

Surgical decisions and methods of surgery highly influence long term QoL for breast cancer (BC) survivors. This study is aimed towards an exploration of the dynamic changes in quality of life (QoL), anxiety/depression status, and body image (BI) among women with BC who received a mastectomy compared with those receiving breast reconstruction (BR) within an 8-year follow-up period. Women with major BC surgeries were invited to complete the World Health Organization Quality of Life-Brief (WHOQOL-BREF), the European quality of life five dimensions questionnaire (EQ-5D), and a body image scale within 8years of surgery. Kernel smoothing methods were applied to describe dynamic changes in QoL, anxiety/depression, and BI at different time points. Linear mixed effects models were constructed to identify the interaction between time, different types of surgery, and the determinants of QoL in these patients. After 1:10 propensity score matching, a total of 741 women who had undergone a BR and mastectomy were included. The BR group exhibiteda high WHOQOL QoL score one to five years after surgery with some fluctuations. The mastectomy group had comparatively stable QoL scores on WHOQOL items and were less depressed/anxious. The BR group generally showed fluctuating, higher BI scores two years after surgery, but they exhibited more anxiety/depression during follow up for 8years. Medical comorbidities, the status of anxiety/depression, and BI were the major factors influencing all domains and items of the WHOQOL BREF among women with BC. The mastectomy group showed a decreased trend toward depression in patients with BC. The BR group showed a significant improvement in QoL in the first 5years with massive fluctuations. These findings should be considered and discussed in patient participatory decision-making and promotion of QoL for breast cancer survivors.

Exploring the impact of a mindfulness meditation class on college student stress levels and quality of life

Objective: This study explored the differences in perceptions of stress levels and quality of life amongst college students enrolled in mindfulness meditation classes and those enrolled in an introductory holistic health class. Participants: 236 undergraduate students at a mid-sized university completed coursework and surveys. Methods: One-credit mindfulness meditation classes and an introductory holistic health class, serving as the control group, were offered over the course of one semester. Pre- and posttest questionnaires on stress and quality of life were administered to the participants. Results: Students enrolled in mindfulness meditation classes began with higher stress levels and lower perceptions of their quality of life compared to the control group. The mindfulness meditation class participants ended with both significantly lower stress levels and higher quality of life scores then the control group. Conclusions: Offering mindfulness meditation classes for credit may help promote positive mental health and well-being for students on a college campus.

A Prospective and Cross-Sectional Study on Quality of Life among Postmenopausal Women in a Coastal Semi Urban area of India

Background: Menopause is the natural process in a woman. Some hormonal changes will happen during the period of menopause. In this study, our main objectives were to find the association between the classifications of demographic variables and the various scores of domains and to find the association of various predictors variables of different domains of quality of life among post-menopausal women. Materials and Methods: We have conducted a prospective and cross-sectional study on Quality of Life (QOL) among one hundred and fifty Postmenopausal Women in Coastal Semi Urban area of Kerala India in the year 2018. Data was collected by using Menopause Specific quality of Life – 29 questionnaire with 7 Likert scale (0 – 7). The association between various scores of domains of QOL scores and selected socio-demographic variables by using analysis of variance test analysis and the association of various predictors of different domains of quality of life of post-menopausal women by using bi-variate logistic regression analysis. Data were analysed using SPSS 21.0 version. Results: Overall mean age of post-menopausal women was 55.7 ± 4.8 (Range: 50 – 65) years. Higher QOL scores were showed higher risk. In our study, using MENQOL scores showed significant associations with p–value&lt;0.05 in QOL based on body mass index, educational status, socio economic status, number of siblings, and marital status. Conclusion: From study findings, we have concluded that low and normal body mass index, higher educational status, upper to lower middle socio-economic status, a smaller number of siblings, and un-marital status were increased the quality of life and reduces menopausal symptoms problems among post-menopausal women. So, further effective intervention programs are needed in this study areas of the population to develop/increase the quality of life among post-menopausal women. Key Words: post-menopausal women, symptoms, quality of life, prospective and cross-sectional study, coastal area

Comparison between the effects of two treatment regimens from GINA guidelines step 3 on quality of life and inflammatory biomarkers of pediatric asthmatic patients: an observational study

Background: Asthma is a complicated condition characterized by chronic airway inflammation and airflow restriction, resulting in various respiratory symptoms such as shortness of breath, wheezing, coughing, and chest tightness. The research intended to evaluate and compare the clinical outcomes of two interchangeable treatment regimens administered to a group of Iraqi asthmatic children. Methods: This observational clinical study was conducted on a sample of pediatric Iraqi asthmatic patients in the central pediatric hospital in Baghdad. The study enrolled asthmatic children with moderate persistent asthma, who a specialized physician had diagnosed. Patients had been allocated to two groups to receive either medium doses of beclomethasone inhaler (80 μg twice a day) for group one, or low doses (40 μg twice a day) plus montelukast chewable tablets (5 mg once daily) for group two. This study used the Child Health Survey–child version (CHS–child version) to investigate the quality of life of included patients. Also, this study investigated the inflammatory blood markers; (eosinophils and prostaglandin D2). Results: This research included 63 patients ranging in age from 7 to 11 years, with a slight male preponderance: group one patients (n=30) and group two patients (n=33). Compared with baseline levels, the study groups had considerably higher quality of life scores at the first follow-up visit (P&lt;0.05). After that, the two groups' scores were non-significantly higher at the second follow-up visit compared with the first follow-up visit (P&gt;0.05). Both groups significantly improved inflammatory biomarkers at the first follow-up visit (P &lt;0.05). The second follow-up visit revealed further improvement in both groups. Conclusion: This research found that both groups generated substantial improvements in study parameters compared with baseline values and that the second group, which included a beclomethasone inhaler with montelukast, was associated with the highest degree of improvement in terms of quality-of-life ratings.

Quality of Life and Associated Risk Factors in Hemodialysis: Perspective from a Center in the Dominican Republic

Background: Chronic kidney disease has an overall prevalence of 10?%. It can progress to a condition called end-stage renal disease. Therapies such as hemodialysis are necessary at this stage. Our study aims to measure the quality of life of patients on hemodialysis. Methods: We conducted an observational, cross-sectional study with 81 patients. Data was collected using a survey that included sociodemographic variables, the Center for Epidemiological Studies Depression Screening Index (CES-D), and the Kidney Disease Quality of Life (KDQOL-SF36). Data were analyzed using the software Epi Info™ 7.2, t-test, ANOVA, and correlation coefficient. Results: The severity of symptoms is more significant in the female sex than in males (65.7117 vs. 74.2874). All of the components of the KDQOL-SF36 showed a negative correlation with the CES-D. Household income had a mild positive correlation with the scale (r = 0.2608, p = 0.0229). Physical activity was shown to be associated with the physical component of the scale (41.6346 vs. 35.7365, p = 0.0412). Patients with partners were associated with higher quality of life scores than single patients (53.6585 vs. 42.6783, p = 0.0348). Conclusion: This is the first study conducted in the Dominican Republic to analyze the variables affecting the quality of life in patients in hemodialysis units. The severity of the symptoms increased in female patients, and patients without a partner are associated with worse quality of life scores.

Physical activity, physical capacity and sedentary behavior among asthma patients

ABSTRACT BACKGROUND: Although exercise and daily physical activity (PA) have long been known to benefit patients with chronic disorders, knowledge is limited regarding asthma. OBJECTIVE: In a Danish setting, our aim was to measure physical activity, sedentary behavior, and physical capacity among patients with asthma. We hypothesized that people with severe asthma would be less active and more sedentary than their mild-moderate counterparts. METHODS: Adults with asthma were recruited through respiratory outpatient clinics and subsequently examined twice, 4 weeks apart. At each visit, participants underwent a series of lung function tests, questionnaires, and maximum oxygen uptake testing (VO2max). Between the visits, participants wore an accelerometer continuously for 4 weeks, measuring sedentary time and daily steps. Sixty patients, 27 with mild-moderate asthma (GINA 1–3) and 33 with severe asthma (GINA 4–5), completed both visits and had valid accelerometer measurements. RESULTS: No significant differences between the two groups were found in sedentary time, number of steps or VO2max. VO2max was significantly correlated with FeNO (r = −0.30, p < 0.05), Short Form-12 Mental Health (r = 0.37, p < 0.05), Asthma Control Questionnaire (r = −0.35, p < 0.05), and Mini Asthma Quality of Life Questionnaire (r = 0.36, p < 0.05). CONCLUSION: No differences were observed between patients with mild-moderate and severe asthma regarding sedentary behavior, daily steps or level of cardiopulmonary fitness. Furthermore, patients with the highest VO2max had the higher quality of life scores. Abbreviations: VO2max: Maximal Oxygen Uptake; CPET: Cardiopulmonary Exercise Testing; BMI: Body Mass Index; FEV1: Forced Expired Volume in the First Second; FVC: Forced Vital Capacity; PEF: Peak Expiratory Flow; EIB: Exercise-Induced Bronchoconstriction; COPD: Chronic Obstructive Pulmonary Disease; ACQ: Asthma Control Questionnaire; Mini-AQLQ: Mini Asthma Quality of Life Questionnaire; SF-12: Short Form 12 Health Survey; SNOT-22: Sino-Nasal Outcome Test 22; GINA: The Global Initiative for Asthma; CRP: C-reactive Protein; Hgb:Hemoglobin count; EOS: Eosinophil count; EVH: Eucapnic Voluntary Hyperventilation; FeNO: Fractional Exhaled Nitric Oxide; PA: Physical Activity ERS: European Respiratory Society; ATS: American Thoracic Society; CRS: Chronic Rhinosinusitis; AHR: Airway Hyperresponsiveness

The Achieving Self-directed Integrated Cancer Aftercare Intervention for Detection of Recurrent and Second Primary Melanoma in Survivors of Melanoma: Pilot Randomized Controlled Trial.

BackgroundMelanoma is common with increasing incidence. Guidelines recommend monthly total skin self-examinations (TSSEs) by survivors to detect recurrent and new primary melanomas. TSSE is underperformed despite evidence of benefit.ObjectiveThis study compares the effect on psychological well-being and TSSE practice of a self-directed digital intervention with treatment as usual in patients treated for a first stage 0 to IIC primary cutaneous melanoma within the preceding 60 months.MethodsThis randomized clinical trial was conducted at 2 UK National Health Service hospitals (Aberdeen Royal Infirmary, Grampian, and Addenbrooke’s, Cambridge). Adults (≥18 years) diagnosed with a first 0 to IIC primary cutaneous melanoma were randomized to receive Achieving Self-directed Integrated Cancer Aftercare (ASICA), a tablet-based intervention prompting and supporting TSSE in survivors of melanoma, or to usual care. The hypothesis was that ASICA would increase TSSE practice in users affected by melanoma and compared with controls without affecting psychological well-being. The main primary outcomes were melanoma worry (Melanoma Worry Scale), anxiety and depression (Hospital Anxiety and Depression Scale), and quality of life (EQ-5D-5L) as well as secondary outcomes collected using postal questionnaires 3, 6, and 12 months following randomization.ResultsA total of 240 recruits were randomized (1:1) into the ASICA (n=121, 50.4%) or control (n=119, 49.6%) groups. There were no significant differences between groups for melanoma worry at 12 months (mean difference: 0.12, 95% CI −0.6 to 0.84; P=.74), 3 months (0.23, 95% CI −0.31 to 0.78; P=.40), or 6 months (−0.1, 95% CI −0.7 to 0.51; P=.76). The ASICA group had lower anxiety scores at 12 months (−0.54, 95% CI −1.31 to 0.230; P=.17), 3 months (−0.13, 95% CI −0.79 to 0.54; P=.71), and significantly at 6 months (−1.00, 95% CI −1.74 to −0.26; P=.009). Depression scores were similar, being lower at 12 months (−0.44, 95% CI −1.11 to 0.23; P=.20) and 3 months (−0.24, 95% CI −0.84 to 0.35; P=.42) but only significantly lower at 6 months (−0.77, 95% CI −1.41 to −0.12; P=.02). The ASICA group had significantly higher quality of life scores at 12 months (0.044, 95% CI 0.003-0.085; P=.04) and 6 months (0.070, 95% CI 0.032-0.107; P<.001) and nonsignificantly at 3 months (0.024, 95% CI −0.006 to 0.054; P=.11). ASICA users reported significantly more regular (>5) TSSEs during the study year and significantly higher levels of self-efficacy in conducting TSSE. They also reported significantly higher levels of planning and intention to perform TSSE in the future.ConclusionsUsing ASICA for 12 months does not increase melanoma worry, can reduce anxiety and depression, and may improve quality of life. ASICA has the potential to improve the well-being and vigilance of survivors of melanoma and enable the benefits of regular TSSE.Trial RegistrationClinicalTrials.gov NCT03328247; https://clinicaltrials.gov/ct2/show/NCT03328247International Registered Report Identifier (IRRID)RR2-10.1186/s13063-019-3453-x

An Assessment of Quality of Life in Patients With Asthma Through Physical, Emotional, Social, and Occupational Aspects. A Cross-Sectional Study.

BackgroundAsthma is a prevalent hyperactive airway disease with physical and emotional impact. Severe asthma is associated with considerable health-related quality of life (HRQoL). The aim of this study is to assess the quality of life through physical, emotional, social and occupational aspects and evaluate the factors affecting HRQoL in patients with asthma.MethodsThis is a cross-sectional multicenter study conducted on adult asthmatic patients enrolled from community pharmacies across different Lebanese geographic areas.ResultsHaving wheezing sometimes and most of the time (Beta = −0.144 and −0.552), experiencing anxiety sometimes and most of the time (Beta = −0.205 and −0.573), encountering sleep problems sometimes and most of the time (Beta = −0.270 and −0.553), having previous chest discomfort sometimes and most of the time (Beta = −0.421 and −0.713), and having depression most of the times (Beta = −0.415) were associated with higher lower quality of life scores. On the other side, holding a secondary level of education was associated with a higher quality of life score (Beta = 0.192).ConclusionThis study highlights that asthma affects adults' quality of life through social, emotional, physical, and occupational impacts. Improved follow-up and patient education may be essential in the future to stop disease progression and achieve ideal therapeutic outcomes.

Psychological Evaluation of Women with Absolute Uterine Infertility Prior to the Introduction of Uterus Transplantation

Background: Uterus transplantation may offer women with absolute uterine infertility the chance for gestational motherhood. Infertility treatment can be associated with psychological distress and the absolute nature of infertility in these women could heighten the risk. While uterus transplantation is promising the potential repercussion of graft failure and organ availability could have repercussions on these families. Understanding the baseline psychological well-being prior to uterus transplant is needed to support these women. Aim: Explore baseline psychological scores in women with acquired and congenital uterine absence. Method: A survey including demographic data and two-validated tools, DASS21 and FertiQOL was given to two groups, women with congenital uterine absence and those with acquired (hysterectomy). Data was compared between groups for DASS21, and against Boivin et al. 1 normative data for women with infertility (FertiQOL). Results: The study included 41 women, (average age 32.6yrs ± 10.4). As a collective only moderate depression, mild anxiety, and mild stress scores were reported however in the congenital uterine absence group 10.5% reported extremely severe anxiety and 5.3% extreme depression. Mean FertiQOL score was 57.76, 3.16 points higher than Boivin’s average. Women with hysterectomy scored on average 15.36 points lower than those with congenital uterine absence. Conclusion: In this study, women with congenital uterine infertility appeared to experience significantly higher levels of depression and anxiety than women post-hysterectomy. The opposite was seen in infertility scores where women with congenital absence reported higher quality of life scores than both the normative values and those post-hysterectomy. It is essential robust psychological screening and support is offered to these women prior to inclusion into a uterus transplant program.

Effectiveness of Comprehensive Nursing in Hemodialysis of Patients with Chronic Renal Failure and the Impact on Their Quality of Life.

Objective To assess the effectiveness of comprehensive nursing in patients with chronic renal failure undergoing hemodialysis and the impact on their quality of life. Methods The present study included 86 patients undergoing hemodialysis for chronic renal failure from January 2020 to October 2021 and randomly assigned them to receive either normal nursing or comprehensive nursing, with 43 cases in each group. Outcome measures included psychological status, treatment compliance, quality of life, and complications of the eligible patients. Results After the intervention, comprehensive nursing resulted in lower Self-Rating Anxiety Scale (SAS) scores and Self-Rating Depression Scale (SDS) scores and higher quality of life scores for patients versus routine nursing (P < 0.05). Comprehensive nursing was associated with a significantly higher overall patient compliance rate versus routine nursing (P < 0.05). Patients receiving comprehensive nursing had a lower risk of developing complications versus those given routine nursing (P < 0.05). Conclusion Comprehensive care increases treatment compliance and self-care capacity of patients undergoing hemodialysis for chronic renal failure, improves their quality of life, and lowers the risk of complications, indicating a high potential for clinical advancement.