Higher Quality Of Life Scores Research Articles

Factors associated with glaucoma-specific quality of life in a US glaucoma clinic in a pilot implementation of an online computerised adaptive test (GlauCAT)

ObjectivesMeasure quality of life (QoL) outcomes using a novel computerised adaptive test in a clinical setting, and determine the social and demographic factors associated with specific QoL domains in patients...

Quality of Life in Women over 65 Years of Age Diagnosed with Osteoporosis.

(1) Background: Today’s society is moving towards active aging, underlining the importance of understanding and improving quality of life (QoL). This QoL in women over the age of 65 years diagnosed with osteoporosis was compared with the QoL of the general population, and risk factors for osteoporosis related to QoL were identified. (2) Methods: This is an observational, descriptive, cross-sectional study with a personal interview. The study population was 704 women over 65 years of age diagnosed with osteoporosis as of 1 November 2018, based on medical records from four health centers of the eastern Valladolid urban health area. This was a random sample of 247 women stratified by health center. Information on osteoporosis risk factors, comorbidities, daily lifestyle habits, and QoL assessed with the EQ-5D was collected. QoL was modeled using sociodemographic variables, lifestyle, and clinical variables. (3) Results: Women with osteoporosis had a positive perception of their health (EQ-5D% VAS 64.9 ± 18.31). High EQ-5D QoL scores were obtained on the dimensions of mobility: 51.6% [95% CI (44.2%, 58.9%)]; self-care: 75.3% [95% CI (68.5%, 81.2%)]; activities of daily living: 71.4% [95% CI (64.4%, 77.6%)]; pain/discomfort: 25.8% [95% CI (19.8%, 32.6%)]; and anxiety/depression: 53.8% [95% CI (46.4%, 61.0%)]. (4) Conclusions: The QoL of the study group was no worse than the QoL of the general population, except for pain/discomfort and anxiety/depression. Age, highest educational level reached, inflammatory diseases, physical activity, and insomnia were independent predictors of QoL in women with osteoporosis.

Self-Reported Amnesia Following Concussion Predicts Greater Deficits in Quality of Life Domains Among Pediatric Athletes

Background:Concussion produces diverse symptoms, functional impairment, and societal limitations that may result in decreased quality of life (QoL). Various factors, including sex, prior concussion and mental health history have been associated with a reduction of QoL compared to baseline. However, the influence of various factors on post-concussion QoL has not been investigated in a prospective, multi-site investigation.Hypothesis/Purpose:To examine factors that may predict decreased post-concussion QoL and increased symptom severity.Methods:Pediatric patients (6-18 years) were enrolled as part of the Sport Concussion Outcomes in Pediatrics (SCOPE) study at 6 children’s medical centers and 9 secondary schools during the initial visit for a diagnosis of sport-related concussion. Patients completed a medical history, the Post-Concussion Symptom Inventory (PCSI), and Patient-Reported Outcomes Measurement Information System Pediatric Profile-25 (PROMIS-PP). The PCSI is an age-specific, validated symptom survey on which patients rate their current concussion symptoms. Higher numbers indicate greater symptom severity. The PROMIS-PP includes six domains: physical functioning and mobility, anxiety, depressive symptoms, fatigue, peer relationships, and pain interference. Lower scores indicate higher QoL for all domains, except peer relationships, where a higher score indicates better QoL. Eight predictor variables (Table 1) were assessed using negative binomial regression models constructed for each dependent variable.Results:The analysis included 141 patients (14.9±2.4 years, 40.4% female). Patients were enrolled 5.2±3.1 days post-concussion (range=1-14 days). The percentage (frequency) of patients with a positive self-reported medical history included prior concussion (38%, n=55), migraines (4% (n=5), ADD/ADHD (11%, n=55), LOC at time of injury (7%, n=10), and amnesia at time of injury (20%, n=29). Table 1 presents the pre-injury characteristics associated with each QoL domain and the total PCSI score. Self-reported amnesia was a significant predictor of lower QoL for the anxiety, depressive symptoms, fatigue, and pain interference domains. Migraines were associated with higher QoL scores in the anxiety domain. Younger age and longer time since injury were associated with higher symptom severity.Conclusion:Self-reported amnesia at the time of concussion was associated with a lower QoL related to anxiety, depressive symptoms, fatigue, and pain interference. Interestingly prior concussion and other pre-injury factors did not significantly impact post-injury QoL at the initial visit. Future studies should assess the influence of these factors on QoL at later post-injury time points using a concussion-specific outcomes instrument. Patients may be able to better reflect on the impact of the concussion on QoL over time during recovery.Table 1.Patient characteristics associated with each quality-of-life domain and total PCSI score. Due to the zero-inflated count variable nature of the PROMIS variables, negative binomial regression models were constructed for each domain. *Significant predictor of QoL domain.

MP21-07 EXPLORING SEXUAL HEALTH OF TRANSFEMININE INDIVIDUALS: AN OPPORTUNITY TO EDUCATE MEDICAL PROVIDERS

You have accessJournal of UrologyCME1 May 2022MP21-07 EXPLORING SEXUAL HEALTH OF TRANSFEMININE INDIVIDUALS: AN OPPORTUNITY TO EDUCATE MEDICAL PROVIDERS Andrew Denisenko, Andrew Salib, Jessica Bulafka, Sabina Spigner, Vishal Swaminathan, Peyton Stauffer, Cassra B. Clark, Andrew Shumaker, Rosemary Frasso, and Paul H. Chung Andrew DenisenkoAndrew Denisenko More articles by this author , Andrew SalibAndrew Salib More articles by this author , Jessica BulafkaJessica Bulafka More articles by this author , Sabina SpignerSabina Spigner More articles by this author , Vishal SwaminathanVishal Swaminathan More articles by this author , Peyton StaufferPeyton Stauffer More articles by this author , Cassra B. ClarkCassra B. Clark More articles by this author , Andrew ShumakerAndrew Shumaker More articles by this author , Rosemary FrassoRosemary Frasso More articles by this author , and Paul H. ChungPaul H. Chung More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002554.07AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Medical providers may not be familiar with the sexual health needs and preferences of transgender patients. This may hinder chances to provide comprehensive care since many patients require prompting to discuss such sensitive issues. To increase awareness and improve care, we aimed to describe the sexual experiences and preferences of transgender individuals. METHODS: IRB approval was obtained to develop (with feedback from the transgender community) and administer a 58-item questionnaire assessing urinary and sexual health. Participants were recruited from the local community and the Philadelphia Trans Wellness Conference and given a $20 gift card for their time. Sexual preferences, symptoms, and quality of life (QOL) responses were compared among respondents who had vaginoplasty, orchiectomy, or no procedure. Patients who had orchiectomy or no procedure were evaluated based on responses to the International Index of Erectile Function (IIEF) categories: erectile function, orgasmic function, and sexual desire. RESULTS: 53 transfeminine individuals (11 vaginoplasty, 10 orchiectomy, 32 no procedure) with a mean age of 40 (range 21-80) finished the survey. Patients who had not undergone vaginoplasty were more likely to engage in sexual activity with others and penetrative anal sex than those who did (p<0.05). Most gave high QOL scores for sexual function, sexual desire, and orgasm, with more than 17 (36%) participants indicating no problems (n=42). However, 25 (48%) patients reported dissatisfaction if they were to retain their current sexual function for life (n=52). For non-vaginoplasty patients, all of whom were on hormone replacement therapy, 23 (55%) said that penile function was important to them. In this group, IIEF erectile function, orgasm, and sexual desire categories had mean scores of 13.3, 5.8, and 5.6, respectively, compared to 25.8, 9.8, and 7.0 from the cis-gender controls from the initial IIEF study. 5 individuals (11.9%) affirmed using oral medications for erectile assistance, while 1 had a penile prosthesis. CONCLUSIONS: We found differences in sexual preferences between transfeminine individuals while QOL differed depending on which aspect was explored, highlighting the variability in this population. While many transgender individuals reported penile function was important, only a minority were on treatment. This highlights an opportunity for improvement for providers by discussing sexual health with their transgender patients and offering treatments if desired. Source of Funding: World Professional Association for Transgender Health © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e329 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Andrew Denisenko More articles by this author Andrew Salib More articles by this author Jessica Bulafka More articles by this author Sabina Spigner More articles by this author Vishal Swaminathan More articles by this author Peyton Stauffer More articles by this author Cassra B. Clark More articles by this author Andrew Shumaker More articles by this author Rosemary Frasso More articles by this author Paul H. Chung More articles by this author Expand All Advertisement PDF DownloadLoading ...

Effect of High-Quality Nursing Based on Comprehensive Nursing on the Postoperative Quality of Life and Satisfaction of Patients with Malignant Glioma.

Objective To explore the effect of high-quality nursing based on comprehensive nursing on postoperative quality of life and satisfaction of patients with malignant glioma. Methods From September 2017 to May 2020, 86 patients with malignant glioma treated in our hospital were recruited and assigned (1 : 1) to receive either comprehensive nursing (comprehensive group) or high-quality nursing plus comprehensive nursing (high-quality group). Outcome measures included preoperative and postoperative self-rating anxiety scale (SAS) scores, self-rating depression scale (SDS) scores, quality of life, and nursing satisfaction. Results High-quality nursing plus comprehensive nursing was associated with significantly lower SAS and SDS scores versus comprehensive nursing alone (P < 0.05). Patients receiving high-quality nursing plus comprehensive nursing showed higher quality of life scores versus those only given comprehensive nursing (P < 0.05). High-quality nursing plus comprehensive nursing resulted in higher nursing satisfaction of the patients versus comprehensive nursing alone (P < 0.05). Conclusion High-quality nursing can relieve the negative emotions of patients with malignant glioma and significantly enhance their quality of life, thereby improving the nursing satisfaction of patients with nursing, so it is worthy of clinical application.

Quality of life of older people in nursing homes in China\u2013evaluation and application of the Chinese version of the life satisfaction questionnaire

BackgroundChinese and global populations are aging, and more older people are living in nursing homes in China. However, there is a lack of research measuring nursing home residents’ quality of life (QOL), and especially associations with nursing home types (publicly versus privately run). Therefore, this study aimed to determine the construct validity and internal consistency of the Chinese version of the life satisfaction questionnaire (LSQ-Chinese) and determine the associations between nursing home types (publicly versus privately run), residents’ sociodemographic characteristics, and their QOL.MethodsA cross-sectional survey measuring QOL among older people living in nursing homes was conducted (n = 419). Confirmatory factor analysis and Cronbach’s alpha were used to assess the construct validity and reliability of the LSQ-Chinese. In addition, multivariate regression analysis was used to examine these associations.ResultsConfirmatory factor analysis indicated acceptable goodness-of-fit statistics for the seven-factor LSQ solution. All factors and the total scale had good internal consistency, with Cronbach’s alpha values > 0.70. The two factors with the highest QOL scores (higher scores indicate a more desirable state) were “physical symptoms” and “socioeconomic situation,” and those with the lowest QOL scores were “quality of close-friend relationships” and “quality of daily activities fun”. Residents living in privately run nursing homes had higher LSQ scores overall and for all factors except “physical symptoms” and “sickness impact” compared with publicly run nursing homes. Multivariate analyses indicated that marital status, number of chronic diseases, education level, main source of income, and nursing home type significantly contributed to the variance in the total LSQ scores. The associated sociodemographic variables differed between the factors, and the variable publicly versus privately run was significant for five of the seven factors.ConclusionsThe LSQ is a suitable instrument for measuring the QOL of Chinese nursing home residents. The total LSQ score was higher among residents in privately run nursing homes than in publicly run ones. According to residents’ needs, staff should work for person-centered activities, and facilitate residents’ social interactions with friends, as both these aspects were scored relatively low.

Modelling quality of life in children with intellectual disability using regression trees.

AimTo identify factors associated with quality of life (QoL) in children with intellectual disability. We aimed to identify patterns of association not observable in previous hypothesis‐driven regression modelling using the same data set from a cross‐sectional observational study.MethodA questionnaire was completed by 442 caregivers of children with confirmed intellectual disability and a diagnosis of autism spectrum disorder, cerebral palsy, Down syndrome, or Rett syndrome. The Quality of Life Inventory‐Disability (QI‐Disability) questionnaire was used to assess child QoL. Independent variables described the child's health, functional abilities, community participation, and sociodemographics. The R package rpart was used to build the regression trees.ResultsThe mean total QI‐Disability score was 69.2 out of a maximum 100. The subgroup with the lowest QoL scores comprised children with a high degree of daytime sleepiness (n=74, mean 57.5) while the subgroup with the highest QoL scores (n=91, mean 80.3) comprised children with little daytime sleepiness who participated more frequently in community activities and displayed good eye contact while listening.InterpretationRegression tree analysis provides insights into the relative importance of associated factors. Sleep problems and community participation were more important than functional abilities in accounting for differences in QoL.What this paper adds A hypothesis‐free regression tree analysis enables examination of multiple factors potentially influencing quality of life (QoL) in children with intellectual disability.Functional abilities were less strongly associated with QoL than sleep problems and community participation.

The Analysis of the Relationship between the Quality of Life Level and Expectations of Patients with Cardiovascular Diseases under the Home Care of Primary Care Nurses.

The World Health Organization defines quality of life as a person’s perception of his or her life situation in relation to the culture and value system in which he or she lives, in relation to and with respect to his or her functioning assumptions, expectations, and standards set by environmental conditions. Meeting the expectations of patients with CVD is one of the factors that positively influences their health status and leads to better diagnostic and treatment outcomes. The aim of this study was to answer three main questions related to patients with chronic cardiovascular disease: (1) What is their quality of life? (2) Are patients’ expectations about the quality of care provided by primary health care physicians/nurses met (and at what level)? (3) Is there a correlation between patients’ quality of life and their expectations of primary health care physicians/nurses? The study involved 193 Polish CVD patients who were cared for at home by a family nurse practitioner working in primary health care facilities. Data were collected from March 2016 to January 2017. The WHOQOL-BREF Quality of Life Questionnaire and the Author Interview Questionnaire were used for the study. Data analysis was based on the Spearman correlation coefficient test. There was a statistically significant association between patients’ expectations of the physician regarding information about the course of the disease and quality of life in the following domains: environmental r = 0.20, p = 0.006, psychological: r = 0.18, p = 0.015, physical: r = 0.18, p = 0.013, and social: r = 0.16, p = 0.025. Patients who did not expect the nurse to be courteous, understanding, or interested were found to have higher quality of life scores in psychological (r = −0.17, p = 0.023) and physical (r = −0.15, p = 0.044) domains. There was a statistically significant relationship between expectations of care from nurses regarding intimacy during care activities and the level of satisfaction with one’s own health (r = −0.15, p = 0.038) and quality of life (r = −0.14, p = 0.045), as well as quality of life in the domains of physical (r = 0.21, p = 0.004), social (r = 0.19, p = 0.010), and psychological (r = 0.16, p = 0.024). There is a need to define the expectations of patients with chronic cardiovascular disease in primary care, as lack of expectations of a physician/nurse continues to be associated with lower quality of life in all domains.

Nutritional status and quality of life are associated with risk of sarcopenia in nursing home residents: a cross-sectional study

Sarcopenia, which is characterized by an age-related decline in skeletal muscle mass, strength, and function, is an important geriatric syndrome that is closely related to the nutritional status and quality of life (QoL) of older adults. The aim of this study was to compare the nutritional status and QoL of nursing home residents according to sarcopenia. We hypothesized that a daily protein intake <1.2 g/kg is associated with a higher risk of sarcopenia. This study was performed with 172 older adults living a nursing home. Sarcopenia was defined according to the consensus of the European Working Group on Sarcopenia in Older People. The nutritional status was evaluated using the Mini Nutritional Assessment-Short Form, 24-hour dietary recall. Frailty was evaluated using the Fatigue, Resistance, Ambulation, Illnesses, and Loss of weight scale and health-related QoL was evaluated by the European Quality of Life-5 Dimensions scale. In addition to the anthropometric measurements associated with sarcopenia, QoL was also lower in sarcopenic individuals. The risk of malnutrition and frailty status were more prevalent among the sarcopenic individuals. In the multivariate logistic regression analysis, a higher QoL score was related with a low risk for sarcopenia, whereas the risk of malnutrition, a daily protein intake that was <1.2 g/kg/d, and being >80 years of age remained predictive of sarcopenia after adjustment. Sarcopenic nursing home residents have a great risk of malnutrition and lower QoL. This study showed that QoL, the risk of malnutrition, and daily protein intake are important factors as potential target areas for the management of sarcopenia in nursing home residents.

Quality of Life of Pregnant Women with Systemic Lupus Erythematosus.

To assess the quality of life (QoL) of pregnant women with systemic lupus erythematosus (SLE) treated at a high-risk prenatal outpatient clinic during the third trimester of gestation. An observational descriptive study was performed in a high-risk prenatal outpatient clinic. Women in the third trimester of pregnancy and undergoing antenatal care between July 2017 and July 2019 answered the abbreviated World Health Organization Quality of Life (WHOQOL-BREF) questionnaire, consisting of 26 questions divided into 4 domains (physical, psychological, social and environmental). We interviewed 50 pregnant women with a mean gestational age of 30 weeks (standard deviation [SD]: 10 weeks) who were diagnosed with SLE. The average age of the participants was 30 years (SD: 14.85), and the average time since the diagnosis of SLE was of 9.06 years (SD: 6.8 years). Most participants had a partner, did not plan their pregnancy (76%), and did not use contraception prior to pregnancy (80%). The score of each domain ranges from 0 (the worst score) to 100 (the best score). The means ± SDs of the scores of the participants on each domain were: physical - 52.21 ± 18.44); psychological - 64.17 ± 18.56); social - 66.33 ± 27.09); and environmental - 64.56 (18.53). The means ± SDs of the general QoL, and health-related QoL items were of 70.50 ± 24.06 and 70.00 ± 30.72 respectively. The physical domain presented the lowest scores compared with the other three domains. Pregnant women with SLE had high overall QoL scores, and their health-related QoL scores were also relatively high.

Navigating Diabetes Online Communities in Clinical Practice.

This purpose of this study was to conduct a rapid review and environmental scan of diabetes online communities (DOCs) to highlight the clinical impact of DOC engagement and provide guidance to health care providers for navigating and prescribing DOCs. This two-phase review included a rapid review of clinical outcomes and an assessment of DOC content. We conducted a literature search for studies evaluating DOC use and glucometric (glycated hemoglobin [A1C], time-in-range, hypoglycemia), behavioral, and psychosocial outcomes. The environmental scan of current DOC sites established key features, including available platforms, target population, content areas, and reach. Twelve papers were included-eight reported DOC use within a context of do-it-yourself (DIY) noncommercial, opensource hybrid closed loop systems community and four were non-DYI related. In latter, all studies were cross-sectional, describing patient-reported outcomes. Two studies reported A1C lowering with DOC use, two DOC use was associated with high self-efficacy, one showed association with higher self-care levels, and one showed higher quality of life scores when compared with population norms. All DIY studies showed improvement in glucometrics after initiation of sensor augmented pump technology with DOC support. Of 54 DOC sites reviewed in the environmental scan, 29 were included. Diabetes online community sites were heterogenous in social media platform and type of diabetes targeted. Diabetes online communities have the potential to improve clinical, behavioral, and psychosocial outcomes. Randomized control trials and/or longitudinal prospective studies evaluating outcomes are needed to further examine the potential benefits of DOC use. Diabetes online communities are diverse and span a variety of social media platforms, providing clinicians opportunities to individualize recommendations for DOC use.

Gender differences in quality of life and the course of schizophrenia: national study.

Evidence from various sources suggests that females with schizophrenia tend to report lower quality of life than males with schizophrenia despite having a less severe course of the disorder. However, studies have not examined this directly. To examine gender differences in the association between quality of life and the risk of subsequent psychiatric hospital admissions in a national sample with schizophrenia. The sample consisted of 989 (60.90%) males and 635 (39.10%) females with an ICD-10 diagnosis of schizophrenia. Quality of life was assessed and scored using the Manchester Short Assessment of Quality of Life. The course of schizophrenia was assessed from the number of psychiatric hospital admissions. Participants completed the quality of life assessment and were then followed up for 18-months for subsequent psychiatric admissions. Hazard ratios (HR) from Cox proportional hazards regression models were estimated unadjusted and adjusted for covariates (age at schizophrenia onset and birth year). Analyses were computed for males and females separately, as well as for the entire cohort. A subsample of 93 males and 55 females was admitted to a psychiatric hospital during follow-up. Higher quality of life scores were significantly (P < 0.05) associated with a reduced risk of subsequent admissions among males (unadjusted: HR = 0.96, 95% CI 0.93-0.99; adjusted HR = 0.96, 95% CI 0.93-0.99) but not among females (unadjusted: HR = 0.97, 95% CI 0.93-1.02; adjusted HR = 0.97, 95% CI 0.93-1.02). Quality of life in schizophrenia is a gender-specific construct and should be considered as such in clinical practice and future research.

Curative Effects of Remote Home Management Combined with Feng's Spinal Manipulation on the Treatment of Elderly Patients with Lumbar Disc Herniation.

Objective To explore the curative effects of remote home management combined with Feng's spinal manipulation on the treatment of elderly patients with lumbar disc herniation (LDH). Methods The clinical data of 100 patients with LDH in our hospital (December 2019–December 2020) were retrospectively reviewed. The 100 patients were equally divided into a routine treatment group and interventional group according to the order of admission. The routine treatment group received conventional rehabilitation training, and the interventional group received remote home management combined with Feng's spinal manipulation. The Oswestry disability index (ODI) and straight leg raising test were adopted for the assessment of the degrees of dysfunction and straight leg raising angles of the two groups after intervention. The curative effects of the two rehabilitation programs were evaluated. Results Compared with the routine treatment group, the interventional group had a remarkably higher excellent and good rate (P < 0.05), a significantly lower average ODI score after intervention (P < 0.001), notably higher straight leg raising angle, surface AEMG (average electromyogram) during stretching and tenderness threshold after intervention (P < 0.001), markedly lower muscular tension, surface AEMG during buckling, and flexion-extension relaxation ratio (FRR; (P < 0.001)), and much higher quality of life scores after intervention (P < 0.001). Conclusion The remote home management combined with Feng's spinal manipulation, as a reliable method to improve the quality of life and the back muscular strength of the elderly patients with LDH, can substantially increase the straight leg raising angle and reduce the degree of dysfunction. Further study is conducive to establishing a better solution for the patients with LDH.

Effect of Continuous Quality Care on HAMA, HAMD Score and Quality of Life in Patients with Acute Myocardial Infarction

Objective: To analyze the impact of continuous quality care on HAMA, HAMD score, and quality of life in patients with acute myocardial infarction. Methods: The 100 patients with acute myocardial infarction admitted to our hospital from January 2020 to January 2021 were selected and divided into control and observation groups according to the random number table method, with 50 patients in each group. Patients in the control group were given routine care after discharge, and patients in the observation group received continuous quality care intervention to compare the changes in HAMA, HAMD and quality of life scores before and after care between the two groups. Results: Lower HAMA, HAMD scores and higher quality of life scores compared to care in the observation group, and the difference between groups before and after care was significant (P&lt;0.05). Conclusion: Continuous quality care can effectively reduce anxiety and depression in AMI patients and improve quality of life, which deserves clinical application.

Comparative Analysis and Exploration of Clinical Value of Kyphoplasty and Conservative Treatment for Osteoporotic Vertebral Compression Fractures

Objective: To explore the clinical value of kyphoplasty and conservative treatment for osteoporotic vertebral compression fractures. Methods: 40 patients with Osteoporotic vertebral compression fracture from May 2019 to November 2021 were selected. The control group was treated with conservative treatment and the experimental group was treated with kyphoplasty. Results: Compared with the control group, the experimental group had higher total effective rate (95.00%), better recovery of Cobb Angle and vertebral height, and higher quality of life score. The data was more meaningful (P &lt; 0.05). Conclusion: For patients with osteoporotic vertebral compression fractures, the application of kyphoplasty can improve the treatment effect, accelerate the recovery of vertebral body function and enhance the quality of life, which is worthy of popularization.

Quality of life and complications after nephron-sparing treatment of renal cell carcinoma stage T1\u2014a systematic review

BackgroundDespite the fact that nephron-sparing treatment is considered preferable from a surgical perspective patients’ quality of life (QoL) following different types of nephron-sparing treatments remains unclear.PurposeTo investigate the quality of life and complications after nephron-sparing treatment of renal cell carcinomas of stage T1.Materials and methodsA systematic search of six databases was carried out. We included studies that reported the quality of life and complications in patients aged 18 years or older following nephron-sparing treatment of renal cell carcinoma stage T1. The quality assessment was performed using the Critical Appraisal Skills Programme (CASP) checklist for cohort studies and the CASP Randomized Controlled Trial Checklist. Data were analyzed using a narrative approach.ResultsEight studies were included, six of which investigated QoL after partial nephrectomy and two after ablation therapies. Seven studies reported complications. Three studies reported higher QoL scores after partial nephrectomy compared to radical nephrectomy. Two studies showed that QoL increased or returned to baseline levels up to 12 months following partial nephrectomy. One study reported a gradual increase in QoL after radiofrequency ablation, and one study reported that all patients recovered to baseline QoL following cryoablation. Across studies, we found a complication rate up to 20% after partial nephrectomy and up to 12.5% after ablation therapy.ConclusionsThe results of this systematic review suggest that nephron-sparing treatment appears to be superior or comparable to other treatment alternatives with regard to QoL outcomes. Additionally, based on the studies included in this review, partial nephrectomy appears to have a higher complication rate compared with ablation therapies.Systematic review registrationPROSPERO CRD42020155594

Client satisfaction to methadone maintenance treatment program in Myanmar

BackgroundTo tackle the long-standing opioid misuse problem, Myanmar introduced the methadone maintenance treatment (MMT) program in 2006, starting with 260 clients. Since then, the program has been expanded across different geographical sites in the country. This study was done in 2017 to explore the treatment satisfaction of the clients towards the MMT program.MethodA total of 210 clients with a minimum of six-month treatment history enrolled in five MMT program sites across Myanmar were recruited through stratified random sampling. Administering the Verona Service Satisfaction Scale for Methadone-Treatment (VSSS-MT), this study assessed the satisfactory responses under three categories viz., 1) clinic staff professional skills; 2) basic drug intervention; 3) specific intervention (individual rehabilitation and psychotherapy).ResultsThe majority (89%, n = 186) of the respondents were satisfied with the current MMT program. Specifically, 89.5% (n = 187) were satisfied with the clinic staff professional skills category, 91.9% (n = 192) with the basic program intervention and 74.6% (n = 156) with specific interventions. Among the respondents, treatment satisfaction with the MMT program was higher (p < 0.05) in those (i) with a higher quality of life score in physical, psychological, social and environmental categories, ii) who were satisfied with their current marital and leisure status, and those iii) who consumed alcohol. Results from stepwise binary logistic regression showed alcohol consumption and physical health status had a significant association with MMT treatment satisfaction.ConclusionTreatment satisfaction of the clients, in general is high. However, the lower percentage of satisfied clients (74.6%) for the specific interventions category compared with 89.5 and 91.9% respectively for staff and basic drug management categories highlights the need for improvement in this category for overall enhancement of the MMT program.

Quality of life assessment in patients on chronic dialysis: Comparison between haemodialysis and peritoneal dialysis at a national hospital in Vietnam.

End-stage renal disease (ESRD) is a chronic disease that can adversely affect the patient's quality of life (QoL) in terms of functional limitation and cognitive impairment. This study aimed to identify the factors associated with QoL in patients with ESRD undergoing dialysis at a national hospital in Vietnam. A descriptive cross-sectional study was conducted among outpatients aged ≥18years who underwent haemodialysis (HD) or peritoneal dialysis (PD) for at least 3months at Thong Nhat Hospital, Ho Chi Minh City, Vietnam from May 2020 to July 2021. QoL was measured using the validated Vietnamese version of the EuroQol-5 Dimensional-5 Level (EQ-5D-5L). The factors associated with the QoL of patients with ESRD undergoing dialysis were identified using multiple linear regression analysis. In total, 131 (73.6%) and 47 (26.4%) patients underwent HD and PD, respectively. Overall, 178 (55.6%) patients were men (median age, 66 [56-79] years). The mean EQ-5D-5L score was significantly higher in patients undergoing PD than in those undergoing HD (0.848±0.183 vs. 0.766±0.231; p=0.030). Older age (β=-0.006; p<0.001) and peptic ulcer disease (β=-0.083; p=0.029) were associated with lower QoL scores. PD treatment was associated with higher QoL scores (β=0.065; p=0.046). It is necessary to improve the QoL of patients undergoing dialysis, especially of elderly patients and patients with peptic ulcer disease. PD may be a better method for maintenance dialysis, if applicable, in terms of QoL.

Religious institutions as a link to substance use treatment: Characterizing the potential service population through national survey data

Background: Relatively few Americans with current alcohol or drug use disorders receive outpatient or residential treatment. Outreach initiatives at local places of religious worship have been proposed as a way of facilitating such service use, but the number and characteristics of adults who may be reached in this way has not been studied. Methods: Data from the 2012–2013 National Epidemiologic Survey on Alcohol and Related Conditions-III, a nationally representative cross-sectional survey of U.S. adults were used to estimate the number of and proportion of adults with substance use disorders (SUDs) who attended monthly religious service and did not receive SUD treatment in the past year and used multinomial logistic regression to compare them to three SUD groups who did or did not receive treatment and/or attend religious services. Results: A total of 5,795 respondents representing 35.8 million Americans met criteria for a past-year SUD, of whom 8.3 million (23.1%) attended religious services monthly and did not receive substance use treatment. This more often African-American group had substantially fewer socio-demographic disadvantages (e.g., unemployment), behavioral problem indicators (e.g., police involvement), a higher quality of life score and less likelihood of an illicit drug use diagnosis than those who received treatment and either did or did not attend religious services. Conclusion: Almost one quarter of adults with a SUD attend religious services monthly and do not receive SUD treatment. Although they have fewer adversities than people who receive treatment, outreach to this population may link this substantial group of people to needed services. Highlights/review National survey data suggest 8 of 36 million Americans with substance use diagnoses’ (23%) do not receive specialized SUD treatment, but they do attend religious services monthly or more. This group, notably, has less numerous problems, such as unemployment, police involvement, and drug use disorder, and have higher quality of life scores than those who receive treatment for SUD. Outreach and linkage initiatives with religious institutions may facilitate use of services by this population.

MENTAL HEALTH PROBLEMS DURING COVID-19 PANDEMIC WERE LOWER AMONG UNDERGRADUATES IN CLINICAL COMPARED TO NON-CLINICAL PROGRAMS IN MALAYSIA

This study aimed to determine undergraduates’ mental health status, quality of life and burn-out status in clinical and non-clinical programs as well as its association during COVID-19 pandemic period. A cross sectional survey was carried out by distributing the questionnaire through online social media platforms such as WhatsApp, Facebook, and Twitter. Mental health, burn-out statuses and quality of life of the undergraduates were assessed using 21-item Depression Anxiety Stress Scale (DASS-21), Copenhagen Burnout Inventory and Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q-SF) respectively. A total of 308 respondents (111 from clinical, 197 from non-clinical programs), mean (SD) age=21.88(1.29) years participated in this cross-sectional online survey. The results revealed that undergraduates in the non-clinical programs are more likely to experience higher levels of depression, anxiety and stress, which demonstrated by higher median (IQR) scores in each component of DASS-21 (Non-clinical VS Clinical) [depression, 18 (10-28) VS 8 (2-20); anxiety, 16 (8-26) VS 10 (2-16), and stress, 20 (12-28) VS 12 (4-22)]. Similarly, higher burnout median score, 58.83 (48.83 - 75.00) was noted among undergraduates in non-clinical programs with a lower mean (SD) Q-LES- Q-SF score=58.75 (18.03). Undergraduates from non-peninsular Malaysia showed lower quality of life scores [2.06(1.03-4.13)], while undergraduates with good internet accessibility had higher quality of life scores [2.06(1.03-4.13)]. The association between lower mental health status, QoL and burn-out among non-clinical students remained significant even after adjustment for gender, household income, type of university (IPTA vs IPTS), race, and internet accessibility at university. Our findings suggest that undergraduates from clinical programs had better mental health status and quality of life when compared to their peers from non-clinical programs during COVID-19 pandemic period.