Impact Scores Research Articles

The Impact of Social and Economic Status on the Marital Behaviour of Young People

The social and economic status significantly influences social development and individual behaviour, cultural factors and a deteriorating economic situation hinder youth marriage. This study aimed to highlight the impact of social and economic conditions on the marital behaviour of young people. The research employed a descriptive approach, based on a sample of 60 individuals. The results indicated that both social and economic conditions play a significant role in shaping the marital behaviour of youth, with an average impact score of 3.39. It was also found that the education level of both partners and tribal and familial affiliations affect this behaviour. Furthermore, the costs of marriage, driven by ostentatious consumption and the desire to emulate others, contribute to the decision-making process surrounding marriage. Finally, the findings confirmed that there is no significant difference in the impact of social and economic status on marital behaviour based on gender.

The Psychometric Properties of the Persian Version of Emotional Abuse Questionnaire

Objective: Intimate partner emotional abuse is a serious issue that can lead to catastrophic outcomes for victims. Emotional abuse involves psychological tactics to control, manipulate, and degrade a person within an intimate relationship. This research aimed to translate the Emotional Abuse Questionnaire (EAQ) developed by Jacobson and Gottman into Persian for use among Iranian university students. Method: The translation of the 66-item EAQ involved a meticulous forward and backward translation process, linguistic matching, and a pilot review. In this cross-sectional study, 346 university students from Rasht, Iran, completed the EAQ. The mean age of participants was 26.78 ± 8.10 years, with most being female (89.0%). Reliability was evaluated using Cronbach's alpha and test-retest analysis while content and face validity were assessed by a panel of experts. Construct validity was examined through confirmatory factor analysis (CFA) and internal consistency measures. Divergent validity was assessed by comparing the EAQ with the ENRICH Marital Satisfaction Scale (EMS). Results: Impact scores for face validity ranged from 2.33 to 3.92, based on respondents' ratings of frequency and importance. Content validity assessment led to removing four items with a CVR below 0.62, resulting in 62 valid items. The EAQ showed strong internal consistency, with a Cronbach’s alpha of 0.97, exceeding the acceptable threshold of 0.70. CFA results confirmed the validity of the second-order factor model of the EAQ (χ2/df = 4.34, CFI = 0.95, RMSEA = 0.098, SRMR = 0.077). The EAQ demonstrated a strong correlation with EMS measures, confirming divergent validity. Conclusion: The Persian version of the EAQ is a reliable instrument for assessing emotional abuse among Iranian university students. Future research should explore the cultural sensitivity of the questionnaire and investigate associations between emotional abuse and other variables of interest, such as mental health outcomes or relationship dynamics. These avenues promise valuable insights into the frequency and effects of emotional abuse across diverse cultural contexts.

Evaluating the Effect of a Novel Digital Ostomy Device on Leakage Incidents, Quality of Life, Mental Well-Being, and Patient Self-Care: An Interventional, Multicentre Clinical Trial

Background: Most people with a stoma worry about leakage, and a quarter experience leakage of stomal effluent outside the baseplate on a monthly basis. Leakage has additional physical and psychosocial consequences, for instance, peristomal skin complications, feeling unable to cope, and self-isolation. Method: An interventional, single-arm, multi-centre study was undertaken in the United Kingdom to evaluate a novel digital leakage notification system for ostomy care, including a support service (=test product) for 12 weeks in patients with a recent stoma formation (≤9 months). Patients completed questionnaires at baseline and after 4, 6, 8, 10, and 12 weeks, evaluating leakage episodes, Ostomy Leak Impact (tool containing three domains), and patient self-management (by PAM-13). Additionally, mental well-being (by WHO-5) and health-related quality of life (QoL) (by EQ-5D-5L) were assessed. Outcomes between baseline and final evaluation were compared by generalised linear and linear mixed models. Results: 92 patients (ITT population) with a mean age of 49.4 years (range 18–81 years) were recruited. Of these, 80% had an ileostomy, and 53% were female. After 12 weeks of using the test product, a significant decrease in mean episodes of leakage outside the baseplate (1.57 versus 0.93, p < 0.046) was observed. Ostomy Leak Impact scores improved across all three domains (p < 0.001), indicating less embarrassment, increased engagement in social activities, and increased control. Patient self-management also improved significantly (PAM-13 score: ∆6.6, p < 0.001), as did the WHO-5 well-being index (∆8.0, p < 0.001). Lastly, EQ-5D-5L profile scores tended to improve (p = 0.075). Conclusions: A new digital leakage notification system demonstrated strong improvements to patients’ stoma self-care, mental well-being, and QoL. Registration number on ClinicalTrials.gov: NCT05135754.

Adaptation of the Colostomy Impact Score for Use in the Turkish Population: A Validity and Reliability Study

Adaptation of the Colostomy Impact Score for Use in the Turkish Population: A Validity and Reliability Study

Functional outcome and quality of life index after endonasal versus external dacryocystorhinostomy

Abstract Purpose: To compare the functional outcome and quality of life (QOL) index following non-endoscopic endonasal dacryocystorhinostomy (NEN-DCR) and external dacryocystorhinostomy (EXT-DCR). Methods: Patients were prospectively allocated to two groups. All adult patients presenting with primary nasolacrimal duct obstruction (PANDO) undergoing EXT-DCR and NEN-DCR at a tertiary eye care center were included. Patients in one group underwent EXT-DCR and others NEN-DCR. Functional outcomes were measured by Munk Score and fluorescein dye disappearance test (FDDT). A validated quality of life questionnaire (EQ-5D-3L) in the local language (Odiya) was used to measure health status (social impact score) before and 1 day, 2 weeks, 6 weeks, and 3 months after surgery. The primary outcome measure was the functional outcome–Munk Score and secondary outcome measures included the QOL index and the FDDT. Results: A total of 110 patients were recruited and equally distributed (n = 55) in both groups. The mean age of the population was 47.6 years (SD = 14.02; range 20–79 years). The majority (71%, 79/110) were female. When longitudinally followed over time, functional outcome and QOL index showed reasonably rapid and marked improvement in both groups after surgery compared to baseline scores. The Munk score (P = 0.037) and QOL index (P = 0.007) were marginally better on the first postoperative day for the NEN-DCR group compared to EXT-DCR but comparable at all subsequent visits. At a median follow-up of 9 weeks (range: 0.5–24 weeks), the anatomical outcome was comparable between both groups. Conclusion: Our results demonstrate that functional outcome and QOL index show rapid and marked improvement in both NEN-DCR and EXT-DCR after surgery. NEN-DCR outcomes were marginally better on the first postoperative day but comparable to EXT-DCR thereafter.

Psychological Anxiety of COVID-19 Pandemic and its Effect on Academic Performance of University Students

The problem and the aim of the study. The COVID-19 pandemic has caused a worldwide emergency, with consequences for more than just physical health, including mental health and educational outcomes. University students are particularly vulnerable since they are dealing with a number of challenges at once, such as the health effects of the pandemic both directly and indirectly, the sudden shift to online schooling, and doubts about their future employment opportunities. Critical to understanding the far-reaching effects of the pandemic on student lives, learning processes, and mental health is research into COVID-19-related psychological anxiety and its impact on academic performance in higher education. This research subject seeks to investigate the extent to which college students are anxious about the COVID-19 pandemic and how this unusual stressor affects their participation in class, grades, and general satisfaction with their education. By looking at it from this perspective, we may identify the many ways in which the epidemic has affected the future generation of researchers and professionals, and then develop strategies to help them cope with the difficulties they will face. Research methods. The study employed a correlational descriptive approach to investigate the psychological distress caused by the COVID-19 epidemic and its influence on the academic performance of university students in Jordan. The sample consisted of 300 undergraduates (male and female) from the College of Educational and Psychological Sciences at Amman Arab University in the 2021–2022 school year, with the entire student body serving as the population. The survey tool was distributed online via social media, leading to 379 respondents, and a chance sample was used because it was feasible to reach a large number of participants—especially during the pandemic. Results. The study results show a detailed range of stress and worry, with average scores varying from 2.8 to 4.1 among 25 items. Major concerns involve social isolation, indicated by an average score of 4.1 for feeling alienated because of social distancing measures, and academic disruptions, with an average score of 4.0 for experiencing a lack of control over academic life owing to the pandemic. There is a significant gender gap between the reported levels of anxiety and its effect on academic performance; 40% of female students and 30% of male students express high levels of anxiety, and the average academic impact score for female students is 3.0 while the average score for male students is 2.5. The data also shows that anxiety levels and the detrimental effect they have on academic performance are getting worse over the years, with fourth-year students having the worst levels of anxiety (45%) and the greatest academic impact score (3.5). The findings highlight the importance of providing students with personalized support to help them cope with the psychological effects of the pandemic. Scientific novelty: Novelty resides in the study's exhaustive examination of COVID-19's psychological effects on Jordanian university students, with a particular emphasis on anxiety levels and how they relate to academic achievement. By looking at the effects of the pandemic across genders and academic years, it shows how anxiety levels rise over time and how there are clear differences between the sexes. The study offers important insights into the many ways in which the pandemic affected students' academic performance and mental health by using a large sample size, a correlational descriptive approach, and social media to reach a wide audience during the epidemic.

Assessing the impacts of public policies towards environmental sustainability in the Centre NUTII of Portugal. The case of POSEUR (2014-2020)

The operational programme for Sustainability and Use of Resources (POSEUR 2014-2020) is the most powerful mechanism of EU Cohesion Policy to be implemented in Portugal concerning sustainable environmental development. The programme has a place-based approach that attends to the territorial characteristics of the Portuguese regions. This study focused its analysis on the POSEURS’ main impacts on the Portuguese Centre NUT II. With a mixed methodological approach, impact scores were produced for five environmental sustainability dimensions: i) low-emissions economy, ii) adaptation to climate change, iii) risk prevention and management, iv) environmental protection, and v) resource efficiency. The qualitative and quantitative data was collected through interviews, literature review, the POSEUR project database analysis and regional environmental indicators. The outcome of the analysis showed that technical and execution barriers contributed to the heterogeneity of the results obtained in the five selected dimensions. An overall balance points out the low positive impact scores promoting small regional changes in environmental sustainability. Nonetheless, elaborating spatial plans for the municipalities and regions turned the adaptation to climate change into a highly positive impact dimension.

Does the impact of medical publications vary by disease indication and publication type? An exploration using a novel, value-based, publication metric framework: the EMPIRE Index

Background The EMPIRE (EMpirical Publication Impact and Reach Evaluation) Index is a value-based, multi-component metric framework to assess the impact of medical publications in terms of relevance to different stakeholders. It comprises three component scores (social, scholarly and societal impact), each incorporating related altmetrics that indicate a different aspect of engagement with the publication. Here, we present an exploratory investigation of whether publication types or disease indications influence EMPIRE Index scores. Methods Article-level metrics were extracted and EMPIRE Index scores were calculated for 5825 journal articles published from 1 May 2017 to 1 May 2018, representing 12 disease indications (chosen to reflect a wide variety of common and rare diseases with a variety of aetiologies) and five publication types. Results There were significant differences in scores between article types and disease indications. Median (95% CI) social and scholarly impact scores ranged from 1.2 (0.3–1.6) to 4.8 (3.1–6.6), respectively, for phase 3 clinical trials, and from 0.3 (0.3–0.4) to 2.3 (1.9–2.6), respectively, for observational studies. Social and scholarly impact scores were highest for multiple sclerosis publications and lowest for non-small cell lung cancer publications. Systematic reviews achieved greater impact than regular reviews. Median trends in the social impact of different disease areas matched the level of public interest as assessed through Google search interest. Although most articles did not register societal impact, mean societal impact scores were highest for migraine publications. Conclusions The EMPIRE Index successfully identified differences in impact by disease area and publication type, which supports the notion that the impact of each publication needs to be evaluated in the context of these factors, and potentially others. These findings should be considered when using the EMPIRE Index to assess publication impact.

Environmental, technological, and economic analysis of supercritical coal-fired power system.

Developing countries primarily rely on fossil-based energy sources to meet their energy demands. The use of fossil fuels has several adverse environmental repercussions that damage the biosphere both directly and indirectly. Among fossil fuels, coal brings about the heaviest environmental externalities, yet its abundance makes its use widespread, particular in countries having significant power generation deficits, such as Pakistan. This study presents an environmental, technological, and economic analysis of a supercritical coal-based power unit located in Pakistan and used for electricity generation. For environmental assessment, the CML-1A baseline method in OpenLCA software was used, and eight midpoint impact indicators were selected. The functional unit chosen was 1 MWh of generated electricity. The results indicated that the category of ozone layer depletion has the least impact, whereas global warming potential has the highest impact score. Except for photochemical oxidation and human toxicity, the plant operational stage dominated most of the selected impact categories. The current paper also reveals that the removal efficiency of CO2 and other pollutants is higher in supercritical compared to subcritical plants. Moreover, the economic feasibility of supercritical plant is compared with chemical looping combustion (CLC)-based supercritical coal-fired power plant, and results shows that CLC-based coal-fired power plant is a more competitive and environmentally friendly option. The utilization of a scientific cleaner energy-management system in real-time, as exemplified in this study, may facilitate the development of a optimalpolicy framework that encouragesfor the adoption of cleaner coal power generation in developing countries, ultimately resulting in improved energy sustainability. Furthermore, this paper also presents some policy implications which could be helpful for policymakers, researchers, and industrialists to improve the sustainability of energy in emerging economies.

Transcultural adaptation and validation of Persian Version of Patient Assessment of Chronic Illness Care (PACIC-5As) Questionnaire in Iranian older patients with type 2 diabetes

BackgroundThe Patient Assessment of Chronic Illness Care (PACIC-5As) questionnaire has been designed to evaluate the healthcare experiences of individuals with chronic diseases such as diabetes. Older adults are at higher risk for diabetes and its associated complications. The aim of this study was transcultural adaptation and evaluation of the validity and reliability of the PACIC-5As questionnaire in older patients with diabetes residing in Qazvin City, Iran.MethodIn this validation study, we recruited 306 older patients with diabetes from Comprehensive Health Centers in Qazvin, Iran. The multi-stage cluster sampling technique was used to choose a representative sample. The PACIC-5As questionnaire was translated into Persian using the World Health Organization (WHO) standardized method. The validity (face, content, and construct) and reliability (Cronbach’s alpha) of the PACIC-5As were assessed. Data analysis was conducted using R software and the Lavaan package.ResultsThe mean age of the older patients was 69.99 ± 6.94 years old. Most older participants were female (n = 180, 58.82%) and married (n = 216, 70.59%). Regarding face validity, all items of PACIC-5As had impact scores greater than 1.5. In terms of content validity, all items had a content validity ratio > 0.49 and a content validity index > 0.79. The results of confirmatory factor analysis demonstrated that the model exhibited satisfactory fit across the expected five factors, including assess, advise, agree, assist, and arrange, for the 25 items of the PACIC-5As questionnaire. The Cronbach’s alpha coefficient for the PACIC-5As questionnaire was 0.805.ConclusionThis study indicates that the Persian version of the PACIC-5As questionnaire is valid and reliable for assessing healthcare experiences in older patients with diabetes. This means that the questionnaire can be effectively used in this population.

Pelvic Organ Prolapse Surgery: Postoperative Quality of Life in Ethiopian Women.

Pelvic organ prolapse (POP) has a profound influence on a woman's quality of life (QoL). Assessment of QoL using patient-reported outcome (PRO) measures in pelvic organ prolapse surgery is common practice in developed countries, but despite the burden of POP in developing countries, such as Ethiopia, the use of PROs to record preoperative and postoperative QoL scores is limited. This study is aimed at assessing the QoL among Ethiopian women with POP before and after surgery using the validated Pelvic Organ Quality of Life (P-QoL) questionnaire.Additionally, we will compare postoperative QoL measurements of reconstructive procedures with those of obliterative procedures. This is a prospective observational study conducted at a single hospital in Ethiopia on women who were scheduled for surgery for symptomatic POP. Patients' QoL was assessed preoperatively using the P-QoL questionnaire and at each subsequent follow-up visit for 1 year (3, 6, 9, and 12months). Patients undergoing an obliterative procedure were evaluated and compared with those having reconstructive procedures. The mean score for general health perceptions, prolapse impact, role limitations, physical limitations, social limitations, and emotions was 0 at 12 months postoperatively. Despite significant improvements from baseline, personal relationships, sleep or energy disturbance, and symptom severity measures continued to negatively impact QoL at 12 months postoperatively. Quality of life among Ethiopian women with POP is poor across all domains. Native tissue repair employing either reconstructive or obliterative methods significantly improves QoL across all domains up to 12months postoperatively. The use of validated tools to assess PROs is essential to provide evidence-based care that improves QoL in ways that are meaningful to patients.

Tracking the trajectory of frankia research through bibliometrics: trends and future directions.

Frankia represent a unique group of filamentous, sporangia-forming bacteria, renowned for their exceptional capacity to establish symbiotic partnerships with actinorhizal plants. The objective of this paper is to offer quantitative insights into the current state of frankia research and its future potential. A comprehensive bibliometric analysis covering the years 2000-2022 was conducted using Scopus and SciVal. A steady increase in both annual publication and international collaboration has been observed, particularly since 2013. Research performance metrics for the last 5 years (2018-2022) indicate China and India as leaders with high Field-Weighted Citation Impact scores. This analysis highlighted prominent authors, research groups, and the evolving research landscape, suggesting an increasing focus on molecular and genomic aspects. The genomic era has transformed our understanding of frankia biology, highlighting their significance in diverse ecological and agricultural contexts. This study comprehensively maps the evolving landscape of frankia research, emphasizing key milestones that have catalysed international interest in frankia-actinorhizal research, expanding our perception of frankia's capabilities beyond its traditional symbiotic role. As research in this field progresses, a deeper comprehension of frankia-plant interactions, symbiotic signalling, and the intricacies of metabolic pathways holds the promise of revealing innovative techniques for optimizing nitrogen fixation and broadening the spectrum of host plants.

Model of Sustainable Household Mobility in Multi-Modal Transportation Networks

Nowadays, urban and suburban areas face increasing environmental pressures, and encouraging sustainable transportation behaviors at the household level has become crucial. This paper presents a model of a decision support system (DSS) for promoting sustainable household mobility choices in multi-modal transport networks. The system was modeled using an enhanced Petri Net approach, allowing for the dynamic representation of complex transport networks and multi-modal journey options. The model incorporated various sustainability factors. These were combined into a single environmental impact score, which was considered alongside travel time and cost in the route optimization process. Simulation results demonstrated the DSS’s capability to guide users toward more sustainable mobility choices. The model also showed potential as a tool for policymakers to assess the impact of various sustainable transportation initiatives and infrastructure investments. This paper discussed the versatile applications of the system. It also addressed the limitations of Petri Net models in transportation systems and suggested future research directions.

Health-Related Quality of Life and Satisfaction in Atrial Fibrillation Patients on Anticoagulant Therapy: Differences between Vitamin K Antagonists and Direct Oral Anticoagulants; Results from the Multicentre REGUEIFA Registry.

Background: Oral anticoagulation (OAC) is pivotal in the clinical management of atrial fibrillation (AF) patients. Vitamin K antagonists (VKAs) and direct oral anticoagulants (DOACs) prevent thromboembolic events, but information about the quality of life (QoL) and patient satisfaction in relation with the anticoagulant treatment is limited. Methods: REGUEIFA is a prospective, observational, and multicentre study that included patients with AF treated by cardiologists. We included patients treated with VKAs or DOACs. The EuroQol-5D (EQ-5D) questionnaire evaluated QoL, and the Anti-Clot Treatment Scale (ACTS) questionnaire investigated patient satisfaction with OAC. Results: A total of 904 patients were included (532 on VKA and 372 on DOACs). A total of 846 patients completed the EQ-5D questionnaire, with results significantly worse in patients on VKAs than on DOACs: more mobility limitations (37.6% vs. 24.2%, p < 0.001), more restriction in usual activities (24.7% vs. 18.3%, p = 0.026), more pain/discomfort (31.8% vs. 24.2%, p = 0.015), a lower visual analogue scale (VAS) score (66.4 ± 16.21 vs. 70.8 ± 15.6), and a lower EQ-D5 index (0.79 ± 0.21 vs. 0.85 ± 0.2, p < 0.001). After adjusting for baseline characteristics, VKA treatment was not an independent factor towards worse EQ-5D results. Also, 738 patients completed the ACTS questionnaire, and burden and profit scores were lower in patients on VKAs than for DOACs (52.1 ± 8.4 vs. 55.5 ± 6.8, p < 0.001 and 11.1 ± 2.4 vs. 11.8 ± 2.6, p < 0.001, respectively). The negative impact score was higher for VKAs than for DOACs (1.8 ± 1.02 vs. 1.6 ± 0.99, p < 0.001), with a general positive impact score lower for VKAs than for DOACs (3.6 ± 0.96 vs. 3.8 ± 1.02, p < 0.001). Conclusions: Patients on VKA have more comorbidity and worse EQ-5D and VAS scores than those on DOACs. VKA has a greater burden and higher negative impact on the patient's life than DOACs.

Impact of Early Admission Surveys on Physicians' Communication Skills on Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) Scores: A Quality Improvement Initiative.

Introduction Effective communication between doctors and patients is one of the 19 core questions on the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey. Positive patient experiences, as reflected in HCAHPS scores, are associated with higher quality of care, reduced mortality, and fewer readmissions. These scores also influence a hospital's financial bonuses or penalties from the Centers for Medicare & Medicaid Services. Methods This quality improvement (QI) initiative evaluated how early surveys of patients' feedback on doctors' communication skills during admission impacted discharge communication scores. The approach involved promptly sharing patients' feedback with physicians and focusing on improving communication skills for those with less-than-perfect scores. Results This QI initiative involved 41 patients. By surveying patients early during admission and addressing communication issues for those with less-than-perfect scores, the percentage of patients achieving a perfect score on all survey questions increased from 18 (43.9%) at admission to 34 (82.9%) at discharge. The largest improvement was seen in perfect scores for doctors' explanations of patients' conditions, which rose from 59% at admission to 90% at discharge. Conversely, the increase in perfect scores for doctors' respectful treatment was smaller, rising from 88% at admission to 98% at discharge. Conclusion Surveying patients about their doctors' communication skills early in admission to identify those with less-than-perfect scores and improving communication for this group resulted in a 39% increase in satisfaction with doctors' communication.

Evolution and significance of amino acid scores for protein quality.

Amino acid scores have become very popular protein quality scores since their definition and recommendation by FAO expert groups. The chemical score is the central pillar of this method, and has been refined with digestibility correction factors, such as protein digestibility for the PD-CAAS and amino acid digestibility for the DIAAS. Several elements need to be taken into account to properly determine these scores, not only from a methodological point of view but also in order to reconcile regulation, pragmatism, accuracy and also biological significance. This review offers a reminder of the main points raised in the FAO reports on protein and AA requirements in 1995 and 2007, and on protein quality in 1991 and 2013. It also highlights the factors that most impact score metrics, and in particular the choice of reference pattern and protein determination in the food. Lastly, the scores are compared, and versus another quality score based on the physiological response, the protein efficiency ratio.

Effects of environmental impact labels on the sustainability of food purchases: A randomised controlled trial in an experimental online supermarket.

Providing consumers with product-specific environmental impact information for food products (ecolabels) may promote more sustainable purchasing, needed to meet global environmental targets. This UK study (N = 1051 participants) investigated the effectiveness of different ecolabels using an experimental online supermarket platform, comparing three labels against control (no label). Significant reductions were found in the environmental impact score (EIS) for all labels compared to control (labels presented: values for four environmental indicators [-3.9 percentiles, 95%CIs: -5.3, -2.6]; a composite score [taking values from A to E; -3.9, 95%CIs: -5.2,-2.5]; or both together [-3.2, 95%CIs: -4.5, -1.9]). Providing ecolabels is a promising intervention to promote the selection of more sustainable products.

Long-term evaluation of psychosocial impact and stuttering severity after intensive stuttering therapy.

The purpose of this study was to assess the long-term stability of objective and subjective psychosocial improvements and fluency more than 10 years after participation in an intensive stuttering therapy camp. Ten former participants in intensive stuttering therapy (IST; mean age at time of intervention 14; 2 years) participated in this study. Outcomes of the IST at that time were assessed with the Stuttering Severity Instrument (SSI-3; Riley, 1994) and a questionnaire to measure the psychosocial impact of stuttering. A semi-structured video call and a general questionnaire for the long-term evaluation were used to gauge the participants' perceptions of the IST. These follow-up data were compared to the therapy outcomes reported by Cook (2011, 2013). Therapy effects on the severity of stuttering and psychosocial impact were stable over the follow-up period of more than 10 years. Moreover, scores for psychosocial impact and severity of stuttering further decreased from the end of the IST to the long-term evaluation. The intensive time and the periodically offered follow-up treatments were described as particularly positive by the participants. Intensive stuttering therapy in childhood or adolescence can have a long-term positive effect on both internal and external stuttering symptoms.

The most impactful endometriosis symptom: An international, cross-sectional, two-round survey study.

There is considerable variation in the types of symptoms experienced by people living with endometriosis, and it is unclear which symptoms impact people the most. This study aimed to identify the specific symptoms that are "most impactful" to people living with the condition. Two sequential online surveys were conducted. Women aged over 18 years with a diagnosis of endometriosis were eligible to participate. Participants first provided a free-text list of all the endometriosis symptoms they experienced (Survey 1, Australian only). Responses were condensed into a shorter list by grouping symptom types and selecting the top 20 most common and most impactful. Survey 2 (international) participants reviewed the list and selected all that they had experienced in the last 3 months, nominated one as their single "most impactful symptom", and rated its impact on one of five randomized scale types. Survey 1 and Survey 2 had 195 and 983 responses, respectively. The mean age of respondents was 30.8 ± 7.9 years. There were 275 separate symptom descriptions from Survey 1, which were condensed into 104 groups, of which 25 met criteria for inclusion in Survey 2. The most commonly experienced symptoms were abdominal pain (93% of respondents), bloating (92%), and fatigue (90%), and the symptoms nominated as causing the most impact were pelvic pain (20%), abdominal pain (15%), and cramps (7%). Nearly everyone (99.7%) in Survey 2 reported experiencing at least one pain symptom. The symptoms that generated the highest impact scores were infertility (99.8/100), irregular menstrual cycles (95.3/100), and constipation (92/100). The average impact score was 87.5/100. There was substantial variation in the symptom selected as causing the most impact, and the level of impact was high. A focus on measuring the "most impactful symptom" in future research may enable us to better capture and measure the true symptom experience.

Disease-specific patient-reported quality of life after fenestrated/branched endovascular aortic aneurysm repair

ObjectivesFenestrated-branched endovascular technology (F/B-EVAR) is increasingly used to repair complex aortic aneurysms. While reintervention, morbidity and mortality after F/B-EVAR have been well-characterized, studies on patient-reported quality of life (QOL) after F/B-EVAR have been limited in their use of non-specific instruments and measures. We report on disease-specific QOL in patients that underwent F/B-EVAR using a validated QOL survey for aortic aneurysms. MethodsProspectively maintained databases were used to contact living patients that underwent F/B-EVAR for pararenal or thoracoabdominal aortic aneurysms at two institutions. Eligible patients (n = 286) were asked to complete a disease-specific QOL survey previously validated in patients that underwent repair of an infrarenal abdominal aortic aneurysm. An emotional impact score (EIS) from 0-100 was derived from the survey with higher scores indicating more emotional impact and worse QOL. Respondent behavior change following F/B-EVAR was evaluated in four domains (strenuous activity, travel, heavy lifting, and sexual activity) previously identified by patients to be most impacted by an aortic aneurysm. ResultsIn total, 234 patients (82%) completed surveys. Mean post-operative interval to survey completion was 3.4 ± 2.8 years. Mean EIS was 16 (range 0-91) for all patients surveyed, with higher mean EIS among those within the first year after F/B-EVAR (20 vs 14). Most respondents demonstrated limited adverse emotional impact after F/B-EVAR. However, the 4th quartile of EIS was broad (22-91), indicating that a subset of respondents had significantly worse QOL after repair. While most patients reported no post-procedure change in each of the activity domains, over 40% of patients did report decrease in strenuous activity and heavy lifting after F/B-EVAR. Those with decreased activity after repair had corresponding deficiencies in disease-specific knowledge for the domains of heavy lifting (P <.001) and sexual activity (P = .17). ConclusionsThe majority of patients who underwent F/B-EVAR in this cohort had low emotional impact on their QOL after repair. One-quarter of patients did report significant post-procedure anxiety about their aneurysm, with improvement observed beyond one year after repair. Most patients reported unchanged or decreased activity levels following F/B-EVAR, and less aneurysm-specific patient knowledge was associated with decreased activity after repair. These findings are similar to those seen in prior work using this survey instrument in patients that underwent infrarenal aneurysm repair. This work confirms the feasibility of using this survey to evaluate QOL in patients with complex aortic disease. Longitudinal evaluation in these patients may identify those at high-risk for worse QOL after F/B-EVAR.