Improvements In Emotional Well-being Research Articles

Quality of life for older patients with metastatic cancer in Brazil: A telehealth-based geriatric assessment and supportive care intervention (GAIN-S).

1514 Background: Older adults with cancer often present unique geriatric and supportive care needs. We sought to evaluate the impact of a telehealth-based multimodal geriatric assessment (GA)-guided supportive care interventions (GAIN-S) program among older patients with metastatic cancer in a Brazilian cancer center. Methods: This is a randomized trial. Patients aged 65+ years with metastatic cancer, undergoing treatment, regardless of ECOG status, were enrolled. Following the baseline assessment, patients were randomized 1:1 to receive usual care or GAIN-S. The GAIN-S intervention provided remote, telehealth-based consultations with a nutritionist, psychologist, psychiatrist, and certified fitness trainer. At baseline and 3-months, patients were assessed for emotional symptoms (Geriatric Depression Scale), functional status (Instrumental Activities of Daily Living), coping (BriefCope), and quality of life (Functional Assessment of Cancer Therapy-General). Independent t-tests and linear mixed model were used. Results: Out of 86 approached patients, 80 were enrolled (40 per arm), with 3 deceased during treatment (usual care: 2, GAIN-S: 1). Most patients were female (56%), with a median age of 73 years (range, 65-68). Most common cancers were genitourinary (28%) and breast (23%). At baseline, there were no differences in the outcome measures between arms. However, from baseline to 3-months, patients assigned to GAIN-S had improvements in emotional symptoms, functional status, and quality of life compared to usual care (Table). Additionally, those assigned to GAIN-S reported increased utilization of active coping, acceptance, and positive reframing at 3-months. Conclusions: GAIN-S demonstrated significant improvements in emotional well-being, functional status, and quality of life among older patients with metastatic cancer. These findings underscore the potential of such telehealth-driven approaches to enhance the supportive care experience in diverse healthcare settings. [Table: see text]

Overestimating the intensity of negative feelings in autobiographical memory: evidence from the 9/11 attack and COVID-19 pandemic

ABSTRACT When recalling autobiographical events, people not only retrieve event details but also the feelings they experienced. The current study examined whether people are able to consistently recall the intensity of past feelings associated with two consequential and negatively valenced events, i.e. the 9/11 attack (N = 769) and the COVID-19 pandemic (N = 726). By comparing experienced and recalled intensities of negative feelings, we discovered that people systematically recall a higher intensity of negative feelings than initially reported – overestimating the intensity of past negative emotional experiences. The COVID-19 dataset also revealed that individuals who experienced greater improvement in emotional well-being displayed smaller biases in recalling their feelings. Across both datasets, the intensity of remembered feelings was correlated with initial feelings and current feelings, but the impact of the current feelings was stronger in the COVID-19 dataset than in the 9/11 dataset. Our results demonstrate that when recalling negative autobiographical events, people tend to overestimate the intensity of prior negative emotional experiences with their degree of bias influenced by current feelings and well-being.

Impact of Customized Content in 3D Virtual Reality Motionless Imagery Exercise through Avatar on Emotional Well-Being, Cognition, and Physiological Response

People in situations where physical activity is difficult face limitations in participating in exercise to maintain health. Participation in exercise is especially difficult when social non-face-to-face situations such as infectious diseases occur. This causes various social problems. Background: The study developed a 3D virtual reality (VR) Motionless Imagery Exercise through Avatar (MIEA), provided customized content such as companion avatars, and aimed to verify its effects. Methods: This study was conducted using a randomized block design experiment. The participants were 40 healthy adults (20 experiment and 20 control group) aged between 19 and 49 years. Both groups engaged in interventions three times per week for 20 min over six weeks. Data obtained from measurements of emotional well-being, cognition, and physiological responses before and after the experiment were analyzed. Results: The experimental group showed significant improvements in emotional well-being compared to the control group, particularly in trait anxiety, resilience, stress, and positive affect. The similar physiological responses observed in the experimental group resembled exercise-induced responses. Verbal memory and working memory in the experimental group improved more in the experimental group than the control group. Conclusions: The results showed the effectiveness of a 3D VR MIEA, indicating its positive impact on exercise outcomes. Furthermore, the provision of customized content including companion avatars was validated to enhance emotional well-being. This suggests that incorporating content-driven companion avatars in developing virtual reality exercise programs can evoke emotional effects.

Effect of modifying agricultural product circulation on mood disorders among consumers

BackgroundMood disorders encompass a category of mental illnesses characterized by fluctuating emotional states, including periods of elevated and diminished emotions. These conditions have the potential to profoundly influence an individual’s behavior and cognitive functions. To effectively intervene in mood disorders, innovation is made in the circulation mode of agricultural products based on the patient’s lifestyle habits, and consumer mental changes are recorded, providing reference opinions for the treatment of mood disorders.Subjects and MethodsA cohort of 140 individuals, who were enthusiastic about agricultural products and exhibited symptoms of mood disorders, was recruited from the general population. All participants displayed clear indications of mood disorders. The circulation mode of agricultural products was reconfigured under the participants’ lifestyle habits. A comprehensive set of measures was implemented as part of the intervention. Over a span of 4 months, the mental symptoms of the 140 participants were meticulously documented. These records formed the basis for subsequent analysis. All collected data were subjected to rigorous statistical examination using SPSS23.0. To gauge changes in participants’ mental states, the Self-Rating Depression Scale was employed. This assessment tool was administered both before and after the intervention period.ResultsThe transformation of the agricultural product circulation mode led to significant improvements in emotional well-being and mental state among patients over the 4-month intervention period. The psychological impact varied based on the specific agricultural product transformation strategy employed. Nonetheless, all strategies demonstrated a capacity to alleviate negative emotions and foster overall patient well-being.ConclusionsAdapting the agricultural product circulation mode in line with individual patient characteristics emerges as a promising strategy for mitigating mental stress and enhancing the well-being of those affected by mood disorders. This innovative approach offers potential avenues for symptom relief and presents actionable recommendations for mood disorder treatment.

Growing old and being old: Emotional well-being across adulthood.

The present study examines change in reports of daily, weekly, and monthly psychological distress over 20 years, and of negative and positive affect over 10 years, using data from the Midlife in the United States study. The study includes three waves of data collection on adults ranging from 22 to 95 years old. Cross-sectional findings reveal that older age is related to lower levels of psychological distress and negative affect and to higher levels of positive affect across each successive age group. Yet, longitudinal findings vary across younger, middle-aged, and older adults. Psychological distress decreases over time among younger adults (although only until age 33 for weekly reports), remains stable in midlife, and is stable (monthly) or slightly increases (daily and weekly) among older adults. For negative affect, levels decrease over time for younger and middle-aged adults, and only increase for the oldest adults for daily and monthly affect. Positive affect is stable over time among younger adults, but decreases in midlife starting in the mid-fifties. In conclusion, overall patterns of findings suggest that being old (assessed cross-sectionally) is related to higher levels of emotional well-being. Growing old (assessed longitudinally) is related to improvements in emotional well-being across younger and early middle adulthood, which mirrors cross-sectional findings. There is relative stability in later midlife, however, and continued stability or slight declines across older age. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

GERD - still current problem of society, diagnosis, practical methods of management and treatment

Introduction and purpose: Gastroesophageal reflux disease (GERD) is a very common digestive disease worldwide. About half of all adults will report symptoms of reflux at some point in their lives. The symptoms of the disease are non-specific, which is why doctors of many specializations face the problem both in doctor's offices and hospital rooms. GERD is a disorder with troublesome symptoms and complications resulting from the regurgitation of gastric contents into the esophagus, causing subjective symptoms and related complications, negatively affecting the quality of life. Symptoms negatively affect the quality of life of patients, lowering well-being, physical activity, and social functioning. Diagnosis is based in most cases on the observation of symptoms, which is why this paper presents the symptoms that should be taken into account when diagnosing patients. Therapeutic procedures, selection of the appropriate form of treatment: conservative, pharmacological and surgical, were discussed.Materials and methods: The review was based on the analysis of materials collected in the "Pubmed" database, books and other scientific articles.Summary: Gastroesophageal reflux disease is an important health problem because it is associated with impaired daily functioning and morbidity. Proper management of GERD symptoms can result in significant improvements in patients' well-being, including reduction in physical pain, increase in vitality, physical and social functioning, and improvement in emotional well-being. In some patients, only lifestyle modification and a change in habits are enough to reduce the occurrence of symptoms. First-line drugs are proton pump inhibitors. Endoscopic examination should be performed when pharmacological therapy is ineffective or in the event of alarm symptoms, i.e. dysphagia, weight loss, anemia, bleeding and recurrent vomiting. Surgical treatment is used as a last resort when pharmacological treatment fails.

Quality of life and clinical factors in women with endometriosis, the role of dienogest vs EE/dienogest over time: a single-center study

PurposeThe aims of this observational study were: to assess the relationship between psychological variables, pain, Duration Untreated Endometriosis (DUE) in a sample of women with Endometriosis; and to assess the effect of dienogest 2 mg/daily (DNG) and dienogest/ethinylestradiol 0.03 mg/daily (EE/DNG) on Symptoms, QoL, HRQoL, pain and sexual satisfaction, over time.Methods64 women constituted the study group; (56%) took DNG and (44%) took EE/DNG. VAS, SF-36, EHP-30 and ISS were used to assess endometriosis-associated pelvic pain, QoL, HRQoL and sexual satisfaction, respectively. The study included one follow-up at 18 months.ResultsAt T0, a longer period of DUE was related both to worst HRQoL and Physical QoL. At T1, a correlation was found between longer DUE and worst HRQoL. At T0, a negative correlation was found between VAS and PCS and between VAS and EHP-30. At T1, the same above correlation was found between VAS and PCS/MCS and VAS and EHP-30 scale. There was a correlation between ISS and VAS. ANOVA showed a reduction in dysmenorrhea, in general pain level and an improvement in emotional wellbeing, relationship with medical profession, and PCS over time, regardless to type of treatment. Moreover, a significant time × treatment group interaction for dysmenorrhea was found.ConclusionDUE and pain are important variables related to psychological aspects of women with endometriosis. Treatment with both DNG and EE/DNG may have positive effects on the QoL, HRQoL and symptoms. Moreover, DNG seems to have a greater effect than EE/DNG on dyspareunia reduction over time.

Moderators of the Effectiveness of UPcomplish on Office Workers’ Sedentary Behaviour, Quality of Life, and Psychosocial Determinants: A Stepped Wedge Design

BackgroundIn the earlier developed and evaluated 12-week UPcomplish intervention, the aim was to reduce sedentary behaviour (SB) among office workers and increase their quality of life (QoL). In the current study, we explored moderators of effectiveness.MethodWe applied a stepped wedge design with five intervention groups starting with time lags of seven weeks (n = 142, 96 females). Participants wore the VitaBit to continuously measure SB and received surveys about QoL and psychosocial determinants at the beginning, middle, and end of the intervention. We regressed baseline participant characteristics and behaviours onto intra-individual improvements (centred around calendar week means) in determinants, SB, performance objectives, and QoL.ResultsThose scoring high in baseline intention, task performance, stress, vitality, and emotional well-being improved less in these variables. Baseline stress (β = − 0.05 [SE = 0.01; 95% CI = − 0.08, − 0.02; pcorrected = .02]) and emotional well-being (β = 0.02 [SE = 0.01; 95% CI = 0.01, 0.03; pcorrected = .02]) were associated with improvement in contextual performance. Baseline attitude (β = − 12.92 [SE = 3.93; 95% CI = − 20.80, − 5.04; pcorrected = .02]) and perceived behavioural control (PBC; β = − 9.27 [SE = 3.04; 95% CI = − 15.37, − 3.16; pcorrected = .03]) were negatively associated with improvements in emotional well-being. Post hoc analyses with a sub-group scoring lower in determinants revealed that improvement in PBC was positively associated with SB registration.ConclusionParticipants scoring low in baseline determinants might profit from UPcomplish via an increase in PBC. In combination with changes within organizations (e.g. the implementation of standing desks), UPcomplish might potentially reduce SB.Trial RegistrationNL7503 — registered 1 February 2019.

NEW SPINS ON CLASSIC IDEAS ABOUT CONTEXT IN ADULT EMOTIONAL DEVELOPMENT

Abstract Individuals often experience improvements in emotional well-being into old age. Understanding mechanisms contributing to these emotional outcomes in daily contexts can inform ways to support healthy aging. Development is embedded within various contexts that shape individuals’ experiences. Novel perspectives are emerging on how to conceptualize context and the way it can contribute to emotional development during the aging process. This symposium illustrates four innovative ways to consider contextual contributions to emotional well-being across adulthood. The first talk will use experience sampling to illustrate age differences in how daily situations contribute to emotion regulation related processes, showing that older adults can more easily distinguish between emotions when in familiar situations. The second talk will take a fresh perspective on psychosocial contexts by distinguishing between types of social interactions in couples, highlighting the important role of affection for well-being in adulthood. The third talk will introduce the idea that the body itself provides context for emotional processes, showcasing that the way this context affects emotional experience changes as individuals age. The fourth talk will center on how renewing our classical developmental models of context in modern ways can help to overcome shortcomings of previous research and provide insight into how engagement with environmental features contributes to well-being across the lifespan. In sum, this symposium features innovative perspectives on how context can be leveraged to gain a deeper understanding of psychosocial development into old adulthood and illustrates specific ways individuals can navigate their social world to preserve or improve mental health across adulthood.

Effect of a novel pilot support group on distress and quality of life in breast cancer patients in Nigeria.

To assess the effect of a new breast cancer support group (BCSG) on breast cancer patients' self-reported distress and quality of life. A single arm pre-post trial providing an eight session healthcare provider led BCSG. Primary outcome variables were distress and quality of life assessed using the National Comprehensive Cancer Network Distress Thermometer (DT) and The Functional Assessment of Cancer Therapy - Breast plus Arm Morbidity (FACT-B+4), respectively. Topics in each session addressed a wide range of issues some of which were pre-selected by the patients themselves. Paired sample t-test was used for data analysis on International Business Machine Statistical Package for the Social Sciences 21. The participants (N=18) had a mean age of 51. Most had secondary school level education (54%), were traders (59%) and had stage 3 or 4 disease (67%). A larger proportion (78% or n=14) of the patients lived in rural areas, while 4 (22%) of the patients lived in Ibadan. Out of the 8 sessions, 12 (67%) of the participants attended 1-3 sessions while 6 (33%) attended 4-8 sessions. There were, significant improvements in emotional wellbeing (t=-4.253; p<0.05) and functional wellbeing (t=-2.191; p<0.05) on the FACT-B+4. There was a significant reduction in the DT score (t=2.345; p<0.05) but the number of items on the problem list were not significantly reduced (t=1.191; p>0.05). Majority (75%) of the patients rated the support group activities as satisfactory. These data show that the support group can benefit breast cancer patients in terms of reduced distress levels along with satisfaction and improvement in the functional and emotional wellbeing indices of quality of life.

FOOD ALLERGEN IMMUNOTHERAPY IS ASSOCIATED WITH A POSITIVE IMPACT ON PATIENT/CAREGIVER-REPORTED WELL-BEING AND SOCIAL INCLUSION

<h3>Introduction</h3> 5-10% of children globally are affected by food allergies, and patients and caregivers suffer from high levels of emotional distress and anxiety. Immunotherapy is gaining recognition as a safe method to treat food allergy. Increased stress and anxiety levels are associated with lower quality of life (QOL), higher activity impairment, and higher suicidal ideation. Few studies have explored patient/caregiver reported outcomes from immunotherapy. <h3>Methods</h3> 61 patients/caregivers completed a survey measuring Patient-Reported Outcomes Measures to assess perceived effects of immunotherapy treatment on general and emotional well-being and the ability to participate in activities of daily living. The survey was distributed through allergist offices and online support groups for patients/caregivers pursuing food allergen immunotherapy, and was open to patients who were either currently pursuing immunotherapy or who had done so previously. Procedures followed were in accordance with the Helsinki Declaration as revised in 2013. <h3>Results</h3> 77% of patients/caregivers reported improvement in general state of well-being with immunotherapy treatment. 65.6% reported improvement in emotional well-being. 70.5% reported improvement in the ability to perform social activities. However, there was not a clear association of food allergen immunotherapy with the ability to participate in physical activities, with 70.5% of patients/caregivers reporting no change. <h3>Conclusion</h3> In this preliminary survey, food allergen immunotherapy treatment was associated with improvement in patient/caregiver-reported well-being and improved ability to participate in social activities. Given the importance of QOL indicators on the decision to pursue food allergen immunotherapy, these results will help to inform the shared decision-making process and set realistic expectations for outcomes.

Impact of a Virtual Wellness Program on Quality of Life Measures for Patients Living With Multiple Sclerosis During the COVID-19 Pandemic.

Patients with multiple sclerosis (MS) were vulnerable to the effects of physical inactivity during the COVID-19 pandemic. As patients returned to in-person visits, providers reported seeing increased weakness, balance issues, falls, worsening pain, and spasticity. Social isolation also contributed to increased stress, depression, and anxiety. This study explored whether attending virtual wellness programs was associated with improvements in standard quality of life questionnaire scores for patients with MS. The purposive convenience sample consisted of 43 patients in the treatment group and 28 in the control group. Patients in the treatment group attended 2 monthly programs for 6 months and completed a demographic questionnaire, the 36-Item Short Form Health Survey (SF-36), the Modified Fatigue Impact Scale, and the Medical Outcomes Study Pain Effects Scale (PES). Patients requested additional topics, resulting in 5 additional programs. The control group consisted of patients who chose not to attend the programs but agreed to complete the questionnaires. In comparing questionnaire responses (6 months minus baseline) among the participants in the treatment group, an association was found between higher meeting attendance and improvements in emotional well-being (P = .038), pain on the PES (P = .011), mindfulness on the SF-36 pain scale (P = .0472), and exercise on the PES (P = .0115). The results of this study suggest that a virtual wellness program may provide beneficial emotional support, physical exercise, and health promotion activities resulting in improved quality of life in people with MS. In addition, mindfulness and exercise programs may be beneficial in pain management.

From ‘prison’ to ‘paradise’? Seeking freedom at the rainforest frontier through urban–rural migration

The lives of the urban poor in the majority world are unfree: blighted by social injustice in its manifold forms, from violence and ill-health to absent economic opportunities. We explore the pursuit of freedom through migration away from the metropole to ramais (colonisation tracks) at the rainforest frontier. Drawing on a case study in Brazilian Amazonia, we reveal urban-rural migration as a frontier dynamic driven by the search for a good life. We theorize freedom and the good life using the capabilities approach, starting from the observation that people in the ramais reported feeling better, and asking why that is. We find that frontiers provide a safer environment, which fosters individual and collective capabilities. A lower risk of violence reduces fears around bodily integrity, pervasive in Latin American cities. This safety fosters freedom and dignity by reducing worries and anxieties, leading to improvements in emotional well-being. We understand this increased sense of freedom as enhanced agency, that is, empowerment. In addition to new forms of political activity and subjectivity, we report a flourishing of senses, imagination and affiliation with others. Inequalities are reduced, positively influencing dignity and self-worth. These new freedoms are threatened by lack of rights provisioning by the State, however. We recommend that the Brazilian state should address social and environmental dimensions of these new forest frontiers. The state should recognize and support these settlements as valid forms of development, because they so clearly contribute to human wellbeing and flourishing. The state should guide and assist livelihood and landscape management toward more ecological approaches such as agroecology and agroforestry, to mitigate deforestation risks typical of forest frontiers.

Active Living After Cancer (ALAC) program: An avenue to improve physical functioning and moderate-intensity physical activity in gynecologic cancer survivors.

e24034 Background: Active Living After Cancer (ALAC) is a 12-week evidence-based program funded by the Cancer Prevention and Research Institute of Texas (CPRIT) to provide physical activity and survivorship education to cancer survivors. Given the limited data evaluating the effects of physical activity educational programs in gynecologic cancer survivors, we aim to assess the effects of the ALAC intervention in this patient population. Methods: A retrospective analysis was performed on gynecologic cancer survivors who participated in ALAC from 2017 to 2021. The 12-week ALAC program included weekly meetings (in-person or virtual) led by a facilitator providing physical activity behavioral skills training, leading 10 minutes of exercise, and discussing topics related to cancer survivorship. Surveys and functional testing assessments were collected pre- and post-program which included: The Godin-Shephard Leisure-Time Physical Activity Questionnaire (GSLTPAQ) and 30-second sit-to-stand. A patient-reported outcomes survey was used to assess patient perceived benefits and program satisfaction. Results: Thirty-two patients participated in ALAC and 22 completed pre- and post-program assessments. The mean age of participants was 60.2 years (range 50.7-69.7 years) and mean number of classes attended was 8 (range 0-12 classes). Prior cancer diagnoses included 14 cervical, 11 uterine, and 7 ovarian cancers. A significant improvement was seen pre- and post-ALAC in moderate-intensity physical activity minutes (n = 17, 97 vs 252 minutes, p = 0.007) by GSLTPAQ and 30-second sit-to-stand test (n = 16, 12.3 vs 15.8 repetitions, p = 0.003) in our cohort. The post-ALAC patient reported outcome survey (n = 22) revealed improvement in emotional well-being (90%), physical well-being (91%), physical activity level (100%), comfort speaking openly in a group (85%), and willingness to discuss their cancer journey (66%). Overall, 95.3% of participants were satisfied with the ALAC program and 100% of participants would recommend the ALAC program to other cancer survivors. Conclusions: Educational physical activity-based programs like ALAC improve physical functioning and moderate-intensity physical activity in gynecologic cancer survivors. Further studies on the long-term health benefits of structured educational programs which promote active lifestyles in gynecologic cancer survivors are needed in larger patient cohorts.

The health-related quality of life changes following surgery in patients with colorectal cancer: a longitudinal study.

Colorectal cancer (CRC) is commonly treated with surgery and its success is frequently defined by cure rates. Impact on other aspects of health and wellbeing are less frequently considered in clinical practice. Patient-reported outcome measures (PROMs) provide a useful means of assessing such impacts. This study examines changes in health-related quality of life (HRQoL) after surgical resection using PROMs. A prospective, longitudinal study was undertaken in 49 adults receiving curative surgery for CRC. Participants completed the Functional Assessment of Cancer Therapy-Colorectal (FACT-C) before surgery, and at 2 to 4 weeks, 3 and 6months post-surgery. Linear mixed models were used to analyse FACT-C wellbeing and subscale scores. Patients reported a clinically important deterioration in functional and physical wellbeing 2 to 4 weeks post-surgery (both P < 0.05); differences at 6months after surgery were trivial. Conversely, patients reported clinically important improvement in emotional wellbeing at 2 to 4 weeks post-surgery; this improvement was sustained at 3 and 6months post-surgery (all P < 0.05). For social wellbeing and colorectal cancer-specific concerns, changes from before surgery at follow-up assessments were not statistically significant (all P > 0.05). While physical aspects of HRQoL are affected in the short term by CRC surgery, clinically significant improvement in emotional wellbeing are reported early (2 to 4 weeks post-surgery). Future research may help identify patients who are at greater risk of surgical impacts on health and wellbeing.

Football and Zumba Training in Female Hospital Staff: Effects after 12 and 40 Weeks on Self-Reported Health Status, Emotional Wellbeing, General Self-Efficacy and Sleep Problems.

Background: This 40-weeks intervention study evaluates the effects on self-reported health status, emotional wellbeing, general self-efficacy and sleep problems among female hospital employees. Methods: 107 employees were cluster-randomized into three groups; football (FG), Zumba (ZG) and control (CG). Outcome measurements were conducted at baseline, 12 and 40 weeks. Weekly training frequencies in the first 12 and next 28 weeks were 2.4 ± 0.3 and 0.8 ± 0.2 in FG and 2.3 ± 0.3 and 0.9 ± 0.2 in ZG. Results: Compared to the CG, the ZG showed significant improvement in self-reported health status (p = 0.025), a reduced frequency of poor and restless sleep (on a 0–4 scale) (p = 0.004), as well as a tendency for reduction in the frequency of problems falling asleep (p = 0.055) and overall sleep problems (p = 0.051). Between baseline and 12 weeks, both the FG (p = 0.017) and the ZG (p = 0.017) showed within-group improvements in emotional wellbeing, whereas this improvement was maintained only in the ZG between baseline and 40 weeks (p = 0.002). The FG showed a significant within-group improvement in general self-efficacy (p = 0.012) between baseline and 12 weeks follow-up, with no such improvements in the other groups. Conclusion: The present findings revealed that a physical activity intervention with Zumba as well as football training may improve mental health and sleep outcomes in female hospital staff.

Prevalence and patterns of meditation related unpleasant experiences among community based yoga practitioners

Yoga is mainly known to restrain the emotional ripples in the mind but according to some studies, it may lead to some overwhelming challenges like uncontrolled emotional venting as meditation-induced adverse effects, along with benefits. This study intended to assess the prevalence and patterns of meditation-related unpleasant experiences (UEs), among 300 community-based yoga practitioners. In this mixed-methods study, a semi-structured interview schedule was developed to carry out the self-assessment survey. The Chi-square test of association was used for finding the pattern between the UEs and other variables. Total 114 (38%) respondents agreed to experience UEs. UEs were reported more in females (&lt;0.01). Reporting of UEs was found to be associated with a longer history of yoga practice (&lt;0.01), &gt; 20 minutes of daily meditation (&lt;0.05), perceived therapeutic effects of yoga in physical suffering (&lt;0.01), perceived improvement in emotional well-being (&lt;0.01), perceived reduction in negative emotional constructs like stress (&lt;0.01), depression (&lt;0.01), and anxiety (&lt;0.01), due to yoga. The study suggests a high prevalence of UEs, which may be associated more with female yoga practitioners, longer yoga and particularly meditation practice, yoga-induced improvement in emotional well-being, stress, depression, and anxiety, and the therapeutic effects of yoga in the physical sufferings.

Effects of a Bacopa monnieri extract (Bacognize®) on stress, fatigue, quality of life and sleep in adults with self-reported poor sleep: A randomised, double-blind, placebo-controlled study

In this 28-day, randomised, double-blind, placebo-controlled trial, 100 adults with self-reported poor sleep received either a placebo or a standardised Bacopa monnieri extract (150 mg twice daily). Outcome measures included the Bergen Insomnia Scale (primary outcome measure), Functional Outcomes of Sleep Questionnaire, Pittsburgh Sleep Diary, Short Form-36 Health Survey, and the Depression, Anxiety, and Stress Scale. Changes in salivary concentrations of cortisol, dehydroepiandrosterone sulfate, immunoglobulin A (sIgA), α-amylase (sAA), C-reactive protein, melatonin, and the fatigue biomarker index were also assessed. Based on the Bergen Insomnia Scale, Bacopa monnieri did not improve sleep patterns more than the placebo; however, it was associated with greater improvements in emotional wellbeing, general health, and pain-related symptoms. Bacopa monnieri was also associated with greater reductions in sIgA and sAA compared to the placebo. Future clinical trials using varying doses, treatment periods, and objective outcome measures will be important to validate these findings.

Short-Term Effects of Gender-Affirming Hormone Therapy on Dysphoria and Quality of Life in Transgender Individuals: A Prospective Controlled Study.

BackgroundGender affirming hormone therapy (GAHT), whilst considered the standard of care in clinical guidelines for the treatment of many transgender (trans) people is supported by low quality evidence. In this prospective longitudinal controlled study, we aimed to examine the effect of newly commencing GAHT on gender dysphoria and quality of life (QoL) over a 6 month period.MethodsAdult trans (including those with binary and/or non-binary identities) people newly commencing standard full-doses of masculinising (n = 42; 35 = trans masculine, 7 = non-binary) or feminising (n = 35; 33 = trans feminine, 2 = non-binary) GAHT and cisgender participants (n=53 male, n=50 female) were recruited to participate in this longitudinal prospective study. This analysis of gender dysphoria measured by the Gender Preoccupation and Stability Questionnaire and QoL measured by the RAND Short-Form 36 Health survey at baseline, 3 and 6 months after commencement of GAHT was a prespecified secondary outcome. Dysphoria and QoL over time in those starting GAHT compared to cisgender comparison group matched for their presumed sex at birth is reported as the mean difference (95% confidence interval) adjusted for age.ResultsIn trans people initiating masculinising GAHT, there was a decrease in gender dysphoria with adjusted mean difference -6.80 (-8.68, -4.91), p < 0.001, and a clinically significant improvement in emotional well-being [adjusted mean difference 7.48 (1.32, 13.64), p = 0.018] and social functioning [adjusted mean difference 12.50 (2.84, 22.15), p = 0.011] aspects of QoL over the first 6 months of treatment relative to the cisgender female comparison group. No significant differences were observed in other QoL domains. In trans people initiating feminising GAHT, there was a decrease in gender dysphoria [adjusted mean difference -4.22 (-6.21, -2.24), p < 0.001] but no differences in any aspects of QoL were observed.ConclusionsIn the short-term, our findings support the benefit of initiating masculinising or feminising GAHT for gender dysphoria. Masculinising GAHT improves emotional well-being and social functioning within 6 months of treatment. Multidisciplinary input with speech pathology and surgery to support trans people seeking feminisation is likely needed. Further longitudinal studies controlled for other confounders (such as the presence of social supports) contributing to QoL are needed.

Health-related quality of life after Gamma Knife radiosurgery in patients with 1\u201310 brain metastases

PurposeIncreasingly more patients with multiple (> 4) brain metastases (BM) are being treated with stereotactic radiosurgery (SRS). Preserving patients’ health-related quality of life (HRQoL) is an important treatment goal. The aim of this study was to assess (individual) changes in HRQoL in patients with 1–10 BM over time.MethodsA total of 92 patients were assessed before (n = 92) and at 3 (n = 66), 6 (n = 53), and 9 (n = 41) months after Gamma Knife radiosurgery (GKRS), using the Functional Assessment of Cancer Therapy-Brain (FACT-Br). The course of HRQoL was analyzed using linear mixed models. Clinical minimally important differences were used to evaluate individual changes.ResultsAt group level, patients’ physical well-being worsened, whereas emotional well-being improved over 9 months. Scores on other HRQoL subscales did not change significantly. Number (1–3 versus 4–10) and volume (small, medium, and large) of BM did not influence HRQoL over time, except for the subscale additional concerns; medium intracranial tumor volume was associated with less additional concerns. On the individual level as well, physical well-being declined while emotional well-being improved in most patients over 9 months after GKRS. At patient level, however, most patients had both declines as well as improvements in the different HRQoL aspects.ConclusionOur results indicate that even in patients with up to 10 BM, both at group and individual subscale level, aspects of HRQoL remained stable over nine months after GKRS, except for an improvement in emotional well-being and a decline in physical well-being. Nevertheless, HRQoL scores varied considerably at the individual patient level.Trail registration numberClinicalTrials.gov Identifier: NCT02953756, November 3, 2016.