Instrument Scores Research Articles

Evaluation of normative data of the instrument European Health Literacy Survey Questionnaire short-short form (HLS-EU-Q6) in Brazilian adults

Objective: To investigate the normative data of the Brazilian Portuguese version of the instrument for measuring health literacy European Health Literacy Survey Questionnaire short-short form (HLS-EU-Q6) in Brazilian adults. Methods: This is a methodological study in which the normative data of scores of HLS-EU-Q6 was evaluated in a sample of 783 adult users of the Brazilian public health system (SUS). The normative analysis went through three stages: descriptive analysis of the items and the instrument scores; analysis of the distribution of the score and confirmation that the cutoffs established in the distribution were able to effectively identify the participants in each range. Results: It was observed that all instrument items had a median of 3 and the median of the total score was 17 points. The results suggest that a model with 3 cutting lines and with different scores two proposals by the authors of the original study turned the classification capacity of the instrument more accurate for this population. Conclusion: It is concluded that the classification criteria of the HLS-EU-Q6 to be used in Brazilian adults should be different from those proposed by the authors of the original study, so as not to generate biases in the measurement of health literacy levels in this population.

374 Shared decision making for eczema patients and caregivers is not dependent on length of relationship with a provider or provider specialty

Abstract Shared decision making (SDM) is used in clinical settings to help patients make decisions regarding their treatment in collaboration with their healthcare provider (HCP). Shared decision making is well-suited for eczema as many treatment and management options exist, and there is significant disease, lived experience and patient preference heterogeneity. While a strong patient–provider relationship is likely important to facilitate SDM, the assumption that a long-term relationship between a patient and an eczema specialist leads to better SDM has not been evaluated. This study aims to understand the impact of the duration of the patient–provider relationship and type of provider on SDM experience, confidence to engage and trust in the HCP. The National Eczema Association conducted an online 64-question survey January 12 to March 14, 2021 of adult patients and caregivers of children with atopic dermatitis (AD). The SDM experience, assessed with the SDMQ9 instrument (score ranges transformed to 0–100), self-reported confidence to engage in SDM (categories: not confident at all/slightly confident/moderately confident vs. very confident/extremely confident) and trust in provider were compared by time with primary eczema HCP (categories: ≤12 months, 13–36 months and >36 months) and whether or not the HCP was a specialist (Dermatologist or Allergist vs. other provider types). Additionally, four groups were created for comparison of SDM experience: (i) patients who considered themselves to be well informed about the causes of eczema currently working with eczema specialists, (ii) patients not adequately informed and working with specialists and patients (iii) informed or (iv)uninformed working with nonspecialists. ANOVA was used for group comparison of continuous variables and Kruskal–Wallis tests were used for proportions. Responses from 767 adults and 177 caregivers (944 total) met inclusion criteria. Patients were primarily female (80.2%) and had a mean eczema RECAP score of 11.4. There was no difference in SDMQ9 score by time with HCP [≤12 months (62.6; n = 281), 13–36 months (66.9; n = 261) and >36 months (65.1; n = 402)], although respondents who saw their HCP longer than 12 months indicated they were more confident to engage in SDM (P < 0.001) and were more likely to ‘always’ trust their HCP (P < 0.001). There was no difference in SDMQ9 score, confidence to engage or trust in HCP for those seeing specialists (n = 734) vs. nonspecialists (n = 210). However, patients who were well informed had higher SDMQ9 scores than those who were not adequately informed, regardless of whether or not they were seeing a specialist (20.1 points higher for those who were well informed/seeing a specialist and 17.6 points higher for well informed/nonspecialist). The same was true for confidence to engage in SDM. Trust and confidence can build over time between patients with AD and providers, which may have an impact on treatment decisions and adherence. However, not all patients with AD and caregivers have access, resources or the ability to have long-term relationships with providers who are eczema specialists. This study shows that neither of those are prerequisite for patients with AD to engage in productive SDM, but that patient knowledge may be highly important. This highlights the need for comprehensive patient education across eczema care settings.

DPIA for Cloud-based Health Organizations in the context of GDPR

The General Data Protection Regulation is the core instrument of the reformed legal framework for personal data protection in the European Union. The GDPR was put into effect on May 25, 2018, and requires assessing and conducting a Data Protection Impact Assessment for processing operations that are likely to result in a high risk to the rights and freedoms of natural persons, specifically using new technologies and considering the nature, scope, context, and purposes of the processing. Although GDPR does not precisely specify the types of processing activities for which a DPIA would be necessary, through the guidelines that it provides, the organization should conduct a DPIA, if there is large scale processing of health data. An example of this, is a Cloud-based Health Organization. Taking into account this parameter, that Cloud-based Health Organization processes personal data that could impact the freedoms and rights of a data subject under the GDPR and that the GDPR does not specify a DPIA process to follow, instead it allows organizations to use a framework that complements their existing processes, this paper presents the last two steps of a DPIA study for a Cloud-based Health Organization and provides guidelines on how to carry them out effectively. This study is part of a project for the compliance of Cloud-based Health Organizations with the General Data Protection Regulation 2016/679. For fulfilling the objectives of this study, the PIA-CNIL methodology is applied, which is in accordance with the data privacy impact assessment that has been described in ISO/IEC 29134. The main contribution of this work is the development of a guide that is designed to help Cloud-based Health organizations identify, analyze and reduce data protection risks in relation to their processing activities. More analytically, this research presents the risks that could be materialized by the data processing activities carried out by a Cloud-based Health Organization regarding its Processing Activities and could have an impact on the fundamental rights and freedoms of natural persons.

Profiling compliers and noncompliers for instrumental variable analysis with covariates: A weighting approach.

Instrumental variable (IV) estimation is an essential tool to estimate the causal effect of a treatment in randomized experiments when noncompliance exists. In such studies, standard statistical approaches can be biased because compliers and noncompliers can differ in unmeasured ways that affect both the compliance behavior and outcome. Based on a few assumptions such as monotonicity, the IV estimand represents the causal effect of compliers. Profiling compliers and noncompliers has important implications because the IV estimand applies only to compliers. A method for estimating the covariate means for compliers and noncompliers has recently been proposed in political sciences literature. However, this approach requires an assumption that the instrument is randomly assigned, which confines the application of this approach to randomized experiments. In this study, we present two weighting methods for profiling compliers and noncompliers when the instrument and compliance behavior are confounded by several covariates. The proposed approach can be used for both experimental and nonexperimental studies, and hence is more broadly applicable. For the development, an instrumental propensity score is adopted to account for confounded instruments. We demonstrate the utility of the proposed methods based on simulation and real data experiments.

Translation and validation of a Finnish version of the Facial Clinimetric Evaluation (FaCE) Scale

Background: The Facial Clinimetric Evaluation (FaCE) scale is a patient-reported health status instrument developed for assessing the health-related quality of life (HRQoL) in patients with facial nerve paralysis. The aim of this study was to translate and validate the FaCE scale for the Finnish-speaking population.Methods: The FaCE scale was translated according to international guidelines. Sixty patients in an outpatient clinic prospectively completed the translated FaCE scale and generic HRQoL instrument (15D). The objective facial paralysis grading was made using the Sunnybrook and House-Brackmann scales. Repeated FaCE and 15D instruments were mailed to patients 2 weeks later. Total scores of the FaCE instrument and subscales were calculated, and floor and ceiling effects were examined. Exploratory factor analysis was made. Internal consistency, reliability, and repeatability were assessed. Convergence with 15D instrument, Sunnybrook, and House-Brackmann scales was examined.Results: The total internal consistency of the FaCE scale was high (Cronbach’s alpha 0.83). There were no statistically significant differences found between mean scores of the subscales in test-retest analysis (p > 0.05). Intra-class correlations coefficients were high, ranging between 0.78 and 0.92, and the correlations were statistically significant (p < 0.001). There were statistically significant correlations observed between the FaCE scale and the 15D, Sunnybrook, and House-Brackmann scores. Conclusion: The FaCE scale was successfully translated and validated in Finnish with good validity and reliability. We also demonstrated statistically significant correlations between the generic HRQoL15D instrument and both the Sunnybrook and House-Brackmann physician-based grading scales. The FaCE scale is now ready for use in Finnish facial paralysis patients.

Quality of Life in Remitted Patients with Schizophrenia: A Cross-Sectional Study

Background: Assessment of the Quality of Life (QOL) is increasingly performed as an efficient method to assess the quality of care provided for patients with schizophrenia. Also, the QOL assessment performed by patients themselves is more affected by the symptoms of schizophrenia. Therefore, a mental health professional evaluation may provide more objective information. This study was undertaken to objectively assess QOL in a group of remitted patients with schizophrenia in Iran by using Quality of Life Scale (QLS).
 Methods: This descriptive cross-sectional study was performed on 85 remitted patients with schizophrenia consecutively referred to Roozbeh Hospital. The mean age of the participants was 37.81±9.92 years, 54 (63.53%) were male, 16 (18.8%) were married, and 19 (22.4%) were employed. The Quality of Life Scale (QLS) was used to collect data through face-to-face interviews.
 Results: The total score of QLS for patients is 2.95±0.93. Among subscales, the interpersonal relations scores (2.44±1.10) and intrapsychic foundations scores (2.90±1.07) were lower than the other domains scores. The QLS score was higher in patients with an associate degree or higher level of education (p-value<0.01) and those living with family members (p-value<0.01). The overall employment rate was low among the patients. There was no significant relationship between current doses of various medications and any QLS domain scores; however, a significant inverse relationship was between the current doses of first- and second-generation antipsychotics and the instrumental role domain score.
 Conclusion: The findings of this study showed that the scores of different domains of QLS were low in the remitted patients with schizophrenia. The impact of different antipsychotic treatments and their side effects on the QOL should be addressed in future studies.

The impact of cancer prehabilitation on psychological outcomes and quality of life in patients with gastro-oesophageal cancer.

e16096 Background: The impact of cancer on psychological health and health related quality of life (HRQoL) is complex and involves an interaction between pre-existing and cancer related psychological morbidity and symptoms. Factors such as self-efficacy are known predictors of recovery and HRQoL. The aim of this study is to assess the impact of multi-modal personalised prehabilitation on psychological outcomes and HRQoL in patients with curable oesophageal and gastric (OG) cancer. Methods: Data was collected for to all patients treated at a specialist centre between Jan 2016 and June 2018. Patients received multi-modal (physical, nutrition and psychological) prehabilitation from diagnosis into the post-operative period. Data on self-efficacy (SE), anxiety and depression (Hospital Anxiety and Depression Scale, HADS) and HRQoL (European Organization for Research and treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30)) were collected at diagnosis (T1), completion of neo-adjuvant chemotherapy (T2) and 3 months after surgery (T3). A previously validated mapping function was used for predicting Euro QoL 5D-3L (EQ-5D-3L) from scale scores of the EORTC QLQ-C30 instrument to derive a EQ health utility (EQ-HU). Results: 137 patients underwent surgery. 86 patients underwent a thoracotomy in addition to a laparotomy. 107 patients received neo-adjuvant treatment. There was a significant improvement in SE [8.2 (6.2-9) to 8.8 (7.8-9.7); p = 0.002] and anxiety [5 (3-8) to 4 (2,7); p = 0.04] but not depression [2 (1-5) to 3 (1-5); p = 0.26] between T1 and T2. There were no differences between T2 and T3. There were no differences in global HRQoL and the individual scales of the EORTC QLQ-C30 between T1 and T2. However, between T2 and T3, there were significant reductions in global HRQoL [69.6 (18.2) to 64.7 (20.9); p = 0.04], physical [83.2 (18.2) to 70.9 (20.5); p = 0.001], role [79 (28.6) to 70.9 (28.3; p = 0.02], cognitive [84.2 (22.3) to 76 (23.3); p = 0.004] and social [79 (24.2) to 65.5 (26.1); p = 0.001] but not emotional functions [80.1 (21.4) to 79.5 (23.3); p = 0.67]. Mapping revealed that there was a significant improvement in EQ-HU from T1 to T2 [0.54 (0.52) to 0.79 (0.34); p = 0.001] and a significant fall from T2 to T3 [ 0.79 (0.34) to 0.58 (0.44); p = 0.001]. The minimum and maximum predicted values matched those of the validated mapping function used. Conclusions: This study shows that prehabilitation can have a significant impact on HU in patients on chemotherapy. Despite the well-recognised limitations of mapping, HU at baseline was comparable to that shown in previous research in OG cancer patients. Reduction in HRQoL seen after surgery was much less than previously published research, suggesting the protective effect of prehabilitation. Physical function deterioration, in particular was much less than anticipated.

Psychological stress and quality of life among infertile women: A mixed methodology study at a tertiary health center

Background: A strong correlation exists between infertility, psychological stress, and quality of life (QoL) among women, and hence, emphasis must be made on improving the psychological context and incorporating psychological counseling as a part of infertility evaluation and management. The Perceived Stress Scale (PSS) and Modified FertiQoL tools are used to measure the stress perceived by an individual and to assess the impact of fertility problems on the QoL of women, respectively. Objectives: The objective was to assess the psychological stress and QoL among the infertile women using the Perceived Stress Scale (PSS) and Modified FertiQoL (Core) instruments, respectively, to find the correlation between psychological stress and QoL among the study participants and to find the experiences of women who received prior infertility treatment. Materials and Methods: A mixed methodology study was conducted by the Department of Obstetrics and Gynecology, Radiodiagnosis and Psychiatry on infertile women attending ESIC Medical College, Hyderabad, Telangana, between December 2020 and August 2021. A total of 274 participants who met the inclusion criteria were enrolled for the quantitative study and 10 participants for the qualitative study. Descriptive statistics (frequency, mean, and standard deviation), comparisons (Student’s t-test), and correlations (Pearson: r-value) were used for quantitative data analysis and thematic content analysis for the qualitative data. Results: The mean age of the participants was 29.17 years (range 22–39 years) with a mean duration of infertility of 6.17 years. The results showed that the mean Perceived Stress Scale (PSS) score among the participants was higher (21.07 ± 4.350) with the low mean Core FertiQoL scores (49.20 ± 7.232). It was also found that there was a significant negative correlation between PSS and total Core FertiQoL scores. The study showed a significant negative correlation between the PSS scores and total FertiQoL, emotional, and mind–body subscales (P < 0.01 significant). It was found that there was a significant negative correlation between PSS scores and subscales of total FertiQoL, in women aged >30 years and those with a duration of infertility of >5 years. Content analysis of in-depth interviews with the women treated for infertility revealed the difficulties the women faced while seeking treatment. Conclusion: The study showed that infertility-related stress was affecting the QoL of women. Based on the recommendations, a holistic approach to the management of infertile women was made, and counseling sessions, yoga, and meditation were started for infertile women.

Low Power Electronic Voltage Transformer Design and Construction

The use of advanced low-power sensing technologies instead of traditional solutions used in the distribution, measurement and control of the power grid has introduced core instrument transformers due to their physical limitations and other reasons. This situation has also brought about the design of low-power voltage transformers. As can be understood from here, analogue measurement and control systems used in power centres are approaching the end of their useful life. This substations need digital automation solutions and new technologies for more efficient performance. Since no iron core is used in the low-power electronic voltage transformer structure, it is robust against network disturbances such as ferroresonance and ferroresonance formation is not encountered. In this study, a low-power electronic voltage transformer is designed and performed experiments are presented. The most essential feature expected in a voltage sensor is that the conversion rate is precise and unchanging. For this reason, the temperature coefficient and leakage capacitance values of the voltage sensor have been designed to have the lowest margin of error. Performance tests were applied to the voltage sensor using mains frequency endurance, partial discharge, accuracy class, linearity and temperature distribution tests. The results of the performance tests show that it has been successfully applied for the design of a precision voltage sensor with an accuracy class conforming to the IEC 61689-11 standard.

Involvement of methodological experts and the quality of clinical practice guidelines: a critical appraisal of clinical practice guidelines and a questionnaire survey of the development groups in Japan

ObjectiveTo evaluate whether the involvement of methodological experts improves the quality of clinical practice guidelines (CPGs) after adjusting for other factors.SettingThe quality of Japanese CPGs published in 2011–2019 was assessed...

Rekonstruksi Diagnostic Test Four Tier Berbasis HOTS (High Order Thingking Skill) Pada Materi Fiqih Kelas X di MA Negeri 3 Jombang

This research was conducted to develop an assessment instrument diagnostic test four tier. Diagnostic test four tier is one of the instruments used to diagnose student’s level of conception oon a concept. The purpose of this study was to design a four-tier diagnostic test assessment instrument based on high order thinking skills (HOTS) and also to determine the feasibility of understanding student’s concept that were valid and reliable. This research is a development research that uses a 4-D model, namely define, design, develop, and disseminate. The data analysis technique uses validation, validit, reliability and difficulty level and using SPSS 21 calculations. The results of the overall validation obtained that the average score of the four-tier diagnostic test instrument was 3.04 and valid or suitable for use. The results of the instrument validity test obtained 17 valid questions and the results of the instrument reliability test obtained a value of 0.901 in the very high category. Therefore, the four-tier diagnostic test assessment instrument based on high order thinking skills (HOTS) on fiqh material for class X MA Negeri 3 Jombang deserves to be tested in the learning process.

Why Do We Learn English? Investigating the First Year Students’ Motives to Learn English in Aceh

Integrative and instrumental motivation both play crucial roles in language learning, so it is crucial for teachers to determine which students' motivations are predominant in a classroom. The motivation of first-year students to learn English was examined in this study. It involved 77 first-year students from the Department of English Education at Universitas Syiah Kuala in Banda Aceh, 56 of whom were females and 21 of whom were males. The research tool utilized to gather the data was a questionnaire. The Attitude/Motivation Test Battery served as its model. The acquired data were analyzed using the Statistical Package for Social Science version 23. The results demonstrated that instrumental motivation's mean score (M=44.18) is higher than integrative motivation's (M=43.38). However, there was little difference (at 0.92 percent ). Therefore, it can be said that these students were driven by both integrative and instrumental motivations. Both of these types of motivations are closely related, and they both function as learning objectives with a lot of value. They benefit by way of the students’ learning outcomes as they become more proficient and successful in the target language.

YouTube as a Source of Hidradenitis Suppurativa Patient Education: A Social Media Content Analysis.

Hidradenitis suppurativa (HS) is a chronic and painful skin condition that is difficult to treat. Patients commonly navigate YouTube's platform for insight into different treatment options; thus, we analyzed the content and quality of the top 100 HS videos to assess which treatment options were most favored. Our study indicated a growing number of informational videos on the platform over 10 years, with the majority of the content from the United States. Surgical videos had higher view counts than nonsurgical ones, even though the level of engagement measured by likes and comments was similar between the two. There were no differences in the presented tone between the two categories. Overall, YouTube videos have a moderate quality with no serious shortcomings based on a previously validated DISCERN instrument score.Healthcare professionals treating HS patients should continue to direct patients to evidenced-based sources of reliable information on their condition.

Development of Gambling Behaviour and Its Relationship with Perceived Social Support: A Longitudinal Study of Young Adult Male Gamblers

Young adult men who gamble frequently face an elevated risk of developing gambling-related problems. So far, little is known about how changing levels of perceived social support interact with the course of gambling behaviour and gambling-related problems in this population. Using data from a prospective single-arm cohort study (Munich Leisure Time Study), we applied hierarchical linear models to investigate the longitudinal association of changes in perceived emotional and social support (hereafter PESS; operationalized as ENRICHD Social Support Instrument score) with gambling intensity, gambling frequency, and fulfilled criteria for gambling disorder. Pooling data from three time points (baseline, 12-month and 24-month follow-ups) to assess two 1-year intervals, these models disentangle the associations of (a) “level of PESS” (cross-sectional, between participants) and (b) “changes in individual PESS” (longitudinally, within-participants). Among the 169 study participants, higher levels of PESS were associated with fewer gambling-related problems (− 0.12 criteria met; p = 0.014). Furthermore, increasing individual PESS was associated with lower gambling frequency (− 0.25 gambling days; p = 0.060) and intensity (− 0.11 gambling hours; p = 0.006), and fewer gambling-related problems (− 0.19 problems; p < 0.001). The results suggest a mitigating influence of PESS on gambling behaviour and gambling-related problems. Increasing individual PESS appears more decisive for this pathway than high initial levels of PESS. Treatment and prevention strategies that activate and reinforce beneficial social resources in people with gambling-related problems are recommended and promising.

Reconstruction of Type IIIB Thumb Hypoplasia Using a Vascularized Hemi-Metatarsal Composite Tissue Flap.

The aim of this study was to determine the clinical outcomes of vascularized hemi-metatarsal composite tissue transfer for the reconstruction of type IIIB hypoplastic thumbs. Twenty-eight patients with type IIIB hypoplastic thumbs treated with vascularized hemi-metatarsal composite tissue transfer were included in this retrospective study with a mean follow-up of 2.4 years. Preoperative digital subtraction angiography was performed to examine the vessel variance. Clinical measures included grip and pinch strength, scar status, and Kapandji thumb opposition score. Subjective Pediatric Outcomes Data Collection Instrument scores and parent satisfaction were also evaluated. Radial arteries were hypoplastic in 82.1% of the cases, and the common palmar digital artery was chosen as the recipient vessel for the tissue transfer. There was no neurovascular complication. The only donor-site complication was a metatarsal fracture that healed with casting. Key pinch and tripod pinch were 29.5% and 45.8% of the normal side, respectively. The mean grip strength was 51.7% of the unaffected side. The mean Kapandji score was 6. The Pediatric Outcomes Data Collection Instrument scores were high for global function; upper extremity function; transfer; and basic mobility, happiness, and comfort. The Vancouver Scar Scale showed an average score of 2.1. All parents were satisfied with the clinical outcomes. Vascularized hemi-metatarsal composite tissue transfer for type IIIB thumb hypoplasia can provide improved subjective outcomes and is a feasible method for the attainment of a five-digit hand. Therapeutic, IV.

Automated Video Analysis of Audio-Visual Approaches to Predict and Detect Mild Cognitive Impairment and Dementia in Older Adults.

Early identification of different stages of cognitive impairment is important to provide available intervention and timely care for the elderly. This study aimed to examine the ability of the artificial intelligence (AI) technology to distinguish participants with mild cognitive impairment (MCI) from those with mild to moderate dementia based on automated video analysis. A total of 95 participants were recruited (MCI, 41; mild to moderate dementia, 54). The videos were captured during the Short Portable Mental Status Questionnaire process; the visual and aural features were extracted using these videos. Deep learning models were subsequently constructed for the binary differentiation of MCI and mild to moderate dementia. Correlation analysis of the predicted Mini-Mental State Examination, Cognitive Abilities Screening Instrument scores, and ground truth was also performed. Deep learning models combining both the visual and aural features discriminated MCI from mild to moderate dementia with an area under the curve (AUC) of 77.0% and accuracy of 76.0%. The AUC and accuracy increased to 93.0% and 88.0%, respectively, when depression and anxiety were excluded. Significant moderate correlations were observed between the predicted cognitive function and ground truth, and the correlation was strong excluding depression and anxiety. Interestingly, female, but not male, exhibited a correlation. The study showed that video-based deep learning models can differentiate participants with MCI from those with mild to moderate dementia and can predict cognitive function. This approach may offer a cost-effective and easily applicable method for early detection of cognitive impairment.

The correlation of the voice and the piano parts in the vocal music of Schubert’s predecessors

This article analyzes the historical and cultural background of F. Schubert’s achievements in the field of chamber vocal music, in particular, in correlation with the vocal and piano parts. We are talking about the fact that the basis of Schubert’s Lied are the traditions of German and Austrian folk songs, the work of minnesingers, meistersingers, predecessor composers. Reliance on folklore determines the intonation, the rhythmic and structural patterns of Schubert’s songs. The influence of the masters of minnesang and meistersang is felt in the harmony and composition logic of the Austrian genius. The legacy of Mozart and Beethoven is especially close to the romantic achievements of Schubert. In the chamber-vocal music of these Viennese classics are used different types of correlation between the vocal and instrumental music scores: accompaniment prevails according to the principles of the general bass, but there are already some examples of relative independence of the music score ensemble. There appear instrumental introductions, conclusions, interludes. The texture of the piano part is diversified according to the types of presentation, and contains an imitation of the sounds of nature.

MP22-10 IMPACT OF SMOKING ON LONGITUDINAL HEALTH RELATED QUALITY OF LIFE MEASURES AMONG BLADDER CANCER SURVIVORS

You have accessJournal of UrologyCME1 Apr 2023MP22-10 IMPACT OF SMOKING ON LONGITUDINAL HEALTH RELATED QUALITY OF LIFE MEASURES AMONG BLADDER CANCER SURVIVORS Hannah Kay, Sarah Silver, Ram Basak, Kimberly Shoenbill, Deborah Usinger, Adam Goldstein, Angela Smith, Richard Matulewicz, Ronald C. Chen, and Marc Bjurlin Hannah KayHannah Kay More articles by this author , Sarah SilverSarah Silver More articles by this author , Ram BasakRam Basak More articles by this author , Kimberly ShoenbillKimberly Shoenbill More articles by this author , Deborah UsingerDeborah Usinger More articles by this author , Adam GoldsteinAdam Goldstein More articles by this author , Angela SmithAngela Smith More articles by this author , Richard MatulewiczRichard Matulewicz More articles by this author , Ronald C. ChenRonald C. Chen More articles by this author , and Marc BjurlinMarc Bjurlin More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003247.10AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Cigarette smoking is the most common risk factor for the development of bladder cancer. However, there is a paucity of data characterizing the relationship between smoking status and longitudinal Health Related Quality of Life (HRQoL) outcomes in bladder cancer patients. We sought to examine the association between current smoking status and HRQoL measures among bladder cancer patients following their cancer diagnosis. METHODS: We performed a longitudinal, prospective study on a sample of patients aged ≥18 years diagnosed with bladder cancer in North Carolina from 2014-2015. The European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire core instrument (QLQ-C30) was administered at 3, 12, and 24 months after bladder cancer diagnosis. This questionnaire has been validated in diverse samples of cancer patients. The main exposure variable was current smoking status, assessed at 3, 12, and 24 months after bladder cancer diagnosis. We analyzed mean differences for each outcome between exposure groups with linear regression using Generalized Estimating Equations (GEE). RESULTS: A total of 167 bladder cancer patients completed at least one survey. Of those, 154 participated in later surveys. A total of 125 patients who did not smoke completed surveys at 3, 108 at 12, and 86 at 24 months. A total of 28 patients who smoked completed surveys at 3, 23 at 12, and 25 at 24 months. Bladder cancer patients who smoked had significantly worse HRQoL measures in the domains of physical function (mean difference (MD) = 6.78, p < .05), emotional function (MD = 6.06, p < .05), fatigue (MD = -7.68, p < .05), and financial difficulties (MD = -10.20, p < .05). When controlling for time, stage, demographic covariates, and treatment type, emotional function (MD = 6.00) and fatigue (MD = -6.98) remained significantly different (Table 1). CONCLUSIONS: Bladder cancer patients who smoke have significantly worse HRQoL scores in the domains of physical function, emotional function, and fatigue. These results underscore the need to treat smoking as an essential component of bladder cancer care. Future work should implement smoking interventions that are directed at patient goals with respect to their unique values regarding life quality. Source of Funding: UNC Lineberger Comprehensive Cancer Center University Cancer Research Fund © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e300 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Hannah Kay More articles by this author Sarah Silver More articles by this author Ram Basak More articles by this author Kimberly Shoenbill More articles by this author Deborah Usinger More articles by this author Adam Goldstein More articles by this author Angela Smith More articles by this author Richard Matulewicz More articles by this author Ronald C. Chen More articles by this author Marc Bjurlin More articles by this author Expand All Advertisement PDF downloadLoading ...

Measurement properties of the Brazilian Portuguese version of the Lower-Extremity Motor Activity Log for chronic hemiparetic poststroke patients.

Stroke is among the three leading causes of disability around the world, and it results in immediate difficulty in mobility and gait. There is a lack of instruments to evaluate what daily life is like for these individuals using their lower limbs in real-life environments (outside of the clinical environment). To perform the translation and cultural adaptation to Brazilian Portuguese of the Lower-Extremity Motor Activity Log (LE-MAL) and test its measurement properties in chronic poststroke individuals. The LE-MAL was translated into Brazilian Portuguese and adapted to the Brazilian culture. The comprehension and relevance of the final version were analyzed by a committee of specialists. The reliability, validity, and responsiveness of the LE-MAL/Brazil to detect changes after lower extremity constraint-induced movement therapy (LE-CIMT) and an intensive conventional therapy were tested. The LE-MAL/Brazil showed excellent inter- and intrarater reliability, with an intraclass correlation coefficient and Cronbach alpha > 0.70, as well as standard error of measurement and smallest detectable change < 10% of the total instrument score when applied by the same evaluators. The responsiveness of the LE-MAL/Brazil to detect changes showed better results after LE-CIMT than after the intensive conventional therapy, with most of the correlations > 0.50.

Sleep Effort and Insomnia Severity: The Role of Bedtime Procrastination

Background and Objective We aimed to investigate the mediating role of bedtime procrastination in the relationship between sleep effort and insomnia severity in this study.Methods We included 497 university students in this study. All the participants completed the sociodemographic data form, Glasgow Sleep Effort Scale (GSES), Insomnia Severity Index (ISI), Depression-Anxiety-Stress Scale-21 (DASS-21), and Bedtime Procrastination Scale (BPS). We divided the participants into groups, according to their GSES and BPS scores, those with high-low sleep effort and those with BP (+) and BP (-), respectively. We compared the variables in these groups. Finally, we analyzed the mediating role of bedtime procrastination in the relationship between sleep effort and insomnia severity.Results The mean age of the participants was 20.41 ± 1.83 years. ISI, BPS, and DASS-21 were statistically significant in the group with high sleep effort (p &lt; 0.01). Among the psychometric instrument scores, the highest correlation with GSES was with ISI, and then there was a statistically significant positive correlation with DASS-21. In addition, there was a statistically significant positive correlation between GSES and BPS. Bedtime procrastination played a partial mediation role in the relationship between sleep effort and insomnia severity.Conclusions Bedtime procrastination partially mediated the relationship between sleep effort and insomnia severity. Therapists should consider sleep effort and bedtime procrastination on their agenda in cognitive behavioral therapy sessions for insomnia.