Life Outcomes For Individuals Research Articles

Efficacy of arm crank ergometry on individuals with spinal cord injury: A systematic review of randomized controlled trials.

To investigate the efficacy of arm crank ergometry (ACE) on physical, psychological, and quality of life outcomes in individuals with spinal cord injury (SCI). A comprehensive search was conducted on PubMed, Scopus, MEDLINE, Physiotherapy Evidence Database (PEDro), Web of Science, REHABDATA, and Embase from inception until July 2023. Studies were included if the sample was composed of individuals with SCI, the intervention followed an ACE intervention, and the study was a randomized controlled trial including at least one outcome measure evaluating physical, psychological, or quality of life. The PEDro scale was used to assess the methodological quality of the included studies. The meta-analysis was not feasible due to the heterogeneity in the treatment protocols and outcome measures among the selected studies. Of 1013 articles, seven studies (n = 200), with 16% of participants being female, were included in this review. The scores on the PEDro scale ranged from 6 to 8, with a median score of 7. There were variations in treatment protocols and outcome measures, resulting in heterogeneous findings. The effects of the ACE interventions on physical, psychological, and quality of life outcomes showed inconsistency. ACE training proves to be a suitable and safe intervention for individuals with traumatic SCI. Nevertheless, the existing evidence concerning its effects on physical, psychological, and quality of life outcomes in individuals with SCI is limited. Further trials are required to investigate the effects of various ACE training protocols on SCI populations.

Comparative Analysis of Health- and Vision-Related Quality of Life Measures among Trinidadians with Low Vision and Normal Vision-A Cross-Sectional Matched Sample Study.

This cross-sectional study investigated the health-related and vision-related quality of life measures of adults with low vision compared to healthy individuals in Trinidad and Tobago. The health-related quality of life (HRQOL-14) and the National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25) were administered to 20 participants with low vision caused by diabetic retinopathy, retinitis pigmentosa, glaucoma, and macular degeneration, as well as 20 participants with no visual problems (control). Participants were recruited from the University Eye Clinic in Trinidad and Tobago. Compared to the controls, more participants in the low-vision group had lower age-adjusted NEI-VFQ-25 scores (48.3% vs. 95.1%; p < 0.001), had poor general (47.5% vs. 10%, p = 0.004) and mental (100% vs. 10%, p < 0.042) health, experienced greater activity limitation due to impairment or health problems (85% vs. 20%, p < 0.001), needed help with personal care (27.5% vs. 0%, p < 0.009) and daily routine (67.5% vs. 0%, p < 0.001), and experienced sleep problems (97.5% vs. 65%, p < 0.001) and symptoms of anxiety (100% vs. 90%, p = 0.042). All the diabetic retinopathy participants (100%, p = 0.028) had two or more impairments or vision problems compared to none in the other low-vision participants. In summary, the HRQOL-14 and NEI-VFQ-25 scores were significantly reduced in low-vision participants, who also demonstrated a greater vulnerability to poor quality of life in the presence of diabetes retinopathy. These findings have important clinical implications regarding offering appropriate support and interventions to improve quality of life outcomes in individuals with low vision.

Cadmium, Lead, Chronic Physiological Stress and Endometrial Cancer: How Environmental Policy Can Alter the Exposure of At-Risk Women in the United States.

The health and life outcomes of individuals are intertwined with the context in which they grow and live. The totality of exposures one experiences affects health in the short term and throughout the life course. Environmental exposure to multiple contaminants can increase stress levels in individuals and neighborhoods with psychosocial stressors such as crime, drug and alcohol misuse, and violence also taking a toll on individual and neighborhood wellbeing. In addition, the availability, organization, and quality of local institutions and infrastructure all affect health in the short and long term. The role of these factors in endometrial cancer will be explored in this paper. In addition, policy implications regarding lead, chronic physiological stress, and endometrial cancer will be explored to ascertain the impact of these factors on at-risk women.

Impacts of breast cancer and chemotherapy on gut microbiome, cognitive functioning, and mood relative to healthy controls

Women diagnosed with breast cancer undergoing chemotherapy experience cognitive impairment, symptoms of anxiety and depression, and physical side effects including disruption in the diversity and community composition of the gut microbiome. To date, there is limited research exploring the associations among these specific challenges. The present cross-sectional study explored the associations of self-reported cognitive functioning, depression, and anxiety symptoms, and gut microbiome diversity and community composition in women who were diagnosed with and undergoing chemotherapy treatment for breast cancer (BC) compared to cancer-free healthy controls (HC). The BC group displayed higher rates of cognitive dysfunction (p < 0.001) and depressive symptoms (p < 0.05) relative to HC. There was a significant difference in microbiome community composition between BC and HC, particularly characterized by a decreased relative abundance of the mucin-degrading genus Akkermansia in BC compared to HC (p < 0.05). Association models identified significant associations among group, cognitive, depression, and microbiome variables (p < 0.001). Overall, the study identified that BC participants experienced significant differences in self-reported cognitive functioning, self-reported depression symptoms, microbiome community composition, and mucin-degrading bacteria of the gut-mucosal barrier, relative to HC. The present study is consistent with the hypothesis that gut microbiome community composition impacts a woman’s experience with breast cancer and treatment suggesting that microbiome-based interventions have potential for improving quality of life outcomes in individuals with breast cancer.

170-OR: Outcomes of a Digital Health Coaching Program Integrating Food Delivery for a Population of Adults with T2DM at Risk of Food Insecurity

Background: Recent reviews suggest that concurrent Type 2 Diabetes Mellitus (T2DM) and food insecurity contributes to poorer outcomes, including worse glycemic control and increased healthcare use. We present outcomes from a real-world program involving digital health coaching (DHC) and bi-weekly food delivery for individuals with T2DM screened for food insecurity. Methods: Individuals with T2DM were enrolled in a payor-supported DHC program and screened for food insecurity through social worker, provider, or payor records. A retrospective analysis compared data from baseline to 3-months of enrollment to evaluate T2DM-related outcomes. Results: Of the 1093 individuals who completed baseline assessments, 75% completed 3 months of DHC. This population was primarily female (74%) , racially/ethnically diverse (38% Black, 54% white, 8% other or multi-racial) , with an average age of 53. At 3 months, there were significant improvements in mean scores on the Diabetes Distress Score (2.76 to 2.09, p&amp;lt;0.001) , HbA1c (8.22 to 7.52, p&amp;lt;0.001) , and USDA Food Security Survey (2.49 to 1.39, p&amp;lt;0.001) among evaluable participants (n=710) . Conclusions: A DHC program with integrated food delivery demonstrated promising results, suggesting that addressing basic needs such as food security may contribute to improved clinical and quality of life outcomes for individuals with T2DM. Disclosure S.Rutland: Employee; Pack Health. J.Moore: None. V.T.Tran: None. M.Allison: None. B.Burton: None. D.Patel: None.

Physical Activity and Health-Related Quality of Life in Adults With a Neurologically-Related Mobility Disability During the COVID-19 Pandemic: An Exploratory Analysis.

Background: During the coronavirus-19 (COVID-19) pandemic various containment strategies were employed. Their impact on individuals with neurological conditions, considered vulnerable to COVID-19 complications, remains to be determined.Objective: To investigate associations between physical activity and health-related quality of life outcomes in individuals with a neurological condition during government mandated COVID-19 restrictions.Methods: An e-survey assessing fear of COVID-19, physical activity level and health-related quality of life outcomes (functional disability and pain, anxiety and depression, loneliness, fatigue, and vitality) was distributed to individuals with a neurologically-related mobility disability living in the United Kingdom. Open-ended questions were also included to contextualize barriers and facilitators to engage in physical activity during the COVID-19 pandemic. Gamma-weighted generalized linear models and tree-structured regression models were employed to determine the associations between physical activity and health-related quality of life.Results: Of 199 responses, 69% reported performing less physical activity compared to pre-pandemic. Tree-structured regression models revealed that lower leisure-time physical activity was significantly associated (p ≤ 0.009) with higher depression and fatigue, but lower vitality. The closure of leisure facilities and organized sport (27%) was the most commonly cited barrier to engage in physical activity, while 31% of participants mentioned concerns around their physical and mental health as a facilitator.Conclusion: Our analysis identified homogenous subgroups for depression, fatigue, and vitality based specifically on leisure-time physical activity cut points, irrespective of additional demographic or situational characteristics. Findings highlight the importance of and need to safely promote leisure-time physical activity during the COVID-19 pandemic in this at-risk population to help support health-related quality of life.

Positive behaviour support: What model of disability does it represent?

ABSTRACTPositive behaviour support (PBS) has become well established as an intervention approach for individuals with intellectual disability and challenging behaviour. However, what remains unexplored is the relationship between PBS and the medical and social models of disability, which historically are the dominant conceptual frameworks put forward in understanding disability. This paper identifies the difficulties in exploring this relationship due to the often simplistic portrayals of such models. Though PBS has a change agenda, typically a characteristic of the medical model, it is change at an ecological level that is central to PBS. An analysis of the practices of PBS demonstrates a concern with pragmatically identifying the interaction between person and environment to reduce the occurrence of challenging behaviour. PBS practices are considered to be more aligned with a supports model because they build an individual ecology of support tied to meaningful quality of life outcomes for individuals with challenging behaviour.

Toward an Intersectional Approach in Developmental Science: The Role of Race, Gender, Sexual Orientation, and Immigrant Status.

Developmental theory and research have often focused on a single social identity category, for example, race or sexual orientation, and examined the consequences of that category on life outcomes. Yet intersectional models of social disadvantage (eg, Cole, 2009; Crenshaw, 1995; King, 1988) suggest that social categories combine to shape the experiences and life outcomes of individuals across life domains. In this chapter, we review empirical research that offers insight into the intersectionality of social identities across three critical developmental periods, namely, middle childhood, adolescence, and emerging adulthood. We also consider the consequences of intersecting identities across several life domains, including intergroup relations and political and civic engagement. Recognizing that the body of work on social identities is expansive, we focus our review on race/ethnicity, gender, sexual orientation, and immigrant status. In each developmental stage, we discuss what we know, drawing from the limited empirical literature, and offer suggestions on where we need to go moving forward. We conclude that research that focuses on as a single category and ignores the specific domain of development provides an incomplete and inaccurate picture that will hinder efforts to develop culturally appropriate and clinically effective prevention and intervention programs to meet the needs of our diverse children and youth living in the United States.

Assessing patients in the early stages of irreversible dementia. The relevance of patient perspectives.

1 Individuals with Alzheimer's dementia are able to describe their personal responses to the disease, including how the disease has affected their perceptions of self. 2 Individual-centered variables, other than those related to the disease, are associated with quality of life outcomes in individuals with Alzheimer's dementia, including the individuals' personality, age, and education level. 3 The importance of maintenance of social activities and past pleasant activities is shown by the relationships among these variables and quality of life outcomes in individuals with dementia. 4 The quality of the relationship between caregivers and individuals with dementia, including the role-stress experiences by the caregivers, is moderately to strongly associated with the individuals' level of depression, psychological well-being, and productive behaviors.