Mean Quality Of Life Score Research Articles

Clinical outcomes of prostate artery embolization for management of benign prostate hyperplasia (prostate larger than 100 mL) with or without hematuria

Background: In this study, we report 1-year follow-up clinical results of prostate artery embolization (PAE) in patients with glandular hematuria or acute urinary retention caused by a large prostate (over 100 mL).Methods: Twenty-one consecutive patients undergoing PAE from March 2018 to July 2020 were included in this retrospective study. Clinical follow-up was conducted for all patients 1, 3, 6, and 12 months after the procedure. The outcome measures included the International Prostate Symptom Score (IPSS), quality of life (QoL), peak urinary flow rate (Qmax), post-void residual (PVR), prostate volume, prostate-specific antigen, and complications. A p-value <0.05 was considered statistically significant.Results: Twenty-one patients with severe benign prostatic hyperplasia (BPH) with acute urinary retention or prostatic hematuria were enrolled in this study. Technical success rate was 90.5% (19/21), and unilateral PAE was done in 2/21 (9.5%) patients by pelvic vascular obliteration. In all patients, the mean IPSS, QoL score, Qmax, and PVR were significantly improved at 12 months post-PAE. The mean IPSS decreased from 26.1 to 12.1 points (p<0.05), mean QoL score decreased from 4.6 to 2.9 points (p<0.05), mean Qmax increased from 2.1 to 9.4 mL/s (p<0.05), and mean PVR decreased from 300.0 to 70.7 mL (p<0.05). The catheter was successfully removed from 19/21 patients and clinical success rate was 90.5%.Conclusions: PAE was an effective and safe treatment option for patients with BPH and very large prostates (>100 mL) and urinary retention or gross hematuria associated with BPH in men unfit for surgery.

Symptoms of anxiety and depression and quality of life in parents of children with autism during the second wave of the pandemic

BackgroundLocal political discord together with isolation and fear marked the COVID-19 pandemic in Brazil. AimsTo determine the prevalence of anxiety and depression symptoms and analyze adult quality of life (QoL) during the pandemic in four groups: “childless”, “children without mental problems”, “children with autism” and “children with other mental problems.” Methods and proceduresA sample of 867 individuals recruited using social media in northeastern Brazil completed the following instruments: the Hospital Anxiety and Depression Scale (HADS, Brazilian version), the WHOQOL-Bref, and a sociodemographic form Outcomes and resultsThe mean score for depression was significantly higher in the “children with autism” group compared to the other groups. The mean anxiety score was significantly higher in the “children with autism” and “childless” groups. Mean QoL scores were lower in the “children with autism” group compared to the other groups for all the domains, with this difference being statistically significant compared with the “children without mental problems” group for all the domains. Conclusions and implicationsAnxiety and depression symptoms were greater and QoL scores were lower in parents of children with autism. All groups benefitted from logistic support during the pandemic, whereas having to care for others negatively impacted QoL.

Olfactory and gustatory dysfunction, evaluation and the impact on quality of life among COVID-19 patients: a multi-centre study

Background: Olfactory and gustatory dysfunctions are frequently reported symptoms among COVID-19 patients. However, several reports suggested that there might be significant variation in the prevalence and clinical picture of chemosensory dysfunction in COVID-19 patients among different population. Objective: To study the prevalence of chemosensory dysfunction, recovery time and its impact on quality of life (QoL) among COVID-19 patients in Saudi population. Methods: This multi-centre observational study was conducted at three COVID-19 centres in Saudi Arabia. Epidemiological and clinical data were extracted at baseline and within the 2-month post-infection. Olfactory and gustatory dysfunctions were assessed via valid taste and smell questionnaire, electronically collected via online survey. Short version of questionnaire of Olfactory disorders-negative statements (sQOD-NS) was used to assess the impact on QoL. Result: Total 1734 patients [926 males and 808 females, the mean age of patients was 37.7±11.6 years] with laboratory confirmed COVID-19 were recruited for this study. Chemosensory dysfunction was reported in 56.5% cases. olfactory and gustatory dysfunctions were significantly high in females (66.2%) and age group younger than or equal to 40 years (62.2%). Among patients with olfactory dysfunction and gustatory dysfunction, recovery rate was 757 (77.2%) and 702 (71.6%). Furthermore, the recovery time was within 8 days of onset of symptoms in 53.6% and 61.3% of olfactory dysfunction and gustatory dysfunction cases, respectively. Overall mean QoL score indicated Olfactory and gustatory dysfunction has significant impact on QoL [11.3±6.2 (P value<0.001)]. female as compared to males (12.8±7). Females had significant impact on QoL (11.4±6.6) as compared to males [12.8±7 (P value<0.001)]. Conclusion: Chemosensory dysfunction among Saudi population was comparable to the European data and significantly higher than Asian supporting the fact that these symptoms vary as per ethnicity. Olfactory and gustatory dysfunction significantly impaired QoL and could present as an early symptom of COVID-19. Recovery rate of these symptoms can serve as a good prognostic data for patient’s counselling. Further long-term follow-up studies would lead to better understanding of prognosis and clinical outcomes.

Quality of Life of People Living with HIV on Antiretroviral Therapy: A Cross-Sectional Study in Monastir, Tunisia.

Despite the benefits of an efficient antiretroviral therapy (ART), HIV/AIDS epidemic still represents the most seriousaffection worldwide that negatively impacts people's quality of life (QoL). As no studies exist on QoL in Tunisia, the aim of the present work was i: to assess, based on WHOQOL-HIV BREF tool, the perception of QoL of people living with HIV (PLHIV) receiving ART and ii: to investigate the relationship between socio-demographic features, disease-related variables and QoL domains' mean scores. This cross-sectional study was conducted at the department of infectious diseases of F. Bourguiba Teaching Hospital in Monastir, Tunisia. One hundred and five participants receiving ART were involved. QoL assessment was based on the WHOQOL-HIV Bref including six domains with 29 items with scores ranged from the lowest (4) to the highest (20). Results were reported as frequencies and means (±SD). The Student's t-test for independent samples and the one-way ANOVA were performed to assess differences in QoL mean scores. Linear regression analysis was used to investigate predictors of QoL. The confidence interval was set at 95%. Clients' mean age was 39.20±10.18 years old with a male to female sex ratio of 3.12. Low mean scores were seen with the environment (12.34±2.90), social relations (12.58±3.94) and psychological domains (12.76±3.31), and moderate mean scores were noted for the physical (14.11±3.52), the spiritual (14.05±3.78) and the level of independence (13.98±3.57) domains. Regression analysis showed that health status and feeling healthy were related to all QoL domains and that profession, marital status and the presence of a confident person were related to environment and spiritual domains. QoL of PLHIV on ART is affected. Concrete measures and strategies should be undertaken by healthcare stakeholders to improve QoL determinants.

Glycemic control versus quality of life in a cohort of diabetic children from South Kerala

Background: Assessment of HRQOL (Health related quality of life) in clinical practice is important to determine the course of the disease, early recognition of problems and the type of insulin therapy that would be adequate to maintain satisfactory metabolic control with less impact on HRQOL in every patient. Methods: A cross-sectional analytical study was conducted in the tertiary care hospital in Kerala. All children’s who aged 4-18 years with type 1 diabetes mellitus (DM) attending pediatric OPD in a tertiary care hospital in Kerala were included. The study period was 18 months. PedsQL diabetes module 3.0 (pediatric quality of life inventory 3.0 diabetes module) and PedsQL generic core module 4 (pediatric quality of life inventory 4.0 generic core scale) were used as tools. Results: The study population included 30 children with type 1 DM. The average duration of diabetes was 5.60±2.990 years. Based on HbA1c level, 16 [53.3%] children had well controlled diabetes and 14 [46.7%] had poorly controlled diabetes. Eighteen [80%] patients had complications in the form diabetic ketoacidosis or hypoglycemia in the past 1 year. Diabetes specific quality of life mean scores were [child report and parent proxy report] 88.4 and 85.9 for poorly controlled diabetes group and 94.4 and 93.0 for well controlled group respectively which showed a significant difference (p value 0.004). Children with better glycemic control also showed better generic score (p value-0.004). Conclusions: Metabolic control, measured by HbA1c value, was significantly associated with QoL in patients with diabetes. Good glycemic control is associated with better quality of life and less diabetes related symptoms.

MV140 sublingual vaccine reduces recurrent urinary tract infection in women Results from the first North American clinical experience study.

This is the first North American clinical evidence for MV140, a novel bacterial sublingual vaccine, developed for prevention of recurrent urinary tract infection (UTI) in women. Female subjects with ≥3 documented UTIs/year underwent three-month vaccination treatment, nine-month efficacy period, and optional three-month followup (total 15 months). Primary outcome was no clinically diagnosed UTI following vaccination (UTI-free rate). Secondary outcomes included absolute, mean, and median overall reduction in UTI compared to pre-vaccination, quality of life, global response assessment, patient satisfaction, microbiology, and safety. Sixty-seven subjects (mean age 56 years, range 18-80) were enrolled; 64 completed the vaccination period and at least one post-vaccination assessment. Prior to vaccination, subjects reported a mean 6.8 UTIs/year. The UTI-free rate for the nine-month efficacy period was 40.6%. Compared to the infection rate in the year prior to vaccination, the reduction was 75.3% for the nine-month efficacy period post-vaccination. At 12-month followup, 80.3% reported that they were moderately/markedly improved; 58.1% were mostly satisfied, pleased, or delighted, while mean quality of life score improved by 1.5 points. Fourteen of the adverse events in nine subjects were potentially related to the vaccine - all mild and resolved by three months. None of the 13 serious adverse events were related to vaccine. This first-in-North-America, prospective case series with the sublingual vaccine, MV140, adds further clinical evidence to its safety and effectiveness in reducing recurrent UTIs in women.

Quality of life among type 2 diabetes mellitus patients at Kamuzu Central Hospital in Lilongwe, Malawi: A mixed-methods study.

Type II diabetes mellitus (T2DM) significantly impacts quality of life (QoL) yet data among these patients in Malawi are lacking. This study was conducted to assess QoL among patients with T2DM. A mixed-method cross-section study was conducted at Kamuzu Central Hospital (KCH), Lilongwe, Malawi. Data collection was done using a modified diabetes quality of life (MDQoL)-17 questionnaire for quantitative data while in-depth interviews and diary methods were used for qualitative data. Demographic data were summarized using descriptive statistics and inferential statistics using t-tests and ANOVA. Thematic analysis was utilized for qualitative data. A sample of 339 participants (mean age 50.3±15.5) was recruited. Overall, the mean QoL score was moderate (mean QoL 63.91±19.54). Those on health insurance had better QoL (QoL 76.71, C.I. 69.22-84.19, p-value 0.005) compared to those without health insurance. Furthermore, the absence of comorbidities was associated with having better QoL (QoL 71.18, C.I. 66.69-75.67, p-value < 0.0001). Qualitatively, T2DM was associated with patients' health status, increased stress levels, and loss of independence. There were QoL-promoting factors among T2DM patients such as diabetes health talks, having a supportive family, and following hospital advice. Inhibiting factors include drug shortages, societal perceptions, a sedentary lifestyle, stress, and despising hospital advice. Overall QoL in patients with T2DM receiving treatment at KCH is moderate. QoL of patients with T2DM is influenced by interrelated factors which require multidisciplinary team care to optimize the QoL among these patients. Health workers need to adopt a holistic approach when treating patients with T2DM, such as managing comorbidities and including assessment of QoL, behavioral change measures like physical exercises, and a healthy diet.

Assessment of health-related quality of life and its determinants among patients with diabetic foot ulcer in Ilorin, Nigeria

Background: The impact of foot ulceration on the psychosocial wellbeing of the Nigerian diabetic patients has not received enough attention. This study therefore attempted to evaluate the effect of diabetic foot ulcer on the quality of life of adults in a Nigerian diabetic population.&#x0D; Methodology: The impacts of diabetic foot ulcer (DFU) on the quality of life (QoL) of 104 adults living with diabetes were assessed using The Diabetes Foot Ulcer Scale and their determinants.&#x0D; Results: The mean QoL score was 42.25. Fifty-five (53.4%) had poor QoL status while 48 (46.6%) had good QoL. Determinants of poor QoL outcome include low socio-economic status (p = 0.017), lack of a tertiary education (p= 0.027), no diabetes-education (p = &lt; 0.001), low socioeconomic status (p = 0.017), multiple ulcers (p = 0.022) and Wagner grade &gt;3 ulcers (p = 0.004).&#x0D; Conclusion: Majority of patients with DFU in UITH, Nigeria have poor QoL and most of the predictors of poor QoL outcome are preventable and modifiable.

The association between plant and animal protein intake and quality of life in patients undergoing hemodialysis.

Hemodialysis (HD) patients often experience a significant reduction in quality of life (QOL). The source of dietary protein intake may influence the renal function and complications of HD patients. The present study assessed the relationship between plant and animal protein intake and QOL in HD patients. 264 adult patients under dialysis for at least three months were included in this cross-sectional study. Dietary intakes were collected using a valid and reliable 168-item semi-quantitative food frequency questionnaire (FFQ) over the past year. Total, animal, and plant proteins were calculated for each patient. To evaluate QOL, Kidney Disease Quality of Life Short Form (KDQOL-SF 1/3) was used. Anthropometric measures were assessed according to standard protocols. In this study, the average age of participants was 58.62 ± 15.26 years old; most (73.5%) were men. The mean of total, plant, and animal proteins intake were 66.40 ± 34.29 g/d, 34.60 ± 18.24 g/d, and 31.80 ± 22.21 g/d. Furthermore, the mean score of QOL was 59.29 ± 18.68. After adjustment for potential confounders, a significant positive association was found between total dietary protein intake and QOL (β = 0.12; p = 0.03). Moreover, there was a significant association between plant-based protein intake and QOL (β = 0.26; p < 0.001). However, the association between animal protein intake and QOL was insignificant (β = 0.03; p = 0.60). Higher total and plant proteins intake were associated with better QOL in HD patients. Further studies, particularly prospective ones, are needed to corroborate these associations.

Racial differences in patient-reported outcomes among men treated with radical prostatectomy for prostate cancer.

Real-world data on racial differences in the side effects of radical prostatectomy on quality of life (QoL) are lacking. We aimed to evaluate differences in patient-reported outcome measure (PROM) among non-Hispanic Black (NHB) and non-Hispanic White (NHW) men using the Expanded Prostate Cancer Index Composite for Clinical Practice (EPIC-CP) questionnaire to measure health-related QoL after radical prostatectomy. We retrospectively assessed prospectively collected PROMs using EPIC-CP scores at a tertiary care center between 2015 and 2021 for men with prostate cancer undergoing radical prostatectomy. The primary endpoint was the overall QoL score for NHB and NHW men, with a total score of 60 and higher scores indicating worse QoL. An imputed mixed linear regression model was used to examine the effect of covariates on the change in overall QoL score following surgery. A pairwise comparison was used to estimate the mean QoL scores before surgery as well as up to 24 months after surgery. Our cohort consisted of 2229 men who answered at least one EPIC-CP questionnaire before or after surgery, of which 110 (4.94%) were NHB and 2119 (95.07%) were NHW men. The QoL scores differed for NHB and NHW at baseline (2.34, 95% confidence interval [CI] 0.36-4.31, p = 0.02), 3 months (4.36, 95% CI 2.29-6.42, p < 0.01), 6 months (3.26, 95% CI 1.10-5.43, p < 0.01), and 12 months after surgery (2.48, 95% CI 0.19-4.77, p = 0.03) with NHB having worse scores. There was no difference in QoL between NHB and NHW men 24 months after surgery. A significant difference in QoL between NHB and NHW men was reported before surgery, 3, 6, and 12 months after surgery, with NHB having worse QoL scores. However, there was no long-term difference in reported QoL. Our findings inform strategies that can be implemented to mitigate racial differences in short-term outcomes.

Health-related quality of life and its influencing factors in patients with breast cancer based on the scale QLICP-BR

Breast cancer is the most common cancer and the leading cause of cancer death among females worldwide. During the past 15 years, quality of life (QOL) has become an important aspect of breast cancer treatment. The purpose of this study was to evaluate QOL of breast cancer patients in China, and investigate its associations with sociodemographic and clinical variables. A cross-sectional study was conducted in 246 breast cancer patients in China. Recruited patients were surveyed for QOL using the QOL instruments for cancer patients-breast cancer QLICP-BR (V2.0). We assessed the associations between potential influencing factors and QOL using multiple linear regression models. The general mean QOL score for our population was 70.24 with SD = 8.70. Results indicated that medical insurance, drinking history, alkaline phosphatase, serum chloride ion level, serum calcium ion level, serum phosphorus ion level, mean corpuscular volume, mean corpuscular hemoglobin, red cell volume distribution width and platelet had significant associations with QOL of breast cancer patients. Our results emphasized that many factors are affecting QOL of breast cancer patients, which may provide a reference for targeted management or intervention strategies of breast cancer patients to improve their QOL.

High-Intensity Focused Ultrasound (Sonablate®) for Prostate Cancer: Preliminary Outcomes in Taiwan.

We reported preliminary outcomes of high-intensity focused ultrasound (HIFU) [Sonablate®] in the combination of transurethral resection of the prostate for localized prostate cancer in Taiwan. Seventy-seven patients using Sonablate® HIFU for localized prostate cancer were enrolled in this study from April 2021 to December 2022. Prostate-specific antigen biochemical recurrence, International Index of Erectile Function (IIEF)-5 scores, International Prostate Symptom Score (IPSS), quality of life (QoL) scores, and postoperative complications were recorded during follow-up. Overall, 19.5% of patients were low-risk, 36.4% were intermediate-risk, and 44.1% were high-risk according to the D'Amico risk classification. The median follow-up was 12.09±5.85 months, and the biochemical-free survival rates for the low-, intermediate-, and high-risk groups were 100% (15/15), 96.4% (27/28), and 79.4% (27/34), respectively. Four patients (5.2%) received salvage radiotherapy and all maintained biochemical-free survival. The mean IPSS and QoL scores before versus after HIFU were 10.4 versus 6.8 (p=0.003) and 3.2 versus 3.0 (p=0.096), respectively. There was no statistically significant change in preoperative and postoperative IIEF scores (20.6 vs. 19; p=0.062) in patients who had an IIEF score of >15 at baseline and received nerve-sparing procedures (subtotal ablation). The results of Sonablate® HIFU in Taiwan indicated adequate short-term cancer control, excellent potency, and continence preservation. HIFU can achieve improvement of IPSS with low complication rates.

Effects of therapeutic patient education program on glycemic control and quality of life among children and adolescents with type 1 diabetes mellitus in Fez city, Morocco.

Type 1 diabetes mellitus (T1DM) is a chronic disease, mainly observed in children or youth, with a significantly increased incidence in young children. Structured therapeutic patient education (TPE) is a must to help them manage their disease effectively and lead a healthy lifestyle. This study aimed to assess the effects of a structured TPE program on glycemic markers and quality of life (QOL) of T1DM children and adolescents in Fez city, Morocco. It is a quasi-experimental study. One hundred T1DM children and adolescents, aged 8-18, participated in a TPE intervention at the pediatric department in a hospital center in Fez, Morocco. Glycemic markers were measured and QOL was assessed by a validated questionnaire. Parametric and nonparametric tests were used and statistical significance determined by P < 0.05. At 3 months' follow-up, both global and dimensional QOL mean scores improved significantly (P ≤ 0.0001), whereas glycosylated hemoglobin (HbA1c) decreased (10.28% vs. 10.62%), tough with no statistical significance (P = 0.160). Furthermore, a significant improvement was observed in the maximum preprandial (2, 11 g/L [1.51-2.58] vs. 2, 37 g/L [1.81-3.21], P = 0.001) and postprandial blood glucose levels (2, 50 g/L [1.90-3.27] vs. 2, 95 g/L [2.07-3.99], P = 0.001) after 3 months; with no significant change in their minimum. Although this TPE intervention was more effective in improving patients' QOL than their HbA1c, it is worth striving to implement regular TPE programs for T1DM pediatric patients and adjust them to achieve a better patients' glycemic markers levels.

Differences in Symptom Severity and Quality of Life among Patients with Cancer Using Conventional Therapies with/without Herbal Medicines in Uganda: A Cross-Sectional Study.

Patients with cancer experience numerous symptoms related to cancer and treatment side effects that reduce their quality of life (QOL). Although herbal medicine (HM) is used to manage such symptoms by patients in sub-Saharan Africa, data on patients' perceived clinical outcomes are limited. We compared differences in QOL and symptom severity between patients with cancer using HM plus conventional therapies (i.e., chemotherapy, hormonal therapy, radiotherapy, surgery) and those using conventional therapies alone. This cross-sectional study included patients with cancer aged >18 years who were consecutively sampled and completed a researcher-administered questionnaire between December 2022 and January 2023. Specifically, data was collected using The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) and the MD Anderson Symptom Inventory for Traditional Chinese Medicine (MDASI-TCM). Data were analyzed using descriptive statistics and chi-square and logistic regression analyses. Of 400 participants (67.5% female), 49% (n=195) used HM plus conventional therapies and 51% (n=205) used conventional therapies alone. Most participants were aged >38 years (73.3%; median age 47 years). A univariate analysis showed the HM plus conventional therapies group had better mean scores for most QOL and symptom severity measures than the conventional therapies alone group. However, only role functioning significantly differed (p=0.046) in the bivariate analysis. There were no statistically significant differences between the two groups after confounder adjustment for all others measures of symptom severity and QOL. HM plus conventional therapies may offer minimal benefits or differences for clinical outcomes among patients with cancer. However, our findings have clinical, research, and public health implications for Uganda and other sub-Saharan African settings.

Quality of life of type 2 diabetes outpatients and the associated factors: A cross-sectional study at Ha Dong General Hospital in 2020

Objectives: This study aimed to describe the quality of life (QOL) of type 2 diabetes outpatients receiving treatment and the associated factors at Ha Dong General Hospital in 2020. Methods: A cross-sectional descriptive study was conducted on 327 type 2 diabetes outpatients treated at Ha Dong General Hospital in 2020 by using the Asian Diabetic Quality of Life (Asian DQOL) questionnaire into Vietnamese. Results: The mean score of overall QOL of type 2 diabetes outpatients is 68.5 ± 9.9 points. 83.2% of outpatients have good overall QOL; there were no outpatients with poor QOL. Married patients have a higher quality of life than other groups; the lowest is in the divorced or widowed group. The family economy at the non-poor level has higher quality than the poor and near-poor groups. Female patients had a higher QOL than male patients. Patients with a disease detection time of 5–10 years had the highest QOL. The group of patients with an overweight BMI had higher quality than other patients The group of patients who did not receive insulin had a higher QOL than the patients who received insulin. Patients without comorbidities had a higher QOL than the group with comorbidities. (p&lt;0,05) Conclusions: Research results show that the majority of people with type 2 diabetes at Ha Dong General Hospital have a good QOL. Marital status, family economic status, gender, time of disease diagnosis, BMI, treatment methods, and comorbidities are factors related to patients' QOL. Key words: Quality of life, diabetes, hospital, Ha Dong

Health-related quality of life and its predicting factors among male oral cancer survivors in Sri Lanka: A cross sectional study

Introduction: Health-related quality of life (QoL) and its predicting factors for oral cancer survivors are varied and little evidence is available in Sri Lanka. This descriptive cross-sectional study aimed to assess the QoL and its predicting factors of male oral cancer survivors.Methods: The study was conducted at Apeksha Hospital (National Cancer Institute, Sri Lanka) from June to December 2018 for a period of six months. QoL of 295 oral cancer survivors was assessed using the WHOQoL-BREF questionnaire. The range of QoL score is from 0 to 100 and higher the score, higher the level of QoL Socio-demographic and disease-specific characteristics were considered as predicting factors for QoL and Multiple linear regression was performed to determine the predicting factors. The significant level was kept as p&lt;0.05.Results: The mean score of QoL was averaged among all domains of WHOQoL-BREF questionnaire, which was depicted as 51.9±15, 52.3±19, 49.5±22 and 59.2±16 in Physical, Psychological, Social Relationship and Environment domains respectively. The number of years from diagnosis, metastasis, cancer stage and cancer site were the predictors of the physical health domain while employment status, metastasis, cancer stage and duration of betel chewing for the psychological domain (p&lt;0.05). Age, education status, monthly income, metastasis, and duration of alcohol consumption were identified as the significant predictors of social relationships while employment, monthly income, metastasis, and duration of betel chewing were predictors of the environment domain (p&lt;0.05).Conclusions: The study revealed that QoL of all domains were around average, but each QoL domain has different predicting factors. Therefore, consideration of these predicting factors are immensely helpful to enhance the QoL of these survivors.

Cardiometabolic multimorbidity and associated patterns of healthcare utilization and quality of life: Results from the Study on Global AGEing and Adult Health (SAGE) Wave 2 in Ghana.

Understanding the patterns of multimorbidity, defined as the co-occurrence of more than one chronic condition, is important for planning health system capacity and response. This study assessed the association of different cardiometabolic multimorbidity combinations with healthcare utilization and quality of life (QoL). Data were from the World Health Organization (WHO) study on global AGEing and adult health Wave 2 (2015) conducted in Ghana. We analysed the clustering of cardiometabolic diseases including angina, stroke, type 2 diabetes, and hypertension with unrelated conditions such as asthma, chronic lung disease, arthritis, cataract and depression. The clusters of adults with cardiometabolic multimorbidity were identified using latent class analysis and agglomerative hierarchical clustering algorithms. We used negative binomial regression to determine the association of multimorbidity combinations with outpatient visits. The association of multimorbidity clusters with hospitalization and QoL were assessed using multivariable logistic and linear regressions. Data from 3,128 adults aged over 50 years were analysed. We identified four distinct classes of multimorbidity: relatively "healthy class" with no multimorbidity (47.9%): abdominal obesity only (40.7%): cardiometabolic and arthritis class comprising participants with hypertension, type 2 diabetes, stroke, abdominal and general obesity, arthritis and cataract (5.7%); and cardiopulmonary and depression class including participants with angina, chronic lung disease, asthma, and depression (5.7%). Relative to the class with no multimorbidity, the cardiopulmonary and depression class was associated with a higher frequency of outpatient visits [β = 0.3; 95% CI 0.1 to 0.6] and higher odds of hospitalization [aOR = 1.9; 95% CI 1.0 to 3.7]. However, cardiometabolic and arthritis class was associated with a higher frequency of outpatient visits [β = 0.8; 95% CI 0.3 to 1.2] and not hospitalization [aOR = 1.1; 95% CI 0.5 to 2.9]. The mean QoL scores was lowest among participants in the cardiopulmonary and depression class [β = -4.8; 95% CI -7.3 to -2.3] followed by the cardiometabolic and arthritis class [β = -3.9; 95% CI -6.4 to -1.4]. Our findings show that cardiometabolic multimorbidity among older persons in Ghana cluster together in distinct patterns that differ in healthcare utilization. This evidence may be used in healthcare planning to optimize treatment and care.

The Impact of Sexual Violence on Quality of Life and Mental Wellbeing in Transgender and Gender-Diverse Adolescents and Young Adults: A Mixed-Methods Approach.

Transgender (trans) and gender-diverse (GD) adolescents and young adults have remained largely invisible in health research. Previous research shows worse outcomes in health indicators for trans and GD people, compared to cisgender controls. Research on the impact of sexual violence focuses on mainly cisgender female adult victims. This study assessed the impact of sexual violence on the quality of life (QoL) and mental wellbeing (GHQ-12) among trans and GD adolescents and young adults, while taking into account the possible role of gender nonconformity in sexual violence and mental wellbeing. An online, anonymous survey and interviews/focus groups were conducted between October 2021 and May 2022 in Belgium. Multiple analyses of covariance (ANCOVAs) were used to assess the associations between sexual violence, mental wellbeing, and gender nonconformity, while controlling for different background variables (gender identity, sexual orientation, age, economic vulnerability, etc.). The interviews and focus groups were used to validate associations between variables that were hypothesized as important. The quantitative sample consisted of 110 respondents between 15 and 25 years old, with 30 trans respondents (27.3%) and 80 GD respondents (72.7%). A total of 73.6% reported experiences with sexual violence over the past two years (n = 81). The mean QoL score was 5.3/10, and the mean GHQ-12 score was 6.6/12. Sexual violence was not significantly associated with QoL (p = 0.157) and only marginally significantly associated with GHQ-12 (p = 0.05). Changing one's physical appearance to conform to gender norms, out of fear of getting attacked, discriminated against, or harassed was significantly associated with QoL (p = 0.009) and GHQ-12 (p = 0.041). The association between sexual violence and changing one's physical appearance to conform to gender norms was analyzed, to assess a possible mediation effect of sexual violence on mental wellbeing. No significant association was found (p = 0.261). However, the interviews suggest that sexual violence is associated with changing one's physical appearance, but this association is not limited to only trans and GD victims of sexual violence. Non-victims also adjust their appearance, out of fear of future sexual victimization. Together with the high proportion of sexual violence, as well as the lower average QoL and higher average GHQ-12 scores among trans and GD adolescents and young adults, compared to general population statistics, this highlights the need for policy makers to create more inclusive environments.

Pediatric obesity and skin disease: cutaneous findings and associated quality-of-life impairments in 103 children and adolescents with obesity.

Little is known about specific cutaneous findings in children and adolescents with overweight and obesity. This study assessed the association of skin signs with pivotal auxological and endocrinological parameters and their influence on the quality of life (QoL) of young people with obesity. All patients initially recruited for a tertiary hospital's weight control program were offered participation in this interdisciplinary, single-center, cross-sectional study. All participants underwent a detailed dermatological examination, anthropometric measurements and laboratory examinations. QoL was assessed with validated questionnaires. A total of 103 children and adolescents (age 11.6 ±2.5 years, 41% female, 25% prepubertal, BMI SDS 2.6 ± 0.5, homeostatic model assessment (HOMA) score 3.3 ± 4.2; mean ± s.d.) were recruited in a 12-month study period. Skin affections were linearly associated with increasing BMI and higher age. The most common skin findings were (%) striae distensae (71.0), keratosis pilaris (64.7), acanthosis nigricans (45.0), acne vulgaris (39.2), acrochordons (25.5) and plantar hyperkeratosis (17.6). The HOMA score was associated with acanthosis nigricans (P = 0.047), keratosis pilaris (P = 0.019) and acne vulgaris (P < 0.001). The general mean QoL(QoL) score, as assessed by the WHO-5, was 70 out of 100. A total of 38.9% of participants reported impaired dermatological QoL. This study shows the high prevalence of skin lesions in children and adolescents with obesity. The association between skin lesions and the HOMA score indicates that skin manifestations are a marker of insulin resistance. To prevent secondary diseases and improve QoL, thorough skin examinations and interdisciplinary cooperation are necessary.

Yanıkta Bakım Veren Yükü ile Yanık Hastasının ve Bakım Verenin Yaşam Kalitesi

Aim: This descriptive study aimed to determine the relationship between burn patients and their caregivers’ quality of life and care burden. &#x0D; Material and Methods: The study was conducted at two university hospitals. Thirty burn patients discharged from the hospitals between September 2015 and January 2016 and their 30 caregivers participated in the study. Data were collected face-to-face with the datasheet for patients, the Burn-Specific Health Scale, the datasheet for caregivers, the World Health Organization Quality of Life (QoL)-Brief, and the Zarit Caregiver Burden Interview Scale.&#x0D; Results: The patients’ mean QoL scores, and sub-scores were higher than 0.53. The highest caregivers’ mean QoL score was for the physical health domain (74.62±16.87). There was a negative correlation between the physical health scores of caregivers and the general health and overall QoL scores of patients (p