Nottingham Health Profile Research Articles

O001. Juvenile-onset spondyloarthritis: a study of 54 cases in Senegal

Abstract Background Juvenile onset spondyloarthritis (JoSpA), also known as enthesitis-related arthritis (ERA), accounts for approximately 10-20% of all juvenile idiopathic arthritis (JIA) and affects four times more boys than girls. It’s characterized by frequent arthritis of the lower limbs and strongly associated with presence of HLA-B27. In sub-Saharan Africa, SpA is considered as a rare disease where the frequency of HLA-B27 is < 1% in the population. However, an interesting exception is found in the Fula ethnic group of Gambia, where the prevalence of HLA-B27 was estimated at 6% to 7.8%. This ethnic group is also present in Senegal Aims: To determine the epidemiological, clinical, Para clinical, therapeutic and disease course aspects of JoSpA in Senegal. Methods A retrospective observational study, was conducted in rheumatology department of Aristide Le Dantec Hospital, between January 2012 and December 2020. Two hundred and fifteen JIA cases were collated, 54 were JoSpA fulfilling the ILAR classification criteria of ERA, with age of onset of symptoms ≤ 16 years. Exclusion criteria were: psoriasis or history of psoriasis, presence of rheumatoid factor and presence of systemic arthritis. Disease activity was assessed by activity indexes (BASDAI and ASDAS), functional impact by BASFI, and Quality of Life by Nottingham Health Profile (NHP). Results A total of 54 patients (29 males and 25 females with a sex ratio M/F of 1.16) were included in the study. The mean age at onset of symptoms was 12.4 years, mean age at diagnosis was 23.2 years. 34 (63%) patients were of Fula ethnicity. The inaugural symptomatology was exclusively peripheral in 33 cases (61.1%), axial and peripheral in 23 cases (42.6%). At the time of diagnosis, arthritis was located in the lower limbs in 92.1% of cases, where knee involvement was predominant in 30 (55.6%) cases, followed by hip involvement in 17 (31.5%) cases. Axial involvement was present in 46 cases (85.2%), dominated by sacroiliac pain/ buttock pain in 73.9%, followed by low back pain in 52.1%. Entheseal involvement was present in 30 cases, dominated by Achilles enthesitis and plantar fasciitis in 83.3%. Involvement of the anterior chest wall was found in 12 patients. Uveitis was present in 3 patients. Biological inflammatory syndrome was found in 55.5% of cases, with a mean CRP level of 17.1mg/l. Search for HLA-B27 was carried out in 34 patients, 25 were HLA-B27 positive (73.5%). Among HLA-B27 positive patients, 21 (84%) were of Fula ethnicity. On radiography, sacroiliitis was present in 29 patients, and 8 had coxitis. On admission, the mean BASDAI and ASDAS-CRP were 4.66/10 and 2.98 respectively, mean BASFI was 4.36/10. NHP showed impairment of all items, especially the concepts of energy, pain, sleep and physical mobility. Treatment was based on: NSAIDs (42 patients, 79.6%), methotrexate (30 patients, 55.5%), sulfasalazine (8 patients, 14.8%), oral steroids (15 patients, 27.7%), intra-articular joint steroid injections (6 patients), hip replacement surgery (2 patients), and functional rehabilitation (5 patients). The evolution was favorable, after 6 months of treatment, mean BASDAI and BASFI were 2.47/10 and 2.19/10 respectively. Conclusion In our study, JoSpA affects both girls and boys. The prevalence of HLA-B27 was 73.5% of cases, especially in the Fula ethnic group. The disease is considered as a source of significant functional impact and impairment of quality of life. The treatment was based mainly on conventional treatment. Evolution was globally favorable after treatment. Further epidemiological studies are needed to obtain reliable prevalence rates and to better understand our findings.

EXAMINATION OF THE RELATIONSHIP BETWEEN PHYSICAL ACTIVITY LEVELS AND LIFE QUALITIES OF TEACHERS WHO TEACH IN SECONDARY EDUCATION INSTITUTIONS

<p>Aim of this research is to compare the relationship between the physical activity levels and quality of life of teachers working in secondary education institutions. A total of 331 secondary school teachers, including 205 men and 126 women from various branches, participated in our study in Batman province and secondary education institutions. The teachers who participated in the research were descriptive such as gender, age range, branch, chronic disease, and what if this disease was present. “International Physical Activity Questionnaire Short Form” for determining information and physical activity levels and “Nottingham Health Profile” questionnaires were applied for their quality of life. The statistical analysis of the data was done by using SPSS 20.0 program, and non- parametric tests such as Kruskal-Wallis, Mann Whitney U Test and Spearman Cholera test were used because the data were not normally distributed. 6.6% of secondary education teachers who participated in the study had a chronic illness, physical activity level according to gender, quality of life according to age groups, physical skill level of special talent teacher compared to other branch teacher and significant differences in quality of life (p <0.05). There were no significant differences in other parameters and in the relationship between physical activity level and life satisfaction (p> 0.05). As a result of the research, it has been concluded that the level of physical activity affects the level of physical activity of the gender and special education teachers and the other branch teachers, the quality of life is affected by the age group, and there is no significant relationship between the level of secondary school teachers' physical activity.</p><p> </p><p><strong> Article visualizations:</strong></p><p><img src="/-counters-/edu_01/0974/a.php" alt="Hit counter" /></p>

Lifestyle differentiation among older adults: exploring the links between individuals’ behaviours, socio-demographic characteristics, health and wellbeing in later life

AbstractThe association between everyday activities, health and subjective wellbeing in older adults has mostly been examined using different activities as separate variables. Which activities are likely to come together in individuals’ daily time-use patterns, or in what context, has not yet been analysed. This study looks at a broad range of spontaneously reported activities, their location and social context to identify latent behavioural classes. The data used in the study came from a sample of 200 non-institutionalised adults aged 65 and above. Activity data were collected using the Experience Sampling Method. Generalised structural equation modelling was used to identify the classes. Three distinctive behavioural classes, representing different lifestyles, emerged: passive domiciliary, active functional and social recreational. They constituted 30, 53 and 17 per cent of the sample, respectively. Class membership was related to individuals’ age, education and selected dimensions of health measured using the Nottingham Health Profile: energy levels and emotional response. There was consistency between the objectively measured class and an individual's subjective assessment of their physical and emotional health. While both class membership and subjective wellbeing were associated with health, the relationship between class and wellbeing was weak and fully explained by socio-demographic and health-related variables.

Platelet-rich plasma treatment improves postoperative recovery in patients with pilonidal sinus disease: a randomized controlled clinical trial

BackgroundPilonidal sinus is a common health problem. The current study aimed to compare the impact of autologous platelet-rich plasma (PRP) with that of minimally invasive techniques in terms of pain reduction, return to daily activities, quality of life, and duration of wound healing after open excision and secondary closure.MethodsPatients who were over 18 years old and had chronic PS disease between March 2018 and January 2019 were enrolled and randomly divided into three groups. Open surgery and moist dressings were applied to patients in group A. Open surgery followed by PRP application was performed on patients in group B. Group C underwent curettage of the sinus cavity followed by application of PRP. In this prospective randomized controlled study, patients completed questionnaires (including the Nottingham Health Profile (NHP), Short Form-36 (SF-36) and clinical information) before and after surgery. Demographics, preoperative characteristics, healing parameters, and quality-of-life scores were evaluated and calculated before and after surgery.Results and conclusionThe cavity volume and wound-healing time were compared among the groups on postoperative days 0, 2, 3, 4, and 21. Each patient was followed up throughout the process of wound healing, and follow-up was continued afterward to monitor the patients for recurrence. Due to the nature of the treatment that group C received, this group achieved shorter healing times and smaller cavity volume than the other groups. In contrast, the recovery time per unit of cavity volume was significantly faster in group B than in the other groups. Overall postoperative pain scores were significantly lower for both PRP groups (open surgery, group B; minimally invasive surgery, group C) than for group A (p < 0.001) and showed different time courses among the groups. In the treatment of PS disease, PRP application improves postoperative recovery in that it speeds patients’ return to daily activities, reduces their pain scores and increases their quality of life.Trial registration The current study is registered on the public website ClinicalTrials.gov (ClinicalTrials.gov identifier number: NCT04697082; date: 05/01/2021).

Older adults’ lifestyles are associated with their structural position, health and wellbeing

Abstract The association between older adults' everyday activities, health and subjective wellbeing has mostly been examined using different activities as separate variables. It has not been analysed which activities are likely to come together in individuals' daily time use patterns, or in what context. Meanwhile, different combinations of activities and contextual variables may indicate distinctive lifestyles. This study looks at a broad range of spontaneously reported activities, their location and social context, and constructs latent behavioural classes. It examines how individuals' class belonging is linked with their structural position, health and wellbeing. The data used in the study came from a sample of 200 noninstitutionalized adults aged 65 and above. Activity data was collected using Experience Sampling Method. Generalized structural equation modelling (GSEM) was used to identify latent classes. Three behavioural classes were identified and labelled as: passive domiciliary, active functional, and social recreational. Lifestyles are related to individuals' structural characteristics and health status. Variables associated with class belonging are age, education, and detailed dimensions of health measured using the Nottingham Health Profile. Class differences in mean subjective wellbeing were statistically significant, but fully explained by sociodemographic and health-related variables. This study shows that behaviours and their settings form distinctive lifestyles, and that there is consistency between objectively measured lifestyles and subjective assessment of individuals' physical and emotional health. Key messages There is association between older individuals' daily behaviours and their subjective evaluation of detailed dimensions of their health. This study points to the life-long effects of education and suggests that individuals' socioeconomic characteristics may predict their lifestyle at older age.

Validity and reliability of the Mini-Osteoarthritis Knee and Hip Quality of Life scale in Turkish population.

Objectives This study aims to investigate the validity and reliability of the Turkish version of the Mini-Osteoarthritis Knee and Hip Quality of Life (Mini-OAKHQoL) scale developed to assess the quality of life (QoL) in patients with knee and/or hip osteoarthritis.Patients and methods Between May 2018 and May 2020, a total of 83 patients (11 males, 72 females; mean age: 58.1±10.0 years; range, 39 to 81 years) with knee and/or hip osteoarthritis were included. Demographic, clinical, and survey data (Mini-OAKHQoL, Nottingham Health Profile, Short Form-36, Western Ontario and McMaster Universities Osteoarthritis Index, Lequesne Index, and Visual Analog Scale of pain intensity) were recorded. Missing data, floor effect, and ceiling effect were calculated. For reliability analysis, internal consistency and test-retest reliability were discovered. Face, content, convergent, and divergent validities were applied.Results Among the patients, 52 (62.65%) had knee osteoarthritis, 26 (31.32%) had hip osteoarthritis, and five (6.02%) had both. Mini-OAKHQoL had a good face and content validity. The average item completion rate was 96.9%, with the time needed to perform was about 4 min. None of the subscales of Mini-OAKHQoL presented floor or ceiling effect, with a good range of responses. The Cronbach alpha coefficients and intraclass correlation coefficient (ICC) analysis of the subscales ranged from 0.927 to 0.676 and 0.987 to 0.843, respectively. Regarding convergent validity, the physical activities, mental health, and pain subscales of Mini-OAKHQoL had moderate to high correlations with the topic-related subset of the other QoL surveys. There were no or weak correlations between Mini-OAKHQoL and non-QoL parameters, indicating its divergent validity.Conclusion The Turkish version of Mini-OAKHQoL is a valid, reliable, simple, practical, accurate, completable, comprehensive, and disease-specific self-report instrument to assess QoL in patients with knee and/or hip osteoarthritis.

Multiple Factors Affecting Health-Related Quality of Life in Women With Chronic Multisite Musculoskeletal Pain: A Cross-Sectional Study in Ankara, Turkey.

Although chronic multi-site musculoskeletal pain is known to cause decreased physical function and impair work and social life, there is insufficient research about its impact on health-related quality of life (HRQoL) in women. The aim of this study was to investigate multiple factors affecting HRQoL in women with chronic multi-site musculoskeletal pain. This study included 227 women with two or more musculoskeletal areas which were painful during the last 3 months. The HRQoL and musculoskeletal system symptoms were evaluated with the Nottingham Health Profile (NHP) and the Nordic Musculoskeletal Questionnaire (NMQ), respectively. Physical activity level, social functionality and depressive symptoms were assessed with the International Physical Activity Questionnaire-Short Form (IPAQ- SF), Social Functioning Scale (SFS) and Beck Depression Inventory (BDI), respectively. Significant predictors for the total score on the NHP were found to be the number of children (p < 0.001), social engagement/withdrawal scale (p:0.094), the number of regions with musculoskeletal pain during the last year (p:0.002) and last 7 days (p:0.036), depressive symptoms (p < 0.001), current employment status (p:0.084), and the presence of chronic disease (p < 0.001). The results of this study demonstrated that both sociodemographic characteristics, and social and psychological factors may affect the HRQoL in women with chronic multi-site musculoskeletal pain.

The effect of vitamin D and exercise on balance and fall risk in postmenopausal women: A randomised controlled study.

To evaluate the effects of vitamin D and exercise on balance, fall risk and quality of life (QoL) in postmenopausal women. In this prospective, randomised, controlled, single-blind study postmenopausal women aged 50-70years were included. Participants with <25nmol/L 25(OH) vitamin D were randomised to three groups: group-I (vitamin D replacement) (n=21), group-II (core and balance exercises) (n=18), and group-III (vitamin D replacement plus core and balance exercises) (n=20). The participants with >75nmol/L 25(OH) vitamin D (group-IV) (n=40) were designated as control group and received the core and balance exercises. The participants were evaluated before and after 8weeks with Berg balance test and Biodex balance system (postural stability and fall risk tests) for balance and Nottingham Health Profile (NHP) for QoL. Group IV had better baseline BBT, NHP pain, NHP emotional reactions, NHP social isolation subdomain and total score. After treatment, all groups showed significant improvement in balance (except group I, mediolateral stability index) and QoL (except group II). There was no significant difference between groups (I, II and III) after intervention. Vitamin D replacement therapy has positive effects on balance and QoL. Core strengthening and balance exercises are essential for better balance and fall prevention in postmenopausal women. Any superior effect of vitamin D or exercise on each other was not determined.

How Does Falling Relate to Fatigue, Fear of Falling, Mood and Quality of Life in Pregnancy?

Objectives: There are many studies on the impact of physical changes on pregnancy falls. We conducted this study to investigate the effects of mental changes as well as physical changes on pregnancy fall. Therefore, we evaluated how people who fell during pregnancy were related to fatigue, fear of falling, mood and health-related quality of life. Patients and Method: Pregnant women were divided into 2 groups as those who failed (group 1) and those who did not (group 2). Pregnant women in both groups were tested to stand on one leg, and the following forms were filled: Fatigue Severity Scale (FSS), Beck Depression Inventory (BDI), Falls Efficacy Scale International (FES), and Nottingham Health Profile (NHP). The groups were compared based on the data obtained. Results: FSS (Group 1: 4.9 ± 1.6, Group 2: 4.0 ± 1.8, p = 0.002), BDI (Group 1: 23.9 ± 12.5, Group 2: 10.8 ± 7.3, p < 0.001), FES (Group 1: 39.5 ± 10.5, Group 2: 26.6 ± 6.6, p < 0.001), and NHP (Group 1: 321.9 ± 123.1, Group 2: 189.4 ± 96.1 p < 0.001) were found to be significantly higher. FES was positively correlated with FSS, BDI and NHP, and significantly negatively correlated with the test of standing on one leg. The test of standing on one leg was negatively correlated with FES, FSS, BDI and NHP. Conclusion: This study shows that mental changes as well as physical changes can have an impact on falls and balance in pregnant women.

Does Neuromuscular Electrical Stimulation Have an Additive Effect on Disability, Pain and Abdominal and Lumbar Muscle Thickness in Chronic Low Back Pain? – A Randomized Controlled Double-Blind Study

Abstract Objective To examine the effect of neuromuscular electrical stimulation (NMES) combined with core stabilization exercises (CSE) in patients with chronic low back pain (CLBP). Methods Thirty-six patients (mean age 33.6±12.6 years) with CLBP were randomly assigned to 4 weeks (12 sessions) of NMES group (NMES combined with CSE) (n=18) vs. Control group (sham NMES and CSE) (n=18). After the 4 weeks, same exercises were given as home exercise program without NMES. The outcome measures were Oswestry Disability Index (ODI), Visual Analog Scale (VAS), Nottingham Health Profile (NHP) and ultrasonography. Ultrasonography was used for measuring transversus abdominis (TrA), internal oblique (IO), external oblique (EO) muscles thickness and lumbar multifidus muscle thickness and area. Assessments were performed at baseline and 4th week and eighth week follow-up. Results In both groups, the change of ODI, VAS and NHP values of the first measurement according to the values of the 4th week and the eighth week were found statistically significant (p=0.001; p&lt;0.01). There were no statistically significant differences in ODI, VAS and NHP scores between the 4th week and the eighth week in both groups (p&gt;0.05). None of NMES and control group measurements with US showed a statistically significant increase in the TrA, IO, EO thickness and multifidus thickness and area (p&gt;0.05). Conclusions It was shown that NMES can be tolerated by patients with CLBP, but the addition of simultaneus NMES to CSE had no contribution to the clinical outcome measures.

THE EFFECT OF COVID 19 FEAR ON QUALITY OF LIFE IN HEMODIALYSIS PATIENTS: A CORRELATION STUDY IN TURKEY

Aim: The study aimed to determine the effect of Covid 19 Fear on Quality of Life in Hemodialysis Patients. &#x0D; Method: Descriptive and cross-sectional study was conducted in Turkey. The research was conducted between October 2020 and January 2021. Data were collected from four dialysis centers. A webbased survey was used. Covid 19 Fear Scale and Nottingham Health Profile tolls was used. &#x0D; Results: It was found that the fear of the patients increased due to the risk of Covid 19 and therefore their quality of life decreased. The pandemic process experienced fear due to emotional problems, sleep problems, social isolation and physical activity limitation. &#x0D; Conclusion and Suggestions: It has been determined that the fear of Covid 19 negatively affects life activities and makes life difficult. In pandemic, it is necessary to carefully evaluate hemodialysis patients. Healthcare professionals serving hemodialysis patients should also help solve their psychological problems.

Decreased exercise capacity, strength, physical activity level and quality of life in adult patients with familial Mediterranean fever

Background Familial Mediterranean fever (FMF) is a systemic autoinflammatory disease that causes recurrent attacks of fever, polyserositis, arthritis or skin eruptions, resulting in pain in the abdomen, muscles, joints and chest. All of these might lead to a reduction in exercise capacity, muscle strength, physical activity level (PAL) and quality of life (QoL). Therefore, assesment of these parameters are important. The aim of this study was to assess exercise capacity, muscle strength, PAL, and QoL in patients with FMF as compared to controls.Materials and methodsA total of 40 subjects with FMF and 36 healthy control subjects participated in the study. The 6-minute walk test (6MWT) was used to assess exercise capacity. Muscle strength measurements for shoulder flexors, extensors and abductors, hip flexors, extensors and abductors, knee flexors and extensors, and ankle dorsiflexors were evaluated by hand-held dynamometer. PAL was assessed using the International Physical Activity Questionnaire-Short Form (IPAQ-SF). QoL was investigated by Nottingham Health Profile (NHP).Results Significant differences were found between patients and healthy subjects for 6MWT (p = 0.003), muscle strength of ankle dorsiflexors (p = 0.001), hip flexors (p = 0.047), extensors (p = 0.003) and abductors (p = 0.004), total scores of IPAQ-SF (p = 0.004), and pain (p < 0.001), physical mobility (p < 0.001) and energy level (p = 0.026) subscales of NHP. However, there were no significant differences between groups for the shoulder flexion (p = 0.089), extension (p = 0.440) and abduction (p = 0.232), hand grip strength (p = 0.160) , and knee flexion (p = 0.744) and extension (p = 0.155) muscle strength and emotional reaction (p = 0.088), sleep (p = 0.070) and social isolation (p = 0.086) subsets of NHP.ConclusionSubjects with FMF demonstrated lower exercise capacity, muscle strength, PAL and QoL than healthy peers. Therefore, it is important to evaluate and improve these parameters in patients with FMF.

The Effectiveness of Client-Centered Intervention With Telerehabilitation Method After Total Knee Arthroplasty.

There is known to be a decrease in quality of life and perceived occupational performance and satisfaction following total knee arthroplasty (TKA). This study was planned to examine the effectiveness of a client-centered (CC) intervention with the telerehabilitation (TR) method on the quality of life, perceived occupational performance, and satisfaction after TKA. A total of 38 patients who had undergone TKA were randomly assigned to the CC and control groups. A 12-day intervention program was applied to the CC group. The Nottingham Health Profile (NHP) and Canadian Occupational Performance Measure (COPM) were applied before and after intervention. The 12-day intervention showed a strong effect on all parameters in the CC group (p<.001). In the postintervention comparisons, a significant difference was found in favor of the CC group (p < .001). CC interventions with the TR method can be used in post-TKA interventions.

Cultural adaptation and Turkish version of Physical Activity Scale for Individuals with Physical Disabilities in individuals with spinal cord injury: a reliability and validity study

Purpose To translate the “Physical Activity Scale for Individuals with Physical Disabilities (PASIPD)” into Turkish, to make a cultural adaptation, and to examine the psychometric properties including validity and reliability. Methods During the translation period cross-cultural adaptation design proposed by guideline was used. Patients completed the Turkish version of the PASIPD and it was applied again a week later. To determine the reliability and internal consistency, Cronbach’s alpha coefficient was calculated. Test–retest reliability was determined by using intraclass correlation coefficient (ICC) and Pearson’s correlation analysis. Construct validity was examined with factor analysis. Convergent validity was examined by comparing PASIPD with Functional Independent Measurement (FIM), Nottingham Health Profile (NHP), and Craig Handicap Assessment and Reporting Technique Short (CHART-SF), and criterion validity was examined by comparing PASIPD with Manual wheelchair propulsion tests scores. Results Cronbach’s alpha coefficient was 0.725. The ICC coefficient for the test–retest reliability was 0.851. PASIPD was explained by three factors. The ratio of explaining the total variance of these 3 factors was determined as 51.66%. FIM (r = 0.307, p = 0.040) and CHART-SF were moderately positively correlated with PASIPD total score. The correlation between the total score of PASIPD and NHP was r = −0.443 (p = 0.002). 20 Meters Propulsion (r = −0.404, p = 0.005) and Slalom Tests (r = −0.305, p = 0.037) were highly negative and 6 min Push Propulsion (r = 0.456, p = 0.001) were moderately positive with PASIPD total score. Conclusion The Turkish version of the PASIPD is a valid and reliable scale in patients with spinal cord injury. IMPLICATIONS FOR REHABILITATION The Turkish and cross-culturally adapted version of PASIPD is a useful physical activity scale to evaluate the physical activity level of SCI. The Turkish version of the PASIPD is a valid and reliable scale and can be used in Turkish patients with SCI. PASIPD can be used to compare physical activity levels between disability types and groups with and without disabilities. PASIPD can be used to evaluate the effectiveness of attempts to increase physical activity in patients with SCI.

The effectiveness of balneotherapy and thermal aquatic exercise in postoperative persistent lumbar pain syndrome.

In our study, we aimed to investigate the effectiveness of balneotherapy and aquatic exercises in patients with postoperative chronic low back pain. Forty-three patients over the age of 18 who had been operated on for herniated disc and who had at least 6months of back and/or leg pain were included in the study. The patients have been distributed randomly into 2 groups prior to the treatment. The program comprising aquatic exercises distributed into 5days a week for 2weeks and 20min (min) a day, in a 33°C spa pool was applied to the first group. After the first group's treatment was completed, a program consisting of walking out of the pool and strengthening and stretching exercises for the hip, abdominal, back, and waist muscles was distributed into 5days a week for 2weeks for a total duration of 20min per day was applied to both groups. The patients subjected to the study were evaluated before treatment, after treatment (2nd week), and at 1st and 6th months after treatment. The Visual Analogue Scale, Modified Schober Test, Finger-to-Floor Distance, Sorensen Test, Progressive Iso-inertial Lifting Evaluation, Rolland Morris Disability Index, Leeds Disability Scale, Beck Depression Inventory, Nottingham Health Profile, and Short Form 36 Health Survey parameters were evaluated. We detected a significant improvement in all parameters except for the Sorensen test, in both groups. We observed that the changes in VAS, Sorensen, NHP, and SF 36 tests in the aquatic exercise group were significantly better than those in the non-aquatic exercise group.

Assessment of the performance of the Brazilian Portuguese Nottingham Health Profile in adult growth hormone deficiency and pulmonary hypertension

Background: The Nottingham Health Profile (NHP) is a generic measure of perceived distress that has been used widely as an outcome measure in clinical practice and trials. The availability of two Brazilian datasets provided the opportunity to assess the psychometric performance of the NHP in different populations - adult growth hormone deficiency (GHD) and pulmonary hypertension (PH). The purpose of the study was to see how valuable the NHP could be in assessing outcomes in diseases where no disease-specific measures are available. Methods: Secondary analyses were performed with NHP data. Patients diagnosed with adult GHD or PH were administered the NHP during clinic visits on two occasions, two weeks apart. A disease-specific measure of quality of life (QoL) was also administered to the relevant sample of patients on each occasion. Results: The psychometric properties of the NHP were good for both disease groups. As expected, both samples reported high scores on energy level, the PH sample scored high on physical functioning and the GHD sample on emotional reactions. For both samples, most of the NHP sections were able to distinguish between groups of respondents with different ratings of perceived general health. While most sections of the NHP were relatively highly correlated with the QoL measures, pain and sleep did not seem to be important predictors of QoL in either of the samples. Conclusions: The use of the NHP in adult GHD and PH populations in Brazil is not recommended as there are high-quality disease-specific measures available for each disease. However, where no disease-specific measures are available, the NHP can provide good descriptive information of the impact of disease on different patient populations.

Health-related quality of life in outpatients with chronic liver disease: a cross-sectional study

BackgroundThe symptoms and complications related to chronic liver disease (CLD) have been shown to affect patient well-being. Currently there is limited research data on how CLD severity may affect both health-related quality of life (HRQOL) and the development of depressive symptoms in CLD patients. Moreover, the ongoing advances in CLD treatment, and its effect on HRQOL, highlight the need for further studies. Therefore, the aim of the present study was to evaluate if the CLD severity may affect the HRQOL and the development of depressive symptoms.MethodsA cross-sectional study was conducted. Patients with CLDs were identified at their regular visits to the outpatient clinic of the Sant’Orsola-Malpighi Hospital in Bologna, between September 2016 and July 2017. HRQOL was measured with Short Form 12 (SF-12) and Nottingham Health Profile (NHP) questionnaires; depressive symptoms were measured with Beck Depression Inventory-II (BDI). CLD severity was measured using the MELD score and the sample was stratified into five classes according to it. Group comparisons were conducted using the Kruskal–Wallis test.ResultsTwo hundred and fifty-four patients were included. Mean age was 62.84 years (SD 11.75) and 57.9% were male. Most participants were affected by compensated cirrhosis (140.2%) and chronic hepatitis (40.2%), with a disease duration ≥ 5 years (69.3%). Regarding the MELD score, 67.7% of patients belonged to Class I, 29.9% to Class II, and 2.4% to Class III. There were not patients belonging to the Classes IV and V.No statistically significant differences were found in all SF-12 and NHP domains between the MELD classes, except for CLD impact on sexual life and holidays (p = 0.037 and p = 0.032, respectively). A prevalence rate of 26% of depressive symptoms was reported, no statistically significant differences were found in BDI-II total scores between the three MELD classes.ConclusionsAll domains of HRQOL and depression were altered in CLDs patients, nevertheless CLD severity was not confirmed as an affecting factor for HRQOL.

Assessment of the performance of the Brazilian Portuguese Nottingham Health Profile in adult growth hormone deficiency and pulmonary hypertension

Background: The Nottingham Health Profile (NHP) is a generic measure of perceived distress that has been used widely as an outcome measure in clinical practice and trials. The availability of two Brazilian datasets provided the opportunity to assess the psychometric performance of the NHP in different populations - adult growth hormone deficiency (GHD) and pulmonary hypertension (PH). The purpose of the study was to see how valuable the NHP could be in assessing outcomes in diseases where no disease-specific measures are available.Methods: Secondary analyses were performed with NHP data. Patients diagnosed with adult GHD or PH were administered the NHP during clinic visits on two occasions, two weeks apart. A disease-specific measure of quality of life (QoL) was also administered to the relevant sample of patients on each occasion.Results: The psychometric properties of the NHP were good for both disease groups. As expected, both samples reported high scores on energy level, the PH sample scored high on physical functioning and the GHD sample on emotional reactions. For both samples, most of the NHP sections were able to distinguish between groups of respondents with different ratings of perceived general health. While most sections of the NHP were relatively highly correlated with the QoL measures, pain and sleep did not seem to be important predictors of QoL in either of the samples.Conclusions: The use of the NHP in adult GHD and PH populations in Brazil is not recommended as there are high-quality disease-specific measures available for each disease. However, where no disease-specific measures are available, the NHP can provide good descriptive information of the impact of disease on different patient populations.

Clinical Outcomes Comparing Two Prosthetic Knee Designs in Individuals with Unilateral Transfemoral Amputation in Turkey.

Clinical outcome assessments provide important input for the rehabilitation of individuals with transfemoral amputation. Differences in prosthetic knee designs may influence clinical outcomes. The aim of this study was to compare functional mobility, balance, prosthetic satisfaction and quality of life in individuals with unilateral transfemoral amputation with microprocessor-controlled (MPK) and non-microprocessor knee designs (Non-MPK). The study included ten experienced MPK (Rheo Knee) users (Group 1) and ten experienced Non-MPK (Total Knee® 2000) users (Group 2). For mobility; the 6 Minute Walk Test (6MWT), for balance; the Berg Balance Scale (BBS), Single Leg Stand Test (SLST) and Four Square Step Test (FSST), for quality of life; the Nottingham Health Profile (NHP) and for prosthetic satisfaction; the Satisfaction with Prosthesis Questionnaire (SATPRO) were administered. 6MWT results of the MPK group were significantly higher than Non-MPK group (p<0.05). In the MPK group a strong negative correlation was found between the FSST and the 6MWT (r=-0.661, p=0.038). No statistically significant differences were found between the groups (p>0.05) comparing balance, prosthesis satisfaction and quality of life values. The findings will inform about the patient's prognosis and the expected clinical outcomes when prescribing an MPK or an Non-MPK. Individuals with unilateral transfemoral amputation covered longer distances using an MPK compared to Non-MPK.

A Comparison between Independently Living Elderly Individuals and Residents in 25 German Nursing Homes Following the Group-Living Principle

Objective: The purpose of this study was to analyses the subjective Quality of Life (QoL) perceived by older people in German nursing homes following the group-living principle. Methods: The Nottingham Health Profile (NHP), a health-related QoL measuring instrument, was employed in 25 nursing homes (n=404 participants). A comparison with a national German representative subsample of independently living elderly individuals (age group over 75) was conducted. Psychometric properties and appropriateness were analyzed. Results: Our findings indicate an acceptable perception of residents’ QoL. The mean NHP scale scores show that except for the NHP subscale physical ability, the perceived QoL of residents in group-living nursing homes reached nearly the same level as that of independently living elderly individuals (national German reference values, age group over 75 years). QoL-related results on life satisfaction and feeling of happiness confirm the NHP findings. The protocol from a preliminary pilot study could be replicated according to good scientific practice. Conclusions and Implications: The report presents the first major investigation in the field of subjective quality of life in group-living nursing homes. The study focused on people over 75 years of age with age-specific reduced physical and mental abilities. The NHP should also be considered a reliable, valid and appropriate instrument for older people. Due to the lack of research on residents’ perspectives, further studies should establish age-specific and care setting specific reference data for nursing home residents. In particular, more research is needed to answer the question of which care setting best meets people’s essential needs in older age.