Quality Of Life For People Research Articles

Effectiveness of a New Microprocessor-Controlled Knee–Ankle–Foot System for Transfemoral Amputees: A Randomized Controlled Trial

Background: Advances in prosthetic technology, especially microprocessor-controlled knees (MPKs), have helped enhance gait symmetry and reduce fall risks for individuals who have undergone transfemoral amputation. However, challenges remain in walking in constrained situations due to the limitations of passive prosthetic feet, lacking ankle mobility. This study investigates the benefits of SYNSYS®, a new microprocessor-controlled knee–ankle–foot system (MPKA_NEW), designed to synergize knee and ankle movements. Methods: A randomized crossover trial was conducted on 12 male participants who had undergone transfemoral amputation who tested both the MPKA_NEW and their usual MPK prosthesis. Biomechanical parameters were evaluated using quantitative gait analysis in various walking conditions. Participants also completed self-reported questionnaires on their quality of life, locomotor abilities, and prosthesis satisfaction. Results: The MPKA_NEW showed a significant reduction in the risk of slipping and tripping compared to standard MPK prostheses, as evidenced by increased flat-foot time and minimum toe clearance during gait analysis. The MPKA_NEW also improved physical component scores in quality-of-life assessments (Short-Form 36 General Health Questionnaire), suggesting enhanced stability and reduced cognitive load during walking. Conclusions: The MPKA_NEW offers significant improvements in gait safety and quality of life for people who have undergone TFA, particularly in challenging conditions. Further studies are needed to assess the long-term benefits and adaptability across diverse amputee populations.

The Role of The University in the Development of Inclusive Entrepreneurship in the City of Pedernales

Objective: The primary objective of this research is to demonstrate the pivotal role that universities play in promoting inclusive entrepreneurship, with a particular focus on individuals with disabilities. Theoretical Framework: This research centers on the university's role as a catalyst for social change, specifically its capacity to foster inclusive entrepreneurship and enhance the quality of life for people with disabilities. The study is rooted in the premise that universities, as institutions of learning and knowledge creation, have a responsibility to engage with the community and address pressing social issues. In this context, social entrepreneurship emerges as a strategy for generating employment opportunities and improving the living conditions of marginalized groups. Method: This research employs a bibliographic approach, utilizing research techniques such as observation, interviews, and surveys of two market segments. Additionally, it presents the findings and a discussion of the topic. Results and Discussion: The research on inclusive entrepreneurship in Pedernales has uncovered a latent opportunity to transform the employment landscape for individuals with disabilities in the canton. While significant challenges exist, such as low employment rates and a lack of effective public policies, key elements have been identified that can drive positive change. Implications: The research on inclusive entrepreneurship in Pedernales carries significant implications at both the local and national levels, extending beyond academia to impact the social and economic spheres. Originality/Value: The research on inclusive entrepreneurship in Pedernales exhibits notable originality by focusing on a specific context and population group, allowing for a detailed analysis of their unique needs and challenges.

Effects of a symptom-titrated exercise program on fatigue and quality of life in people with post-COVID condition – a randomized controlled trial

Fatigue is the most prevalent symptom within the post-COVID condition (PCC). Furthermore, many patients suffer from decreased physical performance capacity and post-exertional malaise. Although exercise has been proposed as an effective therapeutic strategy for PCC, there is limited evidence on individualised and symptom-titrated exercise interventions in patients with fatigue and PEM. Therefore, we conducted a multi-centre randomised controlled trial to investigate the effectiveness of an individualised and symptom-titrated exercise program. We measured fatigue, health-related quality of life, hand-grip strength, endurance capacity and PEM before and after the 10-week intervention. A total of 118 individuals with PCC were included in the final intention-to-treat analysis. All tests and training sessions took place in commercial fitness and health facilities. We found significant effects on fatigue severity, health-related quality of life and physical performance capacity. Adjusting the individual exercise load to daily fatigue has proven to be an effective and safe strategy in PCC patients with fatigue. Under the guidance of qualified professionals and by utilising symptom-titrated training recommendations, commercial fitness and health facilities present an appropriate setting for outpatient exercise rehabilitation in PCC.

Associations of cognitive test performance with self-reported mental health, cognition, and quality of life in adults with functional seizures: A systematic review and meta-analysis

Objective: People with functional seizures (FS) have frequent and disabling cognitive dysfunction and mental health symptoms, with low quality of life. However, interrelationships among these constructs are poorly understood. In this meta-analysis, we examined associations between objective (i.e. performance-based) cognitive testing and self-reported (i) mental health, (ii) cognition, and (iii) quality of life in FS. Method: We searched MEDLINE, Embase, PsycINFO, and Web of Science, with the final search on June 10, 2024. Inclusion criteria were studies documenting relationships between objective cognitive test scores and self-reported (i.e. subjective) mental health, cognition, and/or quality of life in adults with FS. Exclusion criteria were mixed FS/epilepsy samples. A modified Newcastle-Ottawa Scale evaluated risk of bias. This project is registered as CRD42023392385 in PROSPERO. Results: Initially, 4,054 unique reports were identified, with the final sample including 24 articles of 1,173 people with FS. Mean age was 35.9 (SD = 3.9), mean education was 12.6 (SD = 1.3), and proportion of women was 73.9%. Risk of bias was moderate, due in part to inconsistent reporting of confounding demographic variables. Significant relationships were found between global objective cognition and global self-reported mental health (k = 21, Z = −0.23 [0.04], 95% CI = −0.30, −0.16), depression (k = 11, Z = −0.13 [0.05], 95% CI = −0.21, −0.04), cognition (k = 5, Z = −0.16 [0.05], 95% CI = −0.26, −0.06), and quality of life (k = 5, Z = −0.17 [0.05], 95% CI = −0.24, −0.10). Exploratory analyses showed associations between select cognitive and mental health constructs. Conclusions: Objective cognition is reliably associated with self-reported mental health, cognition, and quality of life in people with FS. Scientific and clinical implications are discussed.

Targeting interleukin-6 pathways in giant cell arteritis management: A narrative review of evidence.

Giant cell arteritis (GCA) is a chronic inflammatory vasculitis with a significant impact on vascular and patient health. It may present with non-specific symptoms and can lead to severe complications if not managed effectively. This narrative review explores the treatment of GCA with interleukin-6 pathway inhibitors, focusing on key studies from selected databases published between 2018 and 2024. The findings reveal that the current treatment primarily involves glucocorticoids (GCs), but their long-term use is associated with adverse effects. Targeting the interleukin-6 (IL-6) pathway offers therapeutic benefits by reducing inflammation and sparing GC use. Tocilizumab, a humanized immunoglobulin G1κ monoclonal antibody that blocks the IL-6 receptor, has demonstrated efficacy in achieving sustained remission and improving quality of life in people with GCA. However, challenges remain in understanding the optimal duration of therapy, managing relapse upon discontinuation, and addressing long-term structural vascular outcomes. Additional research is needed to further elucidate the complex pathogenesis of GCA and to optimize treatment strategies to achieve sustained remission both clinically and histologically while minimizing adverse effects. This review provides a comprehensive overview of the evidence of IL-6 inhibition in GCA management, highlighting both its therapeutic benefits and the challenges associated with its use.

Analysis of social determinants with quality of life in people with HIV/AIDS at the voluntary counseling test clinic

Introduction: HIV and AIDS are known to have become an emergency problem around the world, where infection transmission, morbidity rates, and mortality rates are still high. The existence of the HIV/AIDS epidemic is one of the scary scourges among the community because of its unexpected transmission by HIV due to human behaviour. Objective: This study aims to analyze social determinants with quality of life in people with HIV/AIDS in the Voluntary Counseling and Testing Clinic. Methods: This study is an analytical study using a cross-sectional study research design. The population in this study is all HIV/AIDS patients domiciled in Kendari City. The number of samples was 177 respondents which was determined by simple random sampling. Data analysis uses the chi-square test and the multiple logistics test. Result: The results of the study showed that there was a stigma relationship with Odhiv's quality of life at the VCT Clinic of Kendari City Hospital (p = 0.000) and there was a relationship between social support and Odhiv's quality of life at the VCT Clinic of Kendari City Hospital (p = 0.000). The variable that has the greatest influence on the quality of life of ODHIV is the social support variable with an OR of 0.353. Conclusion: The variable that has the greatest influence on the quality of life of People with HIV/AIDS (ODHIV) is social support. Social support has proven to be a very significant factor in improving the quality of life of people living with HIV. Individuals with strong social support, whether from family, friends, or the community, tend to have a better quality of life than those who receive less social support. Social support plays a role in helping people with HIV cope with stigma, reduce psychological pressure, and provide a sense of security and comfort that can have a positive impact on their physical and mental well-being.

Effectiveness and cost-effectiveness of online recorded recovery narratives in improving quality of life for people with psychosis experience (NEON Trial): a pragmatic randomised controlled trial

The Narrative Experiences Online (NEON) Intervention provides self-managed web-based access to mental health recovery narratives (n=659). We evaluated effectiveness and cost-effectiveness in improving quality of life for adults resident in England with mental health problems and recent psychosis experience. Prospectively registered pragmatic parallel-group randomised trial controlling for usual care, recruiting from statutory mental health services and through community engagement activities, with a 52-week primary endpoint (ISRCTN11152837). All trial procedures and the NEON Intervention were delivered by an integrated web-application. Randomisation was through an independently generated list (no stratification). Allocation was masked for statistical staff and the Chief Investigator but not participants. Intervention arm participants received immediate NEON Intervention access. Control arm participants received access after completing primary endpoint questionnaires. The primary outcome was quality of life through the Manchester Short Assessment (MANSA). Serious Adverse Events (SAEs) were collected through web-based safety report forms and identified from health service usage data. The primary analysis was by a prospectively described Intention To Treat principle excluding participants who had registered multiple times, with multiple imputation for missing data. Between 9 March 2020 and 1 March 2021, 739 participants were randomised (intervention:370; control: 369), providing more than 90% power to detect a baseline-adjusted difference of 0.25 in the MANSA score. Mean age was 34.8 years (standard deviation (SD) 12.0), 561 (75.9%) were white British, 443 (59.9%) were female, 609 (82.4%) had accessed specialist care mental health services, and 698 (94.5%) had accessed primary care mental health services. Mean baseline MANSA score was 3.7 for control and intervention arms (SD 0.9 and 1.0). 565 (76.5%) participants provided primary endpoint MANSA data with a mean score of 4.1 (SD 1.0) for both arms. We found no significant difference in Quality of Life between the two arms at the primary endpoint (baseline-adjusted difference 0.07, 95% CI-0.07 to 0.21, p=0.35). The incremental cost-effectiveness ratio (£110,501 per quality-adjusted life-year (QALY)) exceeded the prospectively defined cost-effectiveness threshold (£30,000 per QALY). 158(42.8%) control arm and 194 (52.4%) intervention arm participants accessed narratives outside of the NEON Intervention. There were no related serious adverse events (SAEs). 116 unrelated SAEs were reported by control arm participants, and 107 by intervention arm participants. Our findings do not indicate NEON Intervention access for all people with psychosis experience. Future research should consider a) evaluation with current mental health services users; b) optimisation to enable users to find hope-promoting narratives. National Institute for Health and Care Research (NIHR).

Care Partner Burden and Support Services in Dementia.

Informal care partners are essential to the care of people living with dementia, but they often experience significant burden and receive minimal training, support, and resources. This article provides an overview of care partner experiences, factors contributing to burden, and methods for reducing burden of caregiving in dementia. The US Department of Health and Human Services National Plan to Address Alzheimer's Disease and the World Health Organization Global Action Plan for dementia have identified support for dementia care partners as a top priority for research and policy in recognition of care partners' instrumental but underresourced role in dementia care. The psychological, financial, social, and physical costs of caregiving, particularly without necessary knowledge, skills, and resources, can lead to care partner burden. Reassuringly, multicomponent interventions can mitigate burden and other negative consequences of caregiving, especially when they are theoretically grounded, inclusive, and culturally relevant. Health care providers play a vital role in the early identification of care partner burden through brief, regular assessments. With earlier identification and subsequent intervention (eg, education, skills-based training, local and national resources), the experience of burden and negative health outcomes can be mitigated and quality of life for people living with dementia and their care partners can be improved.

Medical skin camouflage for women in prison with self-harm scars (COVER): randomised feasibility study

ABSTRACT Far more women prisoners self-harm than women in the community or men in prison. There has been little focus on the effects on prisoners of living with self-harm scars. Medical skin camouflage (MSC), designed to cover skin disfigurement, improves quality of life for people in the community with dermatological, burn, surgical or accidental scars or marks. Its use in prison for self-harm scars has not been evaluated. COVER tested the feasibility and acceptability of a wait-list control RCT of peer-delivered MSC for women prisoners with self-harm scars, at one prison. We provide evidence of feasibility to recruit, randomise and retain women in prison in an RCT design using strategies minimising attrition from transfer between prisons or release (51 recruited, 11.8% attrition). We successfully randomised women prisoners and collected outcome measures over 12 weeks from baseline. We report improvements in the primary outcome, the Warwick-Edinburgh Mental Well-Being Scale at follow-up for intervention and control groups and valuable information to inform an economic analysis. Important lessons were learnt, applicable to other research within this unique environment, about minimising attrition and successfully involving prisoners in peer-delivered interventions. Participants and staff found the intervention acceptable and suggested it improves women’s confidence and self-esteem.

The Impact of the Natural Level of Blood Biochemicals on Electroencephalographic Markers in Healthy People.

This study aims to investigate the association between the natural level of blood biomarkers and electroencephalographic (EEG) markers. Resting EEG theta, alpha (ABP), beta, and gamma frequency band powers were selected as linear EEG markers indicating the level of EEG power, and Higuchi's fractal dimension (HFD) as a nonlinear EEG complexity marker reflecting brain temporal dynamics. The impact of seven different blood biomarkers, i.e., glucose, protein, lipoprotein, HDL, LDL, C-reactive protein, and cystatin C, was investigated. The study was performed on a group of 52 healthy participants. The results of the current study show that one linear EEG marker, ABP, is correlated with protein. The nonlinear EEG marker (HFD) is correlated with protein, lipoprotein, C-reactive protein, and cystatin C. A positive correlation with linear EEG power markers and a negative correlation with the nonlinear complexity marker dominate in all brain areas. The results demonstrate that EEG complexity is more sensitive to the natural level of blood biomarkers than the level of EEG power. The reported novel findings demonstrate that the EEG markers of healthy people are influenced by the natural levels of their blood biomarkers related to their everyday dietary habits. This knowledge is useful in the interpretation of EEG signals and contributes to obtaining information about people quality of life and well-being.

Assessment of quality of life in people living with hemophilia: A case study of Yaoundé Hemophilia Treatment Centre, Cameroon

Introduction: Hemophilia is a sex-linked bleeding disorder resulting from deficiencies in coagulation factors, predominantly affecting individuals in developing countries. This study aims to assess the quality of life (QoL) of people living with hemophilia (PLWH) at the Yaoundé Hemophilia Treatment Centre (HTC), as no prior studies have been conducted in Cameroon. Methodology: A descriptive cross-sectional study was conducted from January 2022 to May 2022. We recruited 43 male patients with confirmed hemophilia, utilizing the EQ-5D-5L and EQ-5D-Y questionnaires to evaluate QoL. Data were analyzed using R software, with statistical significance set at p <0.05. Results: The mean age of participants was 17.3 years. Hemophilia A was prevalent in 88.4% of cases, with a mean age at diagnosis of 4.9 years. Most patients (67.4%) received on-demand treatment, and the primary complaint was joint pain. The overall EQ-5D utility score was 0.72, indicating moderate QoL, with VAS scores of 67.6 for both adults and children. Conclusion: The QoL of PLWH at the Yaoundé HTC is moderate according to the Blom cut-off scale.

Addressing Inequity in Continuous Glucose Monitoring Access: Leveraging the Hospital in the Continuum of Care.

While continuous glucose monitoring (CGM) has transformed the care of people with diabetes (PWD) in the ambulatory setting, there continue to be significant barriers to access. With CGM on the horizon in the acute care setting, it is important to consider the potential for this shift to improve ambulatory CGM access to those at the highest risk of morbidity and mortality. In this commentary, we review the existing literature on the specific barriers to CGM access for individuals with diabetes in the United States including racial disparities, provider bias, cost and shortage of specialty diabetes care. Key areas explored include the importance of CGM in diabetes management, the consequences of disparities in access to CGM, and leveraging the inpatient setting to promote equitable care and better outcomes for PWD. We present a vision for a new care model, which leverages the transition of care from the hospital to successfully incorporate CGM into the discharge plan. Given that CGM utilization is associated with improved outcomes and reduced rates of hospitalization and emergency department visits, a care model that facilitates CGM access upon transition from inpatient to ambulatory care can enhance health equity and quality of life for people with diabetes.

A Standard on Accessibility of the Immobable Cultural Heritage.

Architecture has always aimed to improve the quality of life for people by enhancing their interaction with the built environment. This applies not only to domestic settings but also to significant structures that represent our cultural heritage. However, the interaction between accessibility and cultural heritage may seem complex and challenging, even impossible at times. Cultural heritage is an essential part of our collective history and cultural identity. It is crucial to ensure that everyone can fully participate and enjoy it, especially when cultural heritage is integrated into people's daily lives, according to the United Nations Convention on the Rights of Persons with Disabilities. Moreover, improving the accessibility of cultural heritage objects enhances society's appreciation of immovable cultural heritage, emphasizing its significance and visibility. This conforms to the strategic objectives of the World Heritage Convention. This paper discusses the international standard known as ISO 5727 which aims to improve the accessibility of immovable cultural heritage in accordance with a Universal Design approach (UD). ISO 5727, currently under development within the framework of the International Organization for Standardization (ISO), is based on the Spanish standard, the UNE 41531 IN, published in 2018. The purpose of the standard is to provide general and technical criteria and a methodology for interventions in immovable cultural heritage to facilitate its use and enjoyment for all people. The standard should be considered in both restoration and rehabilitation projects, as well as in specific accessibility interventions. However, it should be noted that the standard does not cover accessibility measures related to management, like services, and maintenance. Nonetheless, it has been considered that these may be necessary complements or alternatives to the first. To carry out interventions effectively, it is advisable to adhere to a systematic approach towards the process and documentation involved. Firstly, accessibility objectives should be established. Then strategies to improve accessibility should be identified to focus on the purpose of the intervention. An analysis based on the current state of the cultural object, including its heritage values and accessibility conditions, would serve as a basis for establishing proposals for action. Once the options have been assessed jointly and comparatively, with the validation of all stakeholders- including users regardless of their abilities, age, or background- the proposals that can form part of an intervention plan can be decided on. The intervention plan will establish a set of measures that will configure the accessibility chain to meet the objectives of the intervention. ISO 5727 is conceived as a useful tool to enhance the conservation of immovable cultural heritage and to balance the achievement of specific social goals with the preservation of cultural values. This project is developed with the belief that accessibility can improve and expand the cultural and functional potential of cultural heritage.

Visual Impairment and Lighting: Comparing Guidelines and Illumination in Homes.

Universal Design aims to ensure that as many people as possible can participate equally in society, with equal access to housing, education, workplaces, institutions, and public spaces. In the construction field, many of our existing guidelines still need to catch up regarding the diversity of user needs and preferences. Recent developments in low vision rehabilitation have underscored the pivotal role of domestic lighting in fostering independent living and enhancing the quality of life for people with visual impairments. Moreover, several stakeholder organizations and associations in the field of low-vision rehabilitation have published lighting guidelines for this target group. A direct comparison of the different guidelines is difficult, as their focus, vocabulary, and level of abstraction differ: the rehabilitation process focuses on optimizing lighting to support and aid the individual's abilities in the existing environment. It is not directly related to the design- or construction process. Yet, how do the guidelines for lighting fit the actual settings and conditions in Danish homes of people with incipient vision loss or visual impairment today? In this paper, a selection of these guidelines is assessed and analyzed in relation to three lighting categories: illuminance, luminance, and the visual system. The guidelines are also compared to the initial findings of an ongoing field study. This field study, a crucial component of the research, investigates the role of lighting for individuals experiencing incipient vision loss. This comprehensive approach, which includes both theoretical guidelines and real-world observations, ensures the reliability and relevance of the research, providing a solid foundation for the findings. The practical implications of this research are significant, as it provides valuable insights for architects, researchers, and individuals with visual impairment. Through observations and walk-along interviews in their home environment, we get their personal narratives and observe their lived everyday environments. 37 walk-along interviews were conducted from October 2023 - March 2024 during dark hours. The preliminary findings of the field observations, including observations and measurements, are compared to the guidelines of both the context of building design and -construction and the context of low-vision rehabilitation and stakeholder organizations.

Co-Design of a Facilitated Self-Management Toolkit for People With Parkinson's Disease.

Parkinson's disease is a complex progressive neurodegenerative disease increasing globally. Self-management interventions have shown promise in improving the quality of life for people with chronic conditions. This paper aims to describe the development processes and the core components of a facilitated self-management toolkit to support people with Parkinson's disease to self-manage their condition. An iterative co-design approach was adopted and included the use of systematic reviews, qualitative methods and theory to develop the Live Well with Parkinson's toolkit. A co-design group was established consisting of people with Parkinson's, family carers and health and social care experts to produce and refine an online self-management toolkit to be tested in practice. Five co-design groups were conducted alongside several phases of toolkit development. An online self-management toolkit, called Live Well with Parkinson's, was developed with core aspects such as tailored information to the individual, a well-being section using an asset-based approach and problem-solving skills to create and maintain goals, symptom review and management sections and a tracker of medication, symptoms and activities/actions. A paper-based alternative version was also created for those who cannot use an online resource. The toolkit is fully manualised and facilitated by six sessions from a 'supporter' who is trained in behaviour change techniques. It can be shared with carers and healthcare professionals. The toolkit is a robust and comprehensive approach to self-management of Parkinson's disease. It is evidenced based, incorporates theory and was developed with people with Parkinson's and experts in the area. The Live Well with Parkinson's toolkit has the potential to be embedded within routine healthcare, aligning with self-management policies. Author B.M. is our patient and public involvement (PPI) representative and author on this paper. B.M. supports a team of 15 PPI members who have contributed to the development of the toolkit. This involvement has included attending research team and steering group meetings, attending and facilitating co-designed workshops, reviewing all the toolkit information before approval and supporting with the user testing.

Ashwagandha (Withania somnifera) in Cancer Therapy: Anticancer Activities and Their Mechanisms

Cancers are characterized by rapid development of abnormal cells that multiply uncontrollably, leading to invasive tumors. By 2040, new cancer cases worldwide are expected to reach 30.2 million. In response, research focuses on the anti-cancer properties of ashwagandha (Withania somnifera), used in traditional Indian medicine. Ashwagandha exhibits anti-inflammatory effects by modulating pathways like NF-kB, Nrf2/HO-1, JAK-STAT, MAPK, and NLRP3, reducing cancer-related inflammation. It also has strong antioxidant properties due to compounds like withanolides, increasing antioxidant enzyme activity and reducing oxidative stress, potentially lowering cancer risk. Ashwagandha extract shows cytotoxic effects against cancer cells, inducing apoptosis and arresting cells in the resting phase, leading to DNA damage in cancer cells. It inhibits angiogenesis, the process of forming new blood vessels that supply tumors, through mechanisms such as VEGF inhibition and reduced macrophage infiltration. Additionally, ashwagandha modulates T lymphocytes and cytokine production, enhancing the immune response against cancer, and stimulates NK cell activity, crucial for controlling tumor growth and development. Supplementation with ashwagandha reduces cortisol levels and improves cognitive functions and quality of life in people experiencing stress, potentially lowering cancer risk. Research suggests ashwagandha may be a valuable addition to anti-cancer therapy, acting on various levels of cancer pathogenesis. However, further clinical studies are needed to fully understand its mechanisms of action and to evaluate its efficacy and safety in cancer treatment.

Effect of Mental Health Care Visits on HIV Care Outcomes.

To improve the quality of life for people living with HIV (PLWH), it is vital their treatment plans closely follow the HIV care continuum. However, many barriers, such as mental health disorders (MHD), can complicate treatment. Patients being treated for HIV with comorbid MHD are more likely to not be retained in care and maintain an unsuppressed viral load. As PLWH and people vulnerable to acquiring HIV are more commonly diagnosed with MHD in comparison to the general population, it is important that steps to mitigate the possible effects of MHD are addressed during treatment. This study examines how minimal mental health care in a safety-net hospital system in the U.S. South can show benefits in retaining patients throughout their treatment of HIV. The results showed that older individuals retained a higher level of viral suppression when they followed up regularly with a mental health care provider during treatment. In addition, regardless of age, the higher the number of mental health care visits a patient attended during treatment, the higher the likelihood of viral suppression. By incorporating mental health care into the HIV treatment plan, the patients who met at least one of these criteria had better treatment outcomes and progressed further along the HIV care continuum.

German language adaptation of the Cluster Headache Quality of Life Scale (CH-QoL)

BackgroundCluster headache (CH) can lead to high disability and reduced quality of life (QoL). QoL should be assessed as an important outcome both in research and in clinical care. The 28-item Cluster Headache Quality of Life Scale (CH-QoL) is a valid self-report questionnaire to assess disease-specific QoL. A German version is lacking. This study aims to develop a German-language version and to determine its psychometric properties.MethodsThe CH-QoL was translated into German by two headache experts and blindly back-translated by two professional translators. Additionally, the CH-QoL was tested for comprehensibility by nine persons with CH. In this multi-stage process, linguistic discrepancies were repeatedly discussed in an expert panel and appropriate modifications were conducted to optimize the translation. A cross-sectional online survey, comprising the CH-QoL and further self-report questionnaires such as the Cluster Headache Scales (CHS), yielded a sample of N = 106 persons with CH (53.8% female, M = 45.5 [SD = 11.8] years, 48.1% episodic CH, 51.9% chronic CH, 79.2% currently having recurring CH attacks).ResultsExploratory factor analysis revealed two clearly interpretable factors (“restriction of activities of daily living”, and “impact on mood and interpersonal relationships”), which is in discrepancy to the four factors of the original English version. The model fit was good, with χ2(323) = 590.74, p < .001, RMSEA = 0.088, SRMR = 0.053, TLI = 0.857. Reliability was very good (McDonald’s omega ω = 0.97, Subscale/Factor 1: ω = 0.96, Subscale/Factor 2: ω = 0.92). Correlational analyses (correlations with related questionnaires as well as with clinical parameters) confirmed convergent validity.ConclusionsSince the German version of the CH-QoL has very good psychometric properties, it is suitable for the assessment of disease-specific QoL in people with CH in German-speaking countries.Trial registrationThis study is registered with the German Clinical Trials Register (DRKS-ID: DRKS00028475, registration date 03 March 2022).

Effects of aspirin and omega-3 fatty acids on composite and subdomain scores from the NEI-VFQ-25 questionnaire: the ASCEND-Eye randomized controlled trial

BackgroundThe double-blind, 2 × 2 factorial design, placebo-controlled ASCEND randomized trial compared the effects of 100 mg aspirin daily and, separately, 1 g omega-3 fatty acids (FAs) daily on the primary prevention of cardiovascular disease in 15,480 UK adults with diabetes. We report the effects of these randomized treatment allocations on scores derived from the National Eye Institute’s Visual Function Questionnaire-25 (NEI-VFQ-25) in a subset of participants involved in the ASCEND-Eye sub-study.MethodsOrdinal data from the NEI-VFQ-25 were analyzed using proportional odds regression methods. A common odds ratio with a 95% confidence interval was used to interpret the average effect size of randomization to each study treatment on composite and subdomain scores from the questionnaire.ResultsNeither randomization to aspirin nor omega-3 FAs for 7.5 years significantly affected composite or subdomain scores from the NEI-VFQ-25.ConclusionApplying the NEI-VFQ-25 in ASCEND-Eye represents one of the largest surveys of vision-targeted health-related quality of life in people with diabetes. Further observational analyses of these data are planned, to identify the clinical and demographic characteristics associated with lower composite and subdomain scores in a diabetic population.Trial registrationEudract No. 2004–000991-15; Multicentre Research Ethics Committee Ref No. 03/8/087 (29th December 2003); ClinicalTrials.gov No. NCT00135226 (24th August 2005); ISRCTN No. ISRCTN60635500 (1st September 2005).

EHealth Interventions for Managing Spine Pain-Benefits for Pain, Quality of Life, Catastrophizing and Fear Avoidance Beliefs: An Overview of Systematic Reviews With Meta-analysis.

OBJECTIVE: To summarize the effectiveness of eHealth interventions for improving pain, physical disability, psychological factors, and the quality of life for people with spine pain. DESIGN: Overview of systematic reviews. LITERATURE SEARCH: CINAHL, Embase, PubMed, and SPORTDiscus e-databases were searched. STUDY SELECTION CRITERIA: Systematic reviews with meta-analysis of randomized clinical trials evaluating any type of eHealth were included. DATA SYNTHESIS: AMSTAR 2 was used to assess the methodological quality of included reviews. The degree of overlap between reviews was calculated. RESULTS: Sixteen systematic reviews were included. Of them, 13 reviews were exclusively focused on back pain or low back pain. Exercise and psychological interventions were the primary contents of eHealth interventions. In general, eHealth interventions based on physical exercise may improve the quality of life of people with low back pain. eHealth interventions based on cognitive behavioral therapy may reduce pain catastrophizing and fear-avoidance beliefs for physical activity for people with low back pain. eHealth interventions based on multidisciplinary approaches including physical exercise may reduce low back pain. Few systematic reviews used the GRADE system to evaluate the certainty of evidence, and few specified the content of eHealth interventions. CONCLUSION: eHealth interventions may improve the quality of life, pain catastrophizing, and fear-avoidance beliefs for people with low back pain. It is unclear, based on available systematic reviews, how clinicians should deliver eHealth interventions for people with spine pain (eg, neck pain or low back pain). J Orthop Sports Phys Ther 2024;54(12):1-18. Epub 4 November 2024. doi:10.2519/jospt.2024.12844.