Perception Of Overall Health Research Articles

Perceptions of Overall Health Differences Among Veterans Across Marital Statuses.

We examined the relationship between substance use, marital status, and perceived overall health using national data from a sample of 1,506 retired active-duty veterans. We found that binge drinking and heavy alcohol use among widowed veterans have a negative effect on overall health compared to married veterans who did not use alcohol in the past month. We found that non-binge and binge drinking have a positive effect on perceptions of overall health among divorced or separated veterans compared to those who are married and did not use alcohol in the past month. We discuss these findings and address clinical implications.

Experiences of adolescents and young adults with type 1 diabetes and chronically elevated glucose levels following the transition from multiple daily injections to advanced hybrid closed-loop: A qualitative study.

To understand experiences of using second-generation advanced hybrid closed-loop (AHCL) therapy in adolescents and young adults with chronically elevated glucose levels who were previously using multiple daily injections (MDI) therapy. Semi-structured interviews with participants aged 13-25 years, on AHCL therapy for 3 months as part of a single-arm prospective study. Key inclusions: HbA1c ≥69 mmol/mol (8.5%); diabetes duration ≥1 year; and using MDI therapy prior to the study. Qualitative content analysis was used to identify themes and subthemes. Interviews were conducted among 14 participants with mean age 19.4 ± 4.3 years and mean baseline HbA1c 90 ± 25 mmol/mol (10.4 ± 4.5%). Three themes were identified: (1) substantially improved glucose levels improved perceptions of overall health; (2) features of AHCL aid in adoption and ongoing self-management; and (3) burden of care was reduced through automation of insulin delivery. Overall, there were positive impacts on physical, mental and social well-being. Participants were willing to overlook minor frustrations with AHCL because of the vast benefits that they had experienced. Four participants reported transient pseudo-hypoglycaemia: symptoms of hypoglycaemia when objectively measured glucose was in the clinically recommended range (3.9-10 mmol/L, 70-180 mg/dL). Transition to AHCL therapy positively impacted diabetes management in adolescents and youth with chronically elevated glucose levels. It appears to create a window of opportunity in which youth may re-engage with diabetes management. Pseudo-hypoglycaemia can occur during the transition to AHCL. This could be a barrier to AHCL uptake and is likely to require individualised support.

Examining the relationships between pain, activities of daily living, and perceptions of overall health in older adults with breast cancer: Results from a brief geriatric screening.

273 Background: Geriatric assessment has been identified as an essential component to caring for patients with cancer who are over 65 years old. Prior research suggests that physical pain and illness perceptions each impact important health behaviors. This retrospective study utilized a brief geriatric screen to examine the relationships between pain levels, activities of daily living (ADLs), and perceptions of overall health for older adults with breast cancer. Implications for methods to improve the patient experience for this population are considered. Methods: The Senior Adult Oncology Program (SAOP) screening tool was administered to 429 patients age 65 or older at a breast oncology clinic. A total ADL score was computed by summing patient-reported responses to 13 ADL items, such as ability to dress oneself, feed oneself, and remember to take medications. A higher ADL score indicates greater difficulty with these responsibilities. Pain was assessed using a 10-point scale; scores were dichotomized to form a low-pain group (scores 0-4) and high-pain group (scores 5-10). Overall Health was assessed on a 1-10 scale, with higher scores indicating perceptions of greater health. Demographic and medical information was abstracted from patients’ electronic health records. Independent samples t-tests examined differences between the high-pain and low-pain groups in total ADL score and self-assessed Overall Health. Results: The average age of the sample was 76 years old (range = 65-89 years). Approximately half of the sample identified as White (48%); 20% identified as Black. In comparing the high-pain and low-pain groups, the high-pain group reported significantly greater difficulty with ADLs (M score = 3.25, 1.41, respectively; p=.026). Additionally, patients endorsing high pain levels reported significantly worse Overall Health as compared to patients endorsing low levels of pain (M= 7.50, 6.11, respectively; p=.001). Conclusions: Older adults with breast cancer experiencing high levels of pain demonstrated greater difficulty with ADLs and worse perceptions of overall health. It is critical that pain is assessed early and often for older adults with breast cancer. Early identification of high pain levels in this population could allow those in need to receive pharmacological and/or behavioral treatments for pain, which may maintain stability or promote improvement in ADLs and perceptions of one’s health. Incorporating brief pain assessments into future geriatric screening tools could improve the process of aging during and after breast cancer.

Elucidating the influences of social determinants of health on perceived overall health among African American/Black and Hispanic ovarian cancer survivors using the NIH All of Us Research Program

ObjectivesTo evaluate the influences of social determinants of health (SDOH) on perceived health and well-being among African American (AA)/Black and Hispanic ovarian cancer survivors. MethodsA cross-sectional study was conducted using overall health and SDOH survey data collected by the National Institutes of Health All of Us Research Program from May 2017 to September 2023. ResultsWhile 1250 enrolled participants with ovarian cancer met the inclusion criteria, 414 (33%) completed SDOH surveys: 29 (7%) AA/Black, 33 (8%) Hispanic, and 352 (85%) White. In the ordinal logistic regression models, for every unit increase in the SDOH neighborhood characteristics score, the odds of having a poor perception of general health decreased by 0.96 times. For every unit increase in the SDOH day-to-day discrimination score, the odds of having a poor perception of general health, general mental health, social satisfaction decreased by 0.95, 0.94 and 0.93 times respectively. For every unit increase in the SDOH food and housing security score, the odds of having a poor perception of general health decreased by 0.57 times. Compared to White ovarian cancer survivors, AA/Black and Hispanic ovarian cancer survivors were significantly more likely to have a poor perception of general health, general mental health, and social satisfaction even when adjusting for these SDOH. ConclusionsUnfavorable SDOH conditions negatively influence the overall perception of health. These findings signal an urgency for healthcare professionals and scientists to partner together with local communities in designing feasible and imaginative interventions to overcome cancer care disparities in an equitable manner.

The effect of biomass smoke exposure on quality-of-life among Ugandan patients treated for tuberculosis: A cross-sectional analysis

More than half the global population burns biomass fuels for cooking and home heating, especially in low-middle income countries. This practice is a prominent source of indoor air pollution and has been linked to the development of a variety of cardiopulmonary diseases, including Tuberculosis (TB). The purpose of this cross-sectional study was to investigate the association between current biomass smoke exposure and self-reported quality of life scores in a cohort of previous TB patients in Uganda. We reviewed medical records from six TB clinics from 9/2019-9/2020 and conducted phone interviews to obtain information about biomass smoke exposure. A random sample of these patients were asked to complete three validated quality-of-life surveys including the St. Georges Respiratory Questionnaire (SGRQ), the EuroQol 5 Dimension 3 Level system (EQ-5D-3L) which includes the EuroQol Visual Analog Scale (EQ-VAS), and the Patient Health Questionnaire 9 (PHQ-9). The cohort was divided up into 3 levels based on years of smoke exposure–no-reported smoke exposure (0 years), light exposure (1–19 years), and heavy exposure (20+ years), and independent-samples-Kruskal-Wallis testing was performed with post-hoc pairwise comparison and the Bonferroni correction. The results of this testing indicated significant increases in survey scores for patients with current biomass exposure and a heavy smoke exposure history (20+ years) compared to no reported smoke exposure in the SGRQ activity scores (adj. p = 0.018) and EQ-5D-3L usual activity scores (adj. p = 0.002), indicating worse activity related symptoms. There was a decrease in EQ-VAS scores for heavy (adj. p = 0.007) and light (adj. p = 0.017) exposure groups compared to no reported exposure, indicating lower perceptions of overall health. These results may suggest worse outcomes or baseline health for TB patients exposed to biomass smoke at the time of treatment and recovery, however further research is needed to characterize the effect of indoor air pollution on TB treatment outcomes.

Quality of Life among Elderly People and its Associated Factors in Makwanpur District: A Descriptive Cross-Sectional Study

Introduction: Aging is a universal process and it affects every individual, family, community, and society. It is a normal, progressive, and irreversible process. Objective: To assess quality of life among elderly people at old age home of Makwanpur district, Nepal. Methods: A descriptive cross-sectional study was conducted among 82 elderly people in old age home using complete enumeration sampling. A structured interview session was conducted by using WHOQOL-BREF tool. Data analysis was done in SPSS version 20 using descriptive statistics such as frequency, percentage, mean and standard deviation. Inferential statistics such as Chi square test was used to determine association. Results: Out of 82 respondents, majority of the respondents perceived QOL as neither poor nor good. Among total respondent's, 36.6% were satisfied with overall perception of health. Also the study revealed the mean score was found higher in physical and psychological domain (50.609±11.75) and 50.304±12.13 respectively. The overall quality of life was found to be 71.292 which is good quality of life. There was significant association of age and religion with physical domain.Conclusions: The study concludes the overall quality of life was good among elderly. The mean score was found to be higher in physical and psychological domain in comparison to environmental and social relationship domain. Significant association was found in physical domain with age and religion.

CAN GOOD SELF-RATED HEALTH MITIGATE THE FRAILTY-INDUCED HEALTH CARE EXPENDITURE? EVIDENCE FROM CHINA

Abstract As the pathophysiology of frailty remains unknown, intervention efforts have primarily focused on improving functions and alleviating symptoms instead of treating frailty-causing biology. Frail individuals are not a clinically homogeneous group; further risk stratification may identify subgroups more resilient to health risks. Self-rated health (SRH), a simple measure of an individual’s overall perception of overall health, might be a surrogate of resilience among the frail. This work aims to determine the joint association of frailty and SRH with healthcare expenditure. Data were from the China Health and Retirement Longitudinal Study. Persons were classified as non-frail, prefrail, and frail. SRH was classified as poor (including very poor) and good (fair/good/very good/excellent). Healthcare expenditure was classified into outpatient, inpatient, and self-treatment. The Cox model was used to address the study’s aims. All analyses were adjusted for age, sex, residence, education, income, insurance, smoking, and chronic conditions. Although frailty was positively correlated with poor SRH, 36.0% of the frail reported good health and 26.6% reporting poor health were deemed non-frail. Frailty and SRH were independently associated with higher odds of incurring and higher average expenditures. Among persons with poor SRH, prefrailty and frailty were associated with higher odds of incurring the cost and higher average expenditures than the non-frail, while no association was found between frailty and healthcare expenditure among those with good SRH. Frailty was associated with higher healthcare expenditure only among persons with poor SRH. Frail individuals reporting good health are resilient to frailty-induced health risks.

A STUDY ON BIPOLAR AFFECTIVE DISORDER SUBJECTS UNDER REMISSION – QUALITY OF SLEEP AND QUALITY OF LIFE

Aims and Objectives: People affected with bipolar disorder experience sleep disturbances which precedes an episode of depression or mania. The aim of the present study was to assess the quality of sleep and quality of life (QOL) in subjects with euthymic bipolar disorder. Methods: This was a case–control study conducted between April 2015 and September 2015. All subjects in the age of 18–60 years with bipolar affective disorder (BPAD) under remission for at least 6 months were included as cases and healthy volunteers as controls. Mini-international neuropsychiatric interview plus brief interview, Hamilton depression rating scale and young mania rating scale were used to quantify remission. Pittsburgh sleep quality index (PSQI) and Epworth sleepiness scale were used to assess quality of sleep and the WHO quality of life brief version (WHOQOL-BREF) scale was used to assess QOL. Descriptive data were given in summary statistics, Student’s t-test to compare means, one-way ANOVA to compare means with variables, Pearson’s test for correlation and Chi-square test for qualitative variables were used. p<0.05 was considered significant. Results: Fifty patients and 51 volunteers were included in the study. The mean age was 39.62±11.68 years, males and females were equal, most were married (82.17%), 34.65% had completed high school, 47.52% were unskilled workers and 73.27% were in upper lower socioeconomic status. About 95.05% did not had family history of psychiatric illness. Euthymic BPAD patients were more unmarried (p=0.033), more unemployed (p=0.0003), less full-time employees (p=0.0001), had more PSQI global score (p=0.0003) and more Epworth sleepiness scale (p=0.0004) than controls. As the duration of remission increased, sleep dysfunction improved (p=0.009). WHOQOL scores were lower in BPAD patients and overall perception of health was lower (p=0.044). BPAD patients had poor sleep hygiene and watched more television in bed, had more cigarettes and had more coffee than tea. Conclusion: Patients with BPAD even when in remission had significant sleep disturbances. Sleep hygiene factors have to be modified to improve sleep dysfunction. Psychosocial interventions are needed to achieve better QOL.

Relationship among symptoms, quality of life, and complementary and alternative medicines use among patients undergoing hemodialysis in French-speaking Switzerland

BackgroundChronic renal disease is considered a main public health problem due to its high prevalence in the population. The solution of choice currently available is kidney transplantation but when this option is not available, blood purification treatments, notably haemodialysis (HD), are necessary. The presence of chronic renal disease combined with this demanding medical procedure leads to a hard symptomatology. To face this situation, HD patients often resort to complementary and alternative medicines (CAM) as they perceive that the healthcare professionals aren’t paying enough attention to their quality of life.Given this background, we aim to describe the prevalence and the type of the CAM used among HD patients and their possible relations with patients’ symptomatology and quality of life.MethodsWe interviewed 88 patients, undergoing hemodialysis in three hemodialysis centers in French-speaking Switzerland, about the presence of symptoms, their quality of life, and the possible use of CAM. Cluster analysis was used to create patients’ profiles about CAM use and regression analysis to explore the links between symptoms’ presence, patients’ quality of life, and CAM use.ResultsOur results show a large use of CAM: almost two HD patients out of three uses at least one CAM. Using cluster analysis, we were able to identify five patients’ profiles: non-users (37.5% of our sample), users of herbal medicine (20.5%), users of prayer-based practices (18.2%), people mainly using massages (9.1%), and a residual group including the users of other CAMs, with a predominance of meditation (14.8%). As expected, we observe a negative relation between the number of declared symptoms and patients' quality of life. Contrarily, we observe no relation between the use of CAM and the presence of symptoms. Our results show a positive relationship between the use of CAM and patients’ overall perception of health as well as the psychological dimension of their quality of life. No relationship is observed with other dimensions of quality of life, notably the physical dimension.ConclusionsOur results suggests that CAMs aren’t used as a substitute of official medicine but as a parallel support to HD patients’ quality of life.

Patient-Centered Outcomes With a Multidisciplinary CKD Care Team Approach: An Observational Study.

Multidisciplinary chronic kidney disease (CKD) care has been associated with improved clinical outcomes in comparison to general nephrology care. However, there is little research examining the impact of multidisciplinary care on patient-centered outcomes. We examined if a multidisciplinary approach to CKD care was associated with 4 patient-centered outcomes. Cross-sectional study design using previously established surveys to assess patient-centered outcomes in participants with nondialysis CKD. Adults with CKD stages 1-5 who had not undergone transplant or were not on dialysis. General nephrology care or multidisciplinary care. Patients receiving multidisciplinary care were seen by a pharmacist, social worker, dietitian, and nephrologist, whereas patients receiving general nephrology care only saw a nephrologist. Four patient-centered outcomes: CKD-specific knowledge, disease-related stress, perception of overall health, and perception of health status compared to 1 year ago. Differences were examined using a Welch 2-sample t test and linear regression model. Mean age of participants was 60 years with standard deviation of 17 years. 182 (77%) patients were White, and 230 (96%) had formal education greater than or equal to high school. 121 (49%) were women, and 215 (88%) had CKD stage 3-5. 77 (31%) received multidisciplinary care. We did not identify any significant differences in patient knowledge, stress, or perception of health between multidisciplinary and general nephrology care. However, notably, patients in multidisciplinary care were older and had more advanced CKD than those in general nephrology care. Cross-sectional study designs only identify associations. Study was conducted at clinics located within 30 miles of each other, limiting generalizability. Our results suggest that a team-based approach to care can better support sicker, more vulnerable patients so that they can achieve similar patient-centered outcomes compared to patients who are younger and with less advanced CKD.

Nutrition Habits and Self-Assessment of Health and Quality of Life Among Women from the Kraków Community Participating in the "Healthy Active Senior” Programme

Background: Healthy food choices are among the factors contributing to health, and therefore, a better quality of life at each stage of ontogenesis. The aim of the study was to assess correlations of eating habits with self-rated health and quality of life (QOL) in women participating in the Healthy Active Senior project at the University of Physical Education in Kraków, Poland. Methods: The study was conducted in September 2019 among 201 women aged 60-85 (66 5) using the Questionnaire of Eating Behaviour (QEB) and the WHOQOL-BREF questionnaire. Statistical analysis was performed using Spearman’s rank correlation coefficients (Spearman’s rho), with a significance level set at p<0.05. Results: The study demonstrated that the inclusion of unsweetened foods such as beverages and dairy products as snacks and a preference for baking/roasting as a method of heat treatment of meat led to an increase in self-rated health (p<0.01). On the other hand, overall health assessment decreased (p<0.01) with the consumption of sweetened beverages and sweetened dairy products, and adding salt to ready-made meals or sandwiches. Furthermore, with regular consumption of meals, including unsweetened beverages and dairy products as snacks, and a preference for baking/roasting as a method of heat treatment for meat and consuming wine among alcoholic beverages, the overall perception of quality of life increased (p<0.01). In contrast, choosing sweet snacks and the preference for flavoured water led to a decrease in the overall self-rated QOL (p<0.01). Conclusions: Healthy food choices are associated with an increase in the general perception of health and quality of life while choosing unhealthy foods is related to a decrease in the overall perception of health and QOL in senior women.

Psychological Intervention Based on Mental Relaxation to Manage Stress in Female Junior Elite Soccer Team: Improvement in Cardiac Autonomic Control, Perception of Stress and Overall Health.

Chronic stress may represent one of the most important factors that negatively affects the health and performance of athletes. Finding a way to introduce psychological strategies to manage stress in everyday training routines is challenging, particularly in junior teams. We also must consider that a stress management intervention should be regarded as "efficacious" only if its application results in improvement of the complex underlying pathogenetic substratum, which considers mechanistically interrelated factors, such as immunological, endocrine and autonomic controls further to psychological functioning and behavior. In this study, we investigated the feasibility of implementing, in a standard training routine of the junior team of the Italian major soccer league, a stress management program based on mental relaxation training (MRT). We evaluated its effects on stress perception and cardiac autonomic regulation as assessed by means of ANSI, a single composite percentile-ranked proxy of autonomic balance, which is free of gender and age bias, economical, and simple to apply in a clinical setting. We observed that the simple employed MRT intervention was feasible in a female junior soccer team and was associated with a reduced perception of stress, an improved perception of overall health, and a betterment of cardiac autonomic control. This data may corroborate the scientific literature that indicates psychological intervention based on MRT as an efficacious strategy to improve performance, managing negative stress effects on cardiac autonomic control.

Female Renal Donors: Impact of Donation on Anxiety, Depressive Symptoms and Quality of Life

Introduction: Donating one’s kidney can be a complicated psychological experience. This study was designed to evaluate and compare anxiety, depression and quality of life of married female renal donors during the pre and post donation phase. Methods: In this prospective longitudinal observational study, 39 consecutive female renal donors were assessed using PHQ-9, HAM-A and the WHO QoL-Bref Questionnaire 2 weeks before and 3 months after kidney donation. Results: The mean age of female kidney donors was 41.74 ± 8.85. After donation, prevalence of depression increased from 43.59 % (n = 17) to 53.84 % (n = 21), (t(38) = -2.089, p = 0.04) while prevalence of anxiety in donors increased from 58.97 (n = 23) to 69.23 % (n = 27) and the difference was found to be statistically significant (t(38) = 2.47, p = 0.01). Kidney transplantation resulted in a significant decrease in overall perception score of WHOQOL-Bref Questionnaire. (t(38) = 3.504, p = 0.001), overall perception score of health (t(38) = 3.504, p = 0.001), physical domain (t(38) = 4.180, p = 0.000) and psychological domain (t(38) = 2.469, p = 0.018) after donation. There were no significant changes in the social relationship (t(38) = -0.80, p = 0.936) and environmental health domain scores (t(38) = 0.991, p = 0.328). On multiple regression analysis, presence of pre-transplant depression was independently associated with overall score of WHOQOL-Bref Questionnaire (β = -0.14, p = 0.002), perception of health (β = -0.08, p = 0.001), physical health (β = -1.91, p = 0.08) and psychological health (β = -2.57, p = 0.02). Pre-transplant anxiety was negatively related to overall perception of health (β = -0.08, p = 0.01), physical health (β = -2.05, p = 0.01) and psychological health (β = -1.94, p = 0.02). Conclusion: Significant reduction in quality of life, perception of health, physical health and psychological domain of female renal donors was observed after donation.

Women’s Perceptions of Overall Health and Unsafety in Urban Spaces: A Qualitative and Case Study-Based Analysis of Tehran’s Urban Areas

Women all over the world may, at some point, have had unpleasant experiences which might have caused them physical or mental harm. This study has investigated such experiences, particularly in the city of Tehran, and explored the relationship between unsafe urban spaces and the overall health and well-being of women. Urbanization, while being one of the leading global trends of the 21st century, seems to be having a significant impact on the overall health of people. Due to the changes and modernization in Iran, there is an increasing presence of urban spaces in cities. Tehran, the capital of Iran, is the biggest city in the country and the main destination of migrants because of its several modernistic urban attractions. This phenomenon has many adverse effects on different aspects of the city, such as the loss of green environments, agricultural lands, orchards, increasing air pollution, increasing socioeconomic inequality, and so on. [1] Women, according to the gender equity perspective, should have equal rights for presence in and use of urban public spaces. Various factors and obstacles decrease women’s participation in urban public spaces, for instance, they suffer from harassment and insecurity in a city on a regular basis and confront it in various situations. [2] [1] Ahmad Pourahmad et.al. “The Impact of Urban Sprawl up on Air Pollution”.252-257. [2] Mohammad Reza Bemaniyan te.al. “Assessment of Factors Affecting the Promotion of Women’s Safety in Urban Environments”.

Physical and sexual assault, and negative perceptions of health: Does age of onset matter?

PurposeThe negative health consequences of physical and sexual assault are fairly well established, yet factors related to the context of assaults are less recognized. This study examines the role of the age of onset of physical and sexual assault on overall perceptions of health and autonomy over health. MethodsUsing a follow-up of the original Midlife Development in the United States (MIDUS) study, we use the MIDUS-3 dataset to test hypotheses that earlier age of assault onset is associated with greater negative perceptions of overall health and health autonomy than later onset. ResultsWe find that physical and sexual assault are associated with greater negative perceptions of health but that age of onset only matters for sexual assault. Assault and age of onset do not matter for health autonomy which is influenced primarily by personality characteristics. ConclusionPhysical and sexual assault are related to overall perceptions of health and should be considered by medical professionals and social services when working with survivors of violence. Personality characteristics are influential in health outcomes and should be considered when devising violence prevention and intervention strategies.

Patient Perception of Medical Care for Psoriatic Arthritis in North America and Europe: Results from a Global Patient Survey.

IntroductionTo compare perceptions of disease control and treatment satisfaction between patients with psoriatic arthritis (PsA) in North America and Europe, and between participating countries within each region.MethodsData were collected from patients with self-reported PsA diagnoses using an online survey. Results from questions on perceptions of overall health, disease severity, PsA symptoms, PsA impacts, and treatment satisfaction/preferences were reported using descriptive statistics and Chi-square tests.ResultsA total of 456 patients from North America (Canada, n = 155; US, n = 301) and 417 patients from Europe (France, n = 123; Spain, n = 135; UK, n = 159) were included in this analysis. Patients in North America were more likely to rate their overall health as excellent/good compared with those in Europe (49 vs. 14%), but also rate their disease as severe (27 vs. 15%). Despite treatment, patients in North America and Europe still experienced musculoskeletal (92 vs. 91%) and skin/nail (62 vs. 58%) symptoms. Similar proportions of patients in North America vs. Europe experienced a social impact (81 vs. 85%); more patients in Europe vs. North America experienced PsA-related work impacts (83 vs. 74%). Satisfaction with PsA medication was more common in North America (89%) vs. Europe (79%), and more common in Spain (91%) vs. the UK (82%) or France (66%). Across all regions and countries, ≥ 75% of patients agreed that symptoms were controlled. However, ≥ 66% wished they had more medication choices, and ≥ 84% wanted to change something about their medication.ConclusionsAlthough perception of overall health and disease severity varied, many patients from both regions still experienced symptoms despite receiving medications for PsA, wished they had greater choice of medications, and/or would like to change an aspect of their medications. While these survey findings are subject to selection bias, they do indicate there is scope to improve the treatment of PsA.Supplementary InformationThe online version contains supplementary material available at 10.1007/s40744-022-00435-y.

Concern About Falling, Confidence in Balance, Quality of Life, and Depression Symptoms in Community-Dwelling Older Adults After a 24-week Dual-Task Training With Variable and Fixed Priority: A Randomized Controlled Trial.

To evaluate the effect of a 24-week dual-task training with progression from variable to fixed priority on the concern about falling, confidence in balance, quality of life, and depression symptoms in community-dwelling older adults. A total of 60 participants (60-80 y.o.) were randomly allocated into a dual-task training group with progression from variable to fixed priority (experimental group) or into a dual-task training group with variable priority (control group). No between-group difference was observed after the intervention. A significant time effect showed a reduction in concern about falling [mean difference (MD) = -2.91)] and depression symptoms (MD = -1.66), an increase in the physical function (MD = 7.86), overall mental health (MD = 5.82), perception of vitality, energy, and less fatigue (MD = 10.45), general perception of overall health (MD = 6.81), and their health compared to the last year (MD = 11.89). The experimental protocol was not superior to the control one. However, both protocols improved these outcomes.

Testosterone deficiency in male organ transplant recipients.

Testosterone deficiency is known to affect men with increasing incidence throughout their lifespan. The clinical manifestations of testosterone deficiency, in turn, negatively impact men's quality of life and perception of overall health. The interaction of chronic systemic disease and androgen deficiency represent an area for potential intervention. Here, we explore the topic of testosterone deficiency amongst men with end-stage organ failure requiring transplantation in order to elucidate the underlying pathophysiology of androgen deficiency of chronic disease and discuss whether intervention, including testosterone replacement and organ transplantation, improve patients' outcomes and quality of life.

Quality of life and symptoms in patients selected for ablation of ventricular extrasystoles: a prospective study.

Evaluation of the impact of catheter ablation for ventricular extrasystoles (VES) in structurally normal hearts on quality of life (QOL) and symptomatology. Symptom analysis assessed with a disease-specific questionnaire, EHRA score for AF, and QOL analysis at baseline and 1year after ablation. The study enrolled 39 patients between April 2016 and November 2019. Two patients were excluded from further analysis.At baseline, palpitations were reported in 31/37 (84%); syncope in 12/37 (32%); other cardiac symptoms in 33/37 (89%) of patients. The EHRA score was 3 or 4 in 13 patients (35%). With the modified arrhythmia-specific questionnaire (MASQ) psychological and physical scores were 46 and 39%. The overall perception of health in the SF-36 was 56 ± 16%.Ablation was performed in 35/37 (95%). At regular follow-up, symptoms were reported in 14/37 (38%) patients. ECG suggested a good procedural outcome in 65% with VES burden on Holter < 1% in 68%. At follow-up, palpitations were reported in 61% (P < 0.07); syncope in only 1 patient (P < 0.05). The EHRA score was 3 or 4 in only one patient (P < 0.05). MASQ scores improved to 62 and 60% (both p < 0.001). The overall perception of health in the SF-36 became 64 ± 17% (P < 0.02). Patients with VES suffer from a wide variety of symptoms and have a low quality of life, as demonstrated by the EHRA score and conventional questionnaires. After catheter ablation, palpitations are still reported, but become less frequently present. Syncope becomes rare. Quality of life improves significantly from all perspectives.

Gender Minority Stress, Psychiatric Comorbidities, and the Experience of Migraine in Transgender and Gender-Diverse Individuals: a Narrative Review.

This review aims to discuss the experience of migraine in transgender and gender-diverse individuals as it relates to other psychiatric comorbidities such as anxiety, depression, PTSD, and others. As this population faces stigma and discrimination, literature posits that gender minority stress can also contribute to the experience of pain in these individuals. Though there is little explicit data on these topics, more recent studies have explored the concept of gender minority stress and how stigma and discrimination can affect health outcomes and overall perception of health. These findings, as well as data on psychiatric comorbidities in cisgender individuals with migraine, can be extrapolated to understand how gender minority individuals may experience migraine. Research has demonstrated that stigma and discrimination can affect health outcomes in the transgender and gender-diverse community. A recent study has shown that sexual minority stress associated with stigma, discrimination, and barriers to care can exacerbate migraine. It is known that psychiatric comorbidities such as anxiety, depression, and PTSD can affect migraine frequency and severity in cisgender individuals. Though there are no specific studies in the transgender and gender-diverse patient population, these highly prevalent mental health conditions could potentially contribute to their migraine experience. Hormones, as well, may affect mood in those on gender-affirming hormone therapy, with some studies exploring how this may have both a direct and indirect relationship with migraine. There are clear knowledge gaps that can be addressed by future research in these areas to better understand the migraine experience in transgender and gender-diverse individuals and improve overall care.