Physical Function Health Research Articles

Identifying Patients at Risk for a Facility Discharge Following Elective Total Joint Arthroplasty Using Preoperative Clinical Findings and Patient-Reported Outcome Scores.

Facility discharges following an elective, primary, total joint arthroplasty are infrequent, but are associated with poor outcomes and significant cost. Therefore, investigating ways to identify patients most likely to be discharged to a facility could improve patient care, reduce costs, and potentially lead to strategies to mitigate these risks. A total of 3,198 patients who underwent a total hip or knee arthroplasty between June 2021 and June 2023 were included in this study. Independent factors associated with a discharge to a facility were identified using logistic regressions, and receiver operator curve cut-point analysis was used to determine threshold values for these factors. Facility discharge occurred 138 times (4.3%). A total of 12 factors were associated with a facility discharge. There were nine factors collected preoperatively, of which two were based on demographics and medical history (i.e., age and the Charlson Comorbidity Index) and seven were obtained from patient-reported outcome measures (i.e., the Risk Assessment and Prediction Tool score and individual question responses, the Patient-Reported Outcomes Measurement Information System (PROMIS-10) T-scores for physical function and mental health, and the results of the Brief Resiliency Scale). There were three inpatient variables (i.e., ambulation distance, length of stay, and timed up-and-go results) also noted to be significantly associated with a facility discharge. Patients who had five preoperative factors, or eight factors overall, were most likely to be discharged to a facility. The results of this study indicated that a patient's mental health, mobility, and support structure at home are the most influential factors associated with a facility discharge. Additionally, the results suggested that the patient-reported outcomes measures provide a significant discriminatory ability to identify patients at risk for a facility discharge following a primary total joint arthroplasty.

Assessment of Quality of Life and Psychological Well-Being in Italian Adult Subjects with Prader-Willi Syndrome Using the Health Survey Short Form and the Psychological General Well-Being Index Questionnaires.

Background/Objectives: Prader-Willi syndrome (PWS) is a rare, genetically determined neurodevelopmental disorder. Individuals with PWS face numerous challenges that significantly impact their psychological well-being and quality of life, ultimately limiting their personal and social functioning. This study aimed to evaluate the quality of life and psychological well-being in a sample of Italian adult patients with PWS compared to an age-matched control group of normal-weight Italian individuals. Methods: Thirty patients with PWS (11 men and 19 women; mean age ± SD: 36.4 ± 10.31 years; mean Body Mass Index (BMI: 35.7 ± 8.92 kg/m2) and thirty Italian adult individuals from the general population (5 men and 25 women; mean age ± SD: 32.1 ± 6.86 years; mean Body Mass Index (BMI: 21.8 ± 2.90 kg/m2) were studied. Quality of life and well-being were assessed using the Italian versions of the 36-item Health Survey Short Form and the Psychological General Well-Being Index. Results: Normal-weight subjects scored significantly higher than PWS patients on the physical health (p < 0.001) and social functioning (p = 0.047) subscales of the SF-36. Conversely, PWS patients scored higher on the vitality subscale (p < 0.001). Similarly, the vitality subscale of the PGWBI was significantly higher in PWS patients than in controls (p = 0.010), whereas the Self-Control subscale of the PGWBI was higher in controls compared to PWS patients, albeit not statistically significant (p = 0.057). Discussion: Patients with PWS exhibited impairments in various aspects of quality of life and psychological well-being, including physical, behavioral, and social domains. However, the higher vitality scores observed in PWS patients suggest a preserved dimension of their psychological well-being. Conclusions: These findings enhance the understanding of the psychological condition of patients with PWS and provide valuable insights for improving multidisciplinary psychological treatment approaches for these individuals.

Effects of Physical Activity Level, Strength, Balance, and Body Composition on Perceived Health in Healthy Adults.

Nowadays, not only is a high, long life expectancy desired, but also longevity with quality. Quality of life in adulthood is a multidimensional construct related to the perception of one's own health, psychological and socio-emotional factors, functionality for daily activities, and body composition. This study evaluates the effects of physical activity level (PAL), strength, balance, and body composition on perceived health in healthy adults. An observational, cross-sectional study with consecutive, non-probabilistic inclusion of cases was conducted. Body fat percentage (BFP) was measured by DXA. Physical activity level was assessed using accelerometry. The strength index (S_Index) was estimated using dynamometry. Postural control was assessed through posturography. The composite equilibrium score from the Sensory Organization Test (SOT_CES) was conducted to measure postural stability under various sensory conditions using dynamic posturography. Perceived health was calculated using the SF36 questionnaire, which detects health states, both positive and negative. A linear regression model was generated between each domain of SF36 with SOT_CES, BFP, PAL, and S_Index. A total of 64 males with a mean age of 55 ± 5 years and a mean body mass index of 27 ± 4 kg/m2 were recruited. Results showed a negative correlation between physical function (ß = -0.7; t = -3.163; p = 0.003; R2 = 23.7%) and general health (ß = -0.227; t = -3.425; p = 0.001; R2 = 17.4%) with BFP. Also, it showed a negative correlation between physical function (ß = 0.047; t = -2.643; p = 0.011; R2 = 17.5%) and general health (ß = 0.016; t = -3.044; p = 0.004; R2 = 14.6%) with S_Index. On the other hand, no relation was observed between SF36 and SOT_CES. Finally, only the emotional role showed a positive correlation (ß = -0.02; t = -2.629; p = 0.011; R2 = 23.1%) with PAL. A lower BFP and higher S_Index are associated with increased physical function and general health. Also, the higher the PAL, the greater the emotional health. On the other hand, no relation was observed between SF36 and the balance detected from SOT_CES.

MicroRNA signatures of VO 2 peak in older adult participants of the Study of Muscle, Mobility and Aging.

Peak oxygen consumption during exercise (VO 2 peak), is a direct measure of cardiorespiratory fitness (CF), a key indicator of physical function and overall health. However, the molecular changes that underpin VO 2 peak variation are not clear. Our objective is to understand the miRNA signatures that relate to VO 2 peak variation, which could provide insights to novel mechanisms that contribute to low VO 2 peak. We used small RNA sequencing to analyze serum samples from 72 participants (70-79 yrs old, 53% female) of the Study of Muscle, Mobility and Aging (SOMMA). We analyzed samples from individuals with low or high VO 2 peak (N=18/group) as well as samples from 36 randomly selected participants spanning the entire spectrum of VO 2 peak. We used LIMMA analysis package for regression analysis and to identify differentially expressed miRNAs. We used receiver operating characteristic curve analysis to evaluate the Area Under the Curve (AUC) and sensitivity and specificity rates. We identified 1,055 miRNAs expressed in all serum samples. Expression of 65 miRNAs differed between participants with low and high VO 2 peak (p < 0.05). After p-value adjustment, expression of 5 miRNAs (miR-1301-3p, -431-5p, -501-5p, -519a-3p, and -18a-3p) remained significantly different (FDR = 0.05). The five miRNAs had AUC ranging from 0.77 to 0.84. The optimal sensitivity and specificity ranged from 70 to 80% and 80 to 90%, respectively. After adjustment for age and sex covariates, 46 miRNAs significantly correlated with VO 2 peak (p < 0.05) and miR-519a-3p remained significant based on adjusted of p-values. We identified a miRNA signature of VO 2 peak in older individuals that might provide insights to novel mechanisms that drive low VO 2 peak. Future studies will validate the findings in a larger, longitudinal study cohort.

EVIDENCE THAT TOMORROW’S OLDER POPULATION WILL BE LESS FIT THAN TODAY: A NATIONAL STUDY, 2003–2022

Abstract Entering retirement age with a high level of health, well-being, and functioning is critical for remaining healthy and engaged after retirement and into later life. While recent stagnating trends for mortality have been well documented in pre-retirement age groups, there has been less attention to trends in morbidity, and in particular, what they are like across different levels of income. We use data from the Centers for Disease Control and Prevention Behavioral Risk Factor Surveillance System that includes self-reported data on wellbeing and functioning on more than seven million individuals from 2003 to 2022, to examine how physical health, mental health and functional health have changed over time by age group and income level. We find there are dramatic differences (up to 10 more days of morbidity in the last 30 days) by level of income, and that over this period of time there are increases in the number of days with bad health and functioning for the poorest and lower-middle income groups. These declines are most notable in ages that are pre-retirement years, age 50 to 59. None of these trends or levels were explained by race, BMI, or smoking, although we show substantial differences in these trends across U.S. States. If current national trends persist, the current age 50 to 59 year old population will be entering retirement ages with substantially worse health than previous generations, which has major implications for labor force participation, Medicare expenses and Social Security.

Application of mobile internet management in the continuing care of patients after radical prostatectomy

Prostate cancer, a common malignancy in older men, often requires laparoscopic radical prostatectomy, considered the gold standard treatment. However, postoperative complications can significantly impact quality of life and psychological well-being. The emergence of mobile internet health management offers a promising approach for accessible and effective post-discharge care. This study evaluates the effectiveness of mobile internet management in postoperative care for prostate cancer patients, focusing on disease knowledge, psychological well-being, self-care capabilities, and quality of life. From September 2020 to September 2021, prostate cancer patients who underwent radical surgery at our Department of Urology were divided into a control group receiving standard care and an intervention group receiving mobile internet-based care. Patients were followed over six months, with assessments conducted at both 3 and 6 months post-intervention. We evaluated changes in disease knowledge, psychological status (using SAS/SDS scales), self-care ability (via the ESCA scale), and quality of life (measured by SF-36). A total of 112 patients were divided into two groups of 56 each. Repeated measures ANOVA indicated significant improvements in disease knowledge over time, between groups, and in their interaction (P < 0.05). Mastery scores of disease knowledge increased at both 3 and 6 months post-intervention compared to baseline (P < 0.05). The intervention group showed significantly reduced scores on the self-rating depression scale (SDS) and self-rating anxiety scale (SAS) compared to the control group (P < 0.05). Self-care capabilities—including self-directed concept, nursing responsibility, skills, and health knowledge level—also improved, with more pronounced gains in the intervention group (P < 0.05). Quality of life scores in domains such as social function, mental health, vitality, role emotional, bodily pain, role physical, physical function, and general health were higher in the intervention group than in the control group post-intervention (P < 0.05). Mobile internet management significantly enhances postoperative care for prostate cancer patients by improving disease knowledge, psychological well-being, self-care capabilities, and quality of life. These findings support further research to validate long-term benefits and broader application potentials.

Validity, Stability, and Change in Psychopathic Traits in Older Adults: A Registered Report

Despite the importance of psychopathy—a construct with robust relations with externalizing outcomes—little is known about how psychopathic traits manifest in middle-age to older adulthood. In the present investigation, we used a large and diverse sample of older adults from the St. Louis Personality and Aging Network to examine psychopathy’s nomological network and whether these traits change over four time points spanning approximately 10 years. We also explored whether these changes were associated with changes in other important constructs (e.g., physical and psychological functioning) across the same time span. Psychopathy was operationalized in two ways: (a) via the factors of the triarchic psychopathy model, Meanness, Disinhibition, and Boldness, and (b) using a more macro approach via the Five-Factor Model Psychopathy Resemblance Index. We found that (a) the nomological network of psychopathy appears to be consistent with what has been observed in samples of younger adults, (b) psychopathic traits remain stable over time as adults make the transition from midlife to later life, and (c) changes that were observed are significantly related to changes in several important outcomes, including physical health, mental health, relationship satisfaction, intimate-partner aggression, and social functioning.

Assessing the impact of physical, mental and cognitive impairments on health-related quality of life in sepsis survivors following intensive care admission in New Zealand.

To assess the impact of physical, mental and cognitive impairments on health-related quality-of-life (QoL) of individuals who have survived sepsis after admission to an Intensive Care Unit (ICU) in New Zealand. Survivors from a trial investigating vitamin C as an adjunctive therapy in patients with sepsis in Christchurch Hospital ICU were invited to enrol in a longitudinal QoL follow-up study. Patients were interviewed at hospital discharge, 30, 90 and 180 days, using validated physical and mental health assessment questionnaires (Short-Form-36, EuroQol-5-Dimension). Cognitive function was monitored and results compared with New Zealand population norms. Eighteen of the 26 survivors participated in the 6-month QoL follow-up. At hospital discharge, there were significant physical and mental health issues in the participants interviewed, and although a majority of the subscales improved over the 6-month follow-up, physical function, role-physical and general health were still below population norms. Following discharge, objective parameters (mobility, self-care, usual activities) normalised within 3-6 months, while subjective measures (pain/discomfort and anxiety/depression) improved earlier and were better than population norms at 3-6 months. Cognitive dysfunction persisted over the follow-up period. Short-term (4-day) vitamin C intervention in the ICU did not affect health parameters post hospital discharge. Survivors of septic shock experience elevated physical, mental and cognitive issues at discharge. Most mental health issues had resolved by 6 months, but some physical and cognitive issues had not returned to population norms. Short-term vitamin C administration did not improve long-term health-related QoL; however, ongoing vitamin C supplementation may be required.

Fatigue, impaired physical function and mental health in cancer survivors: the role of social isolation.

Cancer survivors experience an array of physical, psychological, and social problems after treatment has ended. Perceived social isolation may exacerbate the effects of physical problems on mental health. We examined the association between physical health (cancer-related fatigue and physical function) and mental health (depression and anxiety symptoms) in cancer survivors in the first year of survivorship (i.e., up to one year after the end of treatment with curative intent), as well as the moderating role of perceived social isolation. Survey data were collected from 118 cancer survivors who completed treatment with curative intent in the last year. We assessed mental and physical health symptoms, as well as perceived social isolation. In multivariable analyses, fatigue was significantly associated with both depression (β = 0.279, 95% CI: 0.193,0.362) and anxiety symptoms (β = 0.189, 95% CI: 0.106,0.272). Social isolation moderated the effect of fatigue on depression and anxiety such that higher social isolation exacerbated the association of fatigue with mental health. Cancer survivors who continue to experience fatigue after curative treatment are at risk for mental health problems, including depression and anxiety symptoms. For cancer survivors who feel socially isolated, the association between fatigue and mental health may be stronger. The current standard of care for survivorship does not sufficiently address psychosocial needs. Future research should evaluate the inclusion of social support interventions in early-term survivorship care.

Testosterone Effects on Short-Term Physical, Hormonal, and Neurodevelopmental Outcomes in Infants with 47,XXY/Klinefelter Syndrome: The TESTO Randomized Controlled Trial.

47,XXY/Klinefelter syndrome (XXY) is associated with impaired testicular function and differences in physical growth, metabolism, and neurodevelopment. Clinical features of XXY may be attributable to inadequate testosterone during the mini-puberty period of infancy. We tested the hypothesis that exogenous testosterone treatment positively effects short-term physical, hormonal, and neurodevelopmental outcomes in infants with XXY. Double-blind randomized controlled trial, 2017-2021. US tertiary care pediatric hospital. Infants 30-90 days of age with prenatally identified, non-mosaic 47,XXY (n=71). Testosterone cypionate 25mg intramuscular injections every 4 weeks for 3 doses. The a priori primary outcomes were change in percent fat mass (%FM) z-scores and change in the total composite percentile on Alberta Infant Motor Scales (AIMS) assessment from baseline to 12 weeks. The between group difference in change in %FM z-scores was -0.57 [95% CI -1.1, - 0.06], p=0.03), secondary to greater increases in lean mass in the testosterone-treated group (1.5±0.4 kg vs 1.2±0.4, p=0.001). Testosterone suppressed gonadotropins and inhibin B (p<0.001 for all). In contrast, there were no significant group differences in short term motor, cognitive, or language outcomes (p>0.15 for all). In this double-blind randomized controlled trial in infants with XXY, testosterone injections resulted in physical effects attributable to systemic androgen exposure; however, there was no impact on neurodevelopmental outcomes and the hypothalamic-pituitary-gonadal axis was suppressed. These results do not support routine testosterone treatment in infants with XXY, however long term follow up on physical health, neurodevelopment and testicular function is needed.

Exploring the Connections Between Grip Strength, Nutritional Status, Frailty, Depression, and Cognition as Initial Assessment Tools in Geriatric Rehabilitation-A Pilot Study.

Background and Objective: In the context of the rapidly aging global population, the older adult vulnerability poses a significant challenge for public health systems. Frailty, cognitive and nutritional status, depression, and grip strength are essential parameters for staging the vulnerability of older adults. The objective of this study is to identify a rapid but multidimensional geriatric assessment tool that can enhance the rehabilitation process for older adults, tailored to their specific needs. Materials and Methods: This pilot study examines the relationships between grip strength, nutritional status, frailty, depression, and cognition in a group of 80 older adults with a mean age of 69.6 years, 49 male and 31 female, using standardized geriatric scales and digital grip strength measurements. The study employed a digital dynamometer, a portable and reliable tool that facilitated quick and accurate grip strength measurements. Results: The analysis revealed significant correlations among the parameters. Greater grip strength was associated with better cognitive performance (r = 0.237, p = 0.034) and improved nutritional status (r = 0.267, p = 0.016), while it was inversely related to frailty (r = -0.313, p = 0.005). Nutritional status also played a key role, showing an inverse relationship with frailty (r = -0.333, p = 0.003) and depression levels (r = -0.248, p = 0.027). Furthermore, frailty and depression were strongly interconnected, with those experiencing higher frailty levels also displaying more severe depressive symptoms (r = 0.545, p < 0.001). Marital status was also relevant: married participants exhibited higher grip strength, lower frailty, and fewer depressive symptoms, suggesting that social support positively influences both physical and mental health in older adults. Conclusions: These findings not only emphasize the need for integrated care approaches that simultaneously address physical health, nutrition, and cognitive function, but also provide a foundation for the development of a rapid and multidimensional assessment protocol, which consists of using a digital dynamometer and four geriatric scales. Such a tool could play a crucial role in the early detection of frailty syndrome and guide the implementation of multidisciplinary, tailored therapeutic strategies aimed at preserving the autonomy and improving the quality of life of older adults.

The impact of Benson’s relaxation technique on the quality of life of operating room nurses in hospitals southwest Iran: a randomized controlled trial

BackgroundIn clinical settings, continuous changes lead to increased professional stress, affecting the quality of life of nurses. Some complementary interventions may influence the improvement of the quality of life. This study aimed to determine the effect of Benson’s relaxation technique on the operating room nurses’ quality of life.MethodsIn this clinical trial, 180 operating room nurses were randomly allocated to two groups: intervention (Benson’s relaxation technique) and control (routine activity). The study was conducted from December 2021 to March 2022 in hospitals affiliated with Shiraz University of Medical Sciences. Benson’s relaxation technique was performed twice daily by the intervention group for 8 weeks. Quality of life was measured before and after the intervention using the SF-36 questionnaire. Data were analyzed using SPSS version 21 software, with a significance level set at a P < 0.05.ResultsAfter the intervention, the results showed that Benson’s relaxation technique led to an increase in the quality of life in the intervention group (P < 0.0001). In terms of quality-of-life dimensions, significant improvements were observed in the intervention group in the domains of physical problems (P < 0.05), emotional problems (P < 0.05), general health (P < 0.05), pain (P < 0.0001), and social functioning (P < 0.05). However, no significant differences were found in the dimensions of physical functioning, energy, and emotional well-being.ConclusionsBenson’s relaxation technique can serve as a complementary method to improve various dimensions of the operating room nurses’ quality of life.Trial Registration NumberIRCT20211002052650N1 with the Clinical Trial Registry (26.10.2022).

Health Related Quality of Life (HRQoL) Following APER: Early Effects on Ano Rectal Cancer Patients

Background: Colorectal cancer is the third most common cancer worldwide, accounting for approximately 10% of all cancer cases and is the second leading cause of cancer-related deaths worldwide. Treatment of rectal cancer had been primarily focused on oncologic outcome, with detailed assessment of survival and local recurrence. Less attention has been given to functional outcome and quality of life (QoL). Methodology: This prospective study was conducted in the Department of Surgical Oncology, National Cancer Research Institute &amp; Hospital, Dhaka from July, 2019 – March, 2021. Total 33 patients who fulfilled the inclusion and exclusion criteria were included in this study by purposive sampling. The scoring formulas supplied by EORTC was used for both the questionnaires (QLQ-C30 and QLQ-CR29) and in accordance to the scoring manual, the questionnaire items were grouped into scales in the categories – global health status QOL, functional scales and symptoms scales and then compiled. The p value was set as significant if p&lt;0.05. Results: Mean age of the patient was 45.1±13.9 years. Physical function, role function, emotional function, cognitive function, social function and global health status were significantly (p=0.001) decreased after treatment group than before treatment group. Fatigue, nausea and vomiting, pain, dyspnoea, insomnia, appetite loss, constipation, diarrhoea and financial difficulties were significantly increased after treatment group than before treatment group. Conclusion: Surgical oncologist can improve the quality of life of patients by saving the neurovascular structures while performing anterior/posterior/lateral dissection of rectum. Multidisciplinary approach including “Tumour Board” as well as performing sphincter saving procedures (AR) rather than APER could drastically improve the quality of life of cancer patients. Preoperative counselling, taking time to explain and understand patients’ concern results in decreased stress and improve ......

Association between weight reduction achieved with tirzepatide and quality of life in adults with obesity: Results from the SURMOUNT-1 study.

The SURMOUNT-1 trial investigated effects of tirzepatide, a glucose-dependent insulinotropic polypeptide and glucagon-like peptide-1 receptor agonist, on body weight in participants with obesity or overweight. This analysis evaluated changes in patient-reported outcomes (PROs) assessing physical function, psychosocial well-being, and overall health aspects of participants' health-related quality of life (HRQoL) in SURMOUNT-1. PRO instruments included the Impact of Weight on Quality of Life-Lite Clinical Trials version (IWQOL-Lite-CT), Short Form Survey-36 version 2 (SF-36v2) and EQ-5D-5L. Scores were analysed by treatment group and by categorical degree of weight reduction group: >0 to <5%, ≥5 to <10%, ≥10 to <20% and ≥20%. Relevant PROs were evaluated for participants with or without physical or psychosocial limitations at baseline, as measured by Patient Global Impression of Status for physical activity (PGIS) and Patient Health Questionnaire-2 (PHQ-2), respectively. All tirzepatide groups demonstrated significant improvements in PRO scores versus placebo. There was a consistent trend of incremental PRO improvement with greater degrees of weight reduction, starting from ≥5% weight reduction. Participants achieving ≥20% weight reduction demonstrated the greatest changes from baseline to week 72 (SF-36v2 Physical Component Summary, 4.60; SF-36v2 Mental Component Summary, 0.80; IWQOL-Lite CT Total score, 24.7). Those with baseline physical and psychosocial limitations experienced greater improvements than those without. Tirzepatide treatment was associated with improved HRQoL compared to placebo in people with overweight or obesity. Higher percentages of weight reduction were associated with greater improvements. Clinical trial registration number for SURMOUNT-1: NCT04184622.

Comparing 30 Versus 60min Cognitively Loaded Physical Exercise on Cognitive Function and Physical Health in Community-Dwelling Older Adults With Mild Cognitive Impairment: A Double-Blind Randomized Controlled Trial.

Mild cognitive impairment (MCI) is characterized by a mild decline in cognitive function and represents a risk stage for dementia in community-dwelling older adults. Exercise and dual-task training have been used to improve physical health, psychosocial health, and cognitive and learning functions in various subjects. However, the optimal time for these interventions has yet to be clearly identified. This study investigated the effects of cognitively loaded physical exercise (CLPE) on cognitive function and physical health in community-dwelling older adults with mild cognitive impairment and compared the differences according to exercise time. Fifty-one community-dwelling aged 60years or older with MCI were randomly assigned to 30-min CLPE (30CLPE, n=17), 60-min CLPE (60CLPE, n=17), and control (n=17) groups. The CLPE program consisted of a twice-weekly exercise program for 8weeks. During the exercise, a dual task was performed to assess cognitive load. The control group performed a typical exercise program at a dementia center during the same period. The Korean version of the Montreal Cognitive Assessment was used to evaluate cognitive function, and various physical health factors were assessed using the handgrip dynamometer and pinch gauge, Senior Fitness Test, dynamic and static balance abilities, and gait variables. After the intervention, both the 30CLPE and 60CLPE groups showed significant improvements in cognitive function, upper limb strength, senior fitness, balance, and gait (p<0.05), while the control group showed no significant changes in any of the variables (p>0.05). In between-group comparisons, both CLPE groups showed significantly improved cognitive and physical functions compared to the control group (p<0.05). However, there was no significant difference between the 30 CLPE and 60 CLPE groups (p>0.05). The results of this study demonstrate that cognitively loaded physical exercise is effective in improving cognitive and physical function in individuals with MCI. Both the 30-min and 60-min sessions resulted in significant improvements, with no statistically significant differences observed between the two durations. This suggests that persistence and consistency of exercise may be more important than the duration of individual sessions. Clinical Trials.gov: KCT0009053.

Use of Patient-Reported Outcomes in Risk Prediction Model Development to Support Cancer Care Delivery: A Scoping Review.

The integration of patient-reported outcomes (PROs) into electronic health records (EHRs) has enabled systematic collection of symptom data to manage post-treatment symptoms. The use and integration of PRO data into routine care are associated with overall treatment success, adherence, and satisfaction. Clinical trials have demonstrated the prognostic value of PROs including physical function and global health status in predicting survival. It is unknown to what extent routinely collected PRO data are used in the development of risk prediction models (RPMs) in oncology care. The objective of the scoping review is to assess how PROs are used to train risk RPMs to predict patient outcomes in oncology care. Using the scoping review methodology outlined in the Joanna Briggs Institute Manual for Evidence Synthesis, we searched four databases (MEDLINE, CINAHL, Embase, and Web of Science) to locate peer-reviewed oncology articles that used PROs as predictors to train models. Study characteristics including settings, clinical outcomes, and model training, testing, validation, and performance data were extracted for analyses. Of the 1,254 studies identified, 18 met inclusion criteria. Most studies performed retrospective analyses of prospectively collected PRO data to build prediction models. Post-treatment survival was the most common outcome predicted. Discriminative performance of models trained using PROs was better than models trained without PROs. Most studies did not report model calibration. Systematic collection of PROs in routine practice provides an opportunity to use patient-reported data to develop RPMs. Model performance improves when PROs are used in combination with other comprehensive data sources.

Use of dual-energy x-ray absorptiometry for body composition in chronic disease management

As individuals age or contend with chronic diseases, shifts in body composition often emerge, characterized by a loss of muscle mass and an increase in fat mass, even among those with stable body weight. Both obesity and sarcopenia are key drivers of frailty, disability, and heightened morbidity and mortality. The simultaneous decline in skeletal muscle and accumulation of visceral fat can work synergistically, magnifying their detrimental effects on physical function and metabolic health. Today, dual-energy x-ray absorptiometry (DEXA) is widely recognized as one of the most versatile imaging techniques for assessing not only osteoporosis but also sarcopenia and obesity. Whole-body DEXA facilitates comprehensive analysis, offering detailed insights into fat mass, non-bone lean mass, and bone mineral content at both total and regional levels. DEXA is highly valued for its accuracy, reproducibility, speed, affordability, and low radiation exposure. Furthermore, advancements in DEXA technology and software now allow for precise estimation of visceral adipose tissue. This review underscores the clinical applications of whole-body DEXA, focusing on the use of muscle and fat mass indices in diagnosing low muscle mass, sarcopenia, and sarcopenic obesity, aligned with the latest research and guidelines.

THE IMPACT OF USING SMART WATCHES ON STUDENTS’ EFFORT CAPACITY: A COMPARATIVE STUDY

The increasing use of smartwatch technology among university students has raised questions about its potential impact on physical health and effort capacity. This study aims to evaluate the influence of smartwatch usage on the physical performance and effort capacity of students, focusing on those who utilize these devices for monitoring physical activity and health functions. In this comparative study, we employed a questionnaire to assess the adoption and usage patterns of smartwatches among students. The research sample was divided into two groups: a control group and an experimental group. Both groups participated in weekly aerobic gymnastics classes. However, the experimental group, equipped with smartwatches, was tasked with achieving a daily goal of 13,000-15,000 steps or expending 600 kcal. At the conclusion of the experiment, we evaluated the exercise capacity of all students using the Ruffier and Harvard tests. The results revealed significant differences between the two groups, with the experimental group demonstrating notably higher effort capacity. This suggests that the regular use of smartwatches, combined with specific fitness targets, can enhance physical performance and overall health among students. Our findings underscore the potential benefits of integrating wearable technology into student lifestyles, particularly in promoting physical activity and improving exercise capacity. This study contributes to the growing body of literature on the impact of smartwatches on health and fitness, highlighting their role as valuable tools for monitoring and enhancing physical performance in an academic setting. In conclusion, smartwatches can be useful tools for students, but they must be used with discernment. It is important to strike a balance between the benefits and distractions these devices bring. Students' effort capacity may be influenced by how they integrate smartwatches into their daily routine.

A systematic review of health outcomes of public transport use by older adults

Abstract Background and Aim Public transport use has been linked to several health benefits in the general population, and is crucial for older adults’ mobility, due to an age-related decline in mobility, and particularly the ability to use other transport modes. The objective of this systematic review is to determine what is known about the physical and mental health outcomes of public transport use by older adults and to identify remaining gaps in the literature. Methods Five electronic databases were searched in April 2023, with an update in January 2024: Pubmed, Scopus, Web of Science, Ageline and Transport Research International Documentation (TRID). Included were studies that were in English, contained a measure of public transport use as exposure, and any health outcome, including mental or physical health, physical or cognitive function, morbidity, or mortality, among people aged ≥ 60 years. Results Of a total of 2247 unique records that were screened, the full text of 20 was assessed for eligibility and 11 were identified as eligible. Citation search identified two additional studies, amounting to a total of 13 included studies. Significant health outcomes described in assessed studies were decreased obesity and depressive symptoms, and to a lesser extent increased gait speed and cognitive function. Conclusions Initial evidence suggests a positive impact of public transport use on obesity, depressive symptoms, gait and cognitive function, although available research was limited in context and methodology. Further research should focus on determining causality between public transport use and health, and be conducted in more diverse contexts. Transport and urban planners, as well as policymakers, should consider the implications of public transport on the health and independence of older adults. Key messages • Public transport use is linked to reduced obesity and depression among older adults. Links with other health outcomes were reported in several studies, but evidence is scarce. • Current research is limited in terms of quantity, scope, and design. Future research should be conducted in wider contexts, encompass a broader range of health outcomes, and address reverse causality.

Decrease in Primary Caregivers' Quality of Life During the Care of a Relative with Palliative Care Needs: A Prospective Longitudinal Study.

The quality of life is a complex concept that is insufficiently assessed in clinical practice. It is influenced by different factors, as follows: the individual's characteristics, personal values and beliefs, physical and mental state, and relationship to other members of their community. The quality of life of the primary caregiver influences their health and the quality of their care interventions. This study aims to investigate how the quality of life of caregivers changes during palliative patients' care. This is a prospective longitudinal study that assesses the different aspects of the quality of life of primary caregivers who care for patients with palliative needs. The tool used in this study was the Medical Outcomes Scale-Short Form 36 (MOS-SF36). This study included 140 caregivers, of which 63 were involved in the care of patients with cancer and 77 were involved in the care of patients with non-oncological diseases. Almost 9 out of 10 caregivers were a family member of the patient and over two-thirds of these were women. The caregivers of patients with non-malignant diseases had a decreased quality of life in the following aspects: limitations in their usual role due to emotional problems, social functioning, energy, and their perception of their general health. In the group of oncological patients, the caregivers displayed limitations in their daily role due to physical health, emotional problems, and social functioning. The large number of responsibilities, the long time spent caring, and the uncertainty about the evolution of the disease as well as the marginalization and lack of time for oneself are some of the elements that increase caregiver burden. Along with this, the quality of life of caregivers decreases significantly in different aspects, such as physical, psycho-emotional, and social, with the perception of deteriorating general health.