Quality Of Life Participation Research Articles

Pain, disability, and quality of life in participants after concurrent onabotulinumtoxinA treatment of upper and lower limb spasticity: Observational results from the ASPIRE study.

Upper and lower limb spasticity is commonly associated with central nervous system disorders including stroke, traumatic brain injury, multiple sclerosis, cerebral palsy, and spinal cord injury, but little is known about the concurrent treatment of upper and lower limb spasticity with botulinum toxins. To evaluate onabotulinumtoxinA (onabotA) utilization and to determine if concurrent onabotA treatment of the upper and lower limbs has supported improvements in participants with spasticity. Sub-analysis of a 2-year, international, prospective, observational registry (ASPIRE, NCT01930786). International clinic sites (54). Adult spasticity participants across etiologies, who received ≥1 concurrent onabotA treatment of the upper and lower limbs during the study. Participants were treated with onabotA at the clinician's discretion. Baseline characteristics and outcomes of disability (Disability Assessment Scale [DAS]), pain (Numeric Pain Rating Scale [NPRS]), participant satisfaction, physician satisfaction, and quality of life (QoL; Spasticity Impact Assessment [SIA]) were evaluated. Adverse events were monitored throughout the study. Of 744 participants enrolled, 730 received ≥1 dose of onabotA; 275 participants received treatment with onabotA in both upper and lower limbs during ≥1 session; 39.3% of participants were naïve to onabotA for spasticity. The mean (SD) total dose per treatment session ranged from 421.2 (195.3) to 499.6 (188.6) U. The most common baseline upper limb presentation was clenched fist (n = 194, 70.5%); lower limb was equinovarus foot (n = 219, 66.9%). High physician and participant satisfaction and improvements in pain, disability and QoL were reported after most treatments. Nine participants (3.3%) reported nine treatment-related adverse events; two participants (0.7%) reported three serious treatment-related severe adverse events. No new safety signals were identified. More than a third of enrolled participants received at least one concurrent onabotA treatment of the upper and lower limbs, with reduced pain, disability, and improved QoL after treatment, consistent with the established safety profile of onabotA for the treatment of spasticity.

Beta-blockers or Placebo for Primary Prophylaxis (BOPPP) of oesophageal varices: study protocol for a randomised controlled trial

BackgroundLiver disease is within the top five causes of premature death in adults. Deaths caused by complications of cirrhosis continue to rise, whilst deaths related to other non-liver disease areas are declining. Portal hypertension is the primary sequelae of cirrhosis and is associated with the development of variceal haemorrhage, ascites, hepatic encephalopathy and infection, collectively termed hepatic decompensation, which leads to hospitalisation and mortality. It remains uncertain whether administering a non-selective beta-blocker (NSBB), specifically carvedilol, at an earlier stage, i.e. when oesophageal varices are small, can prevent VH and reduce all-cause decompensation (ACD).Methods/designThe BOPPP trial is a pragmatic, multicentre, placebo-controlled, triple-blinded, randomised controlled trial (RCT) in England, Scotland, Wales and Northern Ireland. Patients aged 18 years or older with cirrhosis and small oesophageal varices that have never bled will be recruited, subject to exclusion criteria. The trial aims to enrol 740 patients across 55 hospitals in the UK. Patients are allocated randomly on a 1:1 ratio to receive either carvedilol 6.25 mg (a NSBB) or a matched placebo, once or twice daily, for 36 months, to attain adequate power to determine the effectiveness of carvedilol in preventing or reducing ACD.The primary outcome is the time to first decompensating event. It is a composite primary outcome made up of variceal haemorrhage (VH, new or worsening ascites, new or worsening hepatic encephalopathy (HE), spontaneous bacterial peritonitis (SBP), hepatorenal syndrome, an increase in Child–Pugh grade by 1 grade or MELD score by 5 points, and liver-related mortality. Secondary outcomes include progression to medium or large oesophageal varices, development of gastric, duodenal, or ectopic varices, participant quality of life, healthcare costs and transplant-free survival.DiscussionThe BOPPP trial aims to investigate the clinical and cost-effectiveness of carvedilol in patients with cirrhosis and small oesophageal varices to determine whether this non-selective beta-blocker can prevent or reduce hepatic decompensation. There is clinical equipoise on whether intervening in cirrhosis, at an earlier stage of portal hypertension, with NSBB therapy is beneficial. Should the trial yield a positive result, we anticipate that the administration and use of carvedilol will become widespread with pathways developed to standardise the administration of the medication in primary care.Ethics and disseminationThe trial has been approved by the National Health Service (NHS) Research Ethics Committee (REC) (reference number: 19/YH/0015). The results of the trial will be submitted for publication in a peer-reviewed scientific journal. Participants will be informed of the results via the BOPPP website (www.boppp-trial.org) and partners in the British Liver Trust (BLT) organisation.Trial registrationEUDRACT reference number: 2018–002509-78.ISRCTN reference number: ISRCTN10324656. Registered on April 24 2019.

Effects of Mindful Eating in Patients with Obesity and Binge Eating Disorder.

Binge eating disorder (BED) is a psychiatric illness related to a high frequency of episodes of binge eating, loss of control, body image dissatisfaction, and suffering caused by overeating. It is estimated that 30% of patients with BED are affected by obesity. "Mindful eating" (ME) is a promising new eating technique that can improve self-control and good food choices, helping to increase awareness about the triggers of binge eating episodes and intuitive eating training. To analyze the impact of ME on episodes of binge eating, body image dissatisfaction, quality of life, eating habits, and anthropometric data [weight, Body Mass Index (BMI), and waist circumference] in patients with obesity and BED. This quantitative, prospective, longitudinal, and experimental study recruited 82 patients diagnosed with obesity and BED. The intervention was divided into eight individual weekly meetings, guided by ME sessions, nutritional educational dynamics, cooking workshops, food sensory analyses, and applications of questionnaires [Body Shape Questionnaire (BSQ); Binge Eating Scale (BES); Quality of Life Scale (WHOQOL-BREF)]. There was no dietary prescription for calories, carbohydrates, proteins, fats, and fiber. Patients were only encouraged to consume fewer ultra-processed foods and more natural and minimally processed foods. The meetings occurred from October to November 2023. To carry out inferential statistics, the Shapiro-Wilk test was used to verify the normality of variable distribution. All variables were identified as non-normal distribution and were compared between the first and the eighth week using a two-tailed Wilcoxon test. Non-Gaussian data were represented by median ± interquartile range (IQR). Additionally, α < 0.05 and p < 0.05 were adopted. Significant reductions were found from the first to the eighth week for weight, BMI, waist circumference, episodes of binge eating, BSQ scale score, BES score, and total energy value (all p < 0.0001). In contrast, there was a significant increase in the WHOQOL-BREF score and daily water intake (p < 0.0001). ME improved anthropometric data, episodes of binge eating, body image dissatisfaction, eating habits, and quality of life in participants with obesity and BED in the short-term. However, an extension of the project will be necessary to analyze the impact of the intervention in the long-term.

Exploring the feasibility of evaluating a community alliance welfare advice programme co-located in primary care in Bradford: an uncontrolled before and after study

BackgroundWelfare advice services co-located in health settings are known to improve financial security. However, little is known on how to effectively evaluate these services. This study aims to explore the feasibility of evaluating a welfare advice service co-located in a primary care setting in a deprived and ethnically diverse population. It seeks to investigate whether the proposed evaluation tools and processes are acceptable and feasible to implement and whether they are able to detect any evidence of promise for this intervention on the mental health, wellbeing and financial security of participants.MethodsAn uncontrolled before and after study design was utilised. Data on mental health, wellbeing, quality of life and financial outcomes were collected at baseline prior to receiving welfare advice and at three months follow-up. Multiple logistic and linear regression models were used to explore individual differences in self-reported financial security and changes to mental health, wellbeing and quality of life scores before and after the provision of welfare advice.ResultsOverall, the majority of key outcome measures were well completed, indicating participant acceptability of the mental health, wellbeing, quality of life and financial outcome measures used in this population. There was evidence suggestive of an improvement in participant financial security and evidence of promise for improvements in measured wellbeing and health-related quality of life for participants accessing services in a highly ethnically diverse population. Overall, the VCS Alliance welfare advice programme generated a total of £21,823.05 for all participants, with participants gaining an average of £389.70 per participant for participants with complete financial outcome data.ConclusionsThis research demonstrates the feasibility of evaluating a welfare advice service co-located in primary care in a deprived and ethnically diverse setting utilising the ascribed mental health, wellbeing and quality of life and financial outcome tools. It provides evidence of promise to support the hypothesis that the implementation of a welfare advice service co-located in a health setting can improve health and wellbeing and reduce health inequalities.

Clinical Effectiveness of an Aquatic Exercise Program on Those With Visual Impairment: A Pilot Study

Background and Purpose: Visual impairments impact an individual’s ability to participate in certain activities, like exercise. Often, individuals with visual impairment have difficulty maintaining an active lifestyle, due to inopportunity and safety hazards. There is a lack of research on the use of aquatic exercise as a form of physical activity in those with visual impairments. The purpose of this study was to determine if this population can tolerate and benefit from an aquatic exercise program. Additionally, this study served to determine the effects of aquatic exercise on cardiovascular fitness, strength, and quality of life in individuals with visual impairment. Methods: This was a quasi-experimental study, evaluating participants with visual impairment aged 30 to 80 years, recruited from Northeast Sight Services in Exeter, PA. This study was reviewed and accepted by the Misericordia University Institutional Review Board. Eight participants were guided by physical therapy students and a primary researcher through a biweekly, 8-week aquatic exercise program at the Misericordia University Anderson Center Pool. This study utilized a pretest/post-test design to collect outcome measures. These included the 6-Minute Walk Test, 30-S Chair Stand Test, Modified Borg Ratings of Perceived Exertion (mRPE), the Modified Borg Dyspnea Scale, and the SF-36. Results: Paired t-tests and Cohen’s d were performed for the 6-Minute Walk Test (p = .04).953; Cohen’s d = 0.77, and the 30 Second Chair Stand Test (p = .02); Cohen’s d = 0.95 with large effect and significance. A Wilcoxon Signed Ranks and Cohen’s d were utilized for the mRPE 3 min, Cohen’s d = 0.27, Wilcoxon Signed Ranks 2.032 (p = .042), Borg RPE d = 1.054 and the SF-36 Cohen’s d = 2.3063. Discussion and Conclusion: This aquatic exercise program was tolerated well in this population and the results provide rehabilitation specialists an opportunity to promote health through aquatic programs for those with visual impairment. Furthermore, aquatic exercise was shown to be effective in improving lower extremity strength, cardiovascular endurance, and quality of life in participants, suggesting that aquatic exercise is a feasible intervention for this population.

Prospective Single-Arm Feasibility of Supervised Virtual Exercise in Women Living with Ovarian Cancer: The BE-BALANCED Study

Background: Access to exercise programming that addresses the unique needs of women living with and beyond ovarian cancer is limited. Feasible and accessible supportive care programs to enhance physical function and quality of life are needed. We aimed to assess the feasibility of a 12-week virtually delivered exercise program for women living with and beyond ovarian cancer. Methods: BE-BALANCED was a prospective single-arm feasibility pilot study. Women who had completed primary chemotherapy treatment of ovarian cancer within the past year were recruited through oncologist referrals or self-referral. The 12-week group exercise program targeting aerobic capacity, functional strength, balance, and range of motion was conducted virtually twice weekly using Zoom. Feasibility measures were accrual, attendance, adherence, and attrition. Physical function was evaluated using the Short Physical Performance Battery and selected components of the Senior Fitness Test. Results: Fourteen participants enrolled in the study (47% of the accrual target). Feasibility goals for the exercise sessions were met for attendance (84% ± 19%), adherence to virtual sessions (78% ± 19%), and fidelity of group belonging (18% ± 4%), and met for overall attrition (21%). Improvements were observed in gait speed, 30-second bicep curls, 6-minute walk, chair stand, and emotional well-being (P &lt; .05). Participant satisfaction with the program was high (4.4/5). Conclusion: Our findings demonstrated the feasibility of a virtually delivered exercise program for women living with and beyond ovarian cancer, with favorable attendance, adherence, and safety data. The program showed potential in improving physical outcomes and quality of life for participants. However, recruitment was a challenge. Future interventions could consider different approaches to increase recruitment.

Daily Functioning of Veterans With Type 2 Diabetes: Protocol for an Ambulatory Assessment Study.

Diabetes impacts nearly 25% of veterans. Many veterans do not engage in recommended physical activity and other diabetes self-management behaviors. Type 2 diabetes is generally asymptomatic; as such, the long-term consequences of inadequate self-management and benefits of consistent self-management are not salient in the short term. Furthermore, self-management behaviors typically take place outside of medical visits; however, self-management-related factors are only assessed during medical visits, likely missing large amounts of variability. Thus, ambulatory assessment methods such as ecological momentary assessment (EMA), accelerometry, and continuous glucose monitoring are needed to understand the dynamics of daily self-management and identify potential intervention targets. The overarching goal of this study is to understand daily, time-varying factors (comorbid affective symptoms and social context) that influence physical activity, diabetes self-management, glycemic management, daily functioning, and quality of life in participants' natural environments. We are recruiting veterans with type 2 diabetes (target N=100). Participants are required to complete a battery of baseline assessments related to mental health, psychosocial factors, and self-management behaviors. Participants then receive 5 momentary EMA surveys and 1 daily EMA survey per day, in which veterans report comorbid affective symptoms (mood, stress, and pain), social support, social interactions, physical activity, and other self-management behaviors. Momentary surveys are delivered randomly during daily preprogrammed intervals over a 14-day sampling period. Accelerometry and continuous glucose monitoring are also used to assess physical activity and blood glucose, respectively. The first 6 participants also completed interviews assessing their experience in the study and barriers to participation. These test participants informed modifications to the protocol for the remaining participants. The project received funding in April of 2023. Enrollment began in March of 2023 and is planned to be completed in April 2025. Among the 6 test participants, the overall EMA response rate was 87% (range 74%-95%). The response rate for the EMA survey including daily items (67%, range 21%-93%) was lower than the earlier shorter EMA surveys (89%, range 81%-96%). The mean rate of valid accelerometer wear of at least 20 hours per day was 93% (SD 11%), and continuous glucose monitoring data were available for 91% (SD 17%) of days on average. Participants reported few barriers to completing EMA surveys but noted the random timing of questions made it difficult to plan around, and the end-of-day survey was long. Two participants reported survey items reminded or motivated them to engage in diabetes self-management behaviors. Assessment tools developed from this study can inform clinical decision-making by considering barriers to self-management that occur in daily life. Clinical applications include tailored, adaptive technology-supported interventions to improve self-management that provide the right type and amount of support at the right time by adapting to an individual's changing internal and contextual state. DERR1-10.2196/53874.

Immunotherapy for advanced or metastatic urothelial carcinoma.

Immunotherapy for advanced or metastatic urothelial carcinoma.

PsyCARE study: assessing impact, cost-effectiveness, and transdiagnostic factors of the Italian ministry of health’s “psychological bonus” policy

BackgroundThe prevalence of anxiety and depression disorders is surging worldwide, prompting a pressing demand for psychological interventions, especially in less severe cases. Responding to this need, the Italian government implemented the “Psychological Bonus” (PB) policy, allotting 25 million euros for mental health support. This policy entitles individuals to a minimum of four to twelve psychological sessions. In collaboration with the National Board of Italian Psychologists, our study assesses this policy’s effectiveness. Indeed, the PsyCARE study aims to examine the utilization of the Psychological Bonus, evaluate its impact on adult and adolescent participants’ psychological well-being through pre- and post-intervention assessments and six-month follow-up, and conduct a longitudinal cost-effectiveness analysis of this policy. A secondary aim is to investigate the influence of these interventions on transdiagnostic factors, including emotion regulation and epistemic trust.MethodsThe study involves licensed psychotherapists and their patients, both adults and adolescents, benefiting from the Psychological Bonus. Data collection is underway and set to conclude in December 2023. Psychotherapists will provide diagnostic information and assess patient functioning. In addition, patients will be evaluated on mental health aspects such as clinical symptoms, emotion regulation, epistemic trust, and quality of life. We will employ linear mixed-effects models to analyze the outcomes, accounting for both fixed and random effects to capture the hierarchical structure of the data.DiscussionWe anticipate the study’s findings will highlight reduced psychological distress and improved quality of life for participants and demonstrate the Psychological Bonus policy’s cost-effectiveness. The study will gather data on the role of specific versus nonspecific therapeutic factors in psychotherapy while adopting a patient-tailored approach to identify effective therapeutic elements and examine transdiagnostic factors. Overall, this study’s findings will guide future measures within the Italian healthcare system, fostering a psychological health culture and providing valuable insights to the broader public.Study registrationhttps://osf.io/6zk2j

Rhinosinusitis Treatment with Cineole: Patient-Reported Quality of Life Improvements from a Non-Interventional, Pharmacy-Based Survey.

Rhinosinusitis is commonly treated with decongestants, analgesics, and local corticosteroids. Phytotherapeutics are also utilised for symptomatic relief, including cineole, the main component of eucalyptus oil. The current non-interventional, anonymised survey investigated quality of life in participants with rhinosinusitis (with or without additional symptoms of bronchitis) via the German version of a validated quality of life questionnaire (RhinoQol). Overall, 310 subjects administered a cineole preparation (Sinolpan) and 40 subjects applying nasal decongestant were recruited in German pharmacies. Significant improvements in frequency (64.0%), bothersomeness (52.1%), and impact (53.9%) of rhinosinusitis symptoms were reported upon treatment with cineole over a mean treatment period of seven days (p < 0.001 each). The overall treatment efficacy of cineole was evaluated as good or very good by 90.0% of the participants, and the quality of life during work or leisure time improved upon treatment. Six (non-serious) possibly related side effects were reported in four participants who were administered cineole. The tolerability of the treatment was assessed as good or very good by 93.9% of the participants. Cineole can be considered as a safe and well-tolerated rhinosinusitis treatment conferring a clear improvement in quality of life outcomes.

MSR64 Psychometric Validation of the Electronic Hidradenitis Suppurativa Quality of Life (eHiSQOL) Questionnaire Using Pooled Data from the Phase 3 BE HEARD Trials of Bimekizumab in Hidradenitis Suppurativa

Assess the psychometric properties of the subscale and total scores of the electronic Hidradenitis Suppurativa (HS) Quality of Life questionnaire (eHiSQOL), developed to assess health-related quality of life in participants with HS.

The Effectiveness of Virtual Reality Intervention for COVID-19-Related Psychological Distress: A Systematic Review.

The prolonged coronavirus disease-2019 (COVID-19) pandemic is likely to cause psychological distress in people. This systematic review aimed to identify the effectiveness of virtual reality (VR)-based psychological intervention among individuals with psychological distress during the COVID-19 crisis. PubMed, Ovid MEDLINE, Cochrane Library, Web of Science, Embase, and PsycINFO databases were searched for articles published until July 2022. The available citations were deduplicated and screened by two authors using the title and abstract information. Eligibility criteria were constructed according to the PICOT guidelines. Empirical studies of all designs and comparator groups were included if they appraised the impact of an immersive VR intervention on any standardized measure indicative of psychological distress (stress, anxiety, depression, and post-traumatic symptoms) or improvements in quality of life in participants, including COVID-19 patients, medical staff working with COVID-19 patients, and people who had experienced strict social distancing during the COVID-19 pandemic. The results were discussed using a narrative synthesis because of the heterogeneity between studies. Seven of the studies met the inclusion criteria. There were two randomized controlled trials and five uncontrolled studies on VR interventions. All studies reported significant improvement in a wide range of psychological distress during COVID-19, ranging from stress, anxiety, depression, and post-traumatic symptoms to quality of life, supporting the efficacy of VR-based psychological intervention. Our results suggest that VR intervention has potential to ameliorate COVID-19-related psychological distress with efficacy and safety.

PD11-11 NOVOGLAN FORESKIN TISSUE EXPANDER TREATMENT IS SAFE &amp; EFFECTIVE IN ADULT MALES WITH PHIMOSIS &amp; IT REDUCES PAIN DURING SEXUAL ACTIVITY

You have accessJournal of UrologyCME1 Apr 2023PD11-11 NOVOGLAN FORESKIN TISSUE EXPANDER TREATMENT IS SAFE & EFFECTIVE IN ADULT MALES WITH PHIMOSIS & IT REDUCES PAIN DURING SEXUAL ACTIVITY Phil James, Eric Chung, Dmitry Polikarpov, Hassan Doosti, Hurbert Mazure, Andrew James, Douglas Campbell, and David Gillatt Phil JamesPhil James More articles by this author , Eric ChungEric Chung More articles by this author , Dmitry PolikarpovDmitry Polikarpov More articles by this author , Hassan DoostiHassan Doosti More articles by this author , Hurbert MazureHurbert Mazure More articles by this author , Andrew JamesAndrew James More articles by this author , Douglas CampbellDouglas Campbell More articles by this author , and David GillattDavid Gillatt More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003251.11AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Men with phimosis can endure pain during sexual activity due to phimosis. This can result in anxiety impacting the patients quality of life. While the mainstay of adult phimosis treatment is circumcision, many men are apprehensive of this intervention due to perceived risk of pain, bleeding, hypersensitivity & reduced sexual pleasure. The Novoglan device stimulates new skin cell growth by applying regular controlled pressure between foreskin & glans allowing it to retract properly. We conducted a clinical trial to establish treatment efficacy, safety & tolerability of the Novoglan foreskin tissue expander & compare patient pain, discomfort & anxiety during sexual activity, pre & post treatment. METHODS: Analysis of the first 20 cases in the Novoglan-01 clinical trial used ordinal & scalar outcome variables plus descriptive participant variables. Clinical Trial Participation involved two initial visits to a urology clinic, where the patients were consented, trained & their degree of phimosis determined; two phone follow-ups & a final study visit to again determine the degree of phimosis. Phimosis grades were independently assessed by Consultant Urologist on a 1 to 6 scale, where #1 represents absolutely no foreskin retraction & #6 represents full free foreskin retraction. Participant quality of life with phimosis was measured at Visit 1 & again at Final Visit based on general pain / discomfort; pain / discomfort during sexual function, & anxiety. RESULTS: Efficacy 100% of participants observed full retraction of their foreskin (Phimosis grade 5 or 6) by the final study visit compared with 15% after the first visit. Tolerability 90% reported no pain during treatment. Sexual activity 65% did not experience pain during sexual activity by the final visit vs 5% at the initial visit. 10% experienced moderate pain during sexual activity by the final visit vs 50% at the initial visit. Anxiety 95% reported reduced level of anxiety post treatment 80% no longer considered circumcision an option post Novoglan treatment CONCLUSIONS: Novoglan-01 study confirms foreskin tissue expander balloon device is an effective, well tolerated conservative treatment for adult phimosis, enabling quality of life improvement measured by reduced levels of pain, discomfort & anxiety during sexual activity. Source of Funding: n/a © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e336 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Phil James More articles by this author Eric Chung More articles by this author Dmitry Polikarpov More articles by this author Hassan Doosti More articles by this author Hurbert Mazure More articles by this author Andrew James More articles by this author Douglas Campbell More articles by this author David Gillatt More articles by this author Expand All Advertisement PDF downloadLoading ...

Kronik Alt Ekstremite Ödemi Olan Hastalarda Sakroiliyak Eklem Disfonksiyonu Varlığı ve Postür Analizi

Abstract&#x0D; Background and Aim: Chronic lower extremity edema has been associated with postural impairment, sacroiliac joint dysfunction (SIJD), and abnormal gait. Lymphedema and lipedema are important chronic lower extremity causes. This study aimed to detect the presence of SIJD and postural disorders in patients with lower extremity edema and the relationship between them.&#x0D; Methods: This is a comparative, prospective cohort study. Fifty-three patients with lower extremity edema and 53 healthy subjects were included in the study. Pain provocation tests were used to determine SIJD. Postural analysis was conducted with PostureScreen® Mobile 11.2 (PostureCo, Inc., Trinity, FL) software. The life quality of participants was determined by the Lymphedema Quality of Life (LYMQOL) scale. The functional status of the patients was determined by the Oswestry Disability Index and Lower Extremity Functional Scale.&#x0D; Results: SIJD (18.9%) was more common in the edema group. There was a positive correlation between volume differences, percentages, and the development of SIJD. We found deviations in the head, shoulder, and hip angulations in the edema group. Q angle and lateral shoulder angulation were significantly higher in patients with SIJD in the edema group. In the edema group, LYMQOL-leg total score was higher in patients with SIJD.&#x0D; Conclusion: Chronic lower extremity edema was found to be associated with postural deviations and SIJD. Besides edema control, postural disorders and SIJD should also be considered in these patients.

Personally tailored activities for improving psychosocial outcomes for people with dementia in long-term care.

Personally tailored activities for improving psychosocial outcomes for people with dementia in long-term care.

Effectiveness of ACT-based intervention in compliance with the model for sustainable mental health: A cluster randomized control trial in a group of older adults

IntroductionEpidemiological studies among older adults have demonstrated high rates of subclinical anxiety and depression. This is accompanied by increased distress related to aging and everyday life challenges, thus affecting wellbeing and increasing the risk of developing full mental disorders. This highlights the need for psychological interventions to focus on mental health and improve wellbeing in this population in compliance with the Model for Sustainable Mental Health framework. MethodsThis study investigated the effectiveness of an acceptance and commitment therapy (ACT) program through a cluster randomized controlled trial in a group of older adults in Poland. The participants lived in rural areas and small towns, with minimal or no opportunities to obtain psychological support. The total of 100 older adults were included in the study and randomized to either a 12-week ACT-based training programme or to a control group that participated in Positive Psychology Intervention (PPI). ResultsThe statistical analyses showed that ACT intervention decreased psychopathological symptoms while increasing quality of life. The increases in psychological flexibility, acceptance, defusion, and present moment were statistically significant mediators in the relationship between group membership and increased quality of life. There were also significant decreases in stress, anxiety, and depression among participants exposed to the PPI component. DiscussionThe ACT intervention should help address the issues of mental health and wellbeing in older adults. The training programme increased the quality of life for participants in line with the WHO agenda concerning support for older adults, thus reflecting the conditions outlined in the Model for Sustainable Mental Health.

EFFECT OF COMMUNITY HEALTHCHOICES ON PARTICIPANT QUALITY OF LIFE AND PSYCHOLOGICAL WELL-BEING

Abstract A stratified random sample of participants was interviewed in each region of Pennsylvania during each phase of the implementation. In addition, comparison groups were interviewed from the third implementation region. This allowed us to draw causal inferences regarding the effect of the program on participant quality of life and psychological well-being. The sample was stratified to represent: people age 21-59 and those over age 60 who receive home and community based services (HCBS), plus people age 21 and older who are dually eligible for Medicaid and Medicare but do not use long-term services and supports. We found that engagement in preferred activities both inside and outside the home increased among people who used HCBS and those who did not. In addition, psychological well-being improved slightly while the prevalence of depressive symptoms declined. In general, the implementation of Community HealthChoices appears to have led to improvements in several measures of well-being.

Influence of Comprehensive Lifestyle Intervention (LSI) Program on Health, Fatigue, and Quality of Life in Middle-Aged Women.

Middle age is one of the most important times in a woman's life, and it is a time when multiple changes occur that affect the body and health. The study aimed to investigate the efficacy of a comprehensive lifestyle intervention (LSI) program, including stress management, on middle-aged women's physical, physiological, and mental health. A total of 40 middle-aged women participated in a short-term LSI program, nutrition, exercise, and mental and physical management with various experiential activities. Physical measurements, biochemical indicators, stress hormones, chronic fatigue, and quality of life indicators were evaluated to interpret the clinical efficacy of the program. LSI program significantly improved satisfaction and quality of life in participants. Total chronic fatigue scores reduced significantly compared to scores before the start of the program. Moreover, fat mass and body fat were reduced without loss of muscle mass. Further, blood pressure and triglyceride levels significantly decreased after completing the LSI program. However, changes in stress hormone levels remained insignificant. Adoption of LSI in middle-aged women demonstrated positive implications of the program. LSI efficiently regulates body fat, fat mass, fatigue, hypertension, and triglyceride levels which play a critical role in determining the quality of life. Thus, the LSI program could spread healthy lifestyles among middle-aged women.

SELF-ESTEEM AND QUALITY OF LIFE AMONG STUDENTS WITH AND WITHOUT PHYSICAL DISABILITY

The study was conducted to determine the relationship between self-esteem (SE) and quality of life (QOL) among students with and without physical disabilities. Further, it also explored the gender differences in the level of self-esteem and quality of life in participants. Through purposive sampling 200 participants (100 physically disabled &amp; 100 normal) were selected from 4 universities of Gujrat and Islamabad. The WHO Quality of Life (WHOQOL Group, 1998) and State Self-esteem Scale (Heatherton &amp; Polivy, 1991) were used for data collection. Results revealed that self-esteem has a significant positive relationship with quality of life (r=.89, p=.00). Results indicate that there was a significant difference in the scores of self-esteems and quality of life among normal and disabled students. It was also highlighted that normal and physically disabled female student had a low level of self-esteem and quality of life than normal and physically disabled male students. The findings also indicated that self-esteem is a significant predictor of quality of life among students. This study concluded that the physical disability of participants has not significantly affected the individual’s self-perceptions but it also plays role in determining the quality of life. Keywords: Self-esteem, quality of life, physical disability, students, gender difference, University.

EE214 Impact of Depression Relapse on Participant Quality of Life and Costs to the English NHS: Secondary Analysis from the Antler Study on Antidepressant Discontinuation in Well Patients in Primary Care

Depression is a common and debilitating mental-health condition. Antidepressants are recommended as first-line treatment, often taken for months or years after a depressive episode. The ANTLER study investigated the impact of tapered discontinuation of medication in well patients, compared to maintenance treatment, to determine whether maintenance treatment prevented relapse. The objective was to calculate the impact on health-related quality-of-life (HRQoL) and English National Health Service (NHS) costs of experiencing a depression relapse, using ANTLER patient-level trial data.