Quality Of Life In Persons Research Articles

Energy management education for persons living with long COVID-related fatigue (EMERGE): protocol of a two-parallel arms target trial emulation study in a multicentre outpatient intervention setting with an online control group register

IntroductionEnergy management education (EME) is a manualised, evidence-based self-management education programme developed and delivered by occupational therapists for persons living with chronic disease-related fatigue. Studies have shown that EME can...

Supporting physical activity among students at VSB-TUO

The transition to university, particularly during the first year of study, presents students with numerous challenges and changes. One of these is a shift in lifestyle, often accompanied by reduced levels of physical activity. A lack of physical activity can contribute to issues such as weight gain, unhealthy eating habits, sleep disturbances, and other problems that subsequently affect not only academic performance but also the overall quality of personal life. The aim of this study was to examine how students at VSB-TUO perceive support for physical activity within the context of their university studies. To achieve this aim, we developed an online questionnaire, which was completed by 1,470 respondents, including 1,042 males and 428 females. The questionnaire consisted of 30 questions divided into three main thematic areas and further segmented into nine sections, allowing for branching based on the specific segmentation of respondents. Of these, 25 questions were closed-ended, four were semi-closed, and one was open-ended. Data collection took place in February and March 2024, during the introductory sessions of selected courses at the beginning of the summer semester. The responses revealed that after starting university, 61% of students experienced no change in the frequency of their physical activity. For an additional 25%, the frequency of physical activity increased due to various forms of support. Only 14% of respondents reported a decrease in activity frequency. Based on the results of our study, we conclude that the forms of support implemented at VSB-TUO enable more than four-fifths of first-year students to maintain or increase their frequency of physical activity after entering university.

Diabetic peripheral neuropathy and associated factors among patients attending Mbarara Regional Referral Hospital, Southwestern Uganda: a cross-sectional study

BackgroundDiabetic peripheral neuropathy (DPN) is a microvascular complication of diabetes mellitus (DM), that is associated with increased risks of morbidity and disability, especially ulceration and amputation. Timely identification, diagnosis, and management of DPN are crucial to prevent amputations, mitigate disabilities, and enhance the quality of life for persons with diabetes. We determined the prevalence and factors associated with peripheral neuropathy among patients with diabetes at Mbarara Regional Referral Hospital (MRRH), southwestern Uganda.MethodsWe conducted a cross-sectional study at the Diabetic Clinic of MRRH from November 2023 to January 2024. We used an interviewer-administered questionnaire to obtain data on socio-demographic and medical characteristics, and used the Toronto Clinical Scoring System (TCSS) tool to determine DPN and its severity. Levels/stages of neuropathy were grouped basing on the score as no neuropathy (0–5), mild neuropathy (6–8), moderate neuropathy (9–11), and severe neuropathy ≥ 12. Modified Poisson regression, with robust standard errors was used to evaluate associations between DPN and independent variables.ResultsIn total, 355 participants were enrolled with mean age 55.94 ± 13.43 years. Most participants were female (60%). The prevalence of DPN was 38.03% (n = 135; 95% CI 33.11–43.21%). Having high blood pressure of > 138/80 mmHg (adjusted prevalence ratio [aPR] = 2.73, 95% CI 1.80–4.13), longer duration of diabetes of ≥ 6 years (aPR = 2.01 95% CI 1.46–2.75), being aged ≥ 60 years (aPR = 1.49, 95%CI 1.04–2.13) and having fasting blood sugar > 7mmol/l (aPR = 1.96 95% CI 1.34–2.90) were independently associated with DPN.ConclusionsApproximately one in three DM patients surveyed had DPN. Hypertension, longer diabetes duration, advanced age, and high fasting blood sugar were associated with DPN. Timely detection and targeted interventions, particularly for individuals with modifiable risk factors like hypertension and poor glucose control, could play a crucial role in preventing or delaying the progression of DPN in this setting.

ADVANCING THE SCIENCE OF SENSORY HEALTH AND COGNITION: FROM EPIDEMIOLOGY TO INTERVENTION

Abstract Sensory health and cognition are at the intersection of two major public health challenges facing an aging global population. Sensory impairments are among the most common and disabling comorbidities among individuals at risk for cognitive impairment and those already aging with cognitive impairment. Sensory impairments may also serve as key biomarkers in dementia and may worsen the trajectory of decline. Although prevalent, sensory impairments frequently go unrecognized and unaddressed. Importantly, sensory impairment has been identified as modifiable risk factors for dementia. Optimizing sensory function may be an important yet overlooked approach to reducing the risk of cognitive decline as well as providing potential nonpharmacological interventions to aid in the management of neuropsychiatric symptoms, improve quality of life for persons living with dementia, and reduce burden for care partners. This symposium presents the latest evidence from epidemiology to intervention in advancing our understanding and approach to sensory health and cognition. The symposium begins with a focus on the epidemiology of sensory function among individuals with or at risk for cognitive impairment and then moves to a focus on intervention, understanding the potential impacts of optimizing sensory function on brain structure, barriers to addressing sensory function in clinical settings, and envisioning how to optimize interventions by learning directly from individuals aging with cognitive impairment, their care partners, and experts. This symposium features leaders in the field of sensory health and cognition from diverse career stages, disciplines, and settings.

A NEW LOOK AT NEUROTICISM: FINDINGS FROM THE IOWA UNMARRIED SURVIVORS STUDY

Abstract The purpose of this study was to analyze the association between personality traits and other variables relative to Neuroticism reported by N = 227 (M = 78.2, SD = 8.1) participants from the Iowa Unmarried Survivors Study. Using the development adaptation model as a conceptual framework (and Neuroticism as the dependent variable), a series of blocked multiple regression analyses were conducted. In the first block, age, gender, ethnicity, total years of education, and current marital status were included. The second block contained selected childhood variables, whereas the third block contained the personality variables, and the fourth block included the Venting subscale of the Brief COPE, social support, depression, stress, and loneliness. Recalled childhood abuse emerged as a significant predictor of Neuroticism, β =.118, p <.05. If one was abused in childhood, one would show higher levels of Neuroticism. In addition, both venting and loneliness were significant predictors of Neuroticism, β =.120, p <.05, β =.191, p <.05 respectively. Moreover, stress and depression served as significant predictors of Neuroticism, β =.208, p <.01, β =.432, p <.01 respectively. This model explained 64% of the variance in Neuroticism scores. Although a causal relationship cannot be established via this model, the mulitdirectional nature of Neuroticism is noteworhy. Results from this study have implications relative to how geriatric social workers and aging service providers develop interventions and programming to improve mental health and quality of life for persons who remain unmarried throughout later life.

PARTNERS IN DEMENTIA – NORTHWEST: NEW APPROACHES IN MEDICAL STUDENT SERVICE LEARNING

Abstract Partners in Dementia – Northwest is the first service-learning program at the University of Washington School of Medicine focused on older adults and persons living with memory loss, established in 2023. First year medical student volunteers, “mentees”, were paired with older adults living with memory loss, “mentors”, recruited from a memory disorders clinic based at the University of Washington. In its pilot year, 10 students were paired with 10 older adults and their caregivers, for bimonthly to monthly visits at the Memory Hub, a community space affiliated with the University that provides education, support, and wellness services. Students participate in mentor visits and group activities at the Memory Hub and accompany mentors to medical appointments to experience the health care system from the perspective of a person living with memory loss. The goals of the program are to provide medical students with early clinical exposure to memory disorders, reduce stigma surrounding aging and memory loss, and inspire students to pursue underserved specialties in dementia care. Pre-implementation surveys of students found that reasons for participation in the program included interest in learning more about the dementia disease process, building communication skills, recognizing signs of memory loss to enhance clinic skills, and learning how to maximize quality of life for persons with memory loss. Initial challenges identified by students include difficulties in engaging mentors when a caregiver is not present, navigating conversations, and transportation barriers.

PATIENT-CENTERED OUTCOME MEASUREMENT IN NURSING HOME-BASED PRAGMATIC TRIALS: CAPTURING WHAT COUNTS

Abstract Embedded pragmatic randomized controlled trials (ePCTs) rely on routinely collected data to evaluate study outcomes. Using data from Music & MEmory: A Pragmatic TRial for Nursing Home Residents With ALzheimer’s Disease (METRIcAL), we highlight the strengths and weaknesses of using routinely collected data to evaluate agitated behaviors in nursing home (NH) residents with dementia. We conducted two National Institute on Aging-funded ePCTs, one enrolled 976 residents (483 treatment, 493 control) from 54 NHs between June, 2019 and March, 2020, and the other enrolled 850 residents (431 Treatment, 419 control) from 54 NHs between May, 2021 and September, 2022. In both trials, there was no effect of the intervention on agitated behaviors, as measured by the Minimum Data Set (MDS), a routinely collected, pragmatic source of data in NHs. The intervention also did not affect behaviors as reported by staff using the Cohen-Mansfield Agitation Inventory (CMAI). However, we found a reduction in the frequency of nonaggressive agitated behaviors in response to the personalized music intervention, using the Agitation Behavior Mapping Instrument to conduct structured observations of residents, at standardized times of day, in treatment and control NHs. A personalized music intervention for NH residents with dementia reduced nonaggressive agitation, but these changes were not captured in the routinely collected administrative data (MDS) or by interviewing staff using the CMAI. Temporary reprieve from agitated behaviors may improve the quality of life for persons living with dementia, but these effects are not captured using pragmatic data or tools that rely on staff recall.

UNDERSTANDING THE ROLE OF SPORTS AND PHYSICAL ACTIVITY IN PROMOTING INCLUSION AND QUALITY OF LIFE FOR INDIVIDUALS WITH INTELLECTUAL DISABILITY

Every child that is born with expectation of living and fulfilling life’s expectancy. The quality of life approach focuses on what is most important to every individual. However, each child is born with different challenges and peculiarity in the area of intellectual capacity. The condition could be present at birth as a congenital abnormality. An individual may be physically fit with no brain or body abnormalities and yet be mentally disabled. The terms mild, moderate, severe and profound are often used to classify intellectual disability. In view of this, it has been observed that poor motor control, high physical demand, fear of accident and social exclusion could limit the involvement of persons with intellectual disability in activities related to sport or physical activity. Therefore, it is needful to achieve social inclusion and quality of life for persons with intellectual disability through sports and physical activity.

Affective symptoms and quality of life in persons experiencing subjective cognitive decline: A cross‐sectional analysis

Affective symptoms and quality of life in persons experiencing subjective cognitive decline: A cross‐sectional analysis

Homelessness and Organ Donor-Derived Bartonella quintana Infection.

Louseborne Bartonella quintana infections in the United States occur almost exclusively among persons experiencing homelessness because of inadequate access to hygiene resources. Homelessness is increasing, and persons experiencing homelessness can be organ donors, despite barriers to receiving donated organs themselves. Recent reports have documented B. quintana transmission via organs transplanted from donors who had recently experienced homelessness. Those reports demonstrate the threat of severe bartonellosis in immunosuppressed organ transplant recipients after donor-derived B. quintana infection. Addressing the root causes of B. quintana transmission could improve the quality of life for persons experiencing homelessness and simultaneously mitigate risk for donor-derived B. quintana transmission. Interventions include improved access to housing, consistent access to hot water for showers and laundry, early treatment of body lice infestation and B. quintana infection, and B. quintana testing and prophylactic treatment of recipients of organs from donors who have experienced risk factors for B. quintana, including homelessness.

Trends in Intermittent Scanning Continuous Glucose Monitoring Usage in The Netherlands-An Opportunity for Elderly Individuals with Diabetes.

Background: Intermittent scanning continuous glucose monitoring (is-CGM) technology has gained widespread adoption and is known to improve glycemic control and quality of life for persons with diabetes. The elderly may lag behind in their adoption of the technology, which could be a potential avenue for improving quality of care. In this study, we investigated the adoption of is-CGM technology in the Dutch population, including effects of age. Methods: A retrospective observational study was performed using data from the Drug Information Project, a public database hosted by the Dutch National Health Care Institute. The database contained information concerning healthcare reimbursements from 2017 until 2022 and covered approximately 95% of the total population. Data concerning is-CGM and fast-acting insulin reimbursements were extracted, identifying actual and potential is-CGM users, who were subdivided into the categories 0-24, 25-44, 45-64, 65-74 and ≥75 years old. Results: From 2017 until 2022, is-CGM usage rapidly increased: from 38 to 82.050 actual users. The age categories 0-24 and 25-55 showed the highest is-CGM usage (62% and 84% of the potential population in 2022, respectively), and 65-74 and ≥75 the least (38% and 33%, respectively). However, the elderly had higher growth rates (+75% in the category ≥75 from 2021 to 2022) compared to the youngest (+54% in the category 0-24 in the same period). Conclusions: Data from this study demonstrate that the elderly lag behind in is-CGM adoption. Given the potential advantages of is-CGM for elderly persons with diabetes, we argue that strategies should be developed to address this (paradoxical) underutilization of is-CGM.

Communication Bridge-2 randomized controlled trial: Recruitment and baseline features.

Non-pharmacological interventions may offer significant benefits to the quality of life for persons with primary progressive aphasia (PPA) and their care partners but have lacked efficacy trials. To help fill the efficacy gap, we provide the feasibility of recruitment, enrollment, randomization, and baseline data for the Communication Bridge-2 (CB2) randomized controlled trial (RCT). CB2 is the first international, single enrollment site, Phase 2, Stage 2, parallel-group, active control, RCT delivered via video chat to individuals with PPA and their care partners. Participants were recruited, screened, and randomized into one of two speech-language intervention arms. Ninety-five participant dyads (PPA mean baseline age: 67.1; 48% female) from four countries were enrolled and randomized. Global recruitment, enrollment, and randomization of individuals with PPA into a video chat-delivered non-pharmacologic RCT is feasible. This trial provides a potential model for conducting rigorous non-pharmacologic efficacy trials for Alzheimer's disease and related dementias. Primary progressive aphasia (PPA) negatively impacts communication participation. Communication Bridge-2 (CB2) is a telemedicine-delivered randomized controlled trial. CB2 included global recruitment and randomization of 95 PPA participant dyads. CB2, the first international superiority trial for PPA using video chat shows feasibility. The study provides a model for rigorous non-pharmacologic trials for Alzheimer's disease and related dementias.

Recursive self-feedback improves spontaneous speech in chronic aphasia within real-world settings

ABSTRACT Background Spontaneous speech generation, often impaired in chronic nonfluent aphasia, is essential for natural communication. Treatments aiming to optimize spontaneous speech in real-world settings are critical for improving the quality of life for persons with nonfluent aphasia (PWNA). Traditional treatments frequently rely on models and feedback from external agents, which may not be sustainable in the long-term. Preliminary evidence suggests that PWNA can use self-feedback alone, through recursive self-feedback, to improve their production of scripted sentences. This study developed and examined the impact of spontaneous speech with recursive self-feedback on enabling PWNA to self-improve their spontaneous speech in real-world settings. Method Using a cross-over design, 3 participants received 2 treatments at their homes: spontaneous speech with recursive self-feedback and spontaneous speech with speech model. Recursive self-feedback treatment involved iterative self-monitoring and minimization/correction of errors during spontaneous speech response to narrative prompts. The speech model treatment provided corrective model responses to prompts from an external source which served as reference frames to help improve the participants’ responses. Participants utilized a mobile app to practice the treatments intensively at home for 2 hours each day over a period of 12 to 14 days, spanning 2 to 3 weeks. Direct and generalized treatment effects on microlinguistic measures of spontaneous speech were determined using general linear mixed effects model and standardized mean difference. Results Both treatments led to significant improvements in microlinguistic measures of spontaneous speech, with recursive self-feedback treatment showing broader post-treatment effects on treated prompts and generalization effects. to untreated prompts. Conclusion Recursive self-feedback is a promising procedure for enhancing spontaneous speech in PWNA, providing a simple and flexible self-directed treatment option. This procedure relies primarily on speech-auditory stimulations and self-feedback loops to improve spontaneous speech, suggesting its potential applicability across various spoken language cultures. To validate these findings and assess their broader relevance, further research is recommended.

Dementia.

Dementia, or major neurocognitive disorder, is defined as a decline in 1 or more cognitive domains that causes impairment in everyday function. Alzheimer disease is the most common type of dementia in the United States, with an estimated 6.9 million adults who have Alzheimer disease and are 65 years or older. This article discusses the latest findings in preventing cognitive decline. It also discusses dementia screening, diagnosis, treatment, and the quality of life for persons with dementia and their caregivers.

Exploring the physical, psychological, and social benefits of adaptive outdoor cycling in persons with stroke using a mixed methods approach

Stroke is a leading cause of disability world-wide. Community-based adaptive recreation programs may offer a way to enhance quality of life in persons with stroke. Explore the association between community-based adaptive outdoor cycling program participation and physical, psychological, and social outcomes in persons with stroke using both quantitative and qualitative data collection. Mixed methods design, using prospective longitudinal quantitative data collection during a 16-week adaptive outdoor cycling program (Part 1) and a semi-structured interview/focus group (Part 2). Part 1 included baseline, 8- and 16-weeks assessments of physical, psychological, and social outcomes. Repeated measures analyses of variance (ANOVA) were used to examine within-group changes and effect sizes were calculated. Part 2's transcriptions were coded for physical, psychological, and social outcomes. 30 individuals post-stroke (ages 25-72) were enrolled in Part 1 of the study. ANOVA results showed statistically significant changes in all three areas: physical (resting heart rate, 10-m walk test), psychological (well-being), and social (satisfaction with social roles) outcomes, all with large effect sizes. All other outcomes showed changes in the expected direction but did not reach statistical significance. Findings from qualitative analyses explained and expanded upon quantitative findings. The results highlight the importance of exploring the influence of adaptive recreation on not only physical but psychological and social outcomes. Due to the exploratory design of this pilot, future research is warranted.

Muscle-restricted knockout of connexin 43 and connexin 45 accelerates and improves locomotor recovery after contusion spinal cord injury.

Traumatic spinal cord injury (SCI) results in the disruption of physiological systems below the level of the spinal lesion. Connexin hemichannels (CxHCs) are membrane-bound, non-selective pore proteins that are lost in mature myofibers but reappear de novo on the sarcolemma after peripheral denervation, chronic SCI, diabetes, and severe systemic stress such as sepsis. Cx43 and Cx45 have been implicated as the major CxHCs present in diseased muscle, and muscle-restricted knockout of these genes reduces muscle atrophy after denervation, likely by reducing excess calcium influx with resultant inflammasome activation. A muscle-restricted Cx43/45 conditional knockout (mKO) mouse model was developed and tested to check whether it would improve outcomes following either a complete spinal cord transection at the level of thoracic vertebrae-9 (T9) or a motor-incomplete T9 impact-contusion SCI. mKO had no effect on the body mass after complete T9 transection. There was reduced atrophy of the plantaris 15 days post-SCI that was not associated with molecular markers of inflammation, hypertrophic/atrophic protein signaling, or protein and mRNA expression related to mitochondrial integrity and function. mKO mice had faster and greater locomotor recovery across 28 days after a motor-incomplete contusion SCI with no differences in spared white matter; male mKO mice generally had greater muscle mass than genotype controls post-injury, but muscle sparing was not observed in female mKO mice post-injury. The data establish a new paradigm where muscle Cx43/45 may contribute to the tissue crosstalk that determines the neuromuscular function of sub-lesional musculature after motor-incomplete SCI in a sex-dependent manner. Our novel findings should promote investigation to develop innovative treatment strategies to improve the function and quality of life for persons with SCI.

UM ESTUDO DE CASO SOBRE A QUALIDADE DE VIDA NO EXERCÍCIO DO TRABALHO POLICIAL

In this article, we sought to investigate the perception of military police officers regarding the quality of life in the professional context in which they carry out their activities and what possible impacts they may feel on their personal lives. For this, a data survey was used through a structured questionnaire applied online with military police officers from the 8th Independent Military Police Company (8th CIPM), based on the QWL analysis model of Walton’s eight dimensions (1973). Questionnaires were administered 80 police officers. As a result, based on the interviewees’ answers to the questions present in the questionnaire, it was found that the absence of a defined working day reflects on the quality of personal life, as many are unable to enjoy leisure with their family and added to this, we have the relatively stressful and high-risk environment of their functions, which directly affect the issue of quality of life when carrying out their functions.

Lifestyle intervention improves cognition and quality of life in persons with early Multiple Sclerosis

Lifestyle changes have been demonstrated to impact pathophysiology in Multiple Sclerosis (MS). Various diet and exercise protocols have been reported to improve symptoms and function in persons with MS. Evidence is accumulating that interventions as early as possible in the disease course are warranted. The objective of this study was to investigate the effect of a remotely delivered lifestyle program focusing on specific diet and exercise recommendations in persons with early MS. MS patients, with disease diagnosis no more than 2 years prior, were recruited from the patient population of the MS clinic of the Pacific Neuroscience Institute. Participants followed recommendations for diet and exercise delivered via remote heath coaching. Each participant received 6 sessions with a health coach over a 12-week period. They were given parameters of a Mediterranean-type diet to follow, and specific and individualized recommendations about duration, intensity and type of exercise and physical activity. Outcome measures included Quality of Life (QOL), cognition (Symbol Digit Modalities Test, SDMT), fatigue (Multiple Sclerosis Fatigue Impact Scale, MFIS), fitness (estimated with Metabolic equivalents, METS) and other objective and patient reported outcomes (PRO). Changes in outcomes were analyzed using mixed effects general linear models and standardized pre-post differences.(Cohen's d) RESULTS: Fifteen persons with early (≤ 2 years) MS enrolled in the study, 14 of whom completed the study. We observed significant improvements in QOL (p = 0.02), SDMT (p = 0.006), fatigue(p = 0.005), fitness (p = 0.04), and other PRO and objective metrics at the end of the protocol compared to baseline. Adherence and patient satisfaction measures were high. Specific and individualized lifestyle recommendations can be effectively delivered remotely, and may produce improvement in symptoms and function in persons with early MS. Larger controlled trials of these interventions are warranted.

Investigating the Role of Artificial Intelligence in Developing Eco-Friendly Assistive Technologies for People with Disabilities

Current research indicates that artificial intelligence has immense scope to further the cause of assistive technology in improving the quality of life for persons with disabilities by rendering customized support to mobility aids, visual aids, hearing aids, and smart homes. AI-driven devices make communication, adaptive learning, and independence easier for all, with innovations in prosthetics, wheel chairs, and satellite navigation apps such as Google Maps and Moovit. Voice- activated AI-powered smart devices, like Amazon Echo and Google Home, facilitate independent living with voice activation of light and appliances. AI is also in OrCam to further autonomous living. The study examines that artificial intelligence has immense scope to further the cause of assistive technology in enhancing the quality of life for people with disabilities by providing customized support to mobility aids, visual aids, hearing aids, and smart homes. AI makes environmental sustainability a part of the life cycle of assistive technologies—from design to the use of materials, energy efficiency, and e-waste recycling. Efficient waste management is made possible through AI-based sorting systems and smart recycling bins. Blockchain brings transparency into these processes. It is in social integration and economic efficiency that the following devices and services related to sustainable assistive technology can create environmental sustainability, empowering persons with disabilities, reducing healthcare expenditure, and infusing green practices toward an all-inclusive and sustainable world. UN News, Assistive Ware.

Attitudes and beliefs towards medication burden and deprescribing in Parkinson disease

BackgroundDeprescribing of potentially inappropriate medications is recommended for older adults and may improve health outcomes and quality of life in persons living with Parkinson disease (PD). Patient attitudes, beliefs, and preferences play a crucial role in the success of deprescribing interventions. We aimed to examine the attitudes and beliefs about medication burden and deprescribing among persons living with PD.MethodsWe administered a survey to participants of Fox Insight, a prospective longitudinal study of persons living with PD. The survey included the revised Patients’ Attitudes Towards Deprescribing (rPATD) questionnaire and additional questions about adverse drug effects. We used logistic regression models to explore potential predictors of treatment dissatisfaction and willingness to deprescribe.ResultsOf the 4945 rPATD respondents, 31.6% were dissatisfied with their current medications, and 87.1% would be willing to deprescribe medications. Male sex was associated with a greater willingness to deprescribe (adjusted odds ratio [aOR] 1.62, 95% confidence interval [CI] 1.37–1.93). A greater belief that the medication burden was high or that some medications were inappropriate was associated with treatment dissatisfaction (aORs 3.74, 95% CI 3.26–4.29 and 5.61, 95% CI 4.85–6.50), and more willingness to deprescribe (aORs 1.74, 95% CI 1.47–2.06 and 2.87, 95% CI 2.41–3.42). Cognitive impairment was the adverse drug effect participants were most concerned about when prescribed new medications to treat nonmotor symptoms.ConclusionsPersons with PD are often dissatisfied with their overall medication load and are open to deprescribing. Medications that are associated with cognitive impairment might be prioritized targets for deprescribing interventions in this population.