Physical Health Quality Of Life Research Articles

More than sleep problems? Testing five key health behaviors as reasons for quality of life issues among shift workers

BackgroundThe shift work schedule is a common work arrangement that can disrupt typical sleep-wake rhythms and lead to negative health consequences. The present study aims to examine the effect of shift work on health-related quality of life (QoL) and explore potential behaviorial mediators (i.e., sleep, eating, exercise, smoking, drinking).MethodsA cross-sectional survey was conducted among 4,449 petroleum workers in southwest China. Data on shift work status, health behaviors, and physical and mental health QoL were collected. We tested our model using path analysis and the Monte Carlo approach among 2,129 included participants.ResultsAfter adjusting for covariates, shift work did not exhibit a significant direct association with QoL. However, shift work indirectly related to poorer physical health quality of life via less frequent healthy food consumption; shift work also indirectly related to poorer mental health QoL via both less frequent healthy food consumption and physical exercise. No significant indirect effects were found via sleeping, smoking, or drinking.ConclusionsResults suggest that shift work presents a challenge for QoL among Chinese petroleum workers due to their lesser engagement in two specific health behaviors: healthy eating and physical exercise. Healthy eating and exercise may present an even more prominent threat to shift workers’ QoL than sleep and substance use. Strategies targeting shift work schedule as well as eating and exercise behaviors may help protect against poor QoL and adverse physical and mental health outcomes in this vulnerable group.

COVID-19 Pandemic Effects on Epileptic Children and Interleukin 6 Levels in Recently Diagnosed Epileptic Patients: A Cross Sectional Study

Abstract Background Epilepsy is a disease with wide range of definitions. It is considered a multifactorial condition that may present at various ages and in many forms, which makes it challenging for physicians. In late 2019, SARS-CoV-2 (COVID-19) emerged as a novel coronavirus. Both epilepsy and COVID-19 can be linked in more than one way. Aim of the Study To Determine the effects of COVID-19 pandemic on the health-related quality of life and psychosocial aspects of children with epilepsy & to Determine whether COVID-19 infection is an inflicting cause for epilepsy in newly diagnosed cases. Patients and Methods We interviewed 50 patients with Epilepsy and their parents, for the blood tests we sampled 40 and 40 close relatives with no medical condition of similar age and sex. Results 50 subjects’ results were demonstrated, 28 males and 22 females, median age was 9 years old. Unfortunately, almost all were experiencing depression, data showed that 1 (2%) didn’t have depression, 15 (30%) had mild depression, 27 (54%) had moderate depression and 7 (14%) had been experiencing severe depression, Mostly, all in our study were experiencing anxiety, data showed that 1 (2%) didn’t experience anxiety, 7 (14%) experienced mild anxiety, 16 (32%) experienced moderate anxiety while 26 (52%) experienced severe anxiety. Fair physical, social and emotional health overall, data showed that the average physical health quality of life was 450 (SD 197.65), the average emotional health quality of life was 275 (SD 126.91), the average social health quality of life was 275 (SD 123.61) and the average school performance quality of life was 287.5 (SD 154.31). There were 9 cases newly diagnosed with epilepsy who were COVID IgM. Among subjects with COVID IgM positive, 3 (25%) had no neurological manifestations. Cases had higher levels of IL-6 compared to control children 187.5+/-68.89 and 77.33+/-27.94 respectively with statistically significant difference p < 0.001. However, no significant difference was found upon comparing COVID IgM levels of the 2 relevant groups. Conclusion COVID-19 pandemic has major impacts on health-related quality of life, causing depression, anxiety, decreased social and physical activities and poor school performance. COVID-19 can cause new onset seizures and epilepsy, or increase the frequency of seizures, IL-6 is a useful marker for severity of diseases as COVID-19, also for following up the progression of the disease, but not a marker for diagnosing it.

Effects of cardiac radiation on sleep and psychological distress in adult survivors of pediatric Hodgkin lymphoma without breathing sleep disorders.

10068 Background: Adult survivors of childhood Hodgkin lymphoma (HL) are at higher risk for excessive sleepiness, fatigue, and other morbidities that affect long-term quality of life (QoL). The relationship between radiation dose to the heart delivered during treatment and self-reported sleep quality, fatigue, QoL, and psychological distress in survivors of HL has not been explored. This study examines clusters of cardiac dosimetry and sleep quality and associated symptoms of insomnia, fatigue, QoL, and psychological distress in a subset of adult survivors of pediatric HL without breathing sleep disorders. Methods: Survivors completed standardized surveys of sleep quality (Pittsburg Sleep Quality Index, PSQI), insomnia (Insomnia Severity Index), fatigue (FACIT-F), QoL (SF36 short survey), and psychological distress (BS18). Two consecutive nights of in-home polysomnography were completed with at least 4 hours of recorded sleep in one night. Analyses were conducted on 95 survivors (mean[SD] age=36[7.2] years, 55 female) who demonstrated at least average sleep efficiency (>85%) and demonstrated no evidence of sleep apnea (Apnea-Hypopnea Index <5, or AHI >5 and <15 with no daytime sleepiness as defined by the American Society of Sleep Medicine). Radiation dose to the heart was estimated using dose reconstruction methods for therapeutic radiation exposure developed by the MD Anderson Cancer Center. Radiation/Sleep clusters were found using a silhouette analysis and K-means algorithm. Linear regression associations between clusters and outcomes were adjusted by age and body mass index. Statistical analyses were computed in the statsmodels toolbox for Python3. Results: Sleep and radiation were not correlated (ρ=0.03, p=0.67). Considering good sleep as PSQI<5, three main Radiation/Sleep clusters were found indicating a low-radiation/middling-sleep group (22%; RT = 251[250.7] cGy, PSQI = 7[2.7]), a high- radiation/better-sleep group (46%; RT = 2012[406.8] cGy, PSQI = 4[1.5]), and a high- radiation/worst-sleep group (32%; RT = 2072[472.3] cGy, PSQI = 11[2.5]). Survivors in high-radiation/worst-sleep group demonstrated worse fatigue ( β=-12.3, p=0.001) and insomnia ( β=9.52, p<0.001). This group was associated with poor Mental Health ( β=-2.1, p<0.001) but not Physical Health QoL ( β=-0.4, p=0.154). This latter group also indicated more psychological distress (depression β=11.6, p=0.001, somatization β=11.8, p<0.001), but not anxiety ( β=4.6, p=0.241). Conclusions: Our results highlight the burden of symptoms associated with higher radiation dosimetry in the heart including poor sleep quality, insomnia, fatigue, and increased psychological distress. Understanding the mechanisms of sleep quality and fatigue in HL survivors is warranted as some survivors demonstrate poor sleep quality and fatigue due to factors other than clinical sleep disorders.

Parental cancer: mediating and moderating roles of psychological inflexibility in the links between illness severity and parental quality of life and family outcomes

The challenges of parental cancer while caring for young offspring are often neglected by researchers and healthcare providers. Focusing on parents with cancer, this cross-sectional study examines the mediating and moderating roles of a malleable risk factor, psychological inflexibility, in the relationships between perceived illness severity and parental quality of life (QoL) and family outcomes. Psychological inflexibility was conceptualized using the acceptance and commitment therapy (ACT) framework. A total of 86 parents with cancer caring for young offspring (aged 11–24 years; M = 17.94, SD = 3.68) completed a survey that assessed psychological inflexibility, parental mental and physical health QoL, family outcomes (family functioning, parenting concerns, and openness to discuss cancer), socio-demographics, and illness variables. Mediation analyses indicated that higher perceived illness severity was associated with higher levels of psychological inflexibility, which in turn were related to higher detrimental impacts on parental QoL and family outcomes. Results of moderation analyses were non-significant. Findings highlight the detrimental impacts of illness severity on psychological inflexibility, suggesting that it is a psychosocial risk factor in parents dealing with cancer. ACT-based interventions which foster psychological flexibility are likely to enhance parental QoL and family outcomes.

The phenotype of recovery XI: associations of sleep quality and perceived stress with discounting and quality of life in substance use recovery

PurposeSleep and stress show an interdependent relationship in physiology, and both are known risk factors for relapse in substance use disorder (SUD) recovery. However, sleep and stress are often investigated independently in addiction research. In this exploratory study, the associations of sleep quality and perceived stress with delay discounting (DD), effort discounting (ED), and quality of life (QOL) were examined concomitantly to determine their role in addiction recovery. DD has been proposed as a prognostic indicator of SUD treatment response, ED is hypothesized to be relevant to the effort to overcome addiction, and QOL is an important component in addiction recovery.MethodAn online sample of 118 individuals recovering from SUDs was collected through the International Quit and Recovery Registry. Exhaustive model selection, using the Bayesian Information Criterion to determine the optimal multiple linear model, was conducted to identify variables (i.e., sleep quality, perceived stress, and demographics) contributing to the total variance in DD, ED, and QOL.ResultsAfter model selection, sleep was found to be significantly associated with DD. Stress was found to be significantly associated with psychological health, social relationships, and environment QOL. Both sleep and stress were found to be significantly associated with physical health QOL. Neither sleep nor stress was supported as an explanatory variable of ED.ConclusionTogether, these findings suggest sleep and stress contribute uniquely to the process of addiction recovery. Considering both factors when designing interventions and planning for future research is recommended.

Prevalence and Correlates of Post-Diagnosis Alcohol Use among Cancer Survivors.

Alcohol is a risk factor for cancer and may pose unique risks for cancer survivors. Population-based studies of confirmed cancer cases are needed to estimate the extent of drinking among cancer survivors and to understand which survivors are most at risk of alcohol-related health problems. Cancer survivors who resided in the Puget Sound Surveillance, Epidemiology, and End Results (SEER) region, were ages 21 to 74 years at diagnosis, and were 6 to 17 months post-diagnosis at the start of the recruitment period (April 2020-December 2020) were sent a survey that included demographics, substance use, mental health, and cancer-related items. Data from returned surveys (n = 1,488) were weighted to represent the characteristics of the Puget Sound SEER region. We estimated the prevalence of post-diagnosis alcohol use as well as demographic, behavioral, and clinical correlates of three levels of drinking: any drinking, drinking exceeding cancer prevention guidelines, and hazardous drinking. The weighted prevalence of any drinking, drinking exceeding cancer prevention guidelines, and hazardous drinking was 71%, 46.2%, and 31.6%, respectively. Higher income and cannabis use were associated with increased odds of all three drinking levels. Lower physical health quality of life, having non-colorectal gastrointestinal cancer, and receiving chemotherapy within the last month were associated with decreased odds of all three drinking levels. The prevalence of any drinking and at-risk drinking was higher than in previous studies and differed based on sociodemographic, substance use, and cancer-related factors. Findings highlight the importance of identifying and addressing risky alcohol use in cancer care settings.

Loneliness in older primary care patients and its relationship to physical and mental health-related quality of life.

Loneliness is a significant public health challenge in the United States, especially among older adults. The epidemiology of loneliness among older adults in primary care is lacking, and specific research is needed on how loneliness impacts older primary patients' physical, mental, and cognitive health. A large sample of older primary care patients were recruited for a trial during the COVID-19 pandemic to measure the relationship between loneliness and physical and mental quality of life (QOL). Baseline data come from the Caregiver Outcomes of Alzheimer's Disease Screening (COADS) study, an ongoing randomized controlled trial evaluating benefits and risks of Alzheimer's disease and related dementias screening among primary care patients ages 65 and older, collected April 2020 to September 2021. Loneliness was measured with the 5-item, Loneliness Fixed Form Ages 18+ from The NIH Toolbox Emotion Battery, physical and mental health-related QOL was measured with the SF-36v2, and depression and anxiety severity were measured with the PHQ-9 and GAD-7, respectively. Spearman correlation analyses revealed that loneliness was moderately correlated with mental health QOL (r[601] = -0.43, p < 0.001), anxiety severity (r[601] = 0.44, p < 0.001), and depression severity (r[601] = 0.42, p < 0.001), while weakly correlated with physical health QOL (r[601] = -0.15, p < 0.001). After conducting unadjusted and adjusted linear regression models, we found that loneliness was significantly associated with both lower mental (p < 0.001) and physical (p < 0.001) QOL. Furthermore, loneliness remained significantly associated with worse mental QOL after adjusting for age, gender, race, ethnicity, educational level, perceived income status, neighborhood disadvantage, severity of comorbidities, and comorbid depression and anxiety. Primary care providers should discuss loneliness with their older adult patients and provide resources to help patients develop and maintain meaningful social relationships.

Virtual reality training and pain neuroscience plus motor control on pain, disability, health, and quality of life of women with non-specific chronic back pain

Background: Non-specific chronic low back pain is defined as a complex disorder involving structural, biomechanical, cognitive, psychological, social, and lifestyle factors. This randomized clinical trial study compared the effects of 8-week Virtual Reality Training (VRT) and pain neuroscience plus motor control training (PNE/MCT) on pain, disability, health, and quality of life of women with non-specific chronic back pain. Methodology: This research is a single-center parallel RCT. Thirty-six participants participated in this study. They were divided into two groups: VRT (G1) and PNE/MCT (G2), both with 18 women. The training was performed for eight weeks for 45 minutes – 60 minutes. The VRT was applied by Oculus Quest 2. Visual Analogue Scale (VAS), disability (Oswestry Disability Index), general health (GHQ-28), and quality of life (QOL- WHO) were assessed before and after eight training weeks using a within-between group analysis (ANOVA 2×2). Results: Before training, no difference was observed between the groups (p &gt; 0.05). After the intervention, both groups improved VAS, disability, GHQ, and QOL (all p &lt; 0.001). In the comparison between the groups, the G1 had a better performance according to the p-value and effect size in anxiety (p = 0.001, ES= 0.71), depression symptoms (p = 0.03, ES: 0.25), physical health (p = 0.03, ES: -0.24), mental health (p = 0.001, ES: 0.66), and total QOL (p = 0.048, ES: 0.21) than G2. Conclusion: Despite the effectiveness of both interventions, VRT improved the general health and quality of life in women with NSCLBP more than PNE/MCT.

Quality of life and mental health among gynaecological cancer patients towards the end of COVID-19 pandemic

This study aimed to assess the mental health and quality of life (QOL) in gynaecological cancer patients, and to identify key risk factors for improved management. In addition, during a period of reduced impact of a novel coronavirus (COVID-19) infection, we sought to examine its current impact on mental health and QOL. A cross-sectional study was conducted among 175 gynaecological cancer patients. The survey assessed QOL (The World Health Organization Quality of Life-Bref, anxiety and depression (Hospital Anxiety and Depression Scale (HADS)). Multivariable linear regression was used for analysis. Being diagnosed in the last one year was associated with higher HADS depression score (p &lt; 0.001) and recurrence was associated with both higher HADS anxiety and depression scores (p = 0.004 and p &lt; 0.001). Age ≤60 years old was a significant negative predictor for psychological health (p = 0.002) and overall QOL (p = 0.017). Complications during surgery were identified as a significant negative predictor affecting psychological health (p = 0.018), but did not affect the other domains. Disease recurrence was observed to significantly influence QOL scores in physical health (p = 0.014) and overall QOL (p &lt; 0.001). This study highlights that recurrence has a significant impact on mental health and QOL of gynaecological cancer patients. Patients diagnosed within last year should be carefully assessed for risk of depression. Younger patients and those with surgical complications may experience reduced QOL. Importantly, COVID-19 showed no apparent negative impact on the mental health or QOL in these patients, which is no longer considered a significant contributor to adverse effects.

Exploring the association between sexual motivation and quality of life in China and the United Kingdom.

Previous research suggests that different sexual motivations may be associated with different sexual behaviours and levels of sexual satisfaction, and these may vary with cultural differences. As such, sexual motivations and cultural factors might also be associated with quality of life (QoL); however, this has not yet been explored. Using a biopsychosocial approach, this study aimed to explore associations between sexual motivation and quality of life between participants in the United Kingdom and China. 276 participants (143 British, 133 Chinese, mean age = 21.5 years) completed an anonymous online survey including validated measures for sexual motivation (YSEX?-SF) and QoL (WHOQOL-BREF). In multivariable linear regressions, pleasure motivations for sex were associated with increased physical health QoL (aOR = 0.20, 95%CI:.15-.65), while love and commitment motivations were associated with increased psychological health QoL (aOR = 0.13, 95%CI:.01-.43). Both love and commitment motivations (aOR = 0.21, 95%CI:.09-.35) and pleasure motivations (aOR = 0.20, 95%CI:.08-.36) were associated with increased social support QoL. A significant interaction was found between emotional motivations and culture (p = 0.037) such that among individuals from China, emotional motivations (i.e., love and commitment and expression) were positively associated with psychological QoL. This suggests culture may differentially affect how sexual motivations are associated with QoL and warrants further consideration in future research.

Impact of welding occupation on serum aluminium level and its association with physical health, cognitive function, and quality of life: a cross-sectional study.

There is an occupational health concern about welders' inhalation of toxic aluminium fumes. We investigated whether serum aluminium level (SAL) and demographic variables can significantly predict physical health parameters, cognition, and quality of life (QoL) among welders. The cross-sectional study involved 100 age- and location-matched men (50 welders and 50 non-welders). SAL obtained using a graphite furnace atomic absorption spectrometer, and data collected using blood pressure and body mass index (BMI) apparatuses, biodata form, pain rating scale, General Practitioner Assessment of Cognition, WHOQoL-BREF, and Nordic musculoskeletal symptoms (MSS) questionnaire were analysed using independentsamplest test, chi-square, Pearson's correlation, and hierarchical linear regression. Welders had significantly higher SAL (mean difference [MD] = 1.77µg/L, p < 0.001), lower QoL (MD = 3.92, p = 0.039), and higher prevalence of MSS on the neck (χ2 = 10.187, p = 0.001), shoulder (χ2 = 9.007, p = 0.003), upper back (χ2 = 6.832, p = 0.009), and knee (χ2 = 12.190, p < 0.001) than non-welders. There was a significant bivariate association between SAL, systolic blood pressure (β = 0.313, p = 0.002), and BMI (β = 0.279, p = 0.005), but not pain intensity, cognition, or QoL. SAL remained a significant predictor of systolic blood pressure after adjustment for physical health and QoL parameters (β = 0.191, p = 0.044). The association between SAL and social QoL became significant after adjustment for physical health and other QoL domains (β = - 0.210, p = 0.032) and demographic variables (β = - 0.233, p = 0.046). Welders had significantly higher SAL, musculoskeletal symptoms, blood pressure, and lower QoL than non-welders. SAL was associated with adverse physical health parameters and social-related QoL, not cognition. We recommend routine aluminium bioavailability and physical health checks among welders.

Coping strategies and burden stress in caregivers of patients with schizophrenia and patients with bipolar disorder

BackgroundMental illness has a great impact not only on patients but also on their carers as it makes them more prone to stress, interferes with their daily life activities, and can negatively affect their social, psychological, and physical health quality of life. They neglect seeking medical help that may negatively affect clinical outcome of patients and quality of their life. Therefore, it is important to evaluate the magnitude of burden on such caregivers and to investigate the coping strategies used by them in order to develop tailored biopsychosocial interventions to reduce their stress.ObjectiveTo assess the magnitude of burden and patterns of coping with stress in caregivers of patients with schizophrenia. To assess the magnitude of burden and patterns of coping with stress in caregivers of patients with bipolar affective disorder. To compare both the coping strategies and burden stress scores among carers of patients diagnosed with schizophrenia and bipolar patients.Patients and methodsThis cross-sectional study was done on 100 caregivers to assess burden in caregivers of schizophrenia patients and caregivers of bipolar patients, the coping style used by the caregivers of both groups and comparing between two groups.ResultsThere was statistically significant difference found between bipolar group and schizophrenia group regarding coping inventory scores make fun and behavioral withdrawal, which showed higher median score in schizophrenia group than bipolar group. Burden of caring and coping with this burden, affect each other mutually. As, according to the results of our study, rural residence of caregiver, positive reassessment ≤ 12 and denial > 8 were found significantly associated with high burden in bipolar group. While employed caregivers were associated with high burden among schizophrenia group. Burden is higher in bipolar group than schizophrenia group.ConclusionThe burden placed on caregivers has a significant impact on their capacity to offer service and care to patients. It also has an impact on how service providers adjust to and deal with their families' illnesses. Reduced caregiver load and increased awareness of the condition may help caregivers to use more flexible coping techniques.

Quality of Life and Comorbidities of Adult Survivors of Allogeneic Hematopoietic Cell Transplant Versus Their Siblings

Background: Survivors of allogeneic hematopoietic cell transplant (allo-HCT) are at risk of developing chronic health conditions. Prior studies have shown that survivors of allo-HCT in childhood/young adulthood who mainly received high dose total body irradiation (TBI)-based conditioning experience excess health conditions and more distress vs. their siblings. In recent years, allo-HCT is offered to adults of increasing age and there has been increasing use of chemotherapy +/- low dose TBI conditioning rather than high dose TBI. We set out to describe and compare the QoL and comorbidities of adults who underwent allo-HCT with chemotherapy +/- low dose TBI conditioning vs. their siblings. Methods: Allo-HCT recipients attending 1 of 2 survivorship clinics at ≥2 years post-HCT without active cGVHD or relapse, were enrolled. Beginning in 2023, participants were asked to forward an electronic version of the study survey to their biological sibling(s). The survey includes the PROMIS-Global Health instrument: raw scores are converted to a mental (MH) and physical health (PH) subscale T-score (population mean 50/SD 10). Comorbidities were scored with a published post allo-HCT morbidity index. Associations between MH and PH-related QoL, comorbidities, and patient/transplant-related variables were investigated with linear regression. Patient and sibling comparisons were made with paired sample and chi-square tests. A significance level of &amp;lt;0.05 was statistically significant &amp; a difference in QoL T-score of 5 was clinically significant. Results: Of 330 patients approached during their clinic visit, 320 consented to participate (97%). To date, 105 siblings of 57 recipients have been sent surveys and 47 siblings (45%) of 32 recipients (56%) have completed the survey. Among all recipients, median age at HCT is 47 (IQR 35-57) with 21% ≥60 years old, 48% are female, 78% are Caucasian, 69% are college educated or more &amp; 51% are working full/part-time. Median time post-HCT is 9 years (IQR 6-14). The mean PH T-score is 48.5 (SD 8.6). In the multivariable model, total number of comorbidities (p&amp;lt;0.01) and a work status of disability (p&amp;lt;0.01) are associated with inferior PH QoL. The mean MH T-score was 49.1 (SD 8.4). In the multivariable model, total number of comorbidities (p&amp;lt;0.01) and a work status of disability (p&amp;lt;0.01) are associated with inferior MH QoL. HCT characteristics, including history of moderate-severe cGVHD, and demographic characteristics are not associated with either QoL subscale. Among all recipients, the median number of comorbidities is 3 (IQR 1.5-4). The most common comorbidities include hyperlipidemia (39%), hypertension (25%) &amp; hypothyroidism (24%). At least one severe comorbidity (vascular disease, chronic heart/lung/liver/kidney disease or subsequent malignancy) is present in 23% of patients. In multivariable analysis, a greater number of years post-HCT is associated with a greater number of comorbidities (p=0.03) and full/part-time work status is associated with fewer comorbidities (p=0.01). In the sibling-recipient comparison, median age of siblings and recipients is 55 (IQR 37-66) &amp; 54 (IQR 40-64), respectively. The MH QoL of recipients is statistically, but not clinically, better than their siblings: T-score 52.9 (SD 7.1) versus 49.9 (SD 6.9), respectively, p=0.04. The PH QoL of recipients was not significantly different than their siblings: T-score 52.6 (SD 5.6) versus 50.7 (SD 8.2), respectively, p=0.23. Recipients are suffering from significantly more comorbidities vs. their siblings: median 2.5 (IQR 1.8-4) versus 1 (IQR 0-3), respectively, p=0.03. The prevalence of ≥1 severe comorbidity is greater in recipients vs. siblings, but not statistically significant (13% vs. 2%, p=0.06). Conclusion: Adult recipients of allo-HCT, living without cGVHD or relapse and conditioned without high dose TBI, in aggregate experience similar QoL but suffer excess chronic health conditions as compared to their siblings. One in 4 recipients are suffering from ≥1 severe chronic health condition(s). Time post-HCT is associated with comorbidities, suggesting that recipients continue to accumulate health conditions in the years post-HCT. Number of comorbidities, rather than transplant and demographic factors (including prior cGVHD), is associated with impaired MH and PH QoL. Preventative care after allo-HCT is critical, even in those receiving HCT in adulthood without high dose TBI.

Health-Related Quality of Life Outcome Measures in Individuals With Hereditary Hemorrhagic Telangiectasia: A Scoping Review.

Studies evaluating health-related quality of life (HRQOL) in patients with hereditary hemorrhagic telangiectasia (HHT) have expanded rapidly in the past decade. These studies have evaluated QOL aspects ranging from the general QOL for patients living with HHT to intervention-specific outcomes. However, few tools have been fully validated across the spectrum of disease manifestations and interventions in HHT. In this scoping review, we aim to map the literature on HHT-QOL metrics, identify gaps, inform future QOL research, and facilitate future metric development. We analyzed articles in English that assessed at least 1 measure of general HRQOL, including physical health, mental health, social health, or intervention-specific QOL in patients with HHT. Searches across 2 bibliographic databases (PubMed and Scopus) yielded 186 articles after duplicates were removed. Sixty-three studies met eligibility criteria: 22 prospective studies (34.9%), 20 retrospective studies (31.7%), 12 cross-sectional studies (17.5%), 6 randomized controlled trials or secondary analyses of a randomized controlled trials (9.5%), 2 qualitative studies (3.2%), and 1 case-control study (1.6%). Two additional studies-1 prospective and 1 cross-sectional study-were identified at the October 2022 14th International HHT Conference and included, making a total of 65 studies. The 65 eligible studies used 30 QOL instruments. Twenty studies characterized baseline HRQOL, and 45 studies evaluated QOL before and after treatment. Of those 45 studies, 37 evaluated HRQOL before and after therapies targeting epistaxis and nasal symptoms, 4 targeted therapies for liver arteriovenous malformations and high-output heart failure, 3 evaluated therapies for both epistaxis and gastrointestinal bleeding, and 1 evaluated treatment targeting gastrointestinal bleeding alone. Comparison of results across studies remains challenging given the heterogeneity in outcomes measures. Further development of HHT-specific patient-reported outcomes instruments that capture the global illness experience of HHT is needed.

Mediating effect of symptom severity on the relationship between aggression, impulsivity and quality of life outcomes among patients with schizophrenia and related psychoses.

Aggression and impulsivity among individuals with schizophrenia have been associated with poor clinical outcomes including worsening of symptoms and substance abuse which have been linked to a lower quality of life (QoL). The current study aimed to look at the mediating effect of symptom severity on the relationship between aggression, impulsivity and QoL among outpatients with schizophrenia and related psychoses in a multi-ethnic Asian population. Data (n = 397) were collected from outpatients seeking treatment at the Institute of Mental Health. The World Health Organization quality of life-BREF (WHOQOL-BREF) scale, the symptoms checklist-90 revised (SCL-90-R), Buss Perry aggression questionnaire (BPAQ), and the Barratt impulsiveness scales (BIS) were used to assess subjective well-being, symptom severity, aggression, and impulsivity, respectively. Mediation analysis was performed using the PROCESS macro to understand the mediating effect of symptom severity. Motor impulsivity (MI) was indirectly associated with both the physical and psychological health domains of QoL while self-control was indirectly associated with the physical, psychological, and environmental health QoL domains through increased symptom severity. The significant indirect effect of symptom severity in our study highlights one potential pathway through which impulsivity impacts the QoL of individuals with schizophrenia and related psychoses. Elucidating other factors besides symptom severity that have an indirect effect on the QoL of individuals provides alternative approaches for treatment through which better clinical outcomes can be achieved.

THE IMPACT OF THE MOVEMENT CONTROL ORDER PHASES ON THE QUALITY OF LIFE AMONG MALAYSIAN UNIVERSITY STUDENTS

This study measured the impact of the different phases during movement control order on the quality of life among local Malaysian university students aged &gt;18 years old. An online survey was distributed through a social media platform during the movement control order (MCO; 20 April to 12 May 2020) and conditional movement control order (CMCO; 12 to 20 May 2020). The same participants completed the SF-36 quality of life questionnaire that assessed the overall physical health, mental health, and eight domains which are physical functioning (PF), physical role functioning (RF), bodily pain (BP), general health perceptions (GH), vitality (V), social role functioning (SF), emotional role functioning (EF), and mental health (MH) in both phases. A total of 523 participants (Male = 222, female = 301) completed the survey. A Wilcoxon signed-rank test showed that there was a significant difference in participants’ quality of life between the MCO and CMCO phases. It was revealed in comparison to the CMCO phase, the participants reported lower in both health-related and mental quality of life for PF (Z = -13.79, p &lt;.001), RF (Z = -13.59, p &lt;.001), BP (Z = -11.64, p &lt;.001), GH (Z = -12.97, p &lt;.001), V (Z = -13.15, p &lt;.001), SF (Z = -15.19, p &lt;.001), EF (Z = -13.71, p &lt;.001), and MH (Z = -8.47, p &lt;.001). In overall university students' quality of life, a better score was shown in physical health quality of life (Z = -13.98, p &lt;.001) and mental health quality of life (Z = -13.21, p &lt;.001) during CMCO compared to MCO phase. Variance experiences through the COVID-19 pandemic faced by university students during both phases of movement control order and conditional movement control order were noted to have an impact on their quality of life.

Factors Affecting the Quality of Life of Parents Caring for Pediatric Patients with a Tracheostomy.

Objectives This study aimed to evaluate factors affecting the quality of life (QOL) of parents of children who underwent placement of a tracheostomy while in the pediatric intensive care unit (PICU) through postdischarge use of a standardized questionnaire, Functional Status Scale (FSS) for patients, and WHOQoL-BREF (a QOL scale) for parents. Methods The parents were initially contacted by telephone, postdischarge, during which the standardized questionnaire was completed. The functional status of the patients was evaluated using the FSS, and the QOL of parents was determined through use of the WHOQoL-BREF scale. Results From 2011 to 2021, tracheostomy was performed in 119 PICU patients. Overall, 93 patients were excluded due to death in 66 (56%), decannulation in 24 (20%) and, 3 (2%) were not available for follow-up. The parents of 26 (22%) patients were available for follow-up and for which the standardized questionnaire FSS and WHOQoL-BREF QOL scales were completed. The mean FSS score of the patients was elevated at 17.84. In comparison, reduced mean scores were observed for parental physical health of 20.61, psychological health of 20.57, social health of 11.15, and environmental health of 29.00. As a result, a moderate ( r < 0.80), yet significant ( p ≤ 0.004) negative correlation was found between the FSS scores of patients and the physical, social relationships, environmental, and psychological health QOL scores of parents. Conclusion This study is unique in that, to our knowledge, it is the first to compare parental QOL with the FSS of pediatric patients who have undergone a tracheostomy while hospitalized in the PICU. Our findings indicate that the parental QOL was reduced in four areas and correlates with an elevation in FSS score (indicating a greater functional disorder) of pediatric patients who had previously undergone a tracheostomy while hospitalized in the PICU.

Neighborhood environment and quality of life among community-living older adults in Nigeria: The moderating effect of physical activity

Understanding how neighborhood environments are related to older adults’ quality of life (QoL) and physical activity (PA) is important for public health actions on healthy ageing in sub-Saharan Africa. We examined associations of perceived neighborhood environment attributes with QoL among older adults in Nigeria and investigated the moderating effects of PA on these associations. We conducted a cross-sectional study of 353 older adults (mean age = 68.9 ± 9.1 years) selected from 5 high- and low-income communities in Maiduguri, Nigeria. QoL, attributes of the neighborhood environments and PA were self-reported using validated questionnaires. Multi-level models were used to examine the direct associations between neighborhood environment attributes and each of the four domains of QoL (physical health, psychological health, social relationships, and environmental health), as well as the moderating effects of leisure-time and total PA. Seven of nine neighborhood environment features were positively associated with multiple domains of QoL. Residential density, land-use diversity, land-use mix-access, walking infrastructure, traffic safety and ‘overall walkability’ were positively related to both or either physical health and environmental health QoL among those who are physically active. In contrast, walking infrastructure, traffic safety, and ‘overall walkability’ were negatively related to psychological health QoL among those not physically active. Our findings suggest being physically active moderates the association of neighborhood environments with QoL among Nigerian older adults. We suggest that designing age-friendly communities and simultaneously promoting PA may be needed to improve QoL and help prepare the Nigerian society for the predicted increase in the older adult population.

Long-Term Impacts of COVID-19 Pneumonia on Quality of Life: A Single Institutional Pilot Study

Many studies have demonstrated poor quality of life (QoL) at 3, 6, 12, and 24 months after coronavirus disease 2019 (COVID-19). However, these studies were limited due to cross-sectional design, a longer gap between visits, and lack of controls for comparison. Therefore, the aim of our prospective study was to assess the impact of COVID-19 pneumonia on QoL in both physical and mental health. A prospective study was conducted on adult patients with COVID-19 pneumonia. We used the 36-Item Short Form Health Survey (SF-36) and Euro Quality of Life-5 Dimensions-5 Levels (EQ-5D-5L), EQ visual analogue scale (EQ-VAS), and Hospital Anxiety and Depression Scale to collect data at months, 1, 3, 6, 9, and 12. Thirty-eight patients with COVID-19 pneumonia and twenty-five healthy subjects were completely followed up on all visits. All domains of SF-36, except bodily pain and EQ-5D-5L of the patients, were lower than controls. There was an improvement of EQ-VAS and SF-36 including physical functioning, social functioning, and role limitation (physical problems) domains throughout study period in the COVID-19 pneumonia group. Adult patients who recovered from COVID-19 pneumonia had lower QoL which improved over the one-year follow-up period.

The mediating role of psychological flexibility in the relationship between resilience and distress and quality of life in people with multiple sclerosis.

The purpose of this study is to investigate the role of psychological flexibility in mediating the beneficial effects of resilience on distress and quality of life (QoL) in people with MS (PwMS). The psychological flexibility framework underpinning acceptance and commitment therapy (ACT) was used to conceptualise psychological flexibility. A total of 56 PwMS completed an online survey that assessed global psychological flexibility and each of its six core sub-processes, resilience, distress, mental and physical health QoL, socio-demographics, and illness variables. Mediation analyses showed that, as hypothesised, higher levels of global psychological flexibility and its sub-processes were associated with increases in the positive impacts of resilience on distress and mental and physical health QoL via a mediational mechanism. These findings suggest that psychological flexibility skills build resilience capacities in PwMS. The psychological flexibility framework offers an ACT-based intervention pathway to build resilience and enhance mental health and QoL in PwMS.