Quality Of Life Survey Research Articles

Motorized intramedullary lengthening followed by osseointegration for amputees with short residual femurs: An observational cohort study

Context: Some patients seeking transcutaneous osseointegration for amputees (TOFA) have residual bones so short there is concern whether they provide sufficient surface to support full weight. Our strategy was to lengthen these patients' femurs with a motorized intramedullary lengthening nail (MILN) before TOFA. Aims: The aim of this study is to describe 10 transfemoral amputees' experience with MILN before TOFA, focusing on the complications of MILN and TOFA, and also the patients' preoperative and postoperative quality of life (QOL). Settings and Design: A retrospective registry review of all MILN before TOFA surgeries was performed. Subjects and Methods: The patients' operative complications during/following MILN and TOFA were investigated. Furthermore, the patients' mobility (daily prosthesis wear hours, K-level, Timed Up and Go (TUG), and 6 min Walk Test [6MWT]) and QOL survey data (Questionnaire for Persons with a Transfemoral Amputation [QTFA]) were compared at the initial consultation and at the latest follow-up using Fisher's exact test for frequencies, and Student's t-test for means (significance, P < 0.05). Statistical Analysis Used: Fisher's exact test for frequencies, and Student's t-test for means (significance, P < 0.05). Results: Seven patients had one operative complication each: Three regenerate (autograft and plating), two nail malfunctions (nail replacement), one broken linkage cable (acute length correction with autografting and fixation), and one early consolidation (re-osteotomy). All ten patients had TOFA, an average of 12.0 ± 3.9 months after MILN surgery. One patient had debridement for infection (implant retained) and one patient had the implant removed due to infection. Significant mobility improvements were K-level >2 (2/9 = 22% vs. 9/10 = 90%, P =0.006) and TUG <15 s (1/8 = 13% vs. 6/8 = 75% P = 0.041). Wear hours and 6MWT improved but not significantly. All three aspects of QTFA significantly improved: Global (44.8 ± 29.9 vs. 75.9 ± 26.8, P =0.050), mobility (50.3 ± 30.8 vs. 74.8 ± 18.2, P =.033), and problem (38.8 ± 18.6 vs. 15.6 ± 18.3, P = 0.017). Conclusions: MILN before TOFA reliably achieves stable osseointegration for amputees with short residual femurs. Amputee lengthening remains demanding, but patients report significantly improved QOL and demonstrate improved mobility following TOFA. The minimum length of bone necessary to support a full weight-bearing osseointegrated prosthesis remains unknown.

Abstract PO-096: Caloric restriction may decrease health disparity in AA breast cancer patients due to significant downregulation of the IGF-1R pathway in a window-of-opportunity clinical trial

Abstract Introduction: Health disparities in breast cancer outcomes exist for African American (AA) women who are noted to present with more aggressive cancer with worse survival. Although the underlying reason for this disparity is not apparent, it is likely multifactorial. Interestingly, type 1 insulin-like growth factor receptor (IGF-1R) expression, which plays a critical role in cell growth, survival, and migration, is higher in normal breast tissue in AA women as compared to Caucasian women. Although this has been well established, interventional studies to modulate this pathway have not been performed. We sought to determine if a dietary intervention of caloric restriction could play a role in modulating the IGF-1R pathway to help address the disparities seen in AA breast cancer patients. Methods: On an IRB approved clinical trial, patients were enrolled in a window-of-opportunity clinical trial to assess the effect of caloric restriction, or a 25% reduction of calories from the patients' baseline, on biomarkers in the tumor and blood. Patients recorded their baseline caloric intake for 3-5 days and were then instructed on a target calorie intake for the remainder of the diet. The patients remained on the dietary intervention for 2-12 weeks. Participants had anthropometric evaluation, blood draws to evaluate serum cytokines, tissue collection, and quality of life surveys collected at baseline and completion of diet which was the morning of surgery. Results: We enrolled 19 breast cancer patients between the years 2016 and 2018. The average age of the patients at the time of enrollment was 58 years old with 47% AA and 53% Caucasian. The patients were on the trial for an average of 19 days. Patients lost an average of 4.91 lbs during the trial, with AA patients losing an average of 5.18 lbs and Caucasians losing an average of 4.68 lbs. To determine the importance of IGF-1R in the disparities seen in AA women, we looked at two hundred cytokines from serum samples in patients who underwent caloric restriction. Analysis of the cytokine array data showed that nine cytokines involved in regulating or modulation by the IGF-1R pathway were significantly (p&amp;lt;0.05) downregulated in AA women post-diet. Compared to Caucasian women, AA women showed a significant decrease in IL-12p40 (~51%), VCAM1 (16.8%), IL-2 (28.72%), IL-2Rb (40.81%), CCL28 (36%), ERBB3 (26.6%), PAI-1 (9.4%), Axl (36%) and PDGF-AB (12%). Conclusion: These results demonstrate that caloric restriction significantly downregulated members of the IGF-1R pathway in the AA community. Since this pathway is notably dysregulated in AA patients, an integrated approach, one incorporating dietary changes to alter key pro-survival pathways, should be further investigated to narrow the disparity in breast cancer outcomes in AA patients. Citation Format: Samantha Okere, Anuradha A. Shastri, Kamryn Hines, Pramila Anne, Rita Murphy, Tiziana DeAngelis, Adam Berger, Alliric Willis, Melissa Lazar, Edith Mitchell, Nicole Simone. Caloric restriction may decrease health disparity in AA breast cancer patients due to significant downregulation of the IGF-1R pathway in a window-of-opportunity clinical trial [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-096.

Mental Well-Being Of Patients With Stages 0-2 Of Knee Osteoarthritis After Orthovoltage Radiotherapy: Open Randomized Trial Evaluating Quality Of Life

Objective — To compare the mental component of the quality of life (QOL) in patients with stages 0-2 of knee osteoarthritis (OA) sensu Kellgren-Lawrence after treatment either with symptomatic slow-acting drugs for osteoarthritis (SYSADOA) and non-steroidal anti-inflammatory drugs (NSAIDs), or with SYSADOA, NSAIDs and orthovoltage radiotherapy (OVRT), in an open randomized study, using the SF-36 questionnaire. Material and Methods — The patients were randomly assigned to two groups: SYSADOA and SYSADOA+OVRT. Patients were asked to fill out the SF-36 questionnaire. The results were presented in the form of a mean of scores on each of four QOL survey sections for both groups at five time points: before and immediately after the treatment, at 6 months, 12 months and 36 months. Results — The groups were similar in their baselines characteristics (age, gender, body mass index [BMI], pain syndrome duration). Being initially equal, QOL improved by the end of treatment in both groups with statistically significantly greater improvement after OVRT. Further on, the QOL indicators in the OVRT group kept increasing, peaking at 12 months for social role functioning (SRF), emotional role functioning (ERF) and vitality (V), and at 36 months for mental health (MH). In contrast, the patients of SYSADOA/NSAIDs group were experiencing a decrease in their mental component over the analyzed period of time, and the levels of three out of four indicators at 36 months were even lower than their initial values. Conclusion — Adding OVRT to the standard SYSADOA/NSAIDs treatment for knee OA of stages 0-2 ensured improved mental well-being of patients for at least three years.

Housing and identity expression among in‐situ urbanised rural residents in China

AbstractHousing is an important source of identity expression, but the influence of different housing attributes remains underexplored. Drawing on the ‘4Cs theory of housing’ (housing cost, housing conditions, housing consistency and housing context), this study established an analytical framework linking housing to in‐situ urbanised rural residents′ identity expression in China. Using data from the 2018 Urbanization and Quality of Life Survey, the results show that different housing dimensions are significantly related to identity expression but in different ways. Specifically, housing conditions are primarily associated with urban identity, whereas housing consistency and housing context are significantly related to local identity. Moreover, the relationship between housing and identity expression varies between newly urbanised areas and potential sites for urbanization. The research contributes to understanding the relationship between housing and identity by further clarifying how various housing attributes affect identity expression in the context of urbanising China.

Quality-of-Life Scores for Nursing Home Residents Are Stable Over Time: Evidence From Minnesota

ObjectiveQuality of life (QoL) is a multidimensional construct that assesses the quality of lived experience in nursing homes (NHs). QoL is directly important to NH residents. However, QoL is only publicly reported in a few states, partly because of concerns regarding measure stability. To address these concerns, we tested the stability of Minnesota’s NH QoL measure over one year.Study DesignA pair of two-year cohorts of Minnesota NH residents who responded to the 2012-2013 (N = 4,448) or 2014-2015 (N = 4,644) QoL survey in consecutive years. Stability was measured using the intra-class correlation (ICC) from hierarchical linear models. Models were fit without any covariates, then individual and facility-level characteristics were added. Principal Findings: Overall QoL had ICCs of 0.602 and 0.614 in the earlier and later cohort respectively. Domain-level ICCs were lower, ranging from 0.374 (positive mood) to 0.571 (lack of negative mood) in the 2012-2013 cohort, with similar trends for the later cohort. Adjusting for important covariates reduces the ICCs slightly, but they remained at 0.565 or higher for the summary score.ConclusionsPerson-reported summary QoL has adequate stability over a period of one year. Our results provide impetus to assess and report NH QoL on a national level. Consumers can be confident that if an NH’s QoL scores improve from year to year, that represents a real improvement, and not just the scores varying due to which residents were sampled. Some caution, however, is warranted when presenting facility-level domain scores, as these are less stable.

Cultivating a Patient-Centered Environment (CAPE): Renovations in Long-Term Chronic Care

Achieving institutional goal of full, person-centered care was encumbered by an outdated structural “hospital model” at one long-term care facility that undertook building renovations, transforming long hallways into “neighborhood” of compact households. Quality of Life Survey and Long-term Care Minimum Data Set generated data at baseline and 1-year follow-up, comparing renovated(RU) and non-renovated unit(NRU) residents (n=36) to evaluate achievement of person-centered care. RU residents indicating they could “eat when I want” increased 75% to 81% at follow-up and decreased 17% for NRU residents. Sixty-seven percent of RU residents reported bathing “when they want” in contrast to 40% of NRU residents. Most RU residents agreed, “staff act on my suggestions.”More RU residents (68% vs 53%) agreed: “I spend time with other like-minded residents” and more RU residents (86% vs 43%) reported opportunity to explore new skills, interests. RU residents more often reported (50% vs 37%) “people ask for my help or advice.” Similar differences were observed with “it is easy to make friends here,” 67% RU residents responding affirmatively. RU residents reporting “feeling down” improved, moving from 46% to 50% disagreeing with this item with while increased number of NRU residents (18% to 22%) reported “feeling down” at follow-up.Improvement with independent performance of bed mobility, transfer, walking, and dressing among RU residents was observed while NRU residents had decreased percentages of independence. Evaluation of resident outcomes demonstrated improvement with personal choice, activities, personal relationships, functional independence and mood. Physical unit renovations appear to enhance implementation of person-centered care model.

Developing and evaluating non-invasive healthcare technologies for a group of female participants from a socioeconomically disadvantaged area

When compared to the general population, socioeconomically disadvantaged communities frequently experience compromised health. Monitoring the divide is challenging since standardized biomedical tests are linguistically and culturally inappropriate. The aim of this study was to develop and test a unique mobile biomedical testbed based on non-invasive analysis, as well as to explore the relationships between the objective health measures and subjective health outcomes, as evaluated with the World Health Organization Quality of Life survey. The testbed was evaluated in a socioeconomically disadvantaged neighborhood in Malmö, which has been listed as one of the twelve most vulnerable districts in Sweden. The study revealed that compared to conventional protocols the less intrusive biomedical approach was highly appreciated by the participants. Surprisingly, the collected biomedical data illustrated that the apparent health of the participants from the ethnically diverse low-income neighborhood was comparable to the general Swedish population. Statistically significant correlations between perceived health and biomedical data were disclosed, even though the dependences found were complex, and recognition of the manifest complexity needs to be included in further research. Our results validate the potential of non-invasive technologies in combination with advanced statistical analysis, especially when combined with linguistically and culturally appropriate healthcare methodologies, allowing participants to appreciate the significance of the different parameters to evaluate and monitor aspects of health.

Pharmacokinetic and pharmacogenomic analysis of low-dose afatinib treatment in elderly patients with EGFR mutation-positive non–small cell lung cancer

PurposeAn increasing number of advanced non–small cell lung cancer (NSCLC) cases are being reported in the ageing population. However, studies on the use of afatinib in elderly patients are scarce. We conducted a prospective multicentre, single-arm, and open-label phase II trial for low-dose afatinib (30 mg/day) use in elderly patients with NSCLC with EGFR mutation to assess quality-of-life (QOL) and pharmacokinetic (PK)/pharmacogenomic (PGx) parameters. Patients and methodsThe primary end-point was the objective response rate (ORR), and the planned number of registered cases was 35, with a threshold ORR of 50%, an expected ORR of 75%, α of 0.05, and β of 0.1. Secondary end-points were progression-free survival (PFS), overall survival (OS), the incidence rate of adverse events (AEs), QOL survey (FACT-L), and trough plasma concentration of afatinib at steady state (Css) and at the occurrence of clinically significant AEs. ResultsThe median age of the patients was 79 years. The ORR was 80.0% and the disease control rate was 91.4%. The median PFS and OS were 15.6 and 29.5 months, respectively. Four patients discontinued because of AEs. Treatment-related death was not observed. No significant change in QOL was observed at baseline and after 4, 8, and 12 weeks. Css was comparable with those in previous reports and was significantly higher in patients with grade 3 AEs. Direct correlations between afatinib treatment and PGx profiles were not observed. ConclusionsAn afatinib starting dose of 30 mg/day could be an effective and safe treatment option for elderly patients.

Quality of Life Surveys as a Method of Obtaining Data for Sustainable City Development—Results of Empirical Research

Citizens are beginning to play a key role in the development of the smart city concept, providing a wealth of information for the sustainable development of cities. For this research, we planned and conducted empirical studies to examine the areas influencing the quality of life from the point of view of municipalities. A questionnaire form was developed and a survey was conducted on a sample of 84 municipal offices in Poland. We tabulated, statistically processed and analysed the results and thoroughly investigated the areas influencing the quality of life, their impact and importance. We determined which areas of the city are included in municipal research and checked whether there was a need to expand these areas. We found that the people responsible for research in municipal offices are aware that the quality of life is influenced by many areas and conditions. However, these people only choose selected areas for research and have a problem with indicating what can be extended to them. At the end of the article, the limitations of the conducted research are indicated and the directions for further research are proposed.

Transitioning Eligible Patients from Warfarin to a Direct Oral Anticoagulant: A Prospective Quality Improvement Study

Background:Direct oral anticoagulants (DOACs) are rapidly replacing alternative agents as the preferred choice for anticoagulation. With extended time on the market and expanded guidelines for indications for use, they are now more accessible and affordable. Qualifying patients previously treated with warfarin for long-term anticoagulation may benefit from transitioning to a DOAC. In this prospective quality improvement study, we seek to identify eligible patients and transition them from warfarin to DOAC via shared decision-making and a multidisciplinary approach. Additionally, we will assess changes in quality of life (QOL) through a validated survey.Methods:Identify patients currently on warfarin who are eligible for transition to a DOAC. Eligibility criteria include patients with age >18 years old. Exclusion criteria includes pregnancy, BMI >50 kg/m2, CrCl <15 L/min, patients receiving anticoagulation for APLS or for mechanical heart valves. With the aid of our pharmacy team, we then ensure long-term medication affordability prior to transition. Eligible patients complete a QOL survey pre-transition and 3 months post-transition. The QOL survey is the validated Anti-Clot Treatment Scale (ACTS), which is a 15 question survey which includes a Burden scale composed of 12 questions and a Benefit scale composed of 3 questions and each question is scored from 1 to 5 (1=not at all, 2=a little, 3=moderately, 4=quite a bit, 5=extremely). The Burden scale is reverse scored so that higher ACTS Burden scores indicate greater satisfaction for a score range of 12-60. The Benefit scale is scored conventionally for a score range of 3-15. The Total score is calculated by the addition of the Burden scale and Benefit scale for a score range of 15-75. Paired T-tests were conducted on the Burden scale, Benefit scale, and Total score using GraphPad Prism version 7 (GraphPad Software, La Jolla, CA). P-values were two-tailed, with a p<0.05 considered statistically significant.Results:25 patients out of 60 were identified as eligible for DOAC transition. Total score, Burden scale, and Benefit scale mean values were 49.5, 39.5, 10 for warfarin and 66.8, 53.5, and 13.3 for DOAC, respectively. Preliminary conducted analysis revealed statistically significant improvements in Total, Burden, and Benefit scores with p-values of 0.0046, 0.0075, and 0.0319 and mean improvements of 17.3, 14, and 3.25, respectively.Conclusion:Transitioning patients from warfarin to a DOAC has been found to decrease both patients' sense of burden while also improving their sense of benefit, as evidenced by the QOL survey analysis. Transitioning patients from warfarin to a DOAC has the potential to decrease need for routine INR monitoring, dietary limitations, and fewer drug interactions. Additionally, it improves patient satisfaction with their healthcare and reduces utilization of healthcare resources. [Display omitted] DisclosuresNo relevant conflicts of interest to declare.

Quality of Life and Karnofsky Performance Status in Patients with Relapse or Refractory Primary Central Nervous System Lymphoma during Phase I/II Study of Tirabrutinib

Quality of Life and Karnofsky Performance Status in Patients with Relapse or Refractory Primary Central Nervous System Lymphoma during Phase I/II Study of Tirabrutinib

The midterm effect of exercise capacity and quality of life in adult patients who underwent hybrid transthoracic device closure of ventricular septal defects

ObjectiveTo investigate the midterm effect of exercise capacity and quality of life (QoL) of adult patients who underwent transthoracic device closure of ventricular septal defects (VSDs) and explore the gap in the quality of life and cardiopulmonary function between those patients and healthy people.MethodsFrom January 2010 to January 2015, 58 adult patients who underwent transthoracic device closure of VSD and 60 healthy people matched for age and sex were selected and analyzed. Echocardiography and exercise capacity tests were performed, and the MOS 36-item short-form health survey (SF-36) was used to investigate the changes in QoL.ResultsFifty-five patients completed the study. At the 1-year and 5-year follow-ups, the patients’ left ventricular end-systolic and end-diastolic diameters were smaller than those preoperatively, but the difference was not statistically significant. In the QoL survey, the patients’ scores after treatment showed a trend of improvement, and the improvement effect was not transient. After VSD closure, the difference in QoL between the patients and the control group was significantly reduced. However, in the exercise capacity test, the patients’ results were still worse than those of the controls.ConclusionTransthoracic device closure of VSDs is significant in improving adult patients’ QoL at the midterm follow-up, reflected in their physical and psychological fields. However, they are still unable to achieve normal levels of peak exercise ability. Therefore, further exploration and interventions are worth considering.

Patient-Reported Quality of Life Outcomes After Integrating Exclusive Liquid Meal Replacement in Patients With Head and Neck Cancer Undergoing Chemoradiation: Results From a Phase II Study

<h3>Purpose/Objective(s)</h3> Preventing malnutrition during chemoradiation (CRT) for head and neck cancer (HNC) is crucial for treatment adherence, minimizing treatment-related complications, and maximizing quality of life (QOL). We sought to assess patient-reported QOL outcomes after integrating exclusive liquid meal replacement with Soylent, a novel meal replacement agent, in patients with HNC undergoing CRT. <h3>Materials/Methods</h3> Patients undergoing definitive or adjuvant concurrent CRT for locally advanced HNC enrolled on our single-institution, prospective phase II protocol evaluating nutritional replacement with Soylent. Patients who reached 5% body weight loss during CRT were transitioned to Soylent meal replacement for all nutritional needs. Patients who reached 10% body weight loss were recommended for gastrostomy tube placement. The University of Washington QOL (UW-QOL) and the Functional Assessment of Cancer Therapy-Head and Neck (FACT-H&N) questionnaires were used to assess patient-reported QOL prior to the receipt of CRT (baseline), as well as at 1, 3, 6, 12, and 18 months following conclusion of CRT. Higher scores indicated better QOL for both assessments. Paired t-test or Wilcoxon signed-rank test was applied to assess whether differences between scores at each time point and baseline exist. Multiple testing was addressed via Benjamini-Hochberg procedure with a false discovery rate threshold of 0.2. <h3>Results</h3> Of the 41 patients who completed evaluable QOL surveys, 33/41 (80%) reached the 5% weight loss threshold and 32/33 (97%) were transitioned to Soylent. Subsequently, 11/33 (33%) on Soylent reached the 10% weight loss threshold, but only 1/11 (9%) received a gastrostomy tube. The nadirs for overall and health-related UW-QOL were reached at 1 month and rebounded to exceed baseline by 6 months. The mean overall UW-QOL score was 71 at baseline compared with 62, 69, 77, 73, and 80 at 1, 3, 6, 12, and 18 months, respectively. Comparing individual UW-QOL domains from baseline to 18 months, significant differences were found in only two domains. Saliva scores decreased from 91 to 73 (adjusted <i>P</i> = 0.02) whereas anxiety scores increased from 51 to 81 (adjusted <i>P</i> = 0.11). FACT-H&N survey scores were reduced from 32 at baseline to 20 at 1 month (adjusted <i>P</i> < 0.001) and 26 at 3 months (adjusted <i>P</i> < 0.001), but increased to 29, 30, and 27 at 6, 12, and 18 months, without significant differences as compared to baseline (adjusted <i>P</i> > 0.57 for all). <h3>Conclusion</h3> This study's results reveal encouraging QOL outcomes from exclusive liquid meal replacement with Soylent, which appear potentially comparable with QOL outcomes from contemporary de-escalation trials in HNC pending further direct comparison. Soylent liquid meal replacement with aggressive dietary monitoring appears to be a promising approach for maximizing patient-reported QOL after conventional, concurrent CRT.

Pediatric Patient-Reported Quality of Life Before and after Radiotherapy: A Prospective Registry Study

Pediatric Patient-Reported Quality of Life Before and after Radiotherapy: A Prospective Registry Study

The Cerene Cryoablation Device for the Treatment of Heavy Menstrual Bleeding: 36-Month Outcomes from the Clarity Study

<h3>Study Objective</h3> To evaluate the safety and effectiveness of a novel cryoablation device (<i>Cerene Cryotherapy Device, Channel Medsystems, Berkeley, CA)</i> in premenopausal women with heavy menstrual bleeding (HMB) due to benign causes. <h3>Design</h3> A prospective, multi-center, single-arm, open-label study. <h3>Setting</h3> 8 sites in the USA, 1 in Mexico, 2 in Canada. <h3>Patients or Participants</h3> 242 Intent-to-Treat women, 25 to 50 years of age, with HMB, uterine sound ≤10 cm, and endometrial cavity between 2.5 to 6.5 cm. <h3>Interventions</h3> The Cerene single-use disposable device, delivered a 2.5-minute cryoablation of the endometrium. Analgesia and local anesthesia were administered per investigator discretion: 97% of subjects received a paracervical block with or without oral medications, 3% IV sedation, and none received general anesthesia. 180 USA treatments were performed in the physician office setting and none in the operating room. Subjects were evaluated through Month 12 and long term at Month 24 and 36. <h3>Measurements and Main Results</h3> 201 women were evaluated at Month 36. 88.6% (178/201) reported amenorrhea, a lighter than normal, or normal period. 91% (182/201) reported no or slight limitations in life activities in their Menorrhagia Impact Quality of Life (QoL) questionnaire. 85% (171/201) reported premenstrual symptoms (PMS) at a low frequency (none, rarely, or sometimes) in their PMS Impact QoL Survey. 84.5% (153/181) of subjects who reported level of satisfaction at the final study visit stated that they were satisfied or very satisfied with their treatment outcome. 7% (17/242) underwent a post ablation intervention for menstrual bleeding. <h3>Conclusion</h3> The Cerene endometrial cryoablation device maintains safety and effectiveness for the treatment of HMB through the long-term study visit at 36 months. It is a global endometrial ablation technique that can be performed consistently in the office setting requiring minimal anesthesia or analgesia.

Validity and reliability of the Mini-Osteoarthritis Knee and Hip Quality of Life scale in Turkish population.

Objectives This study aims to investigate the validity and reliability of the Turkish version of the Mini-Osteoarthritis Knee and Hip Quality of Life (Mini-OAKHQoL) scale developed to assess the quality of life (QoL) in patients with knee and/or hip osteoarthritis.Patients and methods Between May 2018 and May 2020, a total of 83 patients (11 males, 72 females; mean age: 58.1±10.0 years; range, 39 to 81 years) with knee and/or hip osteoarthritis were included. Demographic, clinical, and survey data (Mini-OAKHQoL, Nottingham Health Profile, Short Form-36, Western Ontario and McMaster Universities Osteoarthritis Index, Lequesne Index, and Visual Analog Scale of pain intensity) were recorded. Missing data, floor effect, and ceiling effect were calculated. For reliability analysis, internal consistency and test-retest reliability were discovered. Face, content, convergent, and divergent validities were applied.Results Among the patients, 52 (62.65%) had knee osteoarthritis, 26 (31.32%) had hip osteoarthritis, and five (6.02%) had both. Mini-OAKHQoL had a good face and content validity. The average item completion rate was 96.9%, with the time needed to perform was about 4 min. None of the subscales of Mini-OAKHQoL presented floor or ceiling effect, with a good range of responses. The Cronbach alpha coefficients and intraclass correlation coefficient (ICC) analysis of the subscales ranged from 0.927 to 0.676 and 0.987 to 0.843, respectively. Regarding convergent validity, the physical activities, mental health, and pain subscales of Mini-OAKHQoL had moderate to high correlations with the topic-related subset of the other QoL surveys. There were no or weak correlations between Mini-OAKHQoL and non-QoL parameters, indicating its divergent validity.Conclusion The Turkish version of Mini-OAKHQoL is a valid, reliable, simple, practical, accurate, completable, comprehensive, and disease-specific self-report instrument to assess QoL in patients with knee and/or hip osteoarthritis.

Social cohesion and quality of life in Bandung: A cross sectional study.

In Bandung, Indonesia, urban expansion, rapid economic growth, and population increase present enormous challenges to the maintenance of a high quality of life (QOL) for its citizens. Moreover, income distribution in the city has become more unequal, thereby threatening social cohesion. Such situations led us to investigate the states and correlation of social cohesion and QOL in Bandung. In 2018, we conducted a questionnaire survey of social cohesion and QOL using 13 and 18 question items, respectively. We employed the Rasch model analysis to analyze the logit measures of 752 responses. The results revealed that the population of Bandung has high social cohesion and decent QOL. Our findings suggest that in Bandung QOL is significantly correlated with social cohesion, therefore strategies that seek to enhance social cohesion may be beneficial to improve the QOL.

Impact of Clostridioides difficile infection on patient-reported quality of life.

We investigated the quality of life (QoL) of patients hospitalized with C. difficile infection (CDI). Prospective survey study. US tertiary-care referral center, acute-care setting. Adults hospitalized with a diagnosis of CDI, defined as ≥3 episodes of unformed stool in 24 hours and a positive laboratory test for C. difficile. We surveyed patients from July 2019 to March 2020 using the disease-specific Cdiff32 questionnaire and the generic PROMIS GH survey. We compared differences in Cdiff32 scores among demographic and clinical subgroups (including CDI severity, CDI recurrence, and various comorbidities) using 2-sample t tests. We compared PROMIS GH scores to the general population T score of 50 using 1-sample t tests. We performed multivariable linear regression to identify predictors of Cdiff32 scores. In total, 100 inpatients (mean age, 58.6 ±17.1 years; 53.0% male; 87.0% white) diagnosed with CDI completed QoL surveys. PROMIS GH physical health summary scores (T = 37.3; P < .001) and mental health summary scores (T = 43.4; P < .001) were significantly lower than those of the general population. In bivariate analysis, recurrent CDI, severe CDI, and number of stools were associated with lower Cdiff32 scores. In multivariable linear regression, recurrent CDI, severe CDI, and each additional stool in the previous 24 hours were associated with significantly decreased Cdiff32 scores. Patients hospitalized with CDI reported low scores on the Cdiff32 and PROMIS GH, demonstrating a negative impact of CDI on QoL in multiple health domains. The Cdiff32 questionnaire is particularly sensitive to QoL changes in patients with recurrent or severe disease.

Spatio-temporal patterns and changes in environmental attitudes and place attachment in Gauteng, South Africa

ABSTRACT In this study, we employed a number of geospatial techniques to examine the spatio-temporal patterns and changes of environmental attitudes and place attachment values in the Gauteng province of South Africa. The data were obtained from the Gauteng City Region Observatory’s Quality of Life Survey collected at three separate points in time, namely 2013, 2015, and 2017. Results indicated that wards (smallest administrative and analysis units) located on the urban periphery of Gauteng, which are generally less affluent, largely held more negative environmental attitudes and place attachment values during the three time periods. In contrast, centrally located wards, which are generally more affluent, expressed more positive environmental attitudes but less place attachment values, especially in 2017. The findings of this research not only highlight the complex spatio-temporal distribution of environmental attitudes and place attachment values throughout Gauteng but also emphasize the need for spatially targeted state interventions for future environmental planning within the province.

Evaluation Of The Use Of Probiotics In Patients With Irritable Bowel Syndrome

Abstract Background Irritable bowel syndrome (IBS) is one of the most prevalent functional gastrointestinal disorders (FGIDs), afflicting around 11% of the adult population worldwide. Despite the availability of a great variety of therapeutic options, treatment satisfaction is suboptimal for both the patient and the doctor. There is good evidence that the microbiota is a predominant factor in the IBS pathophysiology. Probiotics confers a health benefit on the host associated with modulation of the microbiota . (Dorssman and Hasler, 2016) Aim of the work The aim of the current study is to evaluate the role of probiotics in the improvement of quality of life via Irritable Bowel Syndrome – Quality of Life survey (IBS-QOL). Patients and methods This Double armed clinical trial was conducted on IBS patients, who fulfill ROME IV criteria and the IBS diagnostic questionnaire in Egyptair hospital outpatient clinic, Cairo, Egypt between March and December 2019. Data of the patient, with suspected IBS during the study period, were reviewed and the patients who fulfilled the inclusion criteria were enrolled into this study. The patients who fulfilled the inclusion criteria were followed up after 4 weeks from the first visit. Results The study includes 90 patients divided to 2 equal groups the first were prescribed probiotic and itopride medication and the second were prescribed itopride only. There was a highly significant improvement in the overall QOL terms (dysphoria, interaction with activity, body image, health worry, food avoidance, social reaction, sexual activity and relationship scores) for group 1 with overall mean score (60.64±7.77) at baseline and (81.54±7.87) at 4 weeks (p value &amp;lt;0.001). For group 2 there were high significance for some terms (dysphoria, interference with activity, body image and health worry scores) while other terms (food avoidance, social reaction, sexual activity and relationship) showed no significant changes, the overall score was of no significance too (p value 0.18). Comparing the 2 groups that there was a high significant difference between the 2 groups regarding the overall QOL at 4 weeks (p value &amp;lt;0.001), but there were no significance between the 2 groups regarding; Body image (p value 0.16), food avoidance (p value 0.95) and sexual scores (p value 0.14). Conclusion Our data suggest that probiotics are useful for the improvement of quality of life of the IBS patients.