Quality Of Life Research Articles

An integrated model approach for disaster impact reduction: lessons from a slow onset disaster in Chile

Purpose The prolonged drought in Chile’s Coquimbo region has created a permanent state of emergency, forcing the state to spend millions each year distributing drinking water to rural communities. The purpose of this article is to detail a study focused on optimizing the supply of drinking water through trucks in the 15 communes of the region and how the problem was faced in a context of a slowonset disaster. Design/methodology/approach A geo-referenced census and optimization analysis of the 5.541 households that receive drinking water was conducted to determine the feasibility of removing trucks from the system. To generate a greater reduction in distribution costs, it was suggested to incorporate water distribution infrastructure projects, changing the concept of ‘expenses’ to ‘investment’. Findings The study was born out of the concern for the increased demand for drinking water from rural areas. The proposed and implemented framework allowed an additional 20% reduction in the initial transportation costs; this confirmed the assumption that the proposed optimization model alone would not offer a robust solution and was complemented and integrated with this type of alternative, forming an “integrated model”. Research limitations/implications The paper has implications for the resilience of territories affected by climate change. Practical implications The methodology can be replicated in other areas where similar interactions occur. Social implications Families impacted by drought can improve their quality of life and reduce distress in the face of the constant emergency. Originality/value This research aims to contribute knowledge from the perspective of a slow-onset disaster where water resources are scarce. It presents a framework where two disciplines converge, resulting in an “integrated model” that, through its implementation, reduces the costs of resource delivery while simultaneously improving the sanitary conditions of the beneficiary families.

Spinal cord stimulation induces Neurotrophin-3 to improve diabetic foot disease.

Low-extremity ischemic disease is a common complication in diabetic patients, leading to reduced quality of life and potential amputation. This study investigated the therapeutic effect of spinal cord stimulation (SCS) on patients with diabetic foot disease and a rat model of diabetic foot injury. SCS was applied to patients with diabetic foot disease, with clinical assessments performed before and after therapy. Blood levels of NGF, BDNF, and NT-3 were determined by ELISA. A rat model of diabetic foot injury was established to validate NT-3's role in SCS therapy. SCS therapy improved the condition of patients with diabetic ischemic foot disease and promoted wound healing in the rat model. NT-3 levels significantly increased after SCS therapy in both patients and rats. Recombinant NT-3 administration improved wound healing and re-vascularization in the rat model, while NT-3 neutralization abrogated SCS's therapeutic effect. SCS improves the condition of patients with diabetic ischemic foot disease by inducing NT-3 production. Both SCS and NT-3 supplementation show therapeutic potential for ameliorating diabetic foot disease.

The Correlation between Self-Efficacy of Hemodialysis Patients with Their Quality of Life

Background: Haemodialysis is often associated with decreased quality of life. Self-efficacy is a perception of patient confidence in ability activities. The correlation between self-efficacy and quality of life in the Indonesian sample is not yet explored in depth. Aim: To determine the correlation between self-efficacy and the quality of life in hemodialysis patients. Methods: Cross-sectional study. About 234 respondents were included. The General Self-Efficacy Scale (GSES) questionnaire has been used to measure self-efficacy, and the World Health Organization Quality of Life (WHOQOL-BREF) was used to measure the respondent's quality of life. Kendall's tau statistical approach was used to determine the correlation between self-efficacy and quality of life. Results: Majority of respondents with high self-efficacy as much as 68.8%, and majority of respondents with moderate and good quality of life as much as 48.3%. A significant correlation between self-efficacy and quality of life (p=0.000) with a correlation coefficient value of 0.491 was found. Conclusion: High level of self-efficacy would be a better quality of life of haemodialysis patients. Improving self-efficacy as a nursing care process is recommended as nursing outcomes in order improve the quality of life of haemodialysis patients. Identify self-efficacy predictor factors of haemodialysis patients are recommended for further research.

Females report worse outcomes than males one year after ventral hernia repair.

To assess sex differences in patient-reported quality of life, pain, and hernia recurrence after adjusting for confounding features of hernia disease in a large national registry one year after ventral hernia repair. Data were analyzed retrospectively from the Abdominal Core Health Quality Collaborative national registry from pre-operatively until one year post-operatively. 3,172 patients undergoing elective ventral hernia repair with 1-year follow-up data were included for analysis after propensity score matching (1:1 match; females: mean [interquartile range] age, 60 [49, 68]; body mass index, 32 [27, 36]; males: age, 60 [52, 68]; 31 [28, 35]. The primary outcome of interest between sexes was the Hernia Related Quality of Life survey (HerQLes), and secondary outcome measures included the Patient-Reported Outcomes Measurement Information System Pain Intensity (PROMIS) short form (3a) score and hernia recurrence. Female sex was associated with worse HerQLes and PROMIS pain 3a scores at 1 year follow up (adjusted mean difference, -2.42, 95% confidence interval (CI) -4.11 to -0.72; p = 0.004; adjusted mean difference, 1.27, 95% CI 0.67 to 1.87; p < 0.001) compared to male sex. Hernia recurrence rates at 1 year were not different between sexes. Females reported worse quality of life and higher levels of pain at 1-year post ventral hernia repair after accounting for age, BMI, hernia width, and baseline quality of life compared to males. There were no differences between females and males with respect to hernia recurrence at 1-year follow-up, and 1 in 5 patients experienced a recurrence at this time point.

Evaluating the effects of exercise protocols in hospitalized onco-hematological patients: a systematic review.

Physical activity is associated with improved functionality, independence and quality of life in cancer patients undergoing active treatment. Exercises can be prescribed to improve patient outcomes. Evaluate the effects of applied exercise protocols on functional capacity, quality of life, fatigue and muscle strength in hospitalized onco-hematological patients compared to conventional treatment. Systematic literature review carried out in PUBMED, EMBASE and Scopus databases with the following descriptors: Hematological neoplasms AND Exercise Therapy AND Hospitalization, in November 2023. Studies with adult inpatients with hematological neoplasms who performed an exercise protocol in the intervention group were included. After applying the eligibility criteria, 9 articles were included in the review, 7 of which were randomized clinical trials and 6 were carried out on transplant patients. The most commonly assessed outcome was functional capacity, followed by muscle strength and quality of life, and ending with an assessment of fatigue. Studies have shown positive results for patients, especially those that combine resistance and aerobic exercise protocols. An exercise protocol for patients with onco-hematological diseases can improve the outcomes analyzed. Aerobic and resistance exercises should be performed, but more studies are needed to assess the time and doses required for each activity.

Relationship between Quality of Life and Swallowing in Hypertensive Individuals with Obstructive Sleep Apnea.

Obstructive sleep apnea (OSA) is closely associated with resistant hypertension (RHTN). Individuals with OSA may have sensory and muscular alterations in pharyngolaryngeal structures, potentially resulting in oropharyngeal dysphagia. One objective of this study was to assess and compare the quality of life (QoL) and swallowing ability of resistant hypertensive patients with and without OSA. Another objective was to evaluate the relationship between QoL and changes in swallowing in patients with RHTN and OSA. This work was an analytical observational study with a cross-sectional design that included resistant hypertensive patients who were undergoing polysomnography (the gold standard exam for the diagnosis of OSA), fiberoptic endoscopic evaluation of swallowing (FEES), dysphagia risk assessment (Eating Assessment Tool - EAT-10) and QoL assessment in swallowing (Swal-Qol). Of the 65 participants, 13 (20%) did not have OSA, 13 (20%) had mild OSA, 18 (27.7%) had moderate OSA, and 21 (32.2%) had severe OSA. Compared with those without OSA, patients with OSA had lower swallowing QoL scores ("burden", "symptoms", and "mental health"). Furthermore, pre premature leakage, onset of the pharyngeal phase in the pyriform sinus, laryngeal penetration, pharyngeal residue and oropharyngeal dysphagia were more prevalent among patients with OSA. Resistant hypertensive patients with OSA have a greater prevalence of changes in swallowing and worse Swal-QoL scores than those without OSA, although such changes were not shown in the EAT-10. In addition, Swal-Qol is related to swallowing safety impairments among these individuals.

Artificial intelligence with counseling on the treatment outcomes and quality of life in periodontitis patients.

To evaluate the effects of artificial intelligence (AI)-assisted dental monitoring (DM) with and without health counseling on the treatment outcomes and oral health-related quality of life (OHRQoL) of patients with periodontitis. Patients with periodontitis were randomly assigned to either an AI group (AI group, n=28), an AI and health counseling group (AIHC group, n=27), or a control group (n=27). All patients underwent nonsurgical periodontal treatment. Patients in the AI and AIHC groups underwent additional AI-assisted DM and AI-assisted DM with oral health counseling, respectively, for 6 months. Data on OHRQoL and periodontal measures were collected at baseline and follow-ups. At 3 months of follow-up, the AI and AIHC groups exhibited a significantly greater reduction in probing pocket depth (mean diff: -0.5 and -0.7) and clinical attachment level (mean diff: -0.5 and -0.6) compared with the control group. At 6 months of follow-up, the AI and AIHC groups exhibited a significantly greater improvement in OHRQoL (mean diff: -4.5 and -4.7) compared with the control group. At 3-month follow-up, the AIHC group exhibited a greater improvement in plaque index (mean diff: -0.2) and OHRQoL (mean diff: -4.3) compared with the AI group. AI-assisted DM can be used to remind patients with periodontitis of their oral hygiene at home and effectively improve their periodontal measures and long-term OHRQoL. Gum disease is a common problem, but new technology could help. In this study, researchers looked at how AI affects gum health and quality of life (QoL). The researchers divided participants into 3 groups. One group used an AI system to monitor their gums at home. Another used AI plus got health advice. The third did not use any special technology. After 3 and 6 months, the AI groups had healthier gums, with less deep pockets and better gum attachment, compared to the group without AI. The group that also got health advice saw even greater improvements, like cleaner teeth and a bigger boost to their QoL. This is exciting because gum disease is tricky to manage alone. The AI system seems to help by reminding people to care for their teeth and gums. With expert guidance, the AI becomes an even more powerful tool for improving long-term oral health and well-being. This study shows how new technologies like AI could transform how we approach common health problems. By providing personalized support, AI can empower people to better manage their own health, leading to better outcomes.

Yoga-Based Group Intervention for Inpatients with Schizophrenia Spectrum Disorders-Feasibility, Acceptability, and Preliminary Outcomes of a Rater-Blinded Randomized Controlled Trial.

The efficacy of yoga as an adjunctive treatment for schizophrenia spectrum disorders (SSD) has garnered interest. While yoga may positively influence various symptom domains, further investigation is needed due to the limited number, quality, and generalizability of studies. This study assessed the feasibility and acceptability (primary outcome) of a yoga-based group intervention (YoGI) developed in a participatory approach and explored its preliminary effectiveness. In addition to the primary outcomes, this preregistered randomized controlled trial examined rater-blinded general psychopathology, positive- and negative symptoms, and self-rated depression, anxiety, stress, body mindfulness, mindfulness, psychological flexibility, cognition, social functioning, quality of life, and medication regime at baseline and postintervention as secondary outcomes. Fifty inpatients with SSD received either TAU (n = 25) or YoGI + TAU (n = 25) for four weeks. Outcomes showed 95% protocol adherence of YoGI, feasibility, and retention rates of 91% and 94%, respectively, and a dropout rate of 6%. ANCOVA revealed significant between-group postintervention improvements for YoGI + TAU in positive symptoms, depression, cognitive fusion, and a mindfulness subscale. Medium-to-large pre- to postintervention effects were found for body mindfulness, positive, negative, and general psychopathology, cognitive fusion, depression, anxiety, stress, quality of life, and attention in YoGI + TAU, while within-group changes were consistently smaller in TAU. No severe adverse events were reported. This trial supports the feasibility and acceptability of YoGI for inpatients with SSD and provides preliminary evidence of YoGI's benefits beyond TAU. Further robust, multicentric RCTs are warranted to deepen our understanding of YoGI's therapeutic potential and inform clinical interventions for SSD.

TREINO COGNITIVO MOTOR NO EQUILÍBRIO FUNCIONAL E COGNIÇÃO DE IDOSOS: UMA REVISÃO BIBLIOGRÁFICA

With the aging population, the preservation of cognitive abilities and functional balance in elderly individuals has emerged as a critical issue for maintaining autonomy and quality of life in this population. The practice of activities that combine cognitive and motor stimuli, known as cognitive-motor training, has been suggested as an effective strategy to mitigate the physical and cognitive declines associated with aging. In light of this, the present study aims to analyze the effects of cognitive-motor training on functional balance and cognition in the elderly, based on a literature review. The methodology adopted was a literature review using scientific databases such as Google Scholar and the CAPES Periodicals Platform to select articles addressing the impact of cognitive activities combined with physical exercises on the balance and cognitive abilities of elderly individuals. The main results suggest that cognitive-motor training has positive effects on functional balance, enhancing postural stability and mobility in the elderly. These benefits directly impact the reduction of fall risks, a determining factor for quality of life in older age. Additionally, cognitive-motor training was found to contribute to improvements in memory, attention, and mental processing, highlighting the potential of this intervention for maintaining cognition in elderly individuals. However, the review identified some important limitations, as many of the studies analyzed were conducted in specific contexts, which may limit the generalization of results to different profiles of elderly individuals and environments. Therefore, future research should explore the diversity of approaches and adapt protocols to different realities, seeking to validate the observed effects across a broader range of conditions. It is concluded that cognitive-motor training represents a valuable strategy for promoting balance and cognition in the elderly, potentially contributing to the maintenance of autonomy and quality of life. From this review, the importance of developing personalized interventions and investigating new methodologies that maximize the benefits of cognitive-motor training is emphasized, consolidating it as an effective and safe practice in elderly health care.

Effects of multidisciplinary therapy on energy balance, inflammation, and metabolic diseases in adolescents with obesity: A narrative review.

Obesity is a consequence of multiple factors, including genetics, lifestyle and nutritional choices, physical activity, sleep duration, screen time, and mood disorders. These behavioral elements can impair the regulation of energy balance and obesity management that link obesity to a constellation of chronic conditions that lead to a high prevalence of cardiometabolic risk factors, metabolic syndrome, and nonalcoholic fatty liver disease. Multidisciplinary therapy is defined as an approach delivered by a multidisciplinary-trained health team covering at least two components of behavior, physical activity/exercise, dietary habits, and/or psychological counseling associated with clinical interventions. This narrative review summarizes the effects of multidisciplinary therapy on neuroendocrine regulation of energy balance, inflammatory biomarkers, cardiometabolic risk factors, metabolic syndrome, nonalcoholic fatty liver diseases, behavior, and quality of life. We found that multidisciplinary therapy, including medical, nutritional, exercise, and behavioral counseling, and/or education, was useful for addressing outcomes such as visceral adiposity, neuroendocrine regulation of energy balance, inflammatory biomarkers, cardiometabolic risk factors, nonalcoholic fatty liver disease, and metabolic syndrome. The effects were mediated by improvements in neuroendocrine regulation of energy balance, downregulation of the pro-inflammatory states, and a reduction in comorbidities. Multidisciplinary therapy also improved mood disorders and quality of life.

The Relationship Between Loneliness, Social Isolation, and Inflammatory Bowel Disease: A Narrative Review.

There is clear evidence that loneliness and social isolation have profound health consequences. Documenting the associations of loneliness and social isolation with inflammatory bowel disease (IBD) symptoms, disease severity, and treatment outcomes could meaningfully improve health and quality of life in patients with IBD. The purpose of this narrative review was to synthesize the empirical evidence on the associations of loneliness and social isolation with IBD symptoms, disease severity, and treatment outcomes. Articles were identified through systematic database searches. Quantitative studies that enrolled patients with IBD were included if they examined one of the following outcomes: (a) loneliness or social isolation or (b) IBD-related symptoms, disease severity, or treatment outcomes. We identified 1,816 articles after removing duplicates. Of the 18 studies that met the inclusion criteria, 15 were cross-sectional and 3 were longitudinal. Overall, studies found that loneliness was associated with greater disease activity, functional gastrointestinal symptoms, IBD illness stigma, depressive symptoms, daily IBD symptom burden, reduced resilience, and poorer quality of life. Social isolation was associated with higher prevalence of IBD hospitalizations, premature mortality, and depression. Findings suggest that loneliness and social isolation are associated with poorer health and quality of life in patients with IBD. Prospective cohort studies examining the biobehavioral mechanisms accounting for the associations of loneliness and social isolation with IBD-related outcomes are needed to guide the development of psychological interventions for individuals living with IBD.

Psychometric properties of the Maladjustment Inventory in a Spanish clinical and student sample.

The various systems of diagnosis and classification of mental disorders underline the need to evaluate the interference caused by the different disorders in a person's daily life. The Maladjustment Inventory (MI) evaluates the impairment in the individual's functioning in a brief and self-applied way, through six items. The objective of this research was to explore the psychometric properties of the MI scores through two studies, one with a Spanish clinical sample (Study 1) and another with a Spanish university students' sample (Study 2). The total sample was made up of 928 participants (81.1% women, n = 495 clinical sample). Descriptive analyses, exploration of internal structure and reliability, exploratory and confirmatory factor analyses, relationship with other variables (quality of life, anxiety, depression, neuroticism and extraversion), and percentiles and T-scores were performed. The results showed good psychometric properties of the MI, with a good fit model for one factor solution in both samples, Cronbach's alpha coefficient of 0.84-88, and evidence of validity based on the relationship with other variables. The good psychometric properties of the MI, together with its brevity, make it a recommended instrument for the evaluation of interference in both clinical and research contexts.

Evaluation of the Aral Region Adolescent Nutrition with the FFQ_KZ Questionnaire

ABSTRACT The rapid drop in the Aral Sea’s level since the 1960s has resulted in an environmental disaster and major shifts in quality of life. The research aims to determine the eating habits of adolescents from 11 to 17 years old living in the Aral Sea Basin by using an FFQ questionnaire. The respondents’ diets were found to be unbalanced due to a shortage of proteins, polyunsaturated fatty acids, and complex carbohydrates, with a predominance of easily digestible carbohydrates and plant proteins. The study highlights the need for educational efforts to increase awareness of the consequences of poor nutrition.

Parental and Pediatric Perspectives during the Cancer Trajectory: A Systematic Review

Background: The cancer journey is a complex and emotionally challenging experience for both children diagnosed with cancer and their parents. Understanding the perspectives of both groups can provide critical insights into improving care, psychological support, and overall quality of life during treatment and survivorship. Objectives: This systematic review aims to synthesize existing literature on the perspectives of both pediatric cancer patients and their parents throughout the cancer trajectory, focusing on emotional, psychological, and social aspects. It seeks to highlight key themes and identify gaps in research for potential future studies. Methods: A comprehensive search was conducted across PubMed, C.I.N.A.H.L., PsycINFO, and Scopus for studies published between 2013 and 2023. Eligible studies included those addressing pediatric patients with cancer, their parents, and their experiences during diagnosis, treatment, and post-treatment phases. The studies were critically appraised using the P.R.I.S.M.A. guidelines, and thematic analysis was applied to extract key findings. Results: A total of 6 studies met the inclusion criteria, revealing both parents and children experience anxiety, fear, and uncertainty, especially during diagnosis and treatment initiation. Parental distress often mirrors or exceeds the child’s emotional challenges. Parents seek clear and transparent communication with healthcare providers, while children often desire age-appropriate information about their condition and treatment. Parents and children adopt a range of coping mechanisms, including reliance on healthcare professionals, family support, and religious or spiritual beliefs. Parents express concern about the long-term impact of treatment on the child's health, education, and social life. Pediatric patients often focus on maintaining normalcy, friendships, and school participation during treatment. Both groups emphasize the importance of emotional and psychological support from healthcare teams, family, and peer support networks during the cancer journey. Conclusion: The review underscores the profound emotional and psychological burden of cancer on both pediatric patients and their parents. Effective communication, individualized support systems, and addressing the unique needs of both parties are critical for improving overall well-being during the cancer trajectory. Further research is needed to explore interventions that can mitigate distress and enhance coping strategies for parents and children.

Electronic patient-reported outcomes as digital therapeutics for patients with cancer: a narrative review of current practices and future directions.

Improved cancer treatment outcomes have increased the demand for medical care that considers the quality of life of patients with cancer. Patient-reported outcomes (PROs) help assess the quality of life because they involve direct evaluation of the patients. Recently, electronic PROs (ePROs) have been used in clinical cancer care settings in Europe and the United States. Electronic PROs positively affected communication between patients with cancer and healthcare providers, enhanced education, optimized self-management, contributed to healthcare economics, assisted in monitoring adverse events, and improved prognosis. However, challenges such as adherence, burden on healthcare providers, lack of personalized formats, low digital literacy, and implementation costs remain. Therefore, carefully selecting the items to be recorded by ePROs in alignment with specific objectives is essential. Additionally, developing systems using lifelogs-digital records of daily activities-and creating mechanisms that automatically encourage patient behavioral changes based on the reported data are crucial. This review delineates the advantages and challenges of ePROs according to their history and proposes the prospects of ePRO.

Subcutaneous Insulin Infusion Versus Multiple Administrations of Insulin Analogs: Is Either Method Associated with Better Quality of Life in Pediatric Patients with Type 1 Diabetes Mellitus?

Objectives − Type 1 Diabetes Mellitus (DM1) requires demanding treatment in order to achieve good metabolic control. Our aim was to assess whether either method of insulin administration (multiple daily administrations of insulin analogues (MDIA) or continuous subcutaneous insulin infusion (CSII)) is associated with better health-related quality of life (HRQoL).Methods − We conducted a cross-sectional study. Patients aged 10-18 years with a disease duration of at least six months were included. HRQoL was assessed by having patients and their caregivers complete the DISABKIDS-37 questionnaire.Results − Of the 40 patients included, 22 (55%) had CSII. There were no statistically significant differences between subscale scores and overall HRQoL between patients or between parents of patients with CSII or MDIA. CSII patients and parents scored better on all subscales and on the total scale, although without statistically significant differences. There were no statistically significant differences in the subscale scores and overall HRQoL reported by the patients and their parents, but there was a strong correlation between the children’s and parents’ scores (R=0.770; P&lt;0.01), which was similar in patients with CSII or MDIA (R=0.735 vs R=0.790).Conclusion − Although we did not identify statistically significant differences, there was a trend towards a better HRQoL associated with the use of CSII, both from the perspective of the adolescents and their parents. This could influence therapeutic choice. Consistency between the assessments of adolescents and their carers was observed. The choice between MDIA and CSII should be based on individual preferences in order to optimize the HRQoL of adolescents with DM1.

Web-based pulmonary telehabilitation: a systematic review.

Web-based pulmonary telerehabilitation (WBPTR) can serve as a valuable tool when access to conventional care is limited. This review assesses a series of studies that explore pulmonary telerehabilitation programmes delivered via web-based platforms. The studies involved participants with moderate to severe chronic obstructive pulmonary disease (COPD). Of the 3190 participants, 1697 engaged in WBPTR platforms, while the remaining 1493 comprised the control groups. Sixteen studies were included in the meta-analysis. Web-based pulmonary telerehabilitation led to an increase in daily step count (MD 446.66, 95% CI 96.47 to 796.86), though this did not meet the minimum clinically important difference. Additionally, WBPTR did not yield significant improvements in the six-minute walking test (MD 5.01, 95% CI - 5.19 to 15.21), health-related quality of life as measured by the St. George's Respiratory Questionnaire (MD - 0.15, 95% CI - 2.24 to 1.95), or the Chronic Respiratory Disease Questionnaire (MD 0.17, 95% CI - 0.13 to 0.46). Moreover, there was no significant improvement in dyspnoea-related health status, as assessed by the Chronic Respiratory Disease Questionnaire (MD - 0.01, 95% CI - 0.29 to 0.27) or the modified Medical Research Council Dyspnoea Scale (MD - 0.14, 95% CI - 0.43 to 0.14). Based on these findings, this review concludes that WBPTR does not offer substantial advantages over traditional care. While slight improvements in exercise performance were observed, no meaningful enhancements were noted in dyspnoea or quality of life metrics. Overall, WBPTR remains a complementary and accessible option for managing and monitoring COPD patients. However, further research and innovation are required to improve its efficacy and adapt it to various clinical environments.

Latent class analysis of post-acute sequelae of SARS-CoV-2 infection.

Symptoms post-SARS-CoV-2 infection may persist for months and cause significant impairment and impact to quality of life. Acute symptoms of SARS-CoV-2 infection are well studied, yet data on clusters of symptoms over time, or post-acute sequelae of SARS-CoV-2 infection (PASC), are limited. We aim to characterize PASC phenotypes by identifying symptom clusters over a six-month period following infection in individuals vaccinated (boosted and not) and those unvaccinated. Subjects with ≥1 self-reported symptom and positive RT-PCR for SARS-CoV-2 at CVS Health US test sites were recruited between January and April 2022. Patient-reported outcomes symptoms, health-related quality of life (HRQoL), work productivity and activity impairment (WPAI) were captured at 1 month, 3 months, and 6 months post-acute infection. Phenotypes of PASC were determined based on subject matter knowledge and balanced consideration of statistical criteria (lower AIC, lower BIC, and adequate entropy) and interpretability. Generalized estimation equation approach was used to investigate relationship between QoL, WPAI and number of symptoms and identified phenotypes, and relationship between phenotypes and vaccination status as well. LCA identified three phenotypes that are primarily differentiated by number of symptoms. These three phenotypes remained consistent across time periods. Subjects with more symptoms were associated with lower HRQoL, and worse WPAI scores. Vaccinated individuals were more likely to be in the low symptom burden latent classes at all time points compared to unvaccinated individuals.

Integrating informal and formal care: An innovative, scalable program blueprint.

People have infinite needs, including illness prevention, wellness, self-care, practical support, and quality of life. This article describes community-based, informal care programs that help people identify their needs, set goals, and organize networks of care to address their needs holistically in a way that can also significantly reduce healthcare costs. Approaches can be customized for primary care, home and community, hospice, and other care sectors to facilitate low-cost, high impact adoption. We provide a blueprint for programs that integrate informal and formal care across social, physical, and mental health domains as a key part of healthcare system transformation.

Orthopedic Surgery in Osteogenesis Imperfecta in Adults.

Osteogenesis imperfecta is a genetic disorder, mainly characterized by bone fragility. In adult with osteogenesis imperfecta, surgical treatment may be indicated as an emergency procedure in the event of a fracture, or as a scheduled procedure in case of patient functional impairment due to many causes, such as persistent pain, complex bone deformities, and degenerative arthropathies. In all cases, a multidisciplinary approach is recommended. It is essential to consider the patient's characteristics and expectations regarding treatment, as well as the local conditions, which may be complex due to the poor bone quality, bone deformity, and the presence of hardware implanted during childhood. The procedure can be very complex and challenging and each patient is a unique case. An accurate preoperative planning is mandatory to select the appropriate surgical technique, which can be either conservative or prosthetic, and to evaluate its feasibility and the risk-benefit ratio. The aim is to improve the patient's quality of life and autonomy as long as possible.