Health Scores Research Articles

The frequency of sarcopenia in haemophilia patients: Effects on musculoskeletal health and functional performance.

In patients with haemophilia A, chronic arthropathy develops over time as a result of recurrent joint bleeds, which leads to restricted mobility and disability in the affected joints. There are limited studies in the literature evaluating sarcopenia in patients with haemophilia. The present study aims to determine the prevalence of sarcopenia in severe haemophilia-A patients and to evaluate musculoskeletal health and functional performance. Thirty haemophilia-A patients and 26 adult male volunteers were enrolled in the study. For detection of sarcopenia, the appendicular skeletal muscle mass (ASM) obtained by bioelectrical impedance analysis (BIA) was divided by height squared (m2 ) to obtain the appendicular skeletal muscle mass index (ASMI) value. The thighs of both lower extremities were measured using the Modified Sonographic Tight Adjustment Ratio (STAR) method, which was obtained by adding the bilateral rectus femoris and vastus intermedius muscle thicknesses measured by ultrasound. Hand and quadriceps muscle strength (MS) were measured with a dynamometer. Physical performance was determined using the walking speed (WS), timed up-and-go test (TUGT), 5-repetition sit-to-stand test (5RSTS), and 6-min walk test (6MWT). Haemophilia Joint Health Score (HJHS) and Haemophilia Early Arthropathy Detection-Ultrasonography (HEAD-US) were also used to assess the musculoskeletal system. According to the modified STAR values calculated based on body mass index, sarcopenia was present in 15 (50%) of 30 patients. However, based on the ASMI-BIA values, sarcopenia was present in only two (6.6%) patients. A weak correlation was found between ASMI and HJHS, HEAD-US, WS, TUGT, and hand MS (left), while a moderate correlation was found with knee MS (right), knee MS (left), and 5RSTS. A strong correlation was found between the modified STAR score and HEAD-US, HJHS, knee MS (left), 5RSTS, TUGT, and WS, while a moderate correlation was found with hand MS (left), hand MS (right), and knee MS (right). This study showed muscle loss, joint mobility restrictions, and decreased functional capacity in haemophilia patients and demonstrated the presence of sarcopenia in these patients. The STAR measurement method showed stronger relationships with MS and functional performance values than ASMI measurements in terms of evaluating sarcopenia.

Tracked and self-reported nighttime smartphone use, general health, and healthcare utilization: results from the SmartSleep Study.

Nighttime smartphone use is an increasing public health concern. We investigated whether nighttime smartphone use is associated with general health and primary healthcare utilization. Four thousand five hundred and twenty individuals (age 35.6 ± 9.7 years, 35% male) provided self-reported information on smartphone use frequency, symptoms of depression, and general health (one-item perceived health and cross-symptom composite score). A subset of the study sample (n = 3221) tracked their nighttime smartphone use. Primary healthcare utilization, i.e. the number of weeks in which at least one service from the patient's general practitioner (GP) was billed in 2020, was extracted from Danish population registries. Statistical analysis comprised logistic and multiple linear regression, controlling for sociodemographics. Three hundred and nineteen individuals (7%) reported using their smartphone almost every night or more. More frequent self-reported nighttime smartphone use was associated with poor general health across all measures. Using the smartphone almost every night or more was associated with 2.8 [95% CI: 1.9, 4.1] fold higher odds of reporting poor health and with an average of 1.4 [95% CI: 0.7, 2.1] additional GP utilizations per year compared to no use. Associations were also found for the cross-symptom composite score across all symptoms. Further adjustment for symptoms of depression attenuated some associations. Smartphone use towards the end of the sleep period (sleep-offset use) was associated with poorer self-reported general health, but not with healthcare utilization. Nighttime smartphone use frequency is associated with poor general health and healthcare utilization. Further studies should investigate the underlying causal structure and nighttime smartphone use as a transdiagnostic intervention target.

The association between fear of progression and medical coping strategies among people living with HIV: a cross-sectional study

BackgroundDue to the chronic nature of HIV, mental health has become a critical concern in people living with HIV (PLWHIV). However, little knowledge exists about the association between fear of progression (FoP) and medical coping modes (MCMs) in PLWHIV in China.MethodsA cohort of 303 PLWHIV were consecutively enrolled and their demographic, clinical and psychological information was collected. The Fear of Progression Questionnaire-Short Form (FoP-Q-SF), Social Support Rating Scale (SSRS), Internalized HIV Stigma Scale (IHSS) and MCMs Questionnaire were utilized.ResultsOf the participants, 215 PLWHIV were classified into the low-level FoP group, and 88 were grouped into the high-level FoP group based on their FoP-Q-SF scores, according to the criteria for the classification of dysfunctional FoP in cancer patients. The high-level group had a higher proportion of acquired immunodeficiency syndrome (AIDS) stage (P = 0.005), lower education levels (P = 0.027) and lower income levels (P = 0.031). Additionally, the high-level group had lower scores in social support (P < 0.001) and its three dimensions, with total SSRS scores showing a negative correlation with two dimensions of FoP-Q-SF, namely physical health (r2 = 0.0409, P < 0.001) and social family (r2 = 0.0422, P < 0.001). Further, the high-level group had higher scores in four dimensions of internalized HIV stigma, and a positive relationship was found to exist between IHSS scores and FoP-Q-SF scores for physical health (r2 = 0.0960, P < 0.001) and social family (r2 = 0.0719, P < 0.001). Social support (OR = 0.929, P = 0.001), being at the AIDS stage (OR = 3.795, P = 0.001), and internalized HIV stigma (OR = 1.028, P < 0.001) were independent factors for FoP. Furthermore, intended MCMs were evaluated. FoP were positively correlated with avoidance scores (r2 = 0.0886, P < 0.001) and was validated as the only factor for the mode of confrontation (OR = 0.944, P = 0.001) and avoidance (OR = 1.059, P = 0.001) in multivariate analysis.ConclusionThe incidence of dysfunctional FoP in our study population was relatively high. High-level FoP was associated with poor social support, high-level internalized HIV stigma and a negative MCM among PLWHIV.

Examining Race-Based and Gender-Based Discrimination, Trust in Providers, and Mental Well-Being Among Black Women.

To examine experiences of discrimination among Black women, and to determine if experiencing race- and gender-based discrimination is associated with mental well-being and trust. Data from the TRUST study were used to examine experiences of discrimination among 559 Black women with hypertension receiving healthcare at a safety-net hospital in Birmingham, Alabama. A three-level variable was constructed to combine the race-based and gender-based measures of the Experiences of Discrimination scale. Linear regression was used to examine the association between experiences of discrimination with mental well-being and trust. Women who reported no experiences of race- or gender-based discrimination were older and reported higher mental well-being scores and greater trust. Fifty-three percent of study participants reported experiencing discrimination. Compared to participants who did not experience race- or gender-based discrimination, participants reporting experiences of race- or gender-based discrimination and those reporting experiencing both race- and gender-based discrimination were more likely to report poorer mental health. Reported experiences of gender- and/or race-based discrimination in this study were associated with lower mental health scores and less trust in health care providers. Our findings highlight the importance of examining experiences of discrimination among Black women, and the role of discrimination as a stressor and in reducing trust for providers. Incorporating an understanding and acknowledgement of experiences of discrimination into interventions, programs, and during clinical encounters may foster more trusting relationships between providers and patients.

Effectiveness of a Digital Application-Based Self-Care Management Program in Patients with Type 2 Diabetes in Thai Nguyen Province, Vietnam

Purpose: To evaluate the effectiveness of educational communication intervention using SMDia software in improving knowledge, self-care activities, quality of life and glycemic control in patients with type 2 diabetes in Thai Nguyen province, Vietnam.&#x0D; Methodology: It was an intervention study with control group. Intervention study was conducted from March 2021 to May 2022 on 240 patient’s type 2 diabetes who was randomly assigned to the control group and intervention group, each group had 120 people. It was to evaluate the effectiveness of educational communication intervention using SMDia software for self-care knowledge, self-care activities, and quality of life, using the DSCKQ-30, SDSCA, and V.SF-36v2 toolkits for glycemic control by fasting blood sugar levels, HbA1c at times before and after intervention.&#x0D; Findings: After intervention, there was a clear improvement over time and level in the intervention group compared to the control group after 24 weeks. The self-care knowledge score in the intervention group’s 26.60 ± 2.96 points; the self-care activity score in the intervention group's 69.40 ± 9.31 points; the quality of life score for physical health in the intervention group's 73.25 ± 9.34 points; the mental health quality of life score in the intervention group's 72.74 ± 7.0 points. The intervention effect on change in self-care activities, quality of life and self-care knowledge were 167.8%, 163.6%, and 64.0%, respectively. After 24 weeks, the rates of patients with poor blood sugar control and poor HbA1c in the intervention group was 36.7% and 7.5%. The rate of blood sugar control achieved the target increased by 15.8%, HbA1c reached the target increased by 31.7%. Intervention effectiveness reached 8.2% for blood sugar control and 41.8% for HbA1c control.&#x0D; Unique contribution to theory, practice and policy: Educational communication intervention using SMDia software has shown to significantly improve self-care knowledge, self-care activities, quality of life and glycemic control for patients with type 2 diabetes.

Abstract TMP58: Neuroimaging Markers of Patient-Reported Outcomes in Acute Ischemic Stroke

Objectives: To determine the relationship between patient-reported outcome measures (PROMs) and volumetric biomarkers assessed on clinical imaging in acute ischemic stroke (AIS). Background: AIS is a leading cause of long-term disability. White matter hyperintensity (V_WMH), brain (V_Brain) and stroke lesion volume (V_Lesion) have been linked as potential determinants of functional outcomes after stroke. Recently, there has been surging attention to PROMs, which allow for direct, patient-centered health assessments of stroke victims. However, the link between neuroimaging biomarkers and PROMs is not well studied. Methods: Patients presenting to the Emergency Department at Massachusetts General Hospital between February 2017 and February 2020 with a confirmed AIS on MRI were eligible and underwent a follow-up telephone interview, including PROM-10 questionnaires. V_WMH and V_Brain were automatically determined from clinical MRI. V_Lesion was manually segmented. Regression analyses were performed to identify associations of brain volumetrics and clinical variables with PROM-10 subscores and global mental and physical summary scores. Results: Utilizing data from 150 patients (mean age: 64.7; 41.9% female), higher V_WMH was associated with worse global mental (β = -0.65), global physical (β = -0.60), social activities (OR = 0.59), physical health (OR = 0.68), fatigue (OR = 0.69) and social satisfaction (OR = 0.66) scores. V_Lesions were associated with poorer global mental (β = -0.79), social (OR = 0.55) and physical (OR = 0.66) activities, mental health (OR = 0.68) and emotional distress (OR = 0.68) scores. Higher V_Brain was linked to better global mental (β = 0.93), global physical (β = 0.79), physical activities (OR = 1.72) and mental health (OR = 1.54) scores. Conclusions: Imaging biomarkers were significantly associated with PROMs. The inclusion of these markers with PROMs in routine post-stroke assessment can enhance our understanding of recovery.

Life satisfaction and ideal cardiovascular health score: A cross-sectional study from ELSA-Brasil.

To investigate whether higher levels of life satisfaction are associated with a higher ideal cardiovascular health (CVH) score in middle-aged and older populations in the Brazilian context. Cross-sectional analysis of 12,936 participants of the Brazilian Longitudinal Study of Adult Health, Visit 2 (2012-2014), aged 38-79 years. The response variables were the global, lifestyle, and biological ideal CVH scores, as defined by the American Heart Association Life's Simple 7. The scores were categorized as low, intermediate, and optimal. Life satisfaction was measured by the Satisfaction with the Life Scale. Multinomial logistic regression was used to estimate the magnitude with adjustment for potential confounding factors. Low scores were the categories of reference for the analyses. Only 10.5% of the participants had an optimal (≥5) global ideal CVH score. After total adjustment, 1 SD increment in the life satisfaction score was associated with an odds ratio (OR) of 1.05 (95% confidence interval [CI: 1.01-1.09]) and 1.15 (95% CI [1.07-1.23]) for intermediate and optimal global ideal CVH scores, respectively. Regarding the lifestyle ideal CVH score, the increment of 1 SD in the life satisfaction scale determined an OR of 1.11 (95% CI [1.06-1.15]) and 1.22 (95% CI [1.14-1.31]) for intermediate and optimal lifestyle ideal CVH score, respectively. Life satisfaction was not associated with the biological ideal CVH score. The results suggested that the higher the life satisfaction, the higher the CVH. The findings add to the knowledge of assets to promote CVH. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

A dyadic analysis of financial toxicity and health-related quality of life among bone marrow transplant patients and their caregivers.

Relatively few dyad-based studies have evaluated the shared psychosocial and financial toxicity (FT) experiences of hematologic patients and their caregivers, especially those undergoing bone marrow transplantations (BMTs). This study evaluated the association of FT with health-related quality of life (QOL) among BMT patient-caregiver dyads. Survey and electronic health record data were collected between April 2021 and January 2022 from BMT patients and their caregivers pre- (T1) and post-intervention (T2). Thirty-four patient-caregiver dyads completed surveys; all dyads included a patient experiencing elevated T1 FT. The effect of the total FT score (i.e., the combination of psychological response, coping behaviors, and material conditions domain scores) on physical health, mental health, anxiety, depression and distress scores was evaluated using Actor-Partner Interdependence Modeling (APIM). Patients and caregivers who reported lower total FT scores had better physical and mental health, and lower anxiety, depressive symptoms, distress (APIM actor effects). None of the partner effects were significant in the APIM models. Other model findings indicated that compared with caregivers, patients had lower reported physical health; mental health scores were higher, on average, for all participants at the T2 compared with T1; and members of dyads whose caregiver took time off work reported better physical health and lower depressive symptoms and distress than those whose caregiver did not. Our study addresses a significant gap in dyad-based cancer FT studies; the findings underscore the need for additional research to help develop tailored dyad-level FT interventions for improving health-related QOL among BMT patients.

Novel Antireflux “RELIEF” Stent to Prevent Vesicoureteral Reflux

ObjectiveTo assess efficacy, comfort, & symptoms of a novel ureteral stent (RELIEF) substituting the distal semirigid coil of a traditional double-J (DJ) for a floating, monofilament tether allowing coaptation of the ureteral orifice. Ureteral instrumentation notoriously cause discomfort, urgency, frequency, dysuria & hematuria; prolonged morbidity is likely related to stent-associated vesicoureteral reflux (VUR). We hypothesized this design would eliminate VUR, be safe & provide comfort following intervention. Methods28 patients within a single institution were enrolled. Passive cystography was performed pre- & post-stent placement assessing VUR. Patients completed Ureteric Stent Symptoms Questionnaires (USSQ) before placement (baseline), post-op day 1, & day of removal. Results20 RELIEF stents were placed (11 female and 9 male). 95% demonstrated no VUR following placement. No unexpected adverse complications occurred; 1 patient opted for early stent removal for significant discomfort. Average total USSQ scores demonstrated statistically significant improvement between first and third surveys (p<0.001). Statistically significant improvement in body pain, general health & work performance scores were noted as well (p<0.05). ConclusionsThe RELIEF stent eliminates VUR with similar stent-related morbidity and overall well-tolerance. RELIEF associated USSQ scores were below published mean symptom scores for standard DJ stents and appear safe in this preliminary clinical trial.

Abstract TP103: Association Between Neighborhood-Level Disadvantage and Patient-Reported Mental Health Outcomes in Intracerebral Hemorrhage Survivors

Introduction: The influence of social determinants of health (SDH) is well-documented across a range of medical conditions and health outcomes. Less clear is the impact of SDH on patient-reported outcomes, particularly mental health outcomes, in intracerebral hemorrhage (ICH). This study examines the association between the Area Deprivation Index (ADI), a measure of neighborhood-level disadvantage, and self-reported health outcomes in ICH survivors. Methods: This investigation is nested within the REDUCE clinical trial, an ongoing, randomized trial comparing standard-of-care to spironolactone-containing hypertension regimens in ICH survivors. Participants complete the PROMIS Global Health survey at baseline. Global Mental Health (GMH) and Global Physical Health (GPH) scores are standardized to t-scores (GMH 21.2-67.6; GPH 16.2-67.7) around a reference population mean (50 ± 10). ADI uses elements of income, education, employment, and housing quality to assign a composite score (1-100), with a higher score signifying greater disadvantage. Patients were grouped into tertiles based on ADI. GMH and GPH scores were analyzed against the reference mean via a one-sample t-test and across tertiles with a one-way ANOVA. Bivariable linear regression examined ADI as a continuous variable. Multivariable models adjusted for sex, age, race, ethnicity, ICH to baseline interval, and baseline mRS. Results: Fifty patients were included in the analysis. Those in the third, most disadvantaged, tertile had significantly lower GMH scores (39.5 ± 8.17) than the reference population (p&lt;0.001), the first tertile (54.10 ± 10.20, p&lt;0.001), and the second tertile (50.4 ± 8.90, p=0.003). In multivariable analysis, these differences remained significant (T3 vs. T1, B= -18.31, p&lt;0.001; T3 vs. T2, B= -14.67, p&lt;0.001). Further, ADI as a continuous variable was significantly associated with GMH scores in bivariable (B= -0.22, p&lt;0.001) and multivariable analysis (B= -0.23, p=0.005). No significant relationship was found between ADI and GPH. Conclusions: Higher ADI is associated with worse patient-reported mental health outcomes after ICH. Neighborhood disadvantage, and its constituting factors, should be considered in reporting post-ICH patient care and outcomes.

Exploring the links of skeletal muscle mitochondrial oxidative capacity, physical functionality, and mental well-being of cancer survivors

Physical impairments following cancer treatment have been linked with the toxic effects of these treatments on muscle mass and strength, through their deleterious effects on skeletal muscle mitochondrial oxidative capacity. Accordingly, we designed the present study to explore relationships of skeletal muscle mitochondrial oxidative capacity with physical performance and perceived cancer-related psychosocial experiences of cancer survivors. We assessed skeletal muscle mitochondrial oxidative capacity using in vivo phosphorus-31 magnetic resonance spectroscopy (31P MRS), measuring the postexercise phosphocreatine resynthesis time constant, τPCr, in 11 post-chemotherapy participants aged 34–70 years. During the MRS procedure, participants performed rapid ballistic knee extension exercise to deplete phosphocreatine (PCr); hence, measuring the primary study outcome, which was the recovery rate of PCr (τPCr). Patient-reported outcomes of psychosocial symptoms and well-being were assessed using the Patient-Reported Outcomes Measurement Information System and the 36-Item Short Form health survey (SF-36). Rapid bioenergetic recovery, reflected through a smaller value of τPCr was associated with worse depression (rho ρ = − 0.69, p = 0.018, and Cohen’s d = − 1.104), anxiety (ρ = − 0.61, p = .046, d = − 0.677), and overall mental health (ρ = 0.74, p = 0.010, d = 2.198) scores, but better resilience (ρ = 0.65, p = 0.029), and coping-self efficacy (ρ = 0.63, p = 0.04) scores. This is the first study to link skeletal muscle mitochondrial oxidative capacity with subjective reports of cancer-related behavioral toxicities. Further investigations are warranted to confirm these findings probing into the role of disease status and personal attributes in these preliminary results.

Effects of 16-week circuit training on physical fitness parameters, pulmonary function, and quality of life in healthy women.

Circuit training (CT) is an important type of training that can combine different types of exercises in a single form of training. This study aimed to investigate the effects of 16-week CT on physical fitness parameters, pulmonary function, and quality of life in healthy women. Twenty-nine healthy women (median age: 37.00 [31.50/39.50] years) were included in the study. CT was applied to the participants for a total of 16 weeks. Participants' body composition with the Bioelectrical Impedance Analysis System, knee flexor and extensor muscle strength with the Biodex System-4 Pro, flexibility with the sit-and-reach test, pulmonary function with a spirometer device, and quality of life with Short Form-36 were assessed. A significant difference was found between the participants' pretest and posttest median and interquartile range values of waist-hip ratio, body mass index, right/left knee flexor/extensor mean peak torque (60°/s,180°/s), right hamstring/quadriceps (H/Q) ratio (60°/s), flexibility, and SF-36 Mental Health Score (P˂0.050). There was no significant difference between the participants' pretest and posttest median and interquartile range values of total body fat, fat percentage, right H/Q ratio (180°/s), left H/Q ratio (60°/s,180°/s), pulmonary function, and Short Form-36 Physical Function Score (P˃0.050). CT decreased waist-hip ratio and body mass index, increased knee flexor/extensor strength and flexibility, and improved mental health. The 16-week CT may be an alternative approach to improve physical fitness parameters and mental health without any positive effects on body fat and pulmonary functions in healthy women.

Prospective evaluation of sexual health following radical cystectomy due to bladder cancer.

There is a lack of data concerning sexual health following open radical cystectomy (RC), especially in elderly patients and women. To describe sexual health and its impact on general health as well as survival in patients undergoing standard open RC for the treatment of bladder cancer (BC). Due to limited data, subgroup analysis for elderly patients and women was performed. A prospective noninterventional clinical study was performed evaluating sexual health in RC with any kind of urinary diversion due to BC with a follow-up of 12months after RC. The study was approved by the local ethics review board (A 2021-0175) and was registered at the German Clinical Trial Register (DRKS00026255). Assessment of sexual health was done with the following validated questionnaires: EORTC QLQ-C30 (for quality of life; European Organisation for Research and Treatment of Cancer), EORTC SH22 (for sexual health), and IIEF-5 (5-item International Index of Erectile Function). The standard measurements of EORTC QLQ-C30, EORTC SH22, and IIEF-5 as well as overall survival. Thirty-two patients participated in the study with a mean age of 71.5years (SD, 9.7): 25 (78.1%) were male and 7 (21.9%) were female. Overall there is a heterogenic picture for sexual health in the study population, but sexual satisfaction is significantly higher prior to surgery while the importance of a sex life stays high and stable. Interestingly, the general health score is significantly correlated to sexual satisfaction (Pearson's correlation; r = 0.522, P = .002) preoperatively but not following surgery: r = 0.103 (P = .665) after 3months, r = 0.478 (P = .052) after 6months, r = 0.276 (P = .302) after 9months, and r = 0.337 (P = .202) after 12months. The importance of a sex life is still essential for the patients, especially when recovering from RC; nearly the same can be reported for elderly patients. Unfortunately, the data for women are too limited to report robust results. Evaluation, advice, and monitoring of sexual health must be integrated into clinical practice, particularly in women. At least to our knowledge, this is the first systematic prospective evaluation of sexual health in patients with BC receiving RC. Due to the small sample size, there is a risk of selection bias. Sexual health is important for patients with BC receiving RC, and it is an essential part of quality of life, especially in elderly patients.

Mental Health, Psychosocial Functioning, and Quality of Life in Adolescents With Hirschsprung Disease

BackgroundStudies of mental health in adolescents with Hirschsprung disease (HD) are scarce. This cross-sectional study investigates mental health, psychosocial functioning and quality of life in HD adolescents. MethodsAdolescents (12–18 years) treated at the Department of pediatric surgery at Oslo University Hospital were invited for participation. Mental health was assessed by interview; Child Assessment Schedule (CAS) and questionnaires; parental Child Behavior Checklist (CBCL) and adolescent Youth Self-Report (YSR). Psychosocial functioning was rated by Child Global Assessment Scale (cGAS). Adolescent Quality of Life was assessed by Pediatric Quality of Life inventory (PedsQL) and chronic family difficulties (CFD) by interview. Medical records were reviewed for somatic history. ResultsThirty-seven adolescents, 28 males, median age 14.3 years, participated. By CAS interview, 8 of 37 (44% of females and 14% of males) fulfilled criteria for psychiatric diagnosis all within emotional and related disorders. Twenty-seven percent had CBCL internalizing scores and 16% had YSR internalizing scores in clinical range indicating emotional problems. By interviewer rated cGAS, 27% were scored in clinical range. By PedsQL 16% reported reduced psychosocial health score. Increased CFD, lower psychosocial functioning and reduced QoL as well as less paternal education were significantly associated with psychiatric diagnosis. Twice as many (4/8) adolescents who either had a stoma or bowel management had a psychiatric diagnosis compared to those who had neither stoma nor bowel management (7/28). ConclusionNearly one in four adolescents with HD fulfilled criteria for psychiatric diagnosis. Mental health problems were associated with reduced psychosocial function and reduced QoL. Level of evidenceIII.

"Quality of life" analysis in the long-term follow-up after "Fontan" palliation for CHDs-a single-centre experience.

Complex CHDs are life threatening, and surgical treatment is needed for survival. Fontan palliation led to a significant increase in survival rates during the last decades. Consequently, quality of life became more essential. While a reduced quality of life compared to healthy children has been reported, detailed knowledge about individual quality of life and particular areas is lacking. Furthermore, the effect of different risk factors on quality of life is only rarely evaluated. Database of the department for pediatric cardiology, Heart Center Leipzig, was screened for children after total cavopulmonary connection palliation. n = 39 patients were included in the study, the outcome after total cavopulmonary connection was analysed in detail and quality of life data were collected and analysed using the standardised questionnaire "Pediatric quality of life inventory", version 4.0. We compared the total health score of our patients to the mean score of healthy children in the literature. The mean follow-up time was 6.4 ± 3.2 years, the overall survival was 100% after maximal follow-up time of 11.1 years. We could not find any age or gender dependence, nor an influence of age at total cavopulmonary connection on the later quality of life. Yet, patients with three-staged surgery exhibited a worse quality of life than patients with two-staged palliation. Late complications might influence quality of life, but patient number is too small, to find universal results. The total cavopulmonary connection palliation affects physical and psychological quality of life as well as cardiac health independently from age and gender. More patients and longer observation should be examined to confirm the results.

Prevalence and risk factors of fatigue and its association with quality of life among patients with chronic pancreatitis: A cross-sectional study

BackgroundFatigue is a debilitating symptom found in various chronic diseases and is associated with more severe symptoms and worse quality of life (QoL). However, this symptom has not been adequately addressed in chronic pancreatitis (CP), and there have been no studies on fatigue in patients with CP. MethodsThis cross-sectional study was conducted at the Changhai Hospital in Shanghai, China. Data on the patients’ sociodemographic, disease, and therapeutic characteristics were collected. Fatigue was assessed using the Multidimensional Fatigue Inventory-20. QoL was assessed utilizing the European Organization for the Research and Treatment of Cancer of QoL questionnaire (EORTC-QLQ-C30). Sleep quality, anxiety and depression, and pain was assessed using Pittsburgh Sleep Quality Index, the Hospital Anxiety and Depression Scale, and the Brief Pain Inventory, respectively. ResultsThe prevalence of fatigue among Chinese patients with CP was 35.51 % (87/245). Multivariate analysis showed that steatorrhea (OR = 2.638, 95 % CI: 1.117–6.234), history of smoking (OR = 4.627, 95 % CI: 1.202–17.802), history of endoscopic treatment (OR = 0.419, 95 % CI: 0.185–0.950), depression (OR = 5.924, 95 % CI: 2.462–14.255), and sleep disorder (OR = 6.184, 95 % CI: 2.543–15.034) were influencing factors for the presence of fatigue. The scores for global health and all functional dimensions in the EORTC-QLQ-C30 significantly decreased, whereas the scores for all symptom dimensions significantly increased in patients with fatigue. ConclusionsThis study indicated that Fatigue is a common symptom and has a negative impact on the QoL of patients with CP. Steatorrhea, smoking history, endoscopic treatment, depression, and sleep disorders were associated with fatigue.

The relationship of sexual dysfunction and quality of life in patients with type 2 diabetes

Objective: Diabetes, along with being able to play a role in the formation of many health problems such as psychological, psychosocial, and sexual dysfunction, also indirectly affects the duration and quality of life. This research was conducted as a descriptive, cross-sectional research model to determine the relationship between sexual dysfunction and the quality of life of patients diagnosed with type 2 diabetes.&#x0D; Methods: The research sample consisted of 485 individuals diagnosed with type 2 diabetes. The data were collected through the General Information Form, the Female Sexual Function Index, the Erection Function International Assessment Form, and the Quality of Life Scale (SF-36).&#x0D; Results: It was found that 91% of women have sexual dysfunction and are experiencing sexual desire (92.2%), orgasmic function, arousal (92.9%), and pain, satisfaction, and lubrication (92.5%), respectively. This rate was found to be 91.3% in men, and the degree of erectile dysfunction was found to be moderate (55%), mild (21.6%) and severe (14.7%), respectively. It was found that the problems experienced in the areas of sexual dysfunction were in the sub-dimensions of general satisfaction 20.6%, orgasmic function 49.5%, and sexual desire 50.9%. And relationship satisfaction is 72.5%. In the study, it was found that sexual dysfunction affects the quality of life in both sexes, and the scale sub-dimensions have a statistically significant difference (p &lt; 0.05). It was found that the physical role difficulty, physical function, emotional role, mental health, and social function sub-dimension score had a statistically significant difference in men and women with sexual dysfunction, and the pain and vitality sub-dimension scores in men were significantly lower compared to those without sexual dysfunction (p &lt; 0.05).&#x0D; Conclusion: As a result, sexual dysfunction is common in men and women with Type 2 Diabetes Mellitus, and in parallel, the quality of life is low.

Sexual Well-Being Across the Lifespan: Is Sexual Satisfaction Related to Adjustment to Aging?

Abstract Introduction Sexual satisfaction is relevant to aging well, throughout the lifespan. This study aims to compare the perspectives of sexual satisfaction and adjustment to aging (AtA) in three age cohorts across the lifespan and to analyze whether sexual satisfaction influences the perceptions of AtA. Methods This cross-sectional study comprised 619 participants from three different age cohorts (18–44, 45–64, and 65 + years). Three measures were used to meet the defined objectives: (a) Adjustment to Aging Scale (ATAS), (b) New Sexual Satisfaction Scale (NSSS-S), and (c) sociodemographic, health, and lifestyle questionnaire. Data were subject to MANOVAs and hierarchical regression analyses. Results Social support emerged as the most relevant dimension in the multifactorial nature of AtA. Generational differences were found in sense of purpose and ambitions [F(2, 616) = 14.203, p &lt; .001], zest and spirituality [F(2, 616) = 3.175, p = .042], body and health [F(2, 616) = 8.732, p &lt; .001], and social support [F(2, 616) = 10.646, p &lt; .001], with participants aged 65 and older showing significantly lower levels in all dimensions. Younger participants showed the highest score for body and health. Age-related decreases in sexual satisfaction were also found, as younger participants showed statistically higher levels of sexual satisfaction, followed by middle-aged and older participants. Sexual satisfaction predicts all the dimensions of AtA, exception made for aging in place and stability. Ego-centered sexual satisfaction positively predicted sense of purpose and ambitions (β = .225, p = .015) and social support (β = .297, p &lt; .001), while partner/sexual activity–centered sexual satisfaction was a positive predictor of zest and spirituality (β = .243, p = .010) and body and health (β = .243, p = .008). Conclusions Sexual satisfaction decreases with age and is positively related to dimensions of AtA. Sexual satisfaction is a relevant variable for effective approaches to promoting healthy aging and overall well-being among (older) adults. Policy Implications Gerontological program policies and interventions with older people would strongly benefit of including sexual satisfaction as a relevant variable for aging well along the lifespan.

Value of the Life's Essential 8 score in cardiovascular health and mortality

Value of the Life's Essential 8 score in cardiovascular health and mortality

DOES SURGERY FOR IBD DELIVER ON ITS “PROMIS”ES? IMPACT OF SURGERY ON SHORT-TERM PATIENT REPORTED OUTCOMES FROM THE CROHN’S &amp; COLITIS FOUNDATION’S SURGICAL INNOVATIONS, RESEARCH, &amp; QUALITY COLLABORATIVE

Abstract BACKGROUND As part of the Crohn’s &amp; Colitis Foundation’s IBD Plexus, a novel prospective, longitudinal multicenter surgical inception cohort was implemented. In this first report from the first 100 patients enrolled, we aimed to assess patient reported outcomes before and after IBD surgery. We hypothesized surgery is associated with improved patient reported outcomes. METHODS Beginning in Aug. 2022 patients were prospectively enrolled into a multicenter IRB-approved observational longitudinal cohort at 6 centers with 17 enrolling surgeons. Inclusion criteria: adults undergoing major abdominopelvic surgery for a known diagnosis of IBD. Baseline demographics, intra-operative details, 30-day outcomes, and patient reported outcomes were recorded at baseline and 30-days postoperatively. Overall health status was assess using the PROMIS General Health measures, symptom specific measures: PROMIS Pain Interference, Fatigue, and Sleep scales, and disease-specific measures: the Crohn’s &amp; Ulcerative Colitis Questionnaire items. Figures represent frequency (proportion), median (range). P-values represent Wilcoxon rank-sum test or chi-squared test or Fisher’s exact test. RESULTS A total of 103 patients were enrolled to date; median age 43 (20 – 74), 49% female, diagnoses: Crohns (64%), ulcerative colitis (35%), and IBDu (1%). A total of 69 (67%) patients completed surveys, and 58 (56%) patients completed the post-operative survey. In terms of overall health status within 7 days, improved overall median pain scores (3 vs. 2, p=0.04), overall health (p=0.04), physical health (p=0.03), and less fatigue (p=0.05) were observed after surgery compared to baseline (Table 1), while overall quality of life, mental health, social measures, and emotional problems were similar. Patients reported more difficulties with activities of daily living after surgery (p=0.01). In terms of symptoms within 7 days, less fatigue (p&amp;lt;0.05), but no difference in pain interference or sleep disturbance was observed after surgery (p&amp;gt;0.05). In terms of disease-specific outcomes within 2 weeks, fewer days feeling unwell (5 vs. 3, p=0.02), bloated (5 vs 2, p=0.04), or needing to rush to the toilet (5 vs 1, p=0.007), and no difference in feeling tired, upset, abdominal pain, or nocturnal bowel movements was observed after surgery. CONCLUSIONS In a prospective longitudinal cohort, surgery was associated with improved pain and physical health scores, with fewer days feeling unwell, fatigued, bloating, and fecal urgency. On the other hand, mental, social, and emotional health did not change 30-days after surgery. Our data suggest patients are still recovering 30-days after surgery, and longer follow-up may reveal further improvements. Targeted psychosocial interventions and support at home early in the acute post-operative period may improve the quality of recovery after surgery for patients with IBD. Table 1 Table 2