Scores In Most Domains Research Articles

Prenatal organophosphate esters exposure and neurodevelopment trajectory in infancy: Evidence from the Shanghai Maternal-Child Pairs Cohort

BackgroundConcerns remain about the neurotoxic properties of the ubiquitous organophosphate esters (OPEs), the replacement of the toxicant polybrominated diphenyl ethers. ObjectivesWe examined the associations of prenatal exposure to OPEs and their mixtures with early-life neurodevelopment trajectories. MethodsTotally 1276 mother-child pairs were recruited from the Shanghai Maternal-Child Pairs Cohort. A high-performance liquid chromatography-triple quadrupole mass spectrometer was used to measure the levels of 7 OPEs in cord serum. Ages and Stages Questionnaires was used to examine children's neuropsychological development at 2, 6, 12, and 24 months of age. Group-based trajectory models were applied to derive the neurodevelopmental trajectories. Multiple linear regression and logistic regression model were performed to assess the relationships between OPEs exposure and neurodevelopment and trajectories. Mixtures for widely detected OPEs (n = 4) were investigated using quantile-based g-computation. ResultsTributyl phosphate (TBP), tris (2-butoxy ethyl) phosphate (TBEP), tris(1,3-dichloro-2-propyl) phosphate (TDCPP), and 2-ethylhexyl diphenyl phosphate (EHDPP), had detection rates >50 %. TDCPP had the highest median concentration (1.02 μg/L) in cord serum. EHDPP concentrations were negatively associated with scores in most domains at 12 months of age, with effect values (β) ranging from −1.89 to −0.57. EHDPP could negatively affect the total ASQ (OR = 1.07, 95 % CI: 1, 1.15) and gross-motor (OR = 1.09, 95 % CI: 1.02, 1.17) trajectory in infancy. Joint exposure to OPEs was associated with decreased scores in the total ASQ, gross-motor, fine-motor and problem-solving domain of 12-month-old infants, with β ranging from −5.93 to −1.25. In addition, the qgcomp models indicated significant positive associations between the concentrations of OPEs mixtures and risks of the persistently low group of the total ASQ, gross-motor and fine-motor development in early childhood. The impact of OPEs was more pronounced in boys. DiscussionOur findings suggested OPEs, especially EHDPP, had a persistently negative effect on neurodevelopment during the first 2 years.

The barriers to interprofessional care for cancer cachexia among Japanese healthcare providers: A nationwide survey.

Cancer cachexia is a severe complication of advanced malignancy, with few therapeutic options. To promote interprofessional care for cancer cachexia, healthcare providers' needs should be addressed in detail. This pre-planned subgroup analysis of the Global Educational Needs Evaluation: a systemic interprofessional study in cancer cachexia (GENESIS-CC) survey aimed to identify barriers to interprofessional care of cancer cachexia in Japan. A nationwide survey was electronically conducted for healthcare providers in oncological or general healthcare facilities from January to March 2021 in Japan. The Japanese Regional Advisory Board developed a barrier scoring system with 33 from the 58 original survey items to quantify six domains of barriers: (1) lack of confidence, (2) lack of knowledge, (3) barriers in personal practice, (4) barriers in perception, (5) barriers in team practice and (6) barriers in education. The largest possible barrier score was set at 100 points. We compared the scores by profession. A total of 1227 valid responses were obtained from 302 (24.6%) physicians, 252 (20.5%) pharmacists, 236 (19.2%) nurses, 218 (17.8%) dietitians, 193 (15.7%) rehabilitation therapists and 26 (2.0%) other professionals. Overall, 460 (37.5%) were not very or at all confident about cancer cachexia care, 791 (84.1%) agreed or strongly agreed that care was influenced by reimbursement availability and 774 (81.9%) did not have cancer cachexia as a mandatory curriculum. The largest mean barrier score (±standard deviation) was 63.7±31.3 for education, followed by 55.6±21.8 for team practice, 43.7±32.5 for knowledge, 42.8±17.7 for perception and 36.5±16.7 for personal practice. There were statistically significant interprofessional differences in all domains (P<0.05), especially for pharmacists and nurses with the highest or second highest scores in most domains. There is a need to improve the educational system and team practices of cancer cachexia for most Japanese healthcare providers, especially pharmacists and nurses. Our study suggests the need to reform the mandatory educational curriculum and reimbursement system on cancer cachexia to promote interprofessional care for cancer cachexia in Japan.

Outpatient management of urinary tract infections by medical officers in Nairobi, Kenya: lack of benefit from audit and feedback on adherence to treatment guidelines

IntroductionAcute uncomplicated urinary tract infections are common in outpatient settings but are not treated optimally. Few studies of the outpatient use of antibiotics for specific diagnoses have been done in sub-Saharan Africa, so little is known about the prescribing patterns of medical officers in the region.MethodsAga Khan University has 16 outpatient clinics throughout the Nairobi metro area with a medical officer specifically assigned to that clinic. A baseline assessment of evaluation and treatment of suspected UTI was performed from medical records in these clinics. Then the medical officer from each of the 16 clinics was recruited from each clinic was recruited with eight each randomized to control vs. feedback groups. Both groups were given a multimodal educational session including locally adapted UTI guidelines and emphasis on problems identified in the baseline assessment Each record was scored using a scoring system that was developed for the study according to adequacy of history, physical examination, clinical diagnosis matching recorded data, diagnostic workup and treatment. Three audits were done for both groups; baseline (audit 1), post-CME (audit 2), and a final audit, which was after feedback for the feedback group (audit 3). The primary analysis assessed overall guideline adherence in the feedback group versus the CME only group.ResultsThe overall scores in both groups showed significant improvement after the CME in comparison to baseline and for each group, the scores in most domains also improved. However, audit 3 showed persistence of the gains attained after the CME but no additional benefit from the feedback. Some deficiencies that persisted throughout the study included lack of workup of possible STI and excess use of non-UTI laboratory tests such as CBC, stool culture and H. pylori Ag. After the CME, the use of nitrofurantoin rose from only 4% to 8% and cephalosporin use increased from 49 to 67%, accompanied by a drop in quinolone use.ConclusionThe CME led to modest improvements in patient care in the categories of history taking, treatment and investigations, but feedback had no additional effect. Future studies should consider an enforcement element or a more intensive feedback approach.

Quality-of-life of patients living with thalassaemia in the West Bank and Gaza.

In countries with low resources, the health and quality-of-life of people living with thalassaemia can be severely affected. This study examined the health-related quality-of-life of people living with thalassaemia in the West Bank and Gaza, Palestine. This was a cross-sectional study of a convenience sample of 104 patients (71 adults and 33 children) who lived with thalassaemia and their families in 2015 in the West Bank and Gaza. Participants were surveyed using the 36-item Short Form Health Survey, version 2 (SF36v2), Pediatric Quality of Life InventoryTM (PedsQL) and PedsQL Family Impact Module to assess their quality-of-life. With the SF36v2, we used normed-based scoring and for the PedsQL and Family Impact Module, we used the 0-100 scoring. Scores are reported as means and standard deviations and P < 0.05 considered statistically significant. Quality-of-life scores were low across all domains, indicating poor quality-of-life. For bodily pain in the SF36v2, a significant difference was observed between the West Bank and Gaza. No significant differences were found between males and females. Data from the PedsQL showed no significant differences between the West Bank and Gaza. With the Family Impact Module, the summary score was higher among adults than among paediatric patients. Compared with other countries, thalassaemia patients in Palestine generally had lower quality-of-life scores in most domains. The lack of access to healthcare and blood transfusions, and the geopolitical challenges may be responsible for the low quality-of-life scores of patients living with thalassaemia in Palestine.

Effect of educational intervention programme on the health-related quality of life (HRQOL) of individuals with type 2 diabetes mellitus in South-East, Nigeria

BackgroundDiabetes is one of the most important chronic diseases that have a great impact on health as people with diabetes are constantly being reminded of their disease daily; they have to eat carefully, exercise, and test their blood glucose. They often feel challenged by their disease because of its day-to-day management demands and these affect their quality of life. The study aimed at determining the effect of an educational intervention program on the quality of life of Individuals with type 2 Diabetes Mellitus in South East, Nigeria.MethodsA quasi-experimental controlled study involving three hundred and eighty-two (382) type 2 DM persons recruited from the tertiary health institutions in South East, Nigeria, and randomly assigned to intervention and control groups respectively. Data was collected from the diabetic clinics of the health institutions using the SF – 36 questionnaires. Pretest data collection was done, and thereafter, education on self-care was given to the intervention group. After a 6months follow-up, post-test data were collected from both groups. Analysis was done using an Independent t-test, Analysis of Covariance (ANCOVA), Paired Samples Test, and Spearman rank order correlation at 0.05 alpha level.ResultsThe control group indicated significantly higher mean HRQOL scores in most domains of the HRQOL before intervention (t = -1.927 to -6.072, p < 0.05). However, 6 months after the intervention, the mean HRQOL scores of the intervention group increased significantly in all the domains of HRQOL (p < 0.05) with an effect size of 0.14 (Eta squared). A comparison of the two groups shows a statistically significant difference (64.72 ± 10.96 vs. 58.85 ± 15.23; t = 4.349. p = 0.001) after the intervention. Age was inversely correlated with some domains of HRQOL; as age increases, HRQOL decreases in those domains. Gender had no significant influence on HRQOL.ConclusionEducational intervention was effective in improving HRQOL in individuals with type 2 DM. Hence, it is recommended for inclusion in all diabetes care plans.

The profile of quality of life and mental health of university students in the healthcare field

Objective: to present the profile of quality of life and symptoms of anxiety, depression and stress in university students in the healthcare area. Method: a descriptive study with a quantitative approach to data, carried out with university students in the healthcare field of three Federal Institutions of Higher Education in Minas Gerais. Variables such as sociodemographic, lifestyle, presence of depression symptoms, anxiety and stress, and quality of life (QoL) were measured. The QoL was assessed using the WHOQUOL-bref scale and symptoms of depression, anxiety and stress using the DASS-21 scale. A descriptive data analysis was performed. Results: 321 students participated in the study, mostly female (71.0%). More than 50% of the students had symptoms of depression, anxiety and stress, regardless of the level of severity, while severe/very severe symptoms were present in more than 20% of them, presenting a higher proportion in the nursing course. The psychological domain had the lowest overall QoL score (58.33), and the best was observed in the social relationships domain (66.67). Nursing students had the lowest scores while physical education students had the best scores in most domains. Medical students had the best score in the environment domain (68.75). Conclusion: Suggest the planning of policies and strategies that promote the physical and mental well-being of students, as well as screening and monitoring of most vulnerable ones, as well as those with mental health problems; such strategies can positively impact QoL.

Quality of life and time since diagnosis of Diabetes Mellitus among the elderly

Abstract Objectives: To evaluate the quality of life of the elderly with Diabetes Mellitus and to relate the time since diagnosis of diabetes with the quality of life of elderly persons receiving care at a basic health unit. Method: A cross-sectional quantitative study carried out in a Basic Health Unit with 196 elderly persons. For data collection, three instruments were used: one structured (sociodemographic and clinical variables) and the Whoqol-bref and Whoqol-old, with scores ranging from 0 to 100. Descriptive statistical analysis, Student’s T-test and Pearson’s correlation were performed. Results: Of the 196 diabetic patients, the majority were male (54.6%) with a mean age of 67.5 (±6.5) years. The mean time since diagnosis of Diabetes Mellitus was 9.1 years. The domains of the Whoqol-bref with the highest scores, indicating better quality of life, were Social Relations and Psychological, while a worse quality of life was observed in Environment. The facets of the Whoqol-old with the best scores were: Intimacy and Past, Present and Future Activities, and the worst was Death and Dying. The domains associated with one another were Physical and Psychological, Physical and Social Relations, and Psychological and Environmental. The associated aspects were Past, Present and Future Activities and Social Participation. Elderly persons with more than ten years of Diabetes Mellitus had worse quality of life scores in Physical (p=0.001), Social relations (p=0.002), and in the Autonomy (p=0.0012), Social Participation (p=0.041) and Death and Dying (p=0.001) facets. Conclusion: The time of diagnosis of Diabetes Mellitus was negatively associated with the quality of life of the elderly, with worse scores in most domains and facets of the Whoqol.

Reduced Aerobic Capacity and Quality of Life in Physically Inactive Patients With Systemic Lupus Erythematosus With Mild or Inactive Disease.

To compare aerobic capacity and health-related quality of life (HRQOL) in physically inactive adult systemic lupus erythematosus (A-SLE) and childhood-onset systemic lupus erythematosus (C-SLE) patients with mild/inactive disease versus healthy controls. In a cross-sectional study, 39 patients (C-SLE: n = 18, ages 9-18 years; and A-SLE: n = 21, ages 23-45 years) with inactive disease activity (Systemic Lupus Erythematosus Disease Activity Index ≤4) and low cumulative damage (Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index ≤2) and 30 healthy controls (15 children and adolescents [C-CTRL], 15 adults [A-CTRL]) matched by physical inactivity, age, sex, and body mass index (BMI) were assessed for aerobic capacity and HRQOL. All participants were considered physically inactive according to physical activity guidelines. C-SLE and A-SLE patients showed lower VO2peak (95% CI confidence interval [95% CI] -10.5, -1.2 and -11.1, -3.8, respectively) and higher time-to-exhaustion when compared with C-CTRL and A-CTRL (95% CI -2.8, 0.1 and -3.9, -1.7, respectively). C-SLE patients showed significantly lower scores in scholar functioning from the Pediatric Quality of Life Inventory questionnaire (P < 0.05) whereas A-SLE patients showed lower scores in most domains of the Short Form 36 health survey questionnaire (physical function, role-physical, bodily pain, general health, vitality, social function, and mental health) when compared with healthy controls (P < 0.05 for all). Our study provides novel data suggesting that A-SLE and C-SLE patients with mild/inactive disease have impaired aerobic capacity and HRQOL when compared with controls matched by physical inactivity, age, sex, and BMI. These findings reinforce the recommendation of physical activity in SLE treatment.

EMPLEO, CONDUCTA ADAPTATIVA Y DISCAPACIDAD INTELECTUAL

Las personas con discapacidad intelectual tienen dificultades para acceder a un empleo competitivo, lo que dificulta su inclusión y participación sociolaboral, su independencia económica, una vida independiente, la confianza en sí mismo y el desarrollo de sus habilidades. Los estudios que han profundizado en los factores que dificultan el acceso al empleo de este colectivo son prácticamente inexistentes. En este trabajo se analiza si existen diferencias en algunos factores personales y sociales, y en conducta adaptativa en una muestra de 98 adultos con discapacidad intelectual leve, con edades comprendidas entre los 24 y 60 años (M = 28,74, DT = 11,11), de los cuales el 66,3% tiene un empleo remunerado y el 33,7 % no. Los resultados muestran que los varones con edades comprendidas entre los 31 y 50 años sin otro diagnóstico de problemas de salud mental son las personas que más posibilidad tienen de tener un empleo protegido frente a las mujeres, los menores de 30 años, los mayores de 50, y aquellos que presentan uno o más diagnósticos de enfermedad mental. También se observa que las personas con discapacidad intelectual leve que tienen empleo obtienen mejores puntuaciones en la mayoría de dominios de conducta adaptativa que las personas sin empleo, pero sólo de manera significativa en actividades económicas y prevocacionales-vocacionales.

Body Image attitudes of Premenopausal and Perimenopausal women in Nigeria: association with Physical Activity Level

Background: Body image is a multidimensional construct which comprises of perceptual -body size estimation and appearance as well as attitudinal- relating to feelings and attitudes towards one’s own body. For menopausal women, weight gain is a common occurrence and these body composition changes may influence how a woman feels about the way her body looks. Concerns about body image in menopausal women may sometimes lead to dissatisfaction with their bodies. Additionally, the great pressure for a perfect body may influence either positively or negatively women‘s involvement in physical activity. Objectives: This study assessed body image attitude of a sample of premenopausal and perimenopausal women in Nigeria and their physical activity level. Methods: The multidimensional Body-Self Relations Questionnaire-Appearance Scale (MBSRQ-AS) was used to evaluate appearance satisfaction, body image attitudes and satisfaction while the International Physical Activity Questionnaire was used to evaluate PA level. Data were summarized using descriptive statistics, and analyzed using Chi-square while significance level was set at 0.05. Results: Participants were 392 women aged 42.5±6.0 years and all reported positive body image attitude. Premenopausal women reported higher scores in most domains of the MBSRQ-AS while perimenopausal women reported higher scores on the Overweight Preoccupation and Self-Classified Weight. Majority reported moderate to high PA level. Significant associations were observed between PA level and scores on appearance evaluation (p=0.02) and overweight preoccupation (p=0.01) for premenopausal women while perimenopausal women reported significant association between PA level and scores for appearance orientation (p=0.00), overweight preoccupation (p=0.00) and self-classified weight (p=0.01). Conclusions: Body image attitude appeared to have had a positive impact on PA level. It may be imperative for women in the menopausal transition to maintain a physically active lifestyle to enhance a positive body image.

Scoliosis Research Society-22 Results in 3052 Healthy Adolescents Aged 10 to 19 Years

Cross-sectional survey. The purpose of our study was to evaluate a large population of adolescents from a broad mix of racial/ethnic backgrounds and age groups to better establish baseline normative values for the Scoliosis Research Society-22 (SRS-22). The SRS-22 instrument was developed to assess treatment outcomes in patients with adolescent idiopathic scoliosis. To accurately assess real changes in outcome measures, the SRS-22 must be able to differentiate patients with and without adolescent idiopathic scoliosis. The SRS-22 was administered to 3052 healthy adolescents, 51% female and 49% male, with a mean age of 14.6 years (range, 10-19 yr). We grouped the children into 3 age groups for analysis: 10 to 12 years (362), 13 to 15 years (1487), and 16 to 19 years (1203). Racial/ethnic groups included: Caucasian, 62%; African American, 14%; Hispanic, 9%; Asian, 6%; Native American, 5%; and Pacific Islander, 4%. SRS-22 scores were analyzed to establish normative values for each group. Mean SRS-22 scores were: activity, (4.31 ± 0.54); pain, (4.44 ± 0.67); image, (4.41 ± 0.64); mental, (3.96 ± 0.81); and total, (4.26 ± 0.54). Females had lower scores in the mental domain (3.90) than males (4.04) (P < 0.001). The scores of children aged 10 through 12 years were higher in the domains of activity (P = 0.000), pain (P < 0.001), and mental (P < 0.001) than those of children aged 13 through 15 years and 16 through 19 years. The 13- to 15-year group had significantly higher scores than the 16- to 19-year group (P < 0.001) in each of the same categories. Regarding race/ethnicity, Caucasians tended to report higher scores in most domains than other race/ethnic groups. Hispanics scored lower in all domains than the non-Hispanic group. Age, sex, and race had a significant impact on SRS-22 scores in a large group of healthy adolescents. In general, scores lowered as age increased from 10 to 19 years, Caucasians scored higher in function, pain, and image than other racial groups, and Hispanics scored lower than non-Hispanics in all domains. These factors should be considered when evaluating SRS-22 scores.

Prospective Longitudinal Evaluation of Quality of Life in Patients With Permanent Colostomy After Curative Resection for Rectal Cancer

The aim of this study was to evaluate health-related quality of life in patients with a colostomy immediately before and during the first year after surgery. Patients (aged ≥20 years) who were diagnosed with rectal cancer and scheduled to undergo curative surgery with a permanent colostomy were recruited for this study. Data were collected at 2 university hospitals in Tokyo. Participants were asked to complete a self-administered questionnaire regarding health-related quality of life before surgery and a mailed or hand delivered questionnaire to evaluate quality of life at 2, 6, and 12 months after surgery using the Short Form-36 version 2. For patients who responded at all 4 time points, the scores at each time point were compared using paired t tests to examine longitudinal changes in quality of life after surgery. Mean quality-of-life scores in most domains before surgery and during the first year after surgery were lower than the normal control in the norm-based scoring method. Scores at 2 months after surgery were lower than those before surgery. At 12 months after surgery, however, quality-of-life scores improved almost to the level observed before surgery, with the exception of the score in the social functioning domain. Statistical differences in scores between the time points of the survey were observed in the role-physical, bodily pain, and mental health domains. These results suggest that patients with permanent colostomy after curative resection for rectal cancer need additional medical support and care before surgery and during the first year after surgery.

A pilot assessment of relapse prevention for heroin addicts in a Chinese rehabilitation center

Objectives: To conduct a pilot assessment of relapse prevention (RP) group therapy for heroin-dependent patients in a drug rehabilitation center in China. Methods: A randomized case–control study was conducted to assess the efficacy of RP delivered over a 2-month period to male heroin addicts (n = 50, RP group) in the Shanghai Labor Drug Rehabilitation Center (LDRC) compared with an equal number of participants (n = 50, labor rehabilitation (LR) group) in the LDRC program receiving standard-of-care treatment. Outcomes were assessed by the Beck Depression Inventory (BDI), the Self-Rating Anxiety Scale (SAS), the Self-Efficacy Scale (SE), and the Self-Esteem Scale (SES) after completion of RP, and by the Addiction Severity Index (ASI) and abstinence rates of heroin use at 3-month follow-up post release from the LDRC for both groups. Results: Significant improvements in scores on SAS, SE, and SES were found in the RP group after completion of the 2-month RP group therapy compared with the LR group (SAS 7.85 ± 6.20 vs 1.07 ± 5.42, SE 3.88 ± 3.60 vs .08 ± 2.89, and SES 3.83 ± 3.31 vs .78 ± 2.55). At 3-month follow-up, the RP group participants had more improvements on ASI scores in most domains and had higher abstinence rates than that in the LR group (37.2% vs 16.7%). Conclusions: An RP component can be effective in increasing abstinence rates among post-program heroin-dependent individuals and may help reduce anxiety and improve self-esteem and self-efficacy during and following treatment. Scientific Significance: This study suggests RP as a potentially effective component of treatment for heroin addicts.

Assessment of HRQoL in patients with eating disorders by the beta‐binomial regression approach

To study the influence of clinical variables on health-related quality of life (HRQoL) among women with eating disorder (ED) using beta-binomial regression (BBR) to analyze scores on the Short-Form 36 (SF-36) as dependent variable. Female patients diagnosed with ED completed the SF-36 at the beginning of the study and after 2 years of treatment. Sociodemographic and clinical information was recorded. For the multivariate analysis, we used BBR models to identify factors that influence SF-36. Questionnaires were completed by 193 women at baseline and 158 (82%) after 2 years of treatment. Anxiety, depression, and the severity of ED, explained scores in most domains of the SF-36 at baseline. The main predictor of HRQoL after 2 years of follow-up was the HRQoL in the same domain at baseline. However, depression, anxiety, and duration of symptoms at baseline also significantly influenced HRQoL after 2 years of treatment in some domains. Higher levels of anxiety or depression, longer duration of symptoms, and poorer SF-36 scores at baseline were associated with worse HRQoL after 2 years of treatment and follow-up. BBR models provide understandable results for clinicians and can be used in multivariate models with HRQoL dependent variables.

Clinical Characteristics of Subjects With Symptoms of α 1 -Antitrypsin Deficiency Older Than 60 Years

The clinical characteristics of elderly subjects with alpha(1)-antitrypsin deficiency (AATD)-associated COPD have not been described. The clinical, demographic, health-related quality of life (HRQoL) characteristics and 1-year exacerbation rates of 275 subjects with AATD and COPD receiving augmentation therapy aged > 59 years (mean [+/- SD] age, 66.3 +/- 5.7 years) were compared to those of 354 subjects aged 50 to 59 years (mean age, 54.3 +/- 2.8 years) and 293 subjects < 50 years (mean age, 43.9 +/- 3.8 years). Older subjects received diagnoses later in life (mean age at diagnosis, 55.0 +/- 8.5 years) and had a longer diagnostic delay (mean age at diagnosis, 12.9 +/- 14.3 years) than subjects in the other two age groups. Although the proportion of lifetime nonsmokers was higher in the older group, the majority (64%) had significant tobacco exposure but with a longer interval of tobacco abstinence. The mean FEV(1) values (n = 641) were similar between the three age groups, suggesting a slower disease progression in the oldest group. Subjects in the older group were less symptomatic, had less concomitant asthma, and had significantly better scores in most domains of two HRQoL instruments. During follow-up, older subjects had fewer acute exacerbations. Subjects with AATD-associated COPD who reach an older age exhibit a more indolent clinical course than younger affected individuals, possibly related in part to differences in tobacco exposure. This finding supports current guidelines that recommend screening of all patients with COPD for AATD, regardless of their age and prior smoking history.

Quality of life in patients with chronic idiopathic urticaria: the impact of Axis I and Axis II psychiatric disorders

Objective Chronic idiopathic urticaria (CIU) associated with lower quality of life (QoL) levels. Psychiatric disturbances are frequently present in patients with CIU. This study examined the impact of Axis I and Axis II psychiatric disorders on the QoL of patients with CIU. Method The study sample consisted of 100 subjects including CIU patients with only Axis I psychiatric diagnoses (n=25), CIU patients with only Axis II diagnoses (n=25), CIU patients with both Axis I and Axis II diagnoses (n=25), CIU patients without any Axis I and Axis II diagnosis (n=25), and healthy control subjects with respect to urticaria and psychiatric disorders (n=25). The Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) (SCID-1) and the Structured Clinical Interview for DSM, Revised Third Edition Personality Disorders (SCID-II) was used to determine Axis I and Axis II psychiatric disorders, respectively. QoL levels were assessed by means of the World Health Organization QoL Assessment-Brief (WHOWOL-BREF). Results There were significant differences among the groups with respect to all WHOQOL-BREF subscale scores. The QoL levels were similar among CIU patients with only Axis I psychiatric diagnoses, CIU patients with only Axis II diagnoses and CIU patients with both Axis I and Axis II diagnoses, and between CIU patients without any Axis I and Axis II diagnosis, and healthy control subjects. When compared with those of CIU patients without any Axis I and Axis II diagnosis, CIU patients without concurrent psychiatric diagnoses had significantly lower scores in most domains of the QoL scale. Conclusions Axis I and Axis II psychiatric disorders seem to be considerable factors influencing the QoL in CIU patients.

Quality of Life Related to Swallowing After Tongue Cancer Treatment

The surgical treatment of tongue cancer, with or without reconstruction and/or radiotherapy, leads to different levels of voice, speech, and deglutition disorders. Evaluating the quality of life related to these swallowing alterations is important to further our knowledge about the impact of such alterations from the patient's point of view. Our objective was to describe the quality of life related to swallowing in patients treated for tongue cancer, using specific questionnaires. Twenty-nine patients participated in the study for a minimum of one year after oncologic treatment. Patients with advanced disease who underwent radiotherapy had significantly worse scores in most domains. The aspects related to how to deal with deglutition problems, time taken for meal consumption, pleasure in eating, chewing problems, food sticking in throat and mouth, choking, and the knowledge of feeding restrictions, which were evaluated by different domains of SWAL-QOL, were factors that contributed to a negative impact for patients with advanced-stage tumors who underwent radiotherapy.

Gender and ethnic differences in cancer patients’ needs for help: An Internet survey

Background Although a number of studies have reported different domains of cancer patients’ needs for help, very little is known about gender and ethnic differences in those needs. Gender differences have been implicitly assumed in most studies, and specific ethnic groups have been focused on rather than comparing several ethnic groups. Objectives The purpose of this pilot study was to explore cancer patients’ needs for help among four major ethnic groups in the US, to determine gender and ethnic differences in needs, and to provide direction for future studies. Design This was a descriptive and comparative pilot study using a feminist perspective. Settings and participants A total of 110 self-identified cancer patients were recruited through both Internet and community settings using a convenience sampling method. Methods The instruments included sociodemographic questions, the Cancer Needs Questionnaire-Short Form, and the Supportive Care Needs Survey. The data were analyzed using descriptive statistics and inferential statistics including the Mann–Whitney U tests and Kruskal–Wallis tests. Results The findings indicated that there was no significant gender difference in all domains of needs for help. There were significant ethnic differences in all domains of needs except communication and sexual needs. Asians reported the lowest scores in most domains of needs for help while Hispanics reported the highest scores in most domains of needs for help. Conclusions The findings indicated certain ethnic differences in cancer patients’ needs for help and suggest further in-depth qualitative investigations on cultural beliefs and attitudes that may influence needs, with a careful examination of gender sensitivity and cultural competence of the instruments measuring cancer patients’ needs for help.

Neuropsychiatric manifestations in vascular cognitive impairment patients with and without dementia.

Neuropsychiatric profile has less been well recognized in all subtypes of vascular cognitive impairment (VCI). The aim of this study is to explore the neuropsychiatric manifestations in patients with different subtypes of VCI. A consecutive series of 157 patients with VCI visited the dementia clinic in a regional hospital in mid-Taiwan were investigated in this study. All patients were examined with the Cognitive Abilities Screening Instrument (CASI), the Hachinski's Ischemic Scale (HIS), and the Clinical Dementia Rating (CDR) scale. The Neuropsychiatric Inventory (NPI) was used to assess neuropsychiatric symptoms. Of the 157 participants with VCI, 41 (26.1%) had VCI, without dementia (vascular CIND), 95 (60.5%) had vascular dementia (VaD), 21 (13.4%) had Alzheimer's disease (AD) with a vascular component (mixed AD/VaD). Sleep disturbance was the most common symptom in all patient groups. Apathy is significantly lower in VCI without dementia compared with VCI with dementia. Patients with VaD had the highest mean composite NPI scores in most domains and vascular CIND patients had the lowest composite scores in most domains. Neuropsychiatric symptoms were common in patients with VCI with and without dementia. It deserves attention that neuropsychiatric symptoms as well as cognitive deficits frequently arise from cerebrovascular disease regardless of the development of dementia.

Neuropsychiatric profiles in patients with Alzheimer’s disease and vascular dementia

Objective: To explore the neuropsychiatric manifestations in patients with Alzheimer’s disease (AD) and cortical and subcortical vascular dementia (VaD). Methods: We investigated consecutive patients with dementia. All the participants received...